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Erectile Dysfunction Causes - Part 4

If you're struggling with erectile dysfunction, you're not alone. Learn about the causes of ED and what you can do to treat it.

Causes of Erectile Dysfunction | Part 4

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough for sexual intercourse. It can happen for a variety of reasons, including psychological causes, physical causes, and lifestyle choices.

Psychological Causes

ED can be the result of anxiety or depression. Men who are anxious about their sexual performance may develop ED. Performance anxiety is when a man feels he needs to meet a certain sexual standard. This can be especially true if he has ED. Depression is also a common psychological cause of ED. Depression can interfere with a man’s sexual desire and cause erectile dysfunction.

Physical Causes

There are many physical causes of ED. These include:
  • Atherosclerosis – This is the hardening of arteries. It can cause ED because it limits blood flow to the penis.
  • Diabetes – This can damage nerves and blood vessels, leading to ED.
  • Injury to the penis, spinal cord, prostate, bladder, or pelvis – This can cause ED.
  • Low testosterone – This can lead to ED.
  • Multiple sclerosis – This can lead to ED.
  • Parkinson’s disease – This can lead to ED.

Lifestyle Choices

There are also lifestyle choices that can cause ED. These include:
  • Alcoholism – This can lead to ED.
  • Drug abuse – This can lead to ED.
  • Obesity – This can lead to ED.
  • Smoking – This can lead to ED.
If you are experiencing ED, talk to your doctor. There are treatments available that can help.
What causes ED? Dr. Maia Chakerian, a board-certified interventional anesthesiologist, explains.

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Video transcription:

Hi, I’m dr maya chikarian, a board-certified interventional, anesthesiologist and owner of serena sante, a medispa in los gatos california. Today we’re going to talk about medical conditions which can affect erectile dysfunction commonly referred to as ed. There are primary causes of erectile dysfunction, which means the penis itself is incapable of having or maintaining an erection and secondary causes of erectile dysfunction, meaning something else is impairing the ability for the penis to respond sexually. One of the most common causes of ed is cardiovascular disease. The most pertinent issues in the category of cardiovascular disease are hypertension and coronary artery disease. First, we’ll focus on hypertension. Some men are reluctant to take medication to treat high blood pressure because they have heard that these medications can lead to erectile dysfunction. However, it is not only hypertensive therapy, but hypertension itself that can cause ed left untreated. Hypertension can lead to heart attack and stroke, so it is important to manage high blood pressure. Most men on anti-hypertensive medication can usually be successfully treated for ed. It is important to note that some high blood pressure medications may interact with the commonly prescribed medications for ed and can lead to serious low blood pressure which can be life-threatening. These ed medications include Viagra and Cialis, which are in the class of medications referred to as pde5. Inhibitors, therefore be sure to ask your doctor if it is safe to take ed medications if you are taking any other medications for your heart or your blood pressure. Ed is sometimes referred to as atherosclerosis of the penis atherosclerosis is the medical term for hardening of the arteries men with unstable heart disease are not good candidates for pde5 inhibitors men taking certain drugs for heart disease, such as nitrates, must not take pde5 inhibitors because of the risk of very low blood pressure when taken in combination. Our next classification of diseases, which can cause ed, is endocrine disease. Endocrine diseases which can lead to ed, include diabetes, high thyroid levels, low testosterone and high prolactin levels. Diabetes is the most common endocrine disorder that leads to ed. The prevalence of ed is three times higher in diabetics than in non-diabetics. You may wonder if keeping your blood sugar under good control would improve ed, but there is little evidence that this is true. However, high hemoglobin a1c levels, which indicates poor blood sugar control, has been shown to lead to impaired, smooth muscle function which may possibly worsen ed, because smooth muscle is found in small arteries. So the jury is still out whether tight glucose control improves ed, but always follow your doctor’s recommendations regarding your diabetes management. Another problem for diabetic men is that they respond poorly to pde5. Inhibitors diabetics also have reduced testosterone levels, which is like a triple whammy for erectile function. The second endocrine disorder, which can lead to ed, is high thyroid levels. There are medical treatments to bring the thyroid level back to normal and restoring normal thyroid levels may reverse ed. Testosterone is the male sex hormone and is necessary for developing the sex organs in men and for promoting erectile function. Low testosterone levels may interfere with erectile function. This is the medical state known as androgen deficiency or hypogonadism. Androgen deficiency becomes more pronounced with age and may also be a side effect to a number of medications. This can lead to decreased sex, drive, erections and responsiveness to pde5 inhibitors such as Viagra or Cialis. There is no evidence that giving testosterone to men with normal testosterone levels will treat ed. Prolactin is a hormone secreted by the pituitary gland in the brain. If there is too high a prolactin level in the blood, it can lead to erectile dysfunction, increased prolactin levels can be related to stress or medications. Only about 10 percent of cases is related to a prolactin secreting pituitary tumor, bringing the prolactin level back to normal may improve erectile function. There are many neurological diseases which may cause erectile dysfunction. The first of these would be stroke because stroke is often associated with generalized blood vessel disease. The blood vessels in the penis may also be involved, which would lead to decreased blood flow in the penis. Reducing the ability to have or maintain an erection, the physical disability associated with the stroke can lead to inability to engage in sexual activity with one’s partner. If self-image or cognitive issues from the stroke are present, this could lead to secondary ed spinal cord injury often interferes with normal sexual function. Although some men with paralysis due to spinal cord injury, are still capable of engaging in sexual activity generally, there is no sensation in the genital area, so erections usually occur as a reflex in response to genital stimulation. These erections are usually poorly sustained and may disappear over time. Multiple sclerosis is another neurological disorder which is strongly associated with ed. Ed can sometimes be the presenting symptom of multiple sclerosis. This is another reason to mention erectile dysfunction to your doctor during your annual physical exam. Parkinson’s disease is a neurological disease, characterized by progressive loss of coordinated muscle function with its origin in the brain, ed in parkinson’s is not well understood, there may be a biological factor or it may be related to depression, body image, cognitive impairment and physical disability. Epilepsy is another neurological cause of erectile dysfunction, primarily because it is often associated with decreased sex drive or libido, but in some cases may be related to its treatment. It is important to discuss this with your physician to see if alternative causes or treatments are available. I’ve covered the causes of ed in this short video. Our next video will cover the revolutionary new treatment for erectile dysfunction. We offer at sereno sante. It is called jockwave and uses acoustic, shockwave therapy, a painless fda, approved treatment, administered twice a week for three weeks. It has clinically proven efficacy for up to two years without the use of medications, injections or surgery. This is dr maya chicharian. Thanks for watching you.

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