What are the causes of erectile dysfunction?

What are the causes of erectile dysfunction? In medical terminology, it is the pathogenesis of erectile dysfunction. The pathogenesis mainly includes two categories, one is the psychological pathogenesis and the other is organic factors. Psychological factors mainly refer to the level of penis development hormones, including the process of sexual intercourse, and some physiological developments related to it are normal. Clinically, the occurrence of this psychological erectile dysfunction is mainly due to the patient's relatively high work pressure, poor living environment, poor working environment, and all aspects of family living conditions are affected, affecting the emotional exchange between men and women, etc., which will cause erectile pressure.

The occurrence of ED is not only affected by physical diseases such as age, cardiovascular disease, diabetes and hyperlipidemia, as well as psychological and environmental factors such as sexual partner relationships and home conditions, but also by bad living habits, drugs, surgery, race, culture, religion and socioeconomic factors.

1. Age

Current research suggests that age is the strongest independent factor among ED-related risk factors. As age increases, the serum androgen level decreases significantly, which may be the direct cause, but there is no research result proving that there is a significant relationship between the decrease in serum free testosterone and ED. In addition, as age increases, the structure of the penis tunica albuginea and corpus cavernosum changes, which may lead to a decrease in venous blood return capacity, an increase in the prevalence of cardiovascular and cerebrovascular diseases, hypertension, diabetes, and the treatment of these diseases, all of which damage the penis' erectile function to varying degrees, and this trend also increases with age.

2. Cardiovascular disease

Cardiovascular disease is the main somatic disease associated with ED, including atherosclerosis, peripheral vascular disease, hypertension and myocardial infarction. Cardiovascular disease causes arterial ED by affecting the arterial blood supply to the corpus cavernosum. Some studies have also found that ED may be the primary manifestation or "warning signal" of cardiovascular disease.

3. Diabetes

Diabetes can affect erectile function by affecting the autonomic nervous system, peripheral vascular system and psychoneural system. The severity and prevalence of ED are significantly related to factors such as age of diabetes, type of diabetes, blood sugar control, diabetic neuropathy, diabetic nephropathy and hypertension.

4. Abnormal blood lipid metabolism

The role of hypercholesterolemia in sexual dysfunction is controversial. One study showed that men with total cholesterol (TC) greater than 240 mg/dl had a 1.83 times higher risk of ED than men with TC less than 180 mg/dl. In the MMAS (Massachusetts Aging Male Study), high-density lipoprotein was negatively correlated with the prevalence of ED.

5. Chronic prostatitis

Some patients with chronic prostatitis have symptoms such as premature ejaculation, loss of libido, erectile dysfunction and ejaculation pain. The mechanism of sexual dysfunction caused by chronic prostatitis is unclear. Most scholars believe that anxiety, depression, inferiority, loss of energy, fatigue, suspicion and insomnia are the main causes. The recurrence and non-healing of long-term testicular swelling and pain, perineum and penis discomfort, lower urinary tract symptoms, etc. also increase the psychological burden of patients. Since the sexual dysfunction of most patients with chronic prostatitis is caused by psychological factors, in addition to drug treatment, more psychological counseling and treatment are needed.

6. Chronic liver and kidney dysfunction

The prevalence of ED in patients with alcoholic cirrhosis is 70%, while that in patients with non-alcoholic cirrhosis is 25%, suggesting that the prevalence of ED is related to liver dysfunction. The prevalence of ED in patients with chronic renal insufficiency is as high as 45%, but its pathophysiological mechanism is unclear.