While erectile dysfunction (ED) is often treated as a taboo subject, it is hardly rare. In fact, beginning at age 40, men increasingly experience some form of sexual dysfunction. There are a number of reasons associated with ED, and not all of them are what come to mind when someone first experience symptoms. To develop and sustain a firm erection requires a balance of functions involving numerous systems in the body. It requires healthy responses from the cardiovascular, neurological, hormonal, and psychological systems. A glitch in any of these parts of the whole process will result in problems. It may not be an easy issue to discuss with someone else, but talking to your doctor may not only help your sexual performance and satisfaction, it may just save your life. The same processes that support an erection are also necessary for many other vital functions of the body, so finding the root of the problem, and acquiring treatment that may include medications as well as lifestyle changes can help you live a longer and happier life.
One of the most important components of sustaining an erection is adequate blood flow to the area. As a man is sexually stimulated, nerve impulses cause blood vessels to dilate, sending an increased amount of blood to the area. A substance called nitric oxide is a key player in causing this to happen. Once the area becomes engorged with blood, the pressure in the area increases and small veins that generally carry blood out of the area and back to the heart are compressed. Thus, an erection is maintained because blood cannot readily leave the area. In order for this process to be effective, a man must have a healthy cardiovascular system. This includes a heart that is capable of pumping efficiently enough to deliver the blood to the area; it also includes arteries that are free from disease – open and flexible. When a man develops arteriosclerosis (plaque build-up in the arteries) from hereditary factors, poor diet, poor exercise habits or smoking, all of his arteries are affected – not just those of the heart or the legs. That means that there will be poor blood flow to the penis as well. In fact, a complaint of ED by a patient may be a doctor’s first clue that a man has heart disease. This is why it is so important to share your concerns with your doctor.
Achieving an adequate erection also requires proper function of the nervous system. This includes both your peripheral nervous system and your central nervous system (brain and spinal cord). Sexual excitement can be perceived centrally via any of the senses such as sight or sound. Additionally, touch can transmit sexual stimulation through your peripheral nerves to your brain. Ultimately, the reaction in the nervous system will send impulses that result in the redirection of blood to the penis. This communication occurs in the lower spine between T11 and S4. Any damage to the spinal cord within this area can affect sexual function. Yet again, this area of the spinal cord is also responsible for many other bodily functions including lower body strength and mobility as well as bladder and bowel function. Additionally neuropathy (peripheral nerve damage) can be caused by a number of other things including diabetes and certain medications. This again illustrates the importance of communication with your doctor for all of your concerns.
Diabetes is a chronic illness that affects a person’s ability to use sugar for fuel in his cells. Insulin, an essential hormone in the transport of sugar into your cells, is either in low supply or completely absent. Adequate control of this illness requires not only the taking of either medications or insulin, but also a balance of a healthy diet and adequate exercise. If the disease is not well controlled and sugars remain high, damage can occur in other systems of the body. At least two of these systems are essential for normal sexual function in men. We have already reviewed the importance of cardiovascular health in achieving an erection, and chronically high blood sugar levels increase the risk of cardiovascular disease. Additionally, these same high sugar levels will also damage peripheral nerves, creating neuropathies that interfere with their function. If the neuropathy includes nerves necessary for normal sexual function, this may result in some level of ED.
The notion of strength and masculinity associated with being a man has caused them a disservice, as emotional issues have been largely ignored. However, approximately 6 million men in the U.S. are depressed. As discussed earlier, psychological wellbeing plays a major role in sexual function. Depression and anxiety can both interfere with a man’s sex drive, resulting in ED. However, treating depression can be a balancing act, because, while improved emotional balance should improve sexual function, some common medications used to treat depression can contribute to the problem of ED. It is very important that a man with ED and/or depression work closely with his doctor to find the right treatment. In addition, exercise is known to have beneficial effects in the treatment of depression and anxiety, as well as with ED.
The male hormone, testosterone, plays a major role in normal sexual function. It not only increases libido, but also increases the level of nitric oxide in the blood. This is the neurotransmitter that causes the arteries in the penis to dilate, creating conditions necessary for an erection. However, as men age, their testosterone levels decrease. This decline not only has an effect on sexual function, but also has many other physiological consequences. Low testosterone is also associated with lack of energy, anemia, lower muscle mass, reduced strength, and thinner bones. In some instances, it may be beneficial to take supplemental testosterone, however this is something to discuss carefully with your doctor because there are risks involved.
As in most every other area of our lives, lifestyle choices make a difference in our health and happiness. Researchers looked at habits that are associated with ED, and found that smoking, increased time spent in front of the TV, poor diet, high cholesterol, and lack of exercise are all risks related to sexual dysfunction. Interestingly, high blood pressure, diabetes, heart disease, and sleep apnea are also associated with ED. One would wonder which is the cart and which is the horse, because the above mentioned activities that lead to ED will also lead to all of these chronic conditions. Hence, it makes sense that improving your lifestyle choices will not only improve your overall health, but will also have a positive effect on sexual function.
If you are experiencing ED, you are not alone. However, you have the power to make changes that will improve your situation. First it is important to discuss your concerns with your doctor. As you can see, not only can this be a complex problem that requires the evaluation and guidance of an expert, but there are also a number of other health issues that can be associated with ED that should be addressed. Next, make the changes that will have a positive affect on your sex life, as well as your overall health. If you smoke, stop. If you don’t exercise, get out there – walking is a great way to start. This will also get you out from in front of the TV. But you should always discuss it with your doctor before starting any exercise program.
A healthy diet is the cornerstone of all good health. Try to eat a diet high in lean proteins, fruits, vegetables, and whole grains; and make sure your potions are reasonable, because too much of a good thing is still too much. Also, follow your treatment plan for any chronic illnesses you may have. It is important to keep your diabetes and your blood pressure well controlled. Remember, your sexual health is a part of your overall wellbeing. The positive changes you make will not only improve your sex life, but your overall health and happiness as well.
If you have any questions regarding ED, or any other urological concerns, please call Ironwood Urology at (480) 961-2323 to learn more, or request an appointment online.