Origin of Sexual Impotence
In older men, ED usually has a physical cause such as illness, injury or drug side effects. Any disorder that causes injury to the nerves or impairs blood flow to the penis can cause ED. The incidence increases with age: about 5 percent of men 40 years old and between 15 and 25 percent of men 65 years old experience ED. But erectile dysfunction is not necessarily an inevitable part of aging.
Because an erection requires a precise sequence of events, ED can occur when any of such events is disrupted. The complete sequence includes nerve impulses in the brain, spinal cord and the area around the penis, and the responses of muscles, fibrous tissues, veins and arteries in and near the corpora cavernosa of penis.
The most common cause of ED is damage to nerves, arteries, smooth muscles and fibrous tissues, often as a result of disease. Diseases such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, arteriosclerosis, psoriasis, vascular disease and neurologic disease account for about 70 percent of ED cases. Between 35 and 50 percent of men with diabetes experience ED.
Also surgery (especially radical prostate surgery due to cancer) can injure nerves and arteries near the penis, causing ED. An injury to the penis, spinal cord, prostate, bladder and pelvis can lead to DE, and cause injury to the nerves, smooth muscles, arteries and fibrous tissues of the body cavernosa.
In addition, many common medicines-blood pressure medications, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer medication) - can cause ED as a side effect.
Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self-esteem and fear not perform in intercourse as expected cause of 10 to 20 percent of ED cases. Men with a physical cause of ED often experience the same sort of psychological reactions (stress, anxiety, guilt, and depression).
Other possible causes are smoking, which affects blood flow in the veins and arteries, and abnormalities in hormones, such as insufficient testosterone. The increase of prolactin which can cause some drugs (anxiolytics, antipsychotics (risperidone, olanzapine, haloperidol) can also cause erectile dysfunction. The hormonal causes usually also affect libido.
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