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Erectile Dysfunction in Young Men

Young Man with erectile dysfunction

Young Man with erectile dysfunctionUntil about three decades ago, erectile dysfunction was a taboo topic. Men impacted by the condition, as well as their partners, suffered in silence because it was unacceptable to discuss sexual dysfunction or sexual health.

Since then, it has emerged that ED is often a side effect of many well-known primary medical conditions, such as heart disease, high blood pressure, diabetes, and prostate cancer. Historically, older men have been known to suffer from erectile dysfunction due to a higher risk of these health conditions. However, new research indicates that ED in young men is becoming increasingly common.

In fact, according to a study published in the Journal of Sexual Medicine, one out of four men with newly diagnosed erectile dysfunction is a young man. The study found that among the 439 study participants with new-onset ED, 26 percent were aged 40 or under.

What is causing the rising incidence of erectile dysfunction in young men? Is it a sedentary lifestyle and increasing obesity? Are habits such as alcohol use, cigarette smoking, and other addictions causing young men to develop sexual health problems? And is the condition treatable and reversible? Let’s find out.


Rise in obesity and poor diet


One of the reasons younger men are being increasingly diagnosed with erectile dysfunction is the rising rate of obesity in America. In an article titled “American Adults Just Keep Getting Fatter,” the New York Times reported an almost 23 percent increase in fast food sales from 2012 and 2017. NBC News reported that America is reeling under an obesity epidemic with more than 70 percent of Americans either overweight or obese.

Obesity and poor diet may be causes of erectile dysfunction in the 20s. A poor diet can lead to health issues such as clogged arteries and diabetes which are known to be associated with erectile dysfunction. Obesity leads to many complications, such as high blood pressure, heart disease, and atherosclerosis (plaque deposits on the inner walls of blood vessels), which are all linked to ED.

The interdependence of obesity and diabetes is well known, and more than half the men with diabetes have erectile dysfunction. Obesity also predisposes to hypertension, and according to a study by the American Geriatrics Society, nearly half the men between ages 40 and 79 with high blood pressure have ED.

In addition to the links with obesity and hypertension, recent research has shown that obesity is an independent risk factor for erectile dysfunction. In fact, obesity is now believed to be a considerably greater cause of ED than aging which was traditionally thought to be the predominant causative factor for erectile problems in men. Approximately 8 out of 10 men suffering from erectile disorders have an unhealthy BMI (body mass index).

A BMI above 30 kg/m2 is defined as obese and is associated with 2-3 times greater risk of sexual dysfunction. On the other hand, healthy body weight and a balanced diet with plenty of fresh fruits and vegetables can improve blood flow throughout the body, including the penis. One study found that interventions to lower body weight by 10 percent or more through a reduced caloric intake and increased physical activity led to an improvement in sexual function in about one-third of obese men with erectile dysfunction.


Increasingly sedentary lifestyle


Compared to their parents and grandparents, young Americans are spending increasing amounts of time in environments that involve limited physical activity and prolonged sitting. Technology has helped re-engineer our homes, schools, and workplaces to minimize movement along with a dramatic increase in screen time. This decrease in physical activity has resulted in a detrimental effect on human health, including erectile dysfunction in young men. Studies have shown that men who spend 5 hours or more using computer or TV screens are three times more likely to develop ED compared to men who spend one hour or less performing these activities.

A sedentary lifestyle leads to weight gain, which is a proven contributor to ED. Lack of exercise also causes clogged arteries, which can prevent erection-producing blood from entering the penis. Just 30 minutes of moderate exercise every day can do wonders for the body, leading to better overall health as well as improved sexual function. Running, swimming, and biking are known to increase nitric oxide production, a chemical that widens the arteries and allows free flow of blood into the penis.


This couple seems young to have erectile dysfunction


The concept that physical activity enhances sexual function and overall well-being is well accepted. However, it is unclear exactly how much exercise is necessary to obtain a clinical improvement in erectile dysfunction. The recommendations for men with ED are to follow the physical activity guidelines for a reduction in high blood pressure and high cholesterol, which is 3-4 sessions of moderate to intense physical exercise lasting about 40 minutes per session. This level of physical activity can help increase energy levels, reduce stress, and improve blood circulation, all of which are proven to directly benefit ED.


