The causes of erectile dysfunction

The causes of erectile dysfunction are divided into three types:

1. Psychogenic causesED

Psychogenic ED is caused by various psychological disorders. Psychological disorders can be both the main cause of the ailment, and secondary. They are treated by methods of psychotherapy, under the guidance of a psychotherapist. Read more about the treatment of psychogenic erectile dysfunction.

2. Organic causes:

- Endocrine disorders ( violation of the level of sex hormones( hypogonadism), diabetes, thyroid dysfunction, etc.).

- Vascular system damage. Vascular erectile dysfunction can be based on factors such as arterial insufficiency of the penis and a disorder of the venous outflow of the penis( IF).

Arterial insufficiency of the penis is due to insufficient arterial blood flow to the cavernous tissue of the IF.

The causes of arterial insufficiency of the IF are manifold:

• Congenital defects of the arteries of the penis.
• Atherosclerotic lesion of the aorta.
• The defeat of the blood vessels of the penis on the background of diabetes mellitus.
• Elevated blood cholesterol( hypercholesterolemia).
• Obesity.
• Smoking.
• Hypertensive disease. Injuries of the perineum, post-traumatic disorders of the patency of the arteries of the pelvis.

Disorders of venous outflow of the penis occurs in about a third of patients with impaired erectile function. Venous insufficiency includes venous leakage and veno-occlusive dysfunction.

The problem of venous insufficiency consists in premature discharge of blood through the venous systems of the penis, as a result of which prolonged maintenance of the erection becomes impossible.

In vein-occlusive dysfunction, as a rule, it is difficult to achieve an erection and it is even more difficult to maintain it for an adequate amount of time.

- Organic changes in the penis ( "cavernous" erectile dysfunction).The main reasons:

• Peyronie's disease.
• Injuries.
• Priapism.
• Consequence of intra-carver injection - the introduction of drugs, into the cavernous bodies of the IF.

- Neurological disorders. Neurological diseases( for example, diabetes mellitus) can cause ailment, as well as the consequences of previous operations on the rectum, prostate, bladder.

- Consequence of taking medications. Common medications that negatively affect sexual function include: antidepressants, psychotropic tranquilizers, antihypertensive drugs( see all drugs that reduce sexual function).

3. Mixed

Have both psychogenic and organic nature. In most cases, ED has a mixed nature, becauseOrganic problems tend to provoke psychogenic disorders, and on the contrary, psychological pathologies tend to cause various changes in the physiological aspect( for example, depression provokes the development of androgen deficiency).

Table 1 - Proved risk factors for the development of erectile dysfunction( MMAS, 2005).

Diagnostic minimum for ED:

• Total testosterone.
• Prolactin.
• Blood sugar.
• Lipid spectrum.

Anatomy and physiology of the penis

The penis consists of a spongy body and 2 cavernous. The cavernous bodies are located at the top and along the entire length of the penis, the spongy body is directly below them. The blood supply to each of the bodies is autonomous - they are completely isolated from each other. Both cavernous bodies and spongy bodies consist of lacunae and resemble a sponge.

When a sexual arousal occurs, the brain sends an appropriate signal to the nerve cells of the penis vessels. This leads to a rapid and prolonged expansion of the arteries, narrowing of the veins and filling the lacuna with blood. Thus, the increase in the penis and its erection is due to the accumulation and stagnation of blood in the cavernous and spongy bodies.

Therapy of erectile dysfunction

If problems in the intimate sphere arise due to organic disorders, then the man can be helped only by eliminating the cause. In the case of development of chronic diseases, the patient is recommended to undergo a course of preventive therapy of the underlying disease at least twice a year.

When the cause of ED is vascular disorders in the penis, one of the methods of therapy is the operation on the vessels of this organ. The purpose of the intervention is to increase the flow of blood and reduce the outflow. The effectiveness of the method is 20-80%.

In the absence of the effect of therapy of the pathology that caused erectile dysfunction, and operations on the vessels, it is possible to carry out an endoprosthesis replacement of the male's genital organ. Unfortunately, there are serious disadvantages of this method of treatment:

1. Irreversibility: cavernous and spongy bodies are removed and without a prosthesis a man can not live sexually.
2. Development of inflammatory processes or rejection of implants.
3. Denture break.
4. High transaction cost.

Abbreviations used in the article:

ED - erectile dysfunction;
IF - penis.

Recommended for viewing: