How Do Certain Diseases Lead To Erectile Dysfunction

Often times, people ignore the core pathophysiology of erectile dysfunction by attributing it to an aging related complaint that resolves with prescription and over-the-counter medications; however, this is not always true. It has been observed that erectile dysfunction is often a rather harmless presentation of a more grave pathology. According to an extensive clinical review published in the peer reviewed The Journal of Sexual Medicine (1), scientists investigated various medical and health issues to find the mechanical association between certain health ailments and ED to conclude that any type of stress (physical, emotional, psychological or biochemical) can significantly compromise the quality of sexual performance.

Top 5 Diseases That May Lead To Erectile Dysfunction

1. Cardiovascular Disorders:

The health of your heart is deeply connected to the health of your reproductive and genital system. In order to achieve optimal erection, adequate functioning of vascular and circulatory system is mandatory. Any pathology that affects the patency of blood vessels (such as atherosclerosis) can lead to some cardiac ailments such as arrhythmia, heart failure, cardiac ischemia, valvular dysfunction, stroke etc. The cardiovascular ailments often presents with erectile dysfunction due to circulatory disturbances as well as poor stamina and insufficient energy levels.

2. Metabolic Syndrome:

Certain metabolic diseases such as obesity, poorly controlled diabetes, hyperlipidemia, uncontrolled high blood pressure and physiological aging. The pathophysiology revolves around vascular damage that helps in the penile erection in response to physical and psychological stimulation. According to a new study, diabetic males develop erectile dysfunction approximately 15 years earlier than general population. In addition, ED is 4-times more common in diabetic males when compared to non-diabetics (2).

3. Obesity:

Morbid obesity (BMI more than 30 kg/m2) is also a strong risk factor in the setting of erectile dysfunction for a number of reasons (3); for example:

• Psychologically, obese males are more concerned about their physical appearance and image of self, which may interfere with sexual stimulation. Too much performance anxiety can further worsen ED.
• Metabolically, obesity aggravates the risk of various health issues (such as diabetes, hypertension, hyperlipidemia etc.) that are directly known to deteriorate sexual functions.
• Obesity can also lead to hormonal dysregulation. In other words, most obese males tend to have low serum testosterone levels. In addition, adipose tissues convert existing testosterone into estrogen; thereby further deteriorating hormonal imbalance.

4. Ongoing Inflammatory Diseases:

Inflammation of soft tissues or joints (such as rheumatoid arthritis or poorly managed osteoarthritis) can also present with erectile dysfunction. The effects can be due to:

• Localized pain and rigidity in the affected joints that may interfere with the act of intercourse
• Systemic response of inflammatory mediators that may cause constriction of peripheral blood vessels and hence alters normal filling of penile sinuses in response to sexual stimulation
• Side effect of medications that are advised to manage the symptoms of systemic or localized inflammation.

5. Depression:

More than 15-20% of all the cases of erectile dysfunction have a cause-effect relationship with depression. Depression leads to ED by:

• Direct mechanism: Negative changes in mood, lethargy, weakness, lack of interest in surrounding directly translates into poor libido and low sex drive.
• Indirect mechanism: Most antidepressants (especially tricyclic antidepressants) are known to worsen erectile dysfunction. Other sexual disorders common with antidepressants are dry orgasms and retrograde ejaculation.

In addition, according to a new study (4), men with depression and erectile dysfunction should also be investigated for hypogonadism (or low serum testosterone levels).

Besides the above listed diseases, there are some other ailments that are often linked to erectile dysfunction:

• Chronic gum diseases: According to the results of a new study, approximately 80% ED patients were reported to have poor oral hygiene and chronic gum diseases. The exact cause or association is not known, but it is believed that these individuals have a poor overall health.
• Restless Leg Syndrome: Many studies have linked restless leg syndrome (and other sleep disorders such as sleep apnea) with erectile dysfunction. According to statistics reported in the American Journal of Epidemiology, investigators suggested that males with more than 15 episodes of RLS per month are 78% more likely to develop ED.

It is always a good idea to seek medical help in order to restore normal quality of life. Besides, depending on the core pathophysiology, your doctor may advice you most suitable erectile dysfunction solutions as well as lifestyle and dietary modification choices to control your primary health issue as well as erectile functions.

References

1. Yassin, D. J., Doros, G., Hammerer, P. G., & Yassin, A. A. (2014). Long‐Term Testosterone Treatment in Elderly Men with Hypogonadism and Erectile Dysfunction Reduces Obesity Parameters and Improves Metabolic Syndrome and Health‐Related Quality of Life. The journal of sexual medicine, 11(6), 1567-1576.

2. Malavige, L. S., Jayaratne, S. D., Kathriarachchi, S. T., Sivayogan, S., Ranasinghe, P., & Levy, J. C. (2014). Erectile dysfunction is a strong predictor of poor quality of life in men with type 2 diabetes mellitus. Diabetic Medicine, 31(6), 699-706.

3. García‐Cruz, E., Leibar‐Tamayo, A., Romero, J., Piqueras, M., Luque, P., Cardeñosa, O., & Alcaraz, A. (2013). Metabolic syndrome in men with low testosterone levels: relationship with cardiovascular risk factors and comorbidities and with erectile dysfunction. The journal of sexual medicine, 10(10), 2529-2538.

4. Suija, K., Kerkelä, M., Rajala, U., Jokelainen, J., Laakso, M., Härkönen, P., ... & Timonen, M. (2014). The association between erectile dysfunction, depressive symptoms and testosterone levels among middle-aged men. Scandinavian journal of public health, 42(7), 677-682.

5. Li, Y., Batool-Anwar, S., Kim, S., Rimm, E. B., Ascherio, A., & Gao, X. (2013). Prospective study of restless legs syndrome and risk of erectile dysfunction. American journal of epidemiology, 177(10), 1097-1105.