Men
Erectile Dysfunction
In order to make sense of why erections are a good barometer of overall health it is important to consider how this event unfolds. There are four main factors that need to work in a coordinated fashion.
The first is having normal brain function. The brain needs to feel aroused when there is a sexual stimulus to trigger chemical cascades that allow the nerves of the spinal cord to start signalling. Long term conditions that affect your mood and arousal such as depression, anxiety or insomnia impede proper brain function.
The next is for the nerves to work properly to signal between the brain and penis. Nerves relay signals back and forth between these two organs. Sometimes touch can be the arousing stimulus and this is communicated to the brain via nerves to start the process of an erection. Whether it is a psychogenic or a tactile stimulus the penis needs the nerves to signal it is time for lift-off.
Furthermore assuming our nerves work well they release a substance called nitric oxide or NO for short. Blood vessels of the penis need to also work by dilating in response to this chemical. This lets the spongy tissue of the penis engorge with blood and closes off veins. Hey presto – you have an erection! The erection then goes away due to the action of phosphodiesterase enzymes specifically PDE 5 which breaks down NO. Drugs such as Viagra work by inhibiting PDE 5 so vessels remain dilated in response to NO.
In addition to this many of your hormones need to be in check such as your testosterone, thyroid hormones and prolactin. These influence both libido and the ability to have an erection.
While erectile dysfunction cannot tell you exactly what is wrong it does mean that either your brain, nerves, blood vessels or hormones have a problem. If you have had temporary erectile dysfunction the cause is likely psychological but if the problem has been getting gradually worse and more chronic it is likely a physical problem needs addressing.
Blood vessels can be damaged due to high blood pressure or plaques can block the blood flow needed to get an erection. Because the blood vessels of the penis are finer than the other blood vessels of the body a problem with the cardiovascular system can manifest early on as erectile dysfunction before something more serious such as coronary heart disease occurs where larger plaques begin to affect larger vessels. Both erectile dysfunction and cardiovascular disease have the same risk factors including high cholesterol, high blood pressure, smoking, high BMI and lack of exercise. Men with erectile dysfunction have nearly 50% increased risk of cardiovascular disease, increased risk of stroke and increased risk of dying from all causes.
Alternatively there are non-vascular causes. Your brain and nerves may be affected by injury, nerve compression could also result in a lack of erections. Diabetes or MS are conditions which can damage the nerves. Hormones causing erectile dysfunction can be due to certain underactive or overactive glands throwing the body off-balance. Anything causing scar tissue in the penis, blocking blood flow, e.g. Peyronie’s disease can also stop erections.
Having an erectile dysfunction problem may be more than a nuisance and confidence issue. It can be indicative of physical disease that is already present or may likely develop in the case of cardiovascular issues. Whether or not you are taking a medication to combat erectile dysfunction it is advisable to speak to a doctor to make sure there is no sinister underlying health problem responsible for your erectile dysfunction.
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