Erectile Dysfunction(ED) is a more common medical problem than you might think, affecting nearly 20 million men in the United States alone. Its causes range from psychological to cardiovascular, the latter being the most important at the moment of treatment and future risks.

Sexuality in men is a fundamental part of life, and its problems can seriously affect professional and couple relationships. In addition, there is a major link between erectile dysfunction and cardiovascular health, which we will discuss below.

Erectile dysfunction is the inability to maintain an erection rigid enough to allow satisfactory sexual intercourse. It may not be a problem if it happens only once in a while, but you may need to consult a doctor when it becomes more often than you would like.

You may wonder ‘‘how do I know if it is occasional or persistent?’’ Here are three situations that can help you to define whether or not you have ED:

1. You can only get an erection sometimes, but not every time you want to have sex.
2. You achieve an erection, but it does not last long enough for satisfactory sexual intercourse.
3. You cannot get an erection at any time.

The incidence of ED increases with age and affects 14% of men aged 40 to 49 years, 25% of men aged 50 to 59 years, and 49% of men aged 60 to 69 years. Diabetes, high blood pressure, and heavy smoking also increase this risk.

The main causes of erectile dysfunction are:

• Vascular disorders
• Neurological disorders

These disorders often arise as a consequence of atherosclerosis or diabetes. Unlike popular belief, aging does not cause erectile dysfunction but rather the diseases that come with it, such as the ones already mentioned.

You first need to understand the erection process to identify the problems related to it. Three things must happen for a normal erection:

1. The penis nerves must be functioning properly.
2. The blood vessels must be intact and allow for uninterrupted flow.
3. There must be a brain stimulus that triggers the above reactions.

So basically, a normal erection is a neuro-vascular response to certain psychological or tactile stimuli. The nerve impulse travels through the cavernous nerves that pass through the prostate. Upon reaching the blood vessels of the penis, these nerve fibers release nitric oxide.

The nitric oxide diffuses into the muscle cells of the penile arteries, relaxing the arteries and allowing more blood to flow through them to the corpora cavernosa.

As the corpora fill with blood, intracavernosal pressure increases, compressing the surrounding little venous, causing occlusion and decreased venous flow. The increased blood inflow and decreased outflow further increase intracavernous pressure, contributing to the erection.

If something goes wrong in any of these steps before erection, then erectile dysfunction takes place.

As mentioned above, the erectile process is purely neuro-vascular, so the blood vessels are probably not well functioning when there is erectile dysfunction. Although cardiovascular problems are not the only cause, coronary artery disease, vasculitis, arterial hypertension, and atherosclerosis can develop over time in men with ED.

A study showed that the interaction between androgens, chronic inflammation, and cardiovascular risk factors that define arterial endothelial dysfunction and atherosclerosis result in coronary and penile circulation disorders.

The size of penile arteries is smaller than coronary arteries, so the same degree of endothelial dysfunction results in a more significant reduction of blood flow in erectile tissues than that of the coronary circulation. Therefore, ED could indicate systemic endothelial dysfunction, which first manifests in the penis and involves the heart over the time.

Both erectile dysfunction and heart disease share the same risk factors.

Smoking produces a change in the size of the arteries. Nicotine and the rest of the tobacco components decrease the diameter or lumen of the arteries, making them tighter and more prone to blockages or clots.

Excessive alcohol consumption causes increased blood pressure, hardening of the arteries, and stiffening of the heart muscle in men, increasing the risk of heart attacks and strokes.

When high-fat processed foods are eaten, there is likely to be extra cholesterol in the whole body. This excess leads to the buildup of cholesterol in the arterial walls in plaques, decreasing arterial diameter and increasing the risk of fat clots blocking blood flow. This disease is calledatherosclerosis,which differs from arteriosclerosis because it is preventable with nutrition changes.

Although age is not a cause of ED, it can be a risk factor, even more so when other conditions following it.

Arteries lose elasticity as we age. The walls become stiffer and less flexible to changes in tension, while the small vessels of the penis are the most affected. Therefore, erectile dysfunction in the elderly may be related to vascular alterations resulting from aging.

These risk factors do not mean that you will have erectile dysfunction. On the other hand, some men experience ED of a neurological nature, where the main triggers are stress, anxiety, and depression.

Erectile dysfunction is treatable with medications such as Sildenafil, Tadalafil, or by-products, but also with changes in lifestyle and nutrition, such as exercising, avoiding a sedentary lifestyle, reducing the consumption of processed foods or red meat, and giving up bad habits such as smoking or excessive drinking.

Since arterial endothelial dysfunction leads to a decrease in nitric oxide, the drugs are designed to increase nitric oxide in the cavernosal muscles of the penis to relax them and promote erection.

Consult a physician if you are concerned about whether or not you have erectile dysfunction. Do not feel ashamed or afraid. Fortunately, Doko’s online medical care platforms protect your privacy and safety because we know it is not easy to overcome the diagnosis. Remember that sooner you receive care, the better the treatment will work and lead to better quality of life.

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