In 20-40% of cases, the causes of sexual problems develop in physically healthy people have psychogenic nature. In about 50% of cases, erectile dysfunction develops due to physical complications and 30-50% of which are vascular diseases.
Most often, when a sexual dysfunction occurs, the patient needs to visit a cardiologist. Erectile dysfunction is often accompanied by diseases such as atherosclerosis, coronary heart disease, arterial hypertension. Doctors of other specialties can also reveal this unpleasant condition.
Besides, erectile dysfunction often occurs in men suffering from diabetes, obesity, chronic renal failure, multiple sclerosis, chronic alcoholism. Sometimes problems with erection can occur as a side effect during treatment with specific drugs.
Erectile dysfunction in cardiac patients
The primary cause of erectile dysfunction in people with heart and vascular diseases is endothelial dysfunction or changes in the function of the inner layer of the vascular wall (endothelium). Endothelial dysfunction is an objective risk factor for cardiovascular diseases. That’s why erectile dysfunction is more common in cardiac patients.
Approximately 50% of patients with high blood pressure have erectile dysfunction. Arterial hypertension is a complex disease that involved many organs including the heart, kidneys, brain, retina as well as vessels of the penis.
Coronary heart disease
Erectile dysfunction is diagnosed in 60% of patients with ischemic heart disease since these diseases have similar risk factors. The presence of atherosclerosis, hypertension, and diabetes mellitus in coronary heart disease increases the possibility of the development of sexual dysfunction.
Studies have shown that men who have systemic atherosclerosis also have problems with erection. Erectile dysfunction during atherosclerosis develops in 80% of cases.
Results of examination of men with atherosclerosis showed that the arteries which supply blood to the penis were also affected by atherosclerosis. At the same time, plaques around the walls of blood vessels are similar in structure with atherosclerotic plaques.
It means that atherosclerosis affects the arteries of the penis and causes problems with sexual function.
Multiple sclerosis is a chronic autoimmune disease which caused by a replacement of the normal nervous tissue with connective tissue. Sclerotic changes occur in the nervous tissue throughout the body.
Erectile dysfunction in men with multiple sclerosis develops in almost 90% of cases and accompanied by disorders of urination and defecation. The clinical manifestations are not well understood. There are theories that erectile dysfunction in multiple sclerosis develops as a result of damage to the spinal cord.
Diabetes and erectile dysfunction
Erection disorders are very common in diabetes mellitus, both the first and second types. It occurs in 35-55% of patients with type 1 diabetes, and the risk of this disorder is three times higher in patients with diabetes.
The frequency of development of erectile disorders in patients with diabetes mellitus depends not only on the age of the patient but also on the duration of the disease.
At the same time, diagnosed erectile dysfunction in the presence of diabetes can be a symptom of the development or progression of atherosclerosis and coronary heart disease, as well as diabetic neuropathy.
Neurogenic cause of erectile dysfunction
Development of neuropathy. Changes in the nerve fibers of the penis which disrupt the passage of the impulse along the nerves.
The development of erectile dysfunction occurs as a result of macro- and microangiopathies developing in diabetes mellitus. Changes in blood vessels in diabetes are responsible for the development of atherosclerosis of cerebral vessels, coronary vessels, aorta, limbs, including the arteries supplying the penis. Moreover, the elasticity of cavernous tissue decreases because of this disease.
In some patients, diabetes mellitus is accompanied by a decrease in testosterone levels because of metabolic disorders and obesity, which are frequent companions of diabetes.
In approximately 10% of patients with diabetes mellitus, erectile dysfunction has a psychogenic nature. The diagnosis of diabetes mellitus is high stress, and patients consider occasional failures in bed as a manifestation of a severe disorder, so the following attempts at sexual activity also fail.
People with overweight often have problems in their sexual life. It is due to the correlation of serum testosterone with the volume of visceral adipose tissue in the body.
A decrease in testosterone levels in the blood leads to an accumulation of fatty tissue around the organs;
Visceral obesity (accumulation of intra-abdominal fat) leads to a decrease in total testosterone levels in the blood.
Erectile dysfunction, caused by obesity, is easily reversed. Even a moderate decrease in body weight gives good results restoring an erection function.
The side effect of medications
Some medications used in the treatment of common diseases may harm erection. Most often this is observed in the treatment of diseases of the heart and blood vessels. Blood pressure medications like Lisinopril can cause erectile dysfunction.
Erectile dysfunction, as a side effect of treatment, develops in the therapy with alpha-blockers, beta blockers, diuretics, ganglioblockers, ACE inhibitors, antidepressants, hormonal drugs, calcium channel blockers, such as Diltiazem or Amlodipine, and antifungal medications.
As a rule, after the cancelation of the drug intake or the end of the treatment, the symptoms of erectile dysfunction disappear.
Porn-induced erectile dysfunction and masturbation
Scientists have shown that watching porn on a regular basis (and masturbating to) can cause erectile dysfunction in men. According to the study, the brain loses its ability to respond to dopamine, which means that users need more and more extreme emotions.
Nevertheless, the researchers insist that the recovery of sexual functions is possible within a month if the patient simply rejects pornography and allow the brain to “reboot.”