Overview
Several other causes or contributors to erectile dysfunction (ED) are important to mention, especially because they can exist along with any other causes of erectile dysfunction. These include medical conditions (e.g., diabetes, cardiovascular disease), low testosterone levels, and environmental factors. When talking with your healthcare provider about erectile dysfunction, it is always important to discuss any causative or contributing factors so you can be better prepared to treat it as best as possible.
Medical Conditions that Can Cause Erectile Dysfunction
Diabetes
Men who have diabetes tend to develop erectile dysfunction 10 to 15 years earlier than men without diabetes. Diabetes can cause erectile dysfunction in more than one way. One is the fact that people with diabetes are at greater risk of atherosclerosis, and the reduced blood flow to the penis reduces the ability to achieve an erection. Another way diabetes is associated with erectile dysfunction is the development of diabetic neuropathy, which is a condition characterized by damage to the sensory and autonomic nerves. Diabetic neuropathy develops in about 50 percent of people who have type 2 diabetes, and it is caused by poorly controlled high blood sugar levels. Men with diabetes also develop a muscle disease called myopathy, which compromises the function of the muscles in the corpora cavernosa and results in erectile dysfunction.
High Blood Pressure
Men who have high blood pressure (hypertension) have an increased risk of developing erectile dysfunction. Although scientists are not clear how hypertension causes erectile dysfunction, men with high blood pressure have been found to have low production of nitric oxide, which is essential for an erection to occur. High blood pressure also speeds up the progression of atherosclerosis, which can contribute to erectile dysfunction. In a recent study of 658 men with erectile dysfunction, scientists reported that both high blood pressure and diabetes were significant risk factors for erectile dysfunction, with 17.3 percent of the men having hypertension and 21.4 percent with diabetes. (Zedan 2010)
Cardiovascular Disease
Related to high blood pressure as a risk factor for erectile dysfunction is cardiovascular diseases. Atherosclerosis is the most common cause of cardiovascular diseases in the United States, and it is aggravated by other conditions associated with erectile dysfunction, namely smoking, high blood pressure, and diabetes. Atherosclerosis involves narrowing and hardening of the arteries, including those that supply the penis and pelvic region. Therefore, the more severe the atherosclerosis, the more severe the erectile dysfunction. Other medical conditions that can cause erectile dysfunction include multiple sclerosis, Parkinson’s disease, Peyronie’s disease, venous leak (failure to compress the draining veins from the erection chamber), and pelvic trauma.
See also
Low Testosterone Levels
Testosterone, the main sex hormone in men, is not only a necessary ingredient for libido, it also has a critical role in maintaining nitric oxide levels in the penis. Therefore men who have low testosterone levels may experience erectile dysfunction along with low libido and numerous other side effects associated with low levels of this hormone. See 10 Signs of Testosterone Deficiency.
The normal range of testosterone is 350 to 1,200 ng/dL (nanograms per deciliter), and what is considered to be “normal” for any man depends on his age. Testosterone levels are highest in men in their early twenties, and up to 50 percent of all men at age 40 have testosterone levels lower than what was once considered normal, 450 ng/dL. Although there is no definitive figure that identifies testosterone deficiency, 300 ng/dL is usually viewed to be at the lower limit of normal for a healthy man.
If you or your healthcare provider believe testosterone deficiency may be causing your erectile dysfunction, a simple blood test can identify your levels. At that point, you and your physician may discuss the benefits and risks of testosterone supplementation.
Read more on Testosterone and Erectile Dysfunction
Exposure to Environmental Factors
It is well established that environmental factors have an impact on health, and so prostate health and sexual health should not be exceptions. Studies show that men who work in certain occupations (e.g., tire plant workers, farmers, painters) are more likely to get prostate cancer, and this is believed to be related to their exposure to chemicals. A 2009 study, for example, found a twofold increased risk of prostate cancer among farmers who were exposed to pesticides compared with farmers who were not exposed. (Parent 2009) It’s also been estimated that 90 percent of people in the United States have detectable levels of BPA toxin in their bodies. BPA has been associated with various health problems, including an increased risk of cancer, including prostate cancer. More on cancer and environmental toxins
But what about environmental factors and erectile dysfunction? Much of the research is ongoing and still in early stages, and some is conflicting. For example, in a study of 199 men who had erectile dysfunction, researchers evaluated the possible impact of exposure to pesticides, solvents, and heat on sexual function. They determined that all three factors, but especially pesticides and solvents, are risk factors for erectile dysfunction. (Oliva)
Another study was not as conclusive. At the Cancer Research Institute of Queen’s University, scientists analyzed blood samples from 101 men with erectile dysfunction for the presence of organochlorine pesticides and PCBs (polychlorinated biphenyls). When these blood samples were compared with those gathered from 234 healthy controls, the researchers were not able to identify any evidence of an association between pesticide levels and erectile dysfunction. (Polsky) But this is only one study.
In China, researchers compared the rates of sexual dysfunction among 230 men who worked at factories that produced BPA or a similar chemical with 400 men who were not exposed to BPA at work. They found that men who worked with BPA had a fourfold greater risk of erectile dysfunction and a sevenfold greater risk of ejaculation difficulties than men who were not exposed to the chemical. (Li)
Investigators at Johns Hopkins Hospital report that while further research is needed, there is some evidence that environmental toxins, including lead, pesticides, and organic solvents, can affect erectile function. Effects on the nervous and hormonal systems, as pesticides have hormone-disrupting abilities, have been named as the main ways environmental toxins may impact the ability to achieve and maintain an erection. (Burnett)
Procedures to Treat BPH
Several medical procedures used to treat BPH can cause erectile dysfunction. One is transurethral resection of the prostate (TURP), which reportedly affects less than 5 percent of men who undergo the procedure. (Cornell) Another procedure, transurethral microwave thermotherapy (TUMT) can be administered at either low or high energy. One study reported no effect on erectile function in men who received low-energy TUMT (Francisca), while another found an 18.2 percent rate of erectile dysfunction in men who received high-energy TUMT. (Arai) The relatively new procedure called HIFU (high-intensity focused ultrasound) has been found to cause erectile dysfunction in men who have the treatment for prostate cancer (at a rate of 20 to 49.8%), but thus far there are no reports on its impact on men being treated for BPH. (Mearini)
References
Zedan H et al. Cigarette smoking, hypertension and diabetes mellitus as risk factors for erectile dysfunction in upper Egypt. East Mediterr Health J 2010 Mar; 16(3): 281-85
Burnett AL. Environmental erectile dysfunction: can the environment really be hazardous to your erectile health? J Andrology 2008 May-Jun; 29(3): 229-36
Li D et al. Occupational exposure to bisphenol-A (BPA) and the risk of self-reported male sexual dysfunction. Hum Reprod 2010 Feb; 25(2): 519-27
Oliva A et al. Environmental agents and erectile dysfunction: a study in a consulting population. J Andrology 2002 Aug; 23(4)
Polsky JY et al. Pesticides and polychlorinated biphenyls as potential risk factors for erectile dysfunction. J Andrology 2007 Jan-Feb; 28(1): 28-37
