• Erectile Dysfunction

- What is this?

There are three separate chambers in the normal penis: two interconnected erectile chambers, called the corpora cavernosa, which occupy the penis volume, and the urethra, a tube that can lead to both urine and semen. Erectile chambers are attached to the pubic bone and extend from the abdominal part to the visible portion of the penis. This anchor helps keep the penis hard when the chambers are filled with blood. Each erectile chamber is formed by a similar fabric with a sponge which fills with blood during the excitement phase. Blood becomes trapped in the penis, increasing and hardening it for penetration.

The erection can start by:

Psychological stimulus (imagination of erotic situation) physical stimulus (touch of male genitalia in a sensual way) The nervous system acts in the brain with erotic thoughts, while another center, in the spine reacts to the touch. They both work together to produce an erection as a self-reflection that is aided by the male hormone, testosterone.

This short description of the physiology of erection, one can see that any issue that affects the brain, the spine, the nerve endings in the penis, penile arteries, the spongy bodies, the veins of the penis and testosterone production can disrupt a normal erection.

Erectile Dysfunctions can have its origin in psychological causes, physical causes, as well as both.

Psychological Causes:

  • Anxiety
  • Depression
  • Fatigue
  • Guilt
  • Stress
  • Marriage Problems
  • Financial Problems
  • Performance Anxiety
  • Excessive use of alcohol
  • Conflicts of sexual identity, preference or sexual orientation.

When it happens, most of the time, a simple solution of the problem which is causing the issue allows the patient that his sexual performance comes back to normal. In case that doesn't happen, it might be necessary to seek help with a psychologist. When the cause of the problem is physical, however, it is necessary that the patient goes see a doctor.

Physical Causes: May be of arterial origin (decreased blood supply to the corpora cavernosa), neurogenic (some problem that affects the bone marrow or peripheral innervation of the penis) or even a side effect from the medications can promote as well as the erectile dysfunction, libido's disorders or ejaculatory dysfunction as presented in the item Disorders of Erection.

Alcohol - In small doses may serve as a stimulant to the sexual desire but, in big high amounts starts to show harmful effects on erection, therefore, the muscles go into internal relaxation process.

Smoking – Smoking is a risk factor for the atherosclerosis development in the “pudentas” and penile arteries common in young patients with DE (Rosen net al 1991). The arteries (vessels) that irrigates the penis are from six to eight times thinner than the coronary arteries, and if the cigarette or any other type of smoking "clogs" coronaries arteries, what about any arteries six to eight times thinner than that? The smoking accelerates arterial damages due to an acceleration of the right atherosclerosis intimate by the decrease of HDL cholesterol levels (Fried et al 1986), and causes, as well, a vasoconstriction on the arteries.

Cholesterol - The increase of cholesterol, due to high doses of dietary fat in your diet, causes, as well, the obstruction of the penis circulation, causing impotence..

Surgeries and traumas side effects - Prostate surgery might have a consequence in problems such as Sexual Impotency. It doesn't happen in all cases, but in most of them. What's done is treat the problem of impotency by using one from the infinite resources that is available today, with some of them is presented on this site. Therefore, there is nothing to fear.

Drugs - Drugs, such as Marijuana, Crack, Cocaine, etc., lead to an appreciable extent the sexual part of the individual. There's a huge reduction of circulation of the penile region. leading the individual to have serious problems of erection.

Impotence as a side effect from medications for blood pressure, depression, diuretics, etc. - Most of the medications used on those treatments might lead to erection problems. Once the medications can't be suspended, there is the need to treat the side effects that it causes. This, fortunately, is simple due to the great evolution of impotence treatments. Also, drugs for cardiovascular problems, Parkinson, psychotropic drugs, amphetamines and some hormones can cause this side effect.

Impotence as a side effect from medications for blood pressure, depression, diuretics, etc.

Age Effects – Statistically, the number of men experiencing the Erectile Dysfunction increases with age. The age itself doesn't cause the dysfunction, but the fact is, older men are more likely to have diseases or have undergone treatments (ex: prostate surgery) that might cause the dysfunction.

Impotence Resultant by Traumas - A trauma in any portion from the pelvic region or from the spine can result in impotence, because in the urogenital diaphragm it's where many fragile nerves and arteries that supply the penis are found.

A direct trauma in the penis may result in a fracture or rupture of the erectile compartments. With these trauma, the patient might feel pain and swelling in the penis, being sometimes inviable the sexual activity, becoming necessary a surgery correction.
Traumas in the spine may also cause impotence, because, in case there are injuries in the spinal cord can happen the loss of the nervous center that controls the erections. A damaged spine changes drastically the type of life in a patient. Being confined to a wheelchair limits the life of the person and its active life. If the sexual intercourses may continue, the emotional well-being of the patient and its partner may be kept.
If there is a loss of abilities in getting an erection, it may be used small doses of injectable medications in the penis, or implants of prosthesis.
Nowadays, it's very frequent to have patient with complaints of direct trauma in the spine or even with injuries by bullets from fire guns. The treatment for those patients requires specific exams to study the circulation and the nerves of the penis, well as the degree of the penile sensitivity.
Surgery and trauma on the brain, spine or pelvic region, are associated with the increase of the risk of erection disorders.
Such as:

  • Craniocerebral Trauma
  • Brain Surgery
  • Laminectomy Lumbar
  • Spinal Cord Injury
  • Retroperitoneal Lymphadenectomy Without Preservation of Nerves
  • Aneurysmectomy of the Abdominal Aorta
  • Radical Surgery for Bowel Cancer and Genitourinary

The current violence index, with number of trigger of stray bullets have undoubtedly contributed to the increase in the number of patients with some of the previously described injuries.

Hormonal Problems – Some diseases, such as kidney or liver problems may cause a hormonal change, which controls the erections. Low testosterone levels may also be the aggravating factor.

Priapism – Priapism is an erection that lasts longer than the normal period, and it is caused by other reasons that aren't the sexual desire. Priapism involves the corpora cavernosa and is the result of abnormal inflow into the penis or, in the most common case, decrease or loss of output from this stream. If an erection lasts more than four hours, there is the risk of compromised tissue, which may result in sexual dysfunction. Any inappropriate use of medicines (intrusiveness applications, antihypertensive, cocaine-type drugs) as conditions which lead the hematological disorders such as sickle cell anemia or leukemia can lead to the occurrence of priapism. THERE IS THE URGENT NEED TO SEEK AN EMERGENCY SERVICE SO IT CAN BE USED THE RIGHT CONDUCT TO INTERUPT THE ERECTION.

Neurological Problems – Spinal cord injuries, congenital defects such as spinal spine cord tumors or increased pressure in the skull and muscles diseases such as multiple sclerosis can lead to Erectile Dysfunction.

Obesity - Obesity may be a risk factor in sexual dysfunction in both sex and there is a strong association between obesity and erectile dysfunction, and this risk increases as long as the BMI (Body mass index) increases too. The prevalence of obesity or overweight in people that seek for treatment of ED may arrive to 79%. It's also possible to observe that in a gene way obesity brings psychological repercussions of self-esteem and depression, which might be due to global evaluation of self-image and, more specifically, of the genitals, as the case of the penis' size called "hidden penis" or "buried penis".


  • Avoid smoking and the excess of alcohol.
  • Control the alimentation, avoiding fat and cholesterol in the diet.
  • Regular exercises avoiding being sedentary.
  • Combat obesity.
  • Rigorous control of diabetes
  • See if there's the possibility of dysfunction being a side effect of some medicine that the pacient is taking, and if that's the case, verify with your doctor if there's the possibility to change this medicine for another one without this side effect.
  • Combat the depression.