Top 10 causes of erectile dysfunction (ED)

Erectile Dysfunction is a common condition affecting Australian Men. 1 in 5 suffer from ED at age 40, 26% from 50-59, and that number jumps to 40% at age 60. As lifespans for us Aussies have increased over the last couple of generations, Erectile Dysfunction is a major concern for men who aim to continue their sexual performance as they get older.

Penile erections are a result of erotic stimuli in the lambic system of the brain and a touch mechanism controlled by the sacral nerves of the peripheral nervous system. Both play a part in the dilation of blood vessels which fill the corpus cavernosa (erectile tissues) that engorge and hold blood to maintain an erection.

In Australian Men, 10% of ED is the result of psychological anxiety or depression

However for the vast majority of men there is a physical cause

Those include conditions that affect the blood vessels or nerves supplying the penis or disrupt the hormonal balance in the body. It’s very easy to see why as men get older they face higher risks for conditions which can lead to ED. Cardiovascular problems, atherosclerosis, high blood pressure and diabetes are all risk factors for Erectile Dysfunction. Smoking, drinking excess alcohol and taking medications including antidepressants and blood pressure medicine are as well.

Prostate cancer is one of the most common cancers and can have serious consequences leading to ED

Many prostate cancers are slow growing over a long period of time measured in decades. A wait and see approach has in recent years gained traction with the medical community. For faster growing cancers or when the malignancy has become too big, radiation therapy and surgery are the standard treatments. Not only does the urethra travel through the prostate but the nerves which play a role in erection surround it. While radiation treatments can damage the nerves, surgical removal of the prostate can destroy them leading to severe erectile dysfunction. In recent years nerve sparing surgery in radical prostatectomy has been growing and can be successful in preserving erectile function. Whether nerve sparing surgery is an option or if it will be effective will depend on myriad of factors including the spread of cancer and surgical skill. Spinal cord damage can also lead to the same problem with nerve impairment leading to ED.

A number of treatment options for Erectile Dysfunction exist

Those with severe ED may be able to get a penile prosthesis where rods are surgically inserted into the corpus cavernosa and a squeeze pump is inserted into the scrotum which can be squeezed to fill the prosthesis and create an artificial erection. Penis pumps can be used to treat ED where after pumping a band is tightened on the base of the shaft to prevent blood from flowing back into the body. Vasodilators and smooth muscle relaxants can be injected into the urethra to aid in erection.

Lucky for Australian men there is simple medication that is often very effective in treating Erectile dysfunction

In the 1980s researchers trying to investigate medication for coronary perfusion discovered phosphodiesterase 5 (PDE5) inhibitors worked to treat ED. To form an erection nerves when triggered by erotic thoughts or physical stimulation of the penis release nitric oxide into the blood vessels supplying the penis. The nitric oxide causes cyclic Guanosine Monophosphate, cGMP for short, to bind to receptors in the smooth muscle of vessels that causes it relax and dilate allowing more blood flow triggering an erection. Phosphodiesterase 5 is an enzyme that breaks down cGMP. By taking a PDE5 blocker, more cGMP is available to trigger an erection. This is helpful in people who suffer from Erectile Dysfunction.

Viagra has been around for over two decades and is the most well known ED drug

Taking it does not automatically cause an erection but allows for an erection to occur with normal sexual stimulation, according to the numerous ED commercials, “when the time is right” – Viagra typically lasts for 4 hours. Cialis is also a PDE5 inhibitor that is advertised as working for up to 36 hours. In Australia, Kamagra Jelly is increasingly a popular option for ED sufferers. An edible jelly, it can be taken orally and takes effect in 15 minutes, faster than the pill medications like Viagra or Cialis.

It is important to not take more than the daily dose limits stated on the medication packaging

Like with any drug there are risks. With PDE5 inhibitors like Viagra and Cialis, a condition called priapism can occur where blood gets trapped in the corpus cavernosa and does not drain properly into the dorsal veins to terminate the erection. Having an erection for an extended period of time can lead to damage to the erectile tissues. If the erection does not subside it may require hospitalization in the emergency department for aspiration drainage of the blood through a needle inserted in the shaft or through the glans.

I am a doctor from Melbourne

4 Comments

  1. Cameron King

    Reply

    Erectile dysfunction doesn’t have to impact your life if you don’t want it to. Just start with a low dose and your doctor will raise it until not getting a hard isn’t an issue.

  2. Sebastian Mason

    Reply

    I have dealt with it for a few years now, I find it happens more often when I have been drinking alcohol and smoking cigarettes or if I have not been eating healthy. It can be very embarrassing especially for a single man who is dating. The woman often things it is her fault and she is not turning me on enough. It can be very difficult and embarrassing to tell her that it ED and its not her fault.

  3. Jacob Baker

    Reply

    I am addressing erectile dysfunction from the standpoint of the woman. I feel so bad for my husband because he has the desire and drive, but just can’t perform long enough to satisfy me. I try to be very encouraging to him and sometimes generic orgasms to make him feel like a man.

  4. Louis Thomson

    Reply

    I deal with erectile dysfunction since I turned 30, which has not allowed me to have a full life and lowered my self-esteem remarkably, until I decided to talk about the topic and seek help.

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