ED. What it is, and what causes it?

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ED. What it is, and what causes it?

What Erectile Dysfunction is, and what causes it?

Erectile dysfunction (ED) is medically defined as the ‘persistent inability to attain or maintain an erection sufficient for sexual performance’. In layman’s terms, this means that the penis does not get stiff enough for penetrative sex. Studies have shown that as many as 52% of men will develop some degree of ED at some time in their lives. The best study to date on the prevalence of ED, in my opinion is the Massachusetts Male Aging Study, 0872345556.ED increases as we get older and recent study in 2013 has shown that ED is common in men under the age of 40 affecting 1 in 4.

How does a man get an erection?

Getting an erection is a complex bodily process involving dilatation (swelling) of the arteries bringing blood to the penis, relaxation of the muscles in the penis and the turning on of the system that allows for the temporary blockage of the veins that take the blood away from the penis. All this is under hormonal control, mainly testosterone and the nerves that supply the penis and ensures that an erection happens when desired or required. This means that blood gets trapped in the penis which becomes hard until the blood leaves the penis, for example after ejaculation.

What causes ED?

ED happens when there is a breakdown in this bodily process and can be due to problems with the arteries, veins, muscles, nerves, hormones or even the penis and testicles themselves. This can be a very worrying and distressing problem for men and their sexual partners resulting depression and low self-esteem. It can also cause feelings of unattractiveness, undesirability, and unworthiness. The risk factors that have been most identified for the development ED are increasing age, lack of exercise, being overweight, smoking, high cholesterol or something called metabolic syndrome. Metabolic syndrome is the medical term for a combination of diabetes, high blood pressure (hypertension) and obesity. You may have noticed that these are the same risk factors that are commonly implicated in the development of heart disease. This is very important. ED can be a good predictor of future heart attack or stroke if these risk factors are not addressed. The penis can get ‘blockage of the arteries’ like many other arteries in the body. This is the commonest cause of ED and may be more apparent to you earlier than heart disease so take this seriously and see a doctor.

ED can also be a side-effect of certain medications such as some anti-depressants and some drugs used to treat high blood pressure. It can also be linked to ‘recreational’ drug use such as cocaine or marijuana or heavy drinking. There are also strong links between psychological illness and ED. Depression and stress can cause ED and probably more commonly, prolonged ED can lead to depression and anxiety. Psychological causes of ED might include gender identification issues or unclear sexual preference. Furthermore, you might just not find your sexual partners attractive or worse still, they do not particularly fancy you!

Certain conditions that affect the nerves in the penis such as multiple sclerosis can cause ED and structural problems with the penis such as Peyronie’s disease which causes curvature of the penis can too. Spinal injury or prostate surgery are also potential causes of ED.
Young men in particular are often slow to visit their GPs for routine check-ups. A consultation for ED is an ideal opportunity for a doctor to intervene, to discuss heart disease risk factors including lifestyle, such as lack of exercise, smoking and drinking and to treat the reversible risk factors such as high blood pressure, cholesterol or diabetes. The GP can uncover untreated medical conditions, treat the ED and ideally prevent possible future heart disease.

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