ED refers to persistent difficulty with sexual desire/response, arousal, orgasm, or pain. It affects approximately 30% of men and 40% of women and can affect any age although it is more common in those who get older because it has been linked to deteriorating health associated with aging. It is more common in infertile couples.
Sexual problems that interfere with intercourse and prevent pregnancy can have serious consequences for couples. Infertility can be caused by problems at any stage of the sexual response, such as desire disorders, arousal, orgasm, and pain disorders. This can manifest as decreased desire for sex (reduced libido), inability to get or maintain an erection (erectile dysfunction), difficulty releasing sperm (early and late ejaculation), and tight vaginal muscles that prevents intercourse (vaginismus). All of this prevents a person from feeling satisfied with sexual activity.
Our focus this week will be on male impotence, also known as erectile dysfunction.
What is erectile dysfunction?
Erectile dysfunction (impotence) is the inability to get and maintain an erection enough for sexual intercourse. Having occasional erection problems is not necessarily a cause for concern. But having erectile dysfunction on a regular basis can cause stress, affect self-confidence, and contribute to friction in a relationship. ED can also be an indicator of an underlying health condition that requires treatment, as well as a risk factor for heart disease.
ED can certainly contribute to male infertility because it interferes with ejaculation, which is necessary for sperm to enter the vaginal canal and search for a woman’s egg. On the other hand, infertility can cause anxiety and even depression, both of which contribute to ED. Furthermore, the stress of pregnancy can cause performance anxiety, which may prevent a man from having an erection. As you can see, erectile dysfunction and infertility are closely intertwined, as one can lead to the other.
Causes of erectile dysfunction
Here are some specific causes of erectile dysfunction:
- ageLike many other health problems, erectile dysfunction becomes more common as you age. According to research, approximately 2% to 12% of men in their forties have some form of ED, and this percentage rises with each decade of life. In fact, more than half of men over the age of 70 suffer from some form of ED.
- diabeticErectile dysfunction is a medical problem that many diabetics have to deal with. The longer you’ve had diabetes (type 1 or type 2), the more likely you are to develop erectile dysfunction. However, how well you control your blood sugar levels has a real impact on your risk of erectile dysfunction. Diabetes-related erectile dysfunction cannot always be reversed, but you can certainly improve it or reduce the likelihood of it occurring by following your doctor’s advice to control your diabetes.
- Heart disease, high blood pressure, and high cholesterolErectile dysfunction has an interesting relationship with a man’s cardiovascular health. It has long been known that high blood pressure and high cholesterol contribute to ED. Recent research has found that when healthy men develop erectile dysfunction, many are diagnosed with heart disease less than 5 years later. Therefore, if you have ED and there are no other health problems, you should ask your doctor to check your heart. By recognizing the warning signs early, you may be able to prevent the development of heart disease.
- smokingSmoking and other forms of tobacco use are associated with a variety of health problems, including erectile dysfunction. Tobacco consumption reduces blood flow throughout the body. This includes the blood vessels in a man’s penis. If blood flow is reduced there, achieving and maintaining an erection becomes more difficult. Fortunately, this is reversible. When you stop smoking, your ability to have an erection will improve.
- Sexually transmitted infections (STIs): Sexually transmitted diseases can lead to erectile dysfunction. Certain sexually transmitted infections (STIs) such as chlamydia, gonorrhea, untreated HIV, and viral hepatitis can sometimes cause infections of the prostate gland. If this happens, it is possible that you are experiencing symptoms of ED. Most of the time, treating both the prostate infection and taking steps to control STDs will resolve any ED issues. On the other hand, a prostate infection can cause permanent damage if left untreated.
- Prostate cancer and inflammationIt should come as no surprise that a diseased prostate can cause erectile dysfunction. The prostate produces a component of sperm. While benign prostatic hyperplasia (BPH) is not a cause of erectile dysfunction, the medications used to treat it can. On the other hand, chronic prostatitis or prostate cancer can cause painful ejaculation and difficulty achieving an erection. If you know prostate problems and suffer from ED, consult a urologist.
- Low testosteroneA low level of testosterone in men leads to decreased sex drive, erectile dysfunction, hair loss and insomnia. The lower your testosterone level, the more symptoms you may experience. When testosterone levels return to normal, most men will notice that their erectile dysfunction symptoms improve or disappear completely.
- Some prescribed medicationsA variety of medications, both prescription and over-the-counter, can contribute to or cause erectile dysfunction. Some of these medications include antidepressants, blood pressure medications, antihistamines, acid reflux medications, and opioid pain relievers. This is not an exhaustive list, so it is possible that you may have trouble getting an erection after you recently started taking a new medication. Keep in mind that excessive alcohol consumption and excessive use of recreational drugs (including marijuana) can cause erectile dysfunction.
- Mental health issues and performance anxietyIn the case of erectile dysfunction, the brain plays an important role in the ability to achieve and maintain an erection. When you’re stressed or struggling with your mental health, your brain may have trouble making neural connections and releasing hormones that cause erections. Examples of stressors include depression, anxiety, relationship problems, sadness, watching too much porn, and even performance anxiety in the bedroom. With the right support or treatment, they are manageable and reversible.