You might have your father’s eyes, or your mother’s smile or even your grandfather’s face. Certain things can run in families and be inherited; your genes can give you the characters that you have and even control some of the vital internal biological processes you need to survive. They are also linked to the potential of having a specific disease. Whether or not they are also linked to the problems in the bedroom, is something that will be revealed towards the end of this article.
Erectile dysfunction (ED) is a type of sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity. It is a common public health problem affecting millions of men worldwide. It has been estimated that nearly one in every ten men would have such complaints, being four times more common in men aged in their 60s than those in their 40s. If he is to achieve an erection, a man needs an adequate circulating level of hormones, sufficient blood flow to the penis, intact nerves supplying the penis; and an appropriate sexual desire. If there is a problem with one or more of these mechanisms, the erection may fail.
So, the physical causes that might be imparted in ED include the following:
Low testosterone, high prolactin, and abnormal thyroid hormone levels can cause ED. Scientists haven’t figure out yet the relation between the thyroid hormone and ED. Yet, they reported that high prolactin results in decreased testosterone production which will be reflected in decreasing the interest in sexual function.
is also considered a physical reason because it can result in reduced sensitivity, or reduced signals to the penis to release the chemicals that cause the erection.5 In a Spanish study of 90 men, it has been found that approximately 69% with sexual problems had nerve damage, mostly peripheral nerve damage. Men who reported more symptoms and showed more signs of nerve damage also reported more severe symptoms of sexual dysfunction.
Disease of the blood vessels:
In addition to the previous two, if there is any disease of the blood vessels or a condition linked with vascular diseases such as high blood, high cholesterol and others- vessels often become narrowed and stiffened which would reduce the blood supply to the area, thus the erection wouldn’t be maintained
The spinal cord is a bundle of nerves that extends from the brain and down the spine. Nerves radiate from the spinal cord to the furthest points within your body. Some of those nerves are responsible for helping to control when you have an erection.8 If they become damaged, erections may become difficult to achieve, if not impossible. Therefore, the spinal injuries and any other trauma are added to the list of ED causes. The degree of sexual function after spinal cord injury often depends on the location and severity of the injury.
Damage to the penile tissue after surgery can also lead to ED, an underdiagnosed and under-treated condition which can significantly affect the quality of life of men and their partners. Whether it was on the prostate, bladder or bowel, pelvic surgery may result in nerve damage leading to ED.
Cigarettes can contain up to around 41,000 chemicals, some of which that can cause ED, such as, acetone, arsenic and carbon monoxide. Male smokers have an increased risk of ED due to the damage these chemicals can do to their blood vessels, narrowing the arteries and causing poor blood supply to the penis.11 Nicotine has a direct effect on the blood vessels that carry blood to the penis, by reducing the blood flow and this makes getting and maintaining an erection difficult. It has been reported that in some cases, passive smoking can also cause ED.
The chance of developing sexual dysfunctions appears to increase with increasing quantity of alcohol consumed. Higher levels of alcohol intake may result in greater neurotoxic effects. Episodic erectile failure in alcoholic men was found to be significantly higher in men consuming more than three standard units of alcohol (12 g ethanol) daily. That may be due to the depressant effect of alcohol itself, alcohol-related disease or due to a multitude of psychological forces related to alcohol use.
The most common types of medication that are linked to ED include antidepressants, anti-ulcer drugs, and diuretics—which help the body get rid of sodium and water, and are used to treat heart failure, liver failure, and certain kidney disorders. Other medications that may trigger ED are antihistamines, anti-androgens (used to treat prostate cancer), anticholinergics (used to treat an overactive bladder, incontinence, and symptoms of Parkinson’s disease), and some anticancer drugs. However, the most common type of drug that may lead to ED is blood pressure medication.
Studies of ED suggest that its prevalence in men with diabetes ranges from 35–75% versus 26% in the general population.15 The onset of ED also occurs 10–15 years earlier in men with diabetes than it does in sex-matched counterparts without diabetes. ED in diabetics commonly stems from a combination of blood vessels disease and nerve damage.
