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Impotence
Sign and symptom
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Signs and symptoms

Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. It is analyzed in several ways:

  • Obtaining full erections at some times, such as when asleep (when the mind and psychological issues, if any, are less present), tends to suggest that the physical structures are functionally working.
  • Other factors leading to erectile dysfunction are diabetes mellitus (causing neuropathy).

Causes

  • Drugs (anti-depressants (SSRIs) and nicotine are most common)
  • Neurogenic disorders (spinal cord and brain injuries, nerve disorders such as Parkinson's disease, Alzheimer's disease, multiple sclerosis, and stroke[4])
  • Cavernosal disorders (Peyronie's disease[5])
  • Psychological causes: performance anxiety, stress, mental disorders (clinical depression, schizophrenia, substance abuse, panic disorder, generalized anxiety disorder, personality disorders or traits[6]), psychological problems, negative feelings.[7][not in citation given]
  • Surgery (radiation therapy, surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Prostate and bladder cancer surgery often require removing tissue and nerves surrounding a tumor, which increases the risk for impotence[8])
  • Aging. It is four times higher in men in their 60s than in men in their 40s.[9]
  • Kidney failure
  • Diseases such as diabetes and multiple sclerosis (MS). While these two causes have not been proven they’re likely suspects as they cause issues with both the blood flow and nervous systems.
  • Lifestyle: smoking is a key cause of erectile dysfunction.[10][11] Smoking causes impotence because it promotes arterial narrowing.[12] See also Tobacco and health.

A few causes of impotence may be iatrogenic (medically caused).

Surgical intervention for a number of conditions may remove anatomical structures necessary to erection, damage nerves, or impair blood supply. Complete removal of the prostate gland or external beam radiotherapy of the gland are common causes of impotence; both are treatments for prostate cancer.

ED can also be associated with bicycling due to both neurological and vascular problems due to compression.[13] The increase risk appears to be about 1.7 fold.[14]

A recent study suggests an epidemiological association between chronic periodontitis (periodontal inflammation) and erectile dysfunction,[15] similarly to the association between periodontitis and coronary heart diseases,[16] and cerebrovascular diseases.[17] In all the three conditions (erectile dysfunction, coronary heart disease and cerebrovascular diseases), despite the epidemiological association with periodontitis, no causative connection has proved yet.

February 2011: Men who use non-steroidal anti-inflammatory drugs (NSAIDs) 3 times a day for more than 3 months are at a 22 percent increased risk of erectile dysfunction. A link between NSAID use and erectile dysfunction still existed for different age, race, ethnicity, smoker, diabetes, hypertension, high cholesterol, coronary diasease and other health problems. But due to benefit of NSAID, it's too early for men to avoid NSAIDs based solely on the research stated at Journal of Urology.[18]

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