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Erectile Dysfunction

Erectile dysfunction (ED), also known as impotence, is a type of sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity. ED can have psychological consequences as it can be tied to relationship difficulties and self-image.

A variety of causes may contribute to ED, including vascular, hormonal, neurologic, psychological, and drug-related factors. Often, a combination of these factors contributes to the condition.

Vascular causes may include arteriosclerosis (the hardening of arteries), Peyronie’s disease (the development of plaque within the penis), and cavernosal fibrosis (scarring of the erectile tissue).

Hormonal causes may include abnormal levels of androgens (male hormones) and prolactin (a female hormone).

Neurologic causes may include Parkinson’s disease, multiple sclerosis, and spinal cord injuries. Psychological causes may include anxiety, depression, and relationship difficulties.

Certain medications, including some antidepressants, can also contribute to ED. Drug-related ED may be caused by recreational use of drugs such as cocaine and methamphetamine.

Signs and symptoms

The main symptom of ED is the inability to get or maintain an erection. Other symptoms may include

  • Reduced sexual desire
  • Trouble getting an erection
  • Trouble maintaining an erection
  • Inability to reach orgasm
  • Reduced sexual satisfaction

Causes

A variety of factors may contribute to ED, including

  • Vascular causes: Hardening of the arteries (arteriosclerosis) or damage to the arteries can restrict blood flow to the penis, resulting in ED.
  • Hormonal causes: An imbalance of certain hormones, such as testosterone, prolactin, or thyroid hormone, can cause ED.
  • Neurologic causes: Conditions such as Parkinson’s disease, multiple sclerosis, and spinal cord injuries can damage the nerves involved in erections.
  • Psychological causes: Anxiety, depression, and relationship difficulties can impact sexual performance.
  • Drug-related causes: Certain medications, including some antidepressants, can cause ED. Recreational drug use, such as cocaine and methamphetamine, can also lead to ED.

Risk factors

Risk factors for ED include

  • Age: The risk of ED increases with age.
  • Diseases: Conditions such as diabetes, heart disease, hypertension, and atherosclerosis can contribute to ED.
  • Injuries: Spinal cord injuries or damage to the nerves can cause ED.
  • Lifestyle choices: Smoking, excessive drinking, and drug use can contribute to ED.
  • Medications: Some medications, such as certain antidepressants, can cause ED.
  • Psychological conditions: Anxiety, depression, and stress can impact sexual performance.
  • Relationship problems: Difficulties with a partner can cause ED.
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Video transcription:

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