This again imposes a risk to ED as well. 79% of men presenting erectile disorders have BMI of 25 kg/m2 or greater. BMI in the range 25-30 kg/m2 is associated with 1,5 times and in the range of over 30 kg/m2 with 3 times greater risk of sexual dysfunction. The occurrence of ED in patients with obesity is caused by a number of complications which are characteristic for an excessive amount of fat tissue, e.g: cardiovascular diseases, diabetes or dyslipidemia. by developing chronic diseases of diabetes, heart disease and hypertension. ED and high blood pressure often go hand in hand. Men with ED are about 38% more likely to have high blood pressure than those without ED, according to a study that examined the medical records of more than 1.9 million men.
It is very common to see a combination of psychological and physical causes, but pure psychological causes are seen in less than 1 in 10 (10%) of all affected patients. ED can be caused by stress, depression, anxiety, relationship problems, embarrassment, guilt and other psychological issues. When a man has difficulty getting an erection, whatever the cause, he will often experience pressure to perform. This can lead to a feeling of inadequacy and a sense of loss of manhood (called performance anxiety). These are all common emotions for men with ED.
Regarding genetics, there is intriguing, if very preliminary, evidence that inheriting certain genes may make a man more susceptible to ED. To be more specific, scientists have linked natural variations in the DNA sequence of some genes with a higher risk of developing ED. The data collected are not sufficient to state such a claim.
Erectile dysfunction has many causes that involve a complex relationship between neurologic, vascular, hormonal and psychological components. Certain medical conditions that may lead to erectile dysfunction are hereditary. However, things like injury, medications, and stress can’t be carried within genes. So, don’t blame your parents if you’re having problems in bed. There is still a great deal to be learned about how genes affect the risk of erectile dysfunction. Besides, genes are not destiny. The science is very clear: Eating a healthy diet, exercising, and avoiding bad habits such as smoking can lower your risk for erectile dysfunction and other medical conditions.
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- Boyle P. Epidemiology of erectile dysfunction. Textbook of Erectile Dysfunction, Second Edition. CRC Press, 2008:35-42.
- Melman A, Gingell JC. The epidemiology and pathophysiology of erectile dysfunction. The Journal of urology 1999;161:5-11.
- Heaton JPW, Adams MA. Causes of erectile dysfunction. Endocrine 2004;23:119-23.
- Andersson K-E. Erectile physiological and pathophysiological pathways involved in erectile dysfunction. The Journal of Urology 2003;170: S6-S14.
- Ramos AS, Samso JV. Specific aspects of erectile dysfunction in spinal cord injury. International journal of impotence research 2004;16: S42.
- Esposito K, Giugliano F, Di Palo C, Giugliano G, Marfella R, D’Andrea F, D’Armiento M, Giugliano D. Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial. Jama 2004;291:2978-84.
- Deforge D, Blackmer J, Garritty C, Yazdi F, Cronin V, Barrowman N, Fang M, Mamaladze V, Zhang L, Sampson M. Male erectile dysfunction following spinal cord injury: a systematic review. Spinal cord 2006;44:465.
- Montorsi F, Luigi GG, Strambi LF, Da Pozzo LF, Nava L, Barbieri L, Rigatti P, Pizzini G, Miani A. Recovery of spontaneous erectile function after nerve-sparing radical retropubic prostatectomy with and without early intracavernous injections of alprostadil: results of a prospective, randomized trial. The Journal of Urology 1997;158:1408-10.
- Avoiding long‐term disturbance to bladder and sexual function in pelvic surgery, particularly with rectal cancer 2000. Wiley Online Library.
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- McVary KT, Carrier S, Wessells H. Smoking and erectile dysfunction: an evidence-based analysis. The Journal of Urology 2001;166:1624-32.
- Arackal BS, Benegal V. Prevalence of sexual dysfunction in male subjects with alcohol dependence. Indian Journal of Psychiatry 2007;49:109.
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- Skrypnik D, Bogdański P, Musialik K. Obesity– a significant risk factor for erectile dysfunction in men. Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 2014;36:137-41.
- Düsing R. Sexual dysfunction in male patients with hypertension. Drugs 2005;65:773-86.
- Kerns SL, Stock R, Stone N, Buckstein M, Shao Y, Campbell C, Rath L, De Ruysscher D, Lammering G, Hixson R. A 2-stage genome-wide association study to identify single nucleotide polymorphisms associated with the development of erectile dysfunction following radiation therapy for prostate cancer. International Journal of Radiation Oncology* Biology* Physics 2013;85:e21-e28.
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