Why do men suffer from impotence?

Impotence is a problem that many men have. Impotence may be caused by aging, changes in the structure of the corpus cavernosum, or some diseases, such as cardiovascular disease, diabetes, abnormal blood lipid metabolism, chronic prostatitis, chronic liver and kidney dysfunction, etc. In addition, some bad living habits can also cause impotence.

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.

7. Lifestyle

Lifestyle habits associated with ED include long-term smoking, alcoholism, and drug use.

(1) Smoking: Epidemiological studies have shown that smoking can cause ED or increase the likelihood of ED.

(2) Alcoholism: A survey shows that most male alcoholics have sexual dysfunction, mainly erectile dysfunction and sexual desire disorder.

(3) Living conditions Education level has a positive effect on erectile function. The reason may be that people with low education level and low income often pay less attention to health and have poorer living conditions. At the same time, they are also more likely to smoke and drink.

(4) Traumatic and iatrogenic factors ED is associated with pelvic surgery, especially radical prostatectomy, cystectomy, and rectal surgery.