Erectile Dysfunction – Why?

Guides ● January 2019

In 30 Seconds

  • Don’t panic. There are solutions to erectile dysfunction (ED) and it’s also very common.
  • “An erection is achieved by the collaboration of many aspects of your body, including the nervous system, circulatory system, cardiovascular system, endocrine system and psychological system,” explains Dr Earim Chaudry.
  • If you have ED it’s vital to go and get checked out by your GP. This is because ED can by a symptom of something more serious. Don’t stress. Just see your doc.

With everything else we have to worry about in the world right now, pondering not getting an erection (and wondering ‘Why? Why me?!’) is never a welcome thought. Because we all deserve good sex, right?

So if your erection isn’t as award-winning as it once was, or you’re having trouble getting it up, or maybe there was just that one time, but now you can’t stop worrying if it’ll happen again…our guide to ED (erectile dysfunction) has all the answers.

No need to panic. There are lots of solutions to ED and it’s also very common. So sit back. Relax. And take the first step to getting your mojo back.

Your Erection: The Facts

Erectile dysfunction (ED) happens when you’re unable to achieve or sustain an erection that’s firm enough for fulfilling sex.1 You’d think that something we can do in our sleep would be easy, right? Thing is, getting an erection requires your body to be firing on all cylinders.

“An erection is achieved by the collaboration of many aspects of your body, including the nervous system, circulatory system, cardiovascular system, endocrine system and psychological system,” explains Dr Earim Chaudry. “Various factors –  from the balance of hormones and the dysfunction of the blood vessels to structural problems with the penis or psychological issues, can impair this finely-tuned collaboration and lead to erectile dysfunction.”

Erectile dysfunction (ED) happens when you’re unable to achieve or sustain an erection that’s firm enough for fulfilling sex. You’d think that something we can do in our sleep would be easy, right? Thing is, getting an erection requires your body to be firing on all cylinders.

Causes of ED: Vasculogenic

Wishing you’d paid more attention in GCSE Biology? Us too. According to the professionals, ED can be related to vasculogenic causes. That means factors that can lead to disorders in the blood vessels.2

These include:

  • Diseases of the heart and blood vessels
  • High sugar levels in the blood
  • High cholesterol levels
  • Smoking
  • Treatments carried out by radiation
  • Major pelvic surgery

“During sex, an erection happens when your arteries (blood vessels) relax, which causes blood to flow into the penis. This causes a pressure build-up, which gives you an erection,” says Dr Chaudry. “Vasculogenic diseases or disorders reduce blood flow or cause the blood vessels to contract. The probability of developing vasculogenic ED if you have high blood pressure, high blood sugar, and high blood cholesterol is generally high”.3

Causes of ED: Psychological or Psychosexual

Psychological or psychosexual causes can be general or situational. They are extremely common in men aged 40 and under.  

“If you’re under 40, psychological causes are statistically more likely than physical causes when it comes to ED,” explains Dr Chaudry. “These can often be combined with physical causes that may be temporary, for example after a big night of drinking. Unfortunately, the one-off or occasional physical ED can lead to a more long-term psychological ED as men start worrying about it happening again – and get caught up in performance anxiety.”

The reasons? These are varied and often complex. They include anxiety and depression, problems within the relationship, problems outside of the relationship – such as money worries or work issues, stress and lifestyle factors such as not having enough down-time. There’s even some research that shows that using porn or porn addiction can contribute to ED in younger men, although this is widely disputed in the medical community.

Anxiety and depression in particular are associated with ED, according to several studies. It’s thought that the stronger the level of depression the more likely ED is to occur – and that the severity of the ED is linked to the severity of the depression, according to research.

The best thing to do is to talk it out with your GP. Interestingly, in the past if you had ED it was assumed to have a psychological/psychological cause. Now, research suggests that more than 80% of cases have a physiological or organic cause or origin.4 Another good reason to get checked out at your GP’s.

“Erectile dysfunction can have a substantial negative effect on a man’s quality of life,” says Dr Chaudry.  “Many men with erectile dysfunction experience depressive symptoms and anxiety related to sexual performance and avoid engaging in sexual relations. Many men also avoid seeking treatment for their sexual dysfunction.” This only makes the situation worse. Whether it’s a psychological or physical cause – or a combo of the two – seek help from your GP and get your sex life back on track.

Causes of ED: Neurological

If you have ED it’s vital to go and get checked out by your GP. This is because ED can by a symptom of something more serious. Don’t stress. Just see your doc.

ED can be caused by neurological factors – so they affect the body’s ability to transmit signals in response to events.5 This could be factors that affect your central nervous system (the brain and spinal cord) or the peripheral nervous system (other nerve tissues and organs).

These include6:

  • Injuries to the spinal cord

  • Lack of blood supply to the brain (a stroke)

  • Tumors

  • Parkinson’s disease

  • Degeneration of the peripheral nerves

“In response to sexual urges, the brain (through the spinal cord and other peripheral nerves), sends signals. These prompt the arteries to relax and the veins to contract – and so an erection occurs,” says Dr Chandry. “This implies that your erection starts in the brain. So it follows that any neurological disorder or impairment may curtail erectile function, resulting in ED.”

Causes of ED: Anatomical and Structural

Physical factors, especially around the pelvis and penis can lead to anatomical problems.

These include7:

  • Peyronie disease
  • Congenital narrowing of the foreskin opening (phimosis)
  • Tight foreskin and short glans penis tissue that restricts foreskin movement (frenulum breve).

Causes of ED: Hormonal

“Hormones play an important role in erectile function,” says Dr Chaudry. “Arousal signals transmitted from the brain trigger testosterone, a hormone that’s involved in the complex process of getting an erection.”

  • Data has shown that free testosterone levels at age 75 are around 50% of those found in men aged 25.8 A reason why age is a factor in erectile dysfunction.
  • Erections are androgen-dependent. Men with hypogonadism have less erections – and erections that are less hard.9
  • Hormonal imbalances due to hypogonadism, high levels of prolactin in the blood (hyperprolactinaemia), and under or over active thyroid, Cushing’s disease and hormonal disorders that are associated with the endocrine system are all causes of ED.10

Causes of ED: Medication and Recreational Drugs

Medication and recreational drugs that can potentially affect your blood vessels, heart, nervous system and hormones may lead to drug-induced ED.11

These drugs include12:

  • Antihypertensives

  • Antidepressants

  • Antipsychotics

  • Antiandrogens

  • Beta-blockers

  • Diuretics

  • Hormonal agents, such as luteinizing hormones

  • Anticonvulsants

  • Antihistamines

And recreational drugs including13:

  • Alcohol

  • Heroin

  • Cocaine

  • Marijuana

  • Methadone

  • Steroids

Stats show that an estimated 25% of all ED is a side effect of drugs.14 There’s a debate among scientists as to whether ED is a direct result of the drug itself or of the underlying disease being treated.15

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