Your sexuality is a vital part of your overall health and quality of life, so it can be troubling if you’re unable to get or keep an erection.
The causes of erectile dysfunction vary greatly. Erectile Dysfunction (ED) often results from an underlying health problem related to the blood vessels or nerves that supply the penis. However, certain medicines and lifestyle factors can also make it difficult for you to maintain an erection.
“What we’ve learned in the past few years is that your overall health is really important in how your blood flow goes throughout your body,” said Kathleen Hwang, MD, director, UPMC Male Reproductive Health. “So medical illnesses like diabetes and high blood pressure and high cholesterol can affect sexual health.”
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ED Risk Factors
The most common risk factors for ED affect your body’s endocrine, nervous, or cardiovascular system:
- Atherosclerosis: This narrowing of the blood vessels due to plaque buildup is a common cause of ED. This is because narrowed blood vessels reduce blood flow to the penis, which is necessary for getting and keeping an erection.
- Diabetes: More than half of men with diabetes get ED, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes can cause nerve damage and circulation problems that affect the health of your penis.
- Endocrine disorders: These include thyroid issues and testosterone deficiency.
- Heart disease risk factors: High blood pressure, high cholesterol, obesity, and metabolic syndrome — all risk factors for heart disease — are also linked to ED, according to a study in the American Heart Association’s journal, Circulation.
- Medical procedures: Procedures that can cause ED include pelvic radiation, treatment for prostate cancer, or an enlarged prostate.
- Multiple sclerosis (MS): MS can damage the nerve pathway along your spinal cord that carries signals of sexual arousal from your brain to your penis. Up to 91 percent of men with MS may have sexual problems, according to the National Multiple Sclerosis Society. Spinal cord injuries unrelated to MS can also contribute to ED.
- Parkinson’s disease: ED is the most common sexual problem in men with Parkinson’s disease, according to the Michael J. Fox Foundation for Parkinson’s Research. This can be due to the disease itself, medicines used to treat the disease, and related body image or psychological issues.
- Peyronie’s disease: This rare disease causes scar tissue to form inside your penis, causing your penis to curve. You may still be able to get an erection but having sex might be painful.
- Psychological issues: Some ED cases can have a psychological component. These include depression, stress, anxiety, fatigue, and past sexual trauma or abuse.
Lifestyle factors, including smoking and alcohol and substance use — especially the use of cocaine — can also contribute to ED.
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Medicines That May Cause ED
Some medicines can cause ED. Talk to your doctor to learn if stopping your current medication(s) or switching to another medicine might improve your symptoms. Medicines known to contribute to ED include:
- Antidepressants and anti-anxiety drugs, including monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and tricyclic antidepressants
- Cancer chemotherapy drugs
- Cimetidine, which is used to treat peptic ulcers
- Drugs to treat high blood pressure, such as beta-blockers, clonidine, spironolactone, thiazide diuretics, and possibly loop diuretics
- Hormonal therapy, including estrogens, antiandrogens, and luteinizing hormone-releasing hormone agonists and antagonists
- Prostate treatment drugs
- Some types of sleeping pills
Treatment for ED
Treatment for ED can include lifestyle changes, medicine, penile injections, and penile implants. Discuss with your doctor the best treatment options for you based on your overall health, the underlying cause of your ED, and your preferences.
About Men’s Health Center
The UPMC Men’s Health Center is dedicated to male health and to the evaluation and treatment of conditions affecting men’s sexual and reproductive health. With years of clinical experience in male sexual medicine and surgery, our team has treated a wide variety of conditions and performed thousands of surgeries, providing patients with the highest level of quality care. Our providers understand the intimate nature of male sexual difficulties, and we are dedicated to helping you restore your normal level of sexual function in a comfortable, educational, and discreet environment.