Erectile Dysfunction, Male Impotence. Why Is It Happening to Me?

Erectile dysfunction affects two out of ten men.  There are statistics that greater or lesser intensity can potentially affect 40% of men over 50 years. Today it is a disorder that can be treated. However, only 10% of men go to the urologist and receive further treatment despite its frequency.

Most of the cases can be solved nowadays. However, the vast majority of patients do not seek a solution for many reasons.  The most common reason is because the person feels embarrassed to talk about it (the public recognition). They feel shameful discussing the disease with their (doctor and partner).

Many times the problem does not always occur or has an organic basis, that is, the erection mechanism works correctly, so if we can restore that lost confidence (psychological block), the patient will not have to always resort to treatments to achieve a good erection and therefore a satisfactory sexual relationship.

In any case, it must be said that in approximately 80% of ED cases, there is an underlying physical or organic cause, such as diabetes, high blood pressure, or a cardiovascular problem in general. This last cause is usually very frequent.

Who is affected, and what are the possible causes?

Organic or physical causes…

In 80% of cases, ED’s cause is known and responds to an organic or physical problem. In these cases, the man maintains a normal sexual instinct or libido, that is, he maintains the desire to have sex. Some of those causes are:

Alterations in blood flow

As in other parts of the body, the arteries that carry blood to the penis may suffer some alteration, with the consequent effect on erection. Some risk factors are age, high blood pressure, high cholesterol, smoking, diabetes, etc. 6 out of 10 ED cases are caused by a vascular problem, which occurs due to the narrowing of the penile arteries. (Remember that they are millimetric) and are responsible for transporting blood to the penis.

High levels of plaques of atheroma

Plaques of atheroma ( arteriosclerosis ) form over the years, progressively, in one or more areas of the body, usually in the arteries that go to the heart, legs, brain, and penis. Over time, these atheroma plaques increase in size, causing the narrowing of one or more arteries.

Neurological injuries

For example in the brain or spinal cord. For example, a patient with spinal cord injury (paraplegic) due to a traffic accident. Neurological injuries can cause erectile dysfunction.

Diabetes mellitus

It is one of the most common causes of ED due to the vascular involvement that occurs in the advanced stages of the disease.

Surgical interventions

For example, the treatment of the prostate due to a malignant tumor, either surgically (removing it) or through other therapeutic modalities (brachytherapy, radiotherapy). It should be noted that this does not occur in cases of benign growth surgery.

Treatment of prostate cancer by brachytherapy

Implant of radioactive seeds in the prostate that causes erection problems.

Hypogonadism (Testosterone deficiency)

Testosterone, which is the male hormone par excellence, regulates body processes such as…

• muscle formation
• regulation of fat
• insulin
• sexual function

Thus, the alteration of its levels produces harmful effects, ranging from discomforts that affect the quality of life of men, to serious pathologies such as type II diabetes mellitus or cardiovascular diseases.

This disease not only carries negative effects on the sexual and psychological sphere, but it can also cause physical problems, such as…

• Decrease in muscle mass which translates into a loss of strength
• Increased fatbody, especially in the visceral area
• Decrease in bone density, which can become a pathological fracture

A blood test is performed first thing in the morning to determine the patient’s testosterone levels to diagnose this pathology. A hormone replacement treatment is started that consists of supplying exogenous testosterone to get the man to regain normal physiological levels of testosterone in the blood.

Two routes can administer this hormone: the transdermal in a gel form that is administered every 24 hours or patches every 48 hours, and the intramuscular, every 10-12 weeks.

Side effects of certain medications

• Antidepressants
• Antihypertensives
• Stomach ulcer treatments
• Some diuretics

Abuse of Alcohol, drugs, and smoking

Abuse of these substances can injure (harden) nerves and arteries, causing erection failure.

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