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Erectile Dysfunction
What causes it?
Before discussing the causes of erectile dysfunction, it is important to understand how an erection develops and how an erection is sustained. The penis is made of a mass of tissue composed of several structures of spongy networks that contain blood vessels and smooth muscle tissue. Normal nerve function and blood supply to these areas is essential to experience and maintain an erection. When sexual arousal takes place (whether it be a result of visual stimuli, touches, smells, or thoughts), the brain responds by communicating the arousal to the body's nervous system, which activates blood flow to the penis. As blood flow increases in the penile area, blood vessels supplying the penis dilate so the body of erectile tissue becomes engorged. When the erectile tissue engorges, an erection develops.
If something affects any of the factors responsible for an erection, erectile dysfunction may result. Psychological factors or nonphysical factors may also contribute to erectile dysfunction. Such factors may include depression, stress, anxiety, negative feelings toward a sexual partner, or even feelings of dissatisfaction with sexual function.
Although psychological and nonphysical causes are possible, there are several physical causes that may contribute to erectile dysfunction. Common diseases such as diabetes, high blood pressure, atherosclerosis (hardening of the arteries), thyroid problems, and alcoholism may also cause erectile dysfunction. Spinal cord injury, multiple sclerosis, or other diseases that may affect nerve conduction to the penile area can decrease the likelihood of achieving or maintaining an erection. Low hormone levels (for example, low levels of testosterone or prolactin) may also be a cause of erectile dysfunction, although the incidence of this cause is thought to be much less than the common diseases such as diabetes. Studies have even shown that the pressure obtained from riding a bike, which comes from sitting on a bicycle seat with a nose extension, restricts blood flow to the penis.
Certain prescription medications and illicit drugs may cause erectile dysfunction. Up to 25% of cases of erectile dysfunction result from medication side effects. Examples of prescription medications that may lead to erectile dysfunction include certain antidepressants, medications for high blood pressure, antipsychotics, medications used for anxiety disorders, anticholinergics (e.g. diphenhydramine, benztropine, and atropine), cimetidine, digoxin, and substances of abuse (e.g. alcohol, cocaine, and marijuana). Check with your doctor or pharmacist if you suspect that a medication you are taking may be the cause of erectile dysfunction.
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