This is a topic that apparently no man wants to talk about. Less than half the men who suffer from it. Well, today, we are going to talk about erectile dysfunction. Also, we are going to be talking about the biology of an erection, the causes of this disorder, reveal how to address the problem, and the strategies for eliminating this affliction once and for all.
Erectile dysfunction affects as much as 52% of men, with 40% of men age 40 and 70% of men aged 70 being afflicted. However, only 25% of men are being treated, suggesting that most of us are not reporting the affliction. Why? Because it’s demoralizing, and it negatively impacts our self-esteem and our self-image.
So, what is erectile dysfunction? The clinical answer is when a man can’t achieve or maintain an erection sufficient for satisfactory sexual performance, then that man has ED. As a man ages, his erections change. They become less firm, take longer to rise, and disappear more easily. Some sources claim that this is inevitable and don’t constitute ED, but rather “erectile dissatisfaction.”
The bottom line is that if you’re not able to perform at a satisfactory level to either you or your mate, the definition is less likely to be important to you than a cure. But before jumping into the causes of ED, let’s spend a moment talking about the biology of an erection.
In the penis, there are three columns of erectile tissue: the corpora cavernosa, which runs parallel to each other along the top of the penis, the corpus spongiosum, which runs along the bottom of the penis and surrounds the urethra. During an erection, the corpora cavernosa and the corpus spongiosum, which are rich in blood vessels and lined with endothelial cells, become engorged with blood and expand, making the penis larger and firmer.
This clinical name for this is called vasocongestion. Now, vasocongestion is caused by nerve impulses that are sent from one of two locations in the spinal cord in response to stimuli, either physiological or psychological. The first of these is called the sacral erection center.
It’s located at the base of the spine, and it responds to direct physical stimulation of the penis, and these are the nerve impulses that are physiological in nature. The second is called the thoracolumbar erection center, and it’s located higher in the spine.
It responds to nerve impulses that are derived from sights, sounds, or fantasies that are arousing to a particular individual and are the nerve impulses that are psychological in nature.
When you experience sexual arousal, the endothelial cells, which line the erectile tissue of your penis, release Nitric Oxide (NO), which causes an increase in a chemical compound called cyclic guanosine monophosphate, or cyclic-GMP. Cyclic-GMP causes the smooth muscles of the arteries in the erectile tissue to relax, allowing the blood to rush in.
This increased volume (up to 6X the normal amount) is what causes the erection, also called tumescence. The sudden swelling also causes the veins that carry the blood out of the penis to collapse, trapping the blood in the penis and causing the erection. Cyclic-GMP is broken down, or degraded, by an enzyme called phosphodiesterase type 5, or PDE5, which is naturally expressed in the smooth muscles of the erectile tissue.
As long as the sexual arousal, either physiological or psychological, continues, nitric oxide is continually released, keeping levels of cyclic-GMP high and overcoming the degrading effects of the PDE5. Once sexual arousal ends, as with ejaculation, NO release stops, the PDE5 takes over, relaxing the veins of the erectile tissue allowing the blood to drain from the penis.
This mechanism is call detumescence. So, you want healthy endothelial tissue to release nitric oxide, and you want to block the phosphodiesterase as long as possible. There are two primary causes of ED…and those are either physiological or psychological. If it’s physiological, meaning that there’s a problem with your plumbing, something in your body isn’t working the way that it’s supposed to, there are a myriad of conditions that could be the underlying cause. If it’s psychological, meaning that it’s in your mind and it’s a libido issue, then it could be caused by past trauma or some other emotional reason and is best addressed in therapy.
There’s a traditional test that you can do to determine if the cause is physiological or psychological. If you get morning erections just fine, that means that the plumbing is working just fine, and the problem is psychological. If you don’t know if you get morning erections, place a band of postage stamps around your penis before you go to sleep. When you wake up, if it’s broken, then your getting morning erections, and your problem is not physiological …it’s psychological.
OK, so now that we’ve gotten the biology of erections out of the way, let’s move on to the causes of erectile dysfunction. And there are about 8 of them.
CAUSE #1 LIFESTYLE
The number 1 cause of ED is a lifestyle or how you go about living your life, and changing your lifestyle can often reverse or even cure ED. ED is often called the “check engine light” for your body. Because the blood vessels of your penis are small compared to the job they have to do, serious underlying conditions often manifest themselves first as ED. There are several aspects of your lifestyle that can impact your performance in the bedroom.
Exercise is the best way to strengthen your heart and to increase your stamina, strength, and flexibility. The average heart beats about 100,000 times a day, pumping about 2,000 gallons of blood throughout your body. That’s the equivalent of an Olympic swimming pool every year. To achieve an erection, your penis requires about six times the normal amount of blood. The stronger your heart is and the cleaner your arteries are, the more blood that it will pump with each beat. And exercise is the best way to increase the efficiency of your heart.
