What Factors Influence Sexual Function in Men?
Sexual function in men is influenced by a number of interacting variables. Normal function requires appropriate responses from the nervous, cardiovascular, endocrine and psychological systems. When one or more of these components are compromised in some way, the result can be diminished sexual capacity in one form or another. The primary cause of a penile erection is adequate vascular function, which allows increased blood flow and blood volume in the area. This phenomenon is triggered by neurologic impulses, and then sustained by the presence of appropriate amounts of hormones as well as a positive psychological response.
Erections are triggered by responses of the peripheral and central nervous system. This means that proper function of the brain, spinal cord, and nerves that supply feeling to the genital area is necessary for an erection to occur. In particular, the spinal cord from T11 to S4 reacts to stimuli and sends signals that redirect blood to the penis. Blood enters the area though high-pressure arteries, and returns back toward the heart in lower pressured veins. However, with an increased influx of blood to the area during sexual arousal, the resulting higher pressure creates a force against the walls of the veins, essentially blocking blood flow trying to leave the area. This is what creates a sustained, firm erection. A chemical called nitric oxide is also necessary to maintain an erection. It acts as a neurotransmitter that causes dilation of the arteries leading to the area, which allows a higher blood volume to enter. Therefore, two absolutely essential components of a penile erection are adequate arterial blood flow and nitric oxide levels.
The male hormone, testosterone, also plays an important role in sexual function. It not only increases libido, but also increases the nitric oxide levels necessary to maintain an erection. Age also plays an important role. As a man ages, testosterone levels tend to decrease. In fact, delayed erections, diminished intensity and duration of orgasms, and diminished force of ejaculation are all associated with advancing age.
Causes of ED
Studies have shown that the incidence of sexual dysfunction, including ED, seems to begin to increase at the age of 40. In particular, ED, which has been characterized as consistent or repeated occurrences of the inability to have or maintain an erection that is firm enough to perform sexual intercourse, can be the result of a number of age and/or chronic illness related factors. Basically anything that may interfere with one or more of the essential components necessary to achieve an erection will cause a decrease in sexual function. For instance, disease or injury of disks of the lower back can decrease a man’s ability to perform sexually. Additionally, the same clogging of arteries that causes heart disease can clog the arteries that supply blood to the penis, thus decreasing blood flow and the strength of an erection. Likewise, neuropathies that are caused by uncontrolled blood sugars can affect the nerves necessary to send impulses that stimulate an erection.
Obesity, smoking, increased time in front of the TV, diabetes, heart disease, hypertension, high cholesterol, sleep apnea, prostate cancer, restless leg disorder and other sleep disorders have all been shown to have an association with an increased risk of ED. In addition, some medications, such as antidepressants, diuretics, antifungals, and cimetidine can also increase risk. On the other hand, health related habits such as eating a healthy diet, getting plenty of exercise, maintaining a healthy weight, and getting adequate sleep tend to decrease a man’s chances of experiencing ED. One study indicated that engaging in sexual intercourse at least once weekly decreases the incidence of ED.
Don’t Be Embarrassed: Call Your Doctor
As you can see, like many other illnesses, ED is the result of multiple health-related factors. In this sense, it is often reversible and treatable. Lifestyle changes such as weight loss, increased time exercising, and quitting smoking can all have positive effects on your sexual function. Additionally, it is important that you do everything you can to control any chronic illnesses. If you are a diabetic, follow your diet, exercise, and take your medication as prescribed to maintain the best possible control of your sugar. If you have high blood pressure, take your medicine, modify your diet and get adequate amounts of exercise to control your pressure. If you have sleep apnea, see your doctor because there are treatments such as CPAP or dental devices that can help. If you smoke, quit. If you have high cholesterol, take your medication and follow your diet. These are all things you can do under the supervision of you doctor to improve your sex life.
Additionally, there are medications your doctor can prescribe for you to counter ED. If your problem is caused by low testosterone, it may be possible, depending on your overall health, to replace this hormone. Also, a class of medications called phosphodiesterase (PDE-5) inhibitors enhances the action of nitric oxide, thus supporting and maintaining the blood flow necessary to sustain an erection.
The basic message to take with you is that ED is a medical condition that can be caused by any number of factors. While it is a sensitive topic, it is one that you should not be embarrassed about. Instead, it is important to share your concerns with your doctor so that you might find a solution that will improve your sexual function.
If you have any further questions regarding ED, or any other concerns regarding sexual dysfunction, please call Ironwood Urology at (480) 961-2323 to learn more, or request an appointment online.