Poor nutrition can cause, among a variety of other things, obesity. And obesity is a primary risk factor for ED. Excess belly fat, or visceral fat, can also cause a reduction in testosterone. Obesity can also damage the endothelial tissue in your penis, preventing the release of nitric oxide, which in turn can cause ED. A small decrease in body fat percentage can improve ED.
Men who smoke are twice as likely to experience ED. Smoking damages your blood vessels. Stopping smoking can improve ED in as little as 2 weeks or as much as 3 months.
Alcohol is a nervous system depressant and can block messaging between the brain and the body. Drinking over 3 glasses of alcohol a day can allow the muscles to relax, enabling the flow of blood to the penis, but it can also prevent the veins from closing and trapping the blood in the penis. Long term, excessive alcohol consumption can cause liver damage, high blood pressure, and can damage your blood vessels – all contributing to ED.
In addition to increasing your risks for a cardiac event, slowing your metabolism, weakening your immune system, and diminishing cognitive function, a lack of sleep can also decrease your testosterone, which in turn can increase the likelihood of ED and decrease your libido. You need to get both enough sleep and high-quality sleep.
Chronic stress can lead to high blood pressure, heart disease, obesity, and diabetes – all things that can foster ED. Stress can also increase the production of cortisol, and it can affect blood flow and your ability to achieve and maintain an erection. Additionally, when your cortisol production is up, your testosterone production is down, and low T can lead to ED. So exercising and getting good nutrition, getting the right amount of high-quality sleep, and eliminating smoking, alcohol, and stress from your life can dramatically improve your ED.
CAUSE #2 AGE
Although there’s not much you can do about your actual chronological age, the process of aging can have a big impact on your sexual performance. As we get older, we become more and more likely to have ED, with 70% of men in their 70’s reporting erectile dysfunction. However, there are strategies to turn back the clock on aging, and improving erectile dysfunction is absolutely on the list of things you can enhance.
CAUSE #3 LOW TESTOSTERONE
Low T can cause a host of problems for the aging man, and erectile dysfunction is one of the big ones. Decreases in testosterone have been linked to both lower libido as well as ED. Study after study have shown that increasing the production of testosterone can improve both of these dramatically. And there are a number of things that you can do to dramatically, and naturally, boost your testosterone production.
CAUSE #4 CARDIOVASCULAR RISK
ED is often an early warning sign for more serious physiological problems like high blood pressure (or hypertension), diabetes, obesity, and high cholesterol. The blood vessels in the penis are smaller than in the rest of the body, particularly in the heart and brain. So ED is often the first sign of high cholesterol or high blood pressure before a blockage can cause more serious problems, like a heart attack or a stroke. If you have existing risk factors for heart disease like diabetes, obesity, high cholesterol, high blood pressure or a family history of heart disease, and you have ED, it might be a good idea to schedule a checkup. Improving heart health and blood flow can result in better and more frequent erections.
CAUSE #5 MEDICALLY INDUCED
Many of the most commonly prescribed medication, as well as over-the-counter drugs, list ED as a possible side effect, and they can decrease libido and interfere with blood flow. Medications that commonly cause ED includes SSRIs, beta-blockers, blood pressure meds, diuretics, antifungals, antihistamines, muscle relaxants, and non-steroidal anti-inflammatory drugs. If you’re experiencing ED, a frank discussion with your doctor about the medications that you’re taking can lead to alternative medication…and a better discussion about your ED. Just remember, do not stop taking your prescription medications without consulting with your physician.
CAUSE #6 RECREATIONAL DRUGS
Almost all recreational drugs have been implicated in ED. Alcohol and nicotine, and also marijuana, amphetamines, barbiturates, cocaine, methadone, and opiates. They don’t just suppress the nervous system – they also can damage your blood vessels. And any damage to your blood vessels or to your normal blood flow will eventually cause ED. So you need to weigh the risks of ED against whatever pleasure you might derive from recreational drug use.
CAUSE #7 DIABETES
Diabetes can and does cause vascular complications throughout the human body, and the penis is no exception. Studies have found that the majority of men with diabetes over the age of 55 have ED. And most of them have never been asked about their sexual function. So if you have diabetes, you need to have a talk with your doctor about ED.
CAUSE #8 CYCLING
And finally, we get to cause # 8. That’s right, cycling. Although this is controversial, research shows a link between cycling and ED. Cycling puts pressure on your pudendal artery, which can lead to penile numbness and ED. The pudendal artery supplies blood to the sex organs, the perineum, and all the structures in that area. If you’re cycling a lot and you’re experiencing ED, this might be something to take a look at with your doctor.
OK, here are the top 8 causes of erectile dysfunction. And almost every one of them is something that you can change to improve your ED.