Abuse of alcohol and nicotine


Some of the changes young men with sexual dysfunction can consider making are quitting smoking and drinking alcohol only in moderation. The link between alcohol and erectile dysfunction has been extensively studied. Research in animal models indicates that alcohol leads to an increase in a chemical called endothelin-1, which causes constriction of the corpora cavernosa and reduced erectile response. The dehydration caused by alcohol leads to a reduction in blood volume, and prolonged abuse can lead to irreversible nerve damage, both of which can affect erectile function. In fact, sexual dysfunction is common among men who are alcohol dependent.

Consumption of a large amount of alcohol is associated with a higher rate of ED. Studies have revealed that heavy alcohol drinkers and teetotalers are at increased risk compared to moderate drinkers of 1-7 drinks per week). It would therefore appear that the amount of alcohol consumed is a major predictor of alcohol-related erectile dysfunction. Heavy drinking significantly increases the risk of experiencing erectile problems. It is worth noting that ED can occur in alcohol abusers even during periods of sobriety.

There are strong parallels and shared risk factors between nicotine use and erectile dysfunction. Scientists have evidence that chemicals in tobacco smoke affect penile erections by impairing smooth muscle relaxation. It is estimated that smoking increases the risk of moderate to severe erectile dysfunction by two-fold. Interestingly, in a specific study where all the participants were under the age of 40, smoking was found to be a significant risk factor for ED in young men.

The effect of smoking on erectile function is dose-dependent. Heavy smokers (more than 20 cigarettes/day) are more than twice as likely to develop severe ED compared to those who smoke fewer cigarettes. This would indicate that for some smokers a gradual reduction in the number of cigarettes could lead to a noticeable improvement in sexual performance and erection quality. Complete cessation of tobacco use has a positive effect on erections. There is an improvement in penile blood flow within 24-36 hours of stopping. However, former smokers continue to have an increased risk of erectile disorders compared to men who have never smoked. Nonetheless, there is mounting evidence that if young men stop smoking prior to middle age (50 years old) and do not restart, the damage is reversible.


Leading stressful lives


In spite of the conveniences of modern life, human beings continue to live stressful lives. Fast-paced, competitive lifestyles predispose young men to a number of stressors, including relationship problems, issues at the workplace, and financial burdens. Any type of psychological stress can impact a man’s sexual health and the ability to achieve and/or maintain erections and engage in satisfying sex. In addition, stress can lead to excessive alcohol consumption, tobacco use, and lack of motivation to exercise, all of which are contributing factors to erectile dysfunction in young men. High levels of stress predispose young men to other health problems, such as high blood pressure, heart disease, and high cholesterol, which are also known causes of ED.

The good news is that stress-induced erectile dysfunction is treatable and reversible. Sex therapy, sex education, couples counseling, and other forms of psychological intervention can provide significant benefit in restoring erectile function. Studies show that in young men with erectile dysfunction, a combination of oral ED medication and stress management programs produce superior results compared to drug therapy alone. Alternative therapies such as yoga, meditation, and relaxation techniques can help manage stress and anxiety and provide additional benefits alongside physician-prescribed treatments such as vacuum erection devices or prescription drugs.


Exposure to internet pornography


Another factor that could explain the sharp rise in ED among young men is the easy availability of internet pornography. The limitless novelty, ease of escalation to more extreme or kinky material, and HD video format are potent conditioning factors for sexual arousal. The arousal experienced with online porn is often difficult to replicate during sex with a real-life partner. A study on high school seniors found that frequent use of pornography resulted in low sexual desire. Another study found that 70 percent of young men with very frequent porn use (more than 7 hours per week) suffered from sexual dysfunction. 

Porn-induced erectile dysfunction (PIED) refers to the inability to achieve and/or sustain erections in response to sexual arousal with a partner due to high exposure to pornography. Men with PIED become desensitized and develop the need for more extreme stimulation from hardcore pornography in order to be aroused. In addition, excessive porn can lead a man to become dissatisfied with his own body and/or sexual performance, triggering anxiety-induced erectile dysfunction. Excessive use of sex toys can desensitize the nerves in the penis and make it more difficult to achieve an erection with stimulation from a partner during sexual intercourse. Yet, PIED remains a controversial theory with anti-porn advocacy groups pushing the notion while scientists claim the evidence linking porn and erectile dysfunction is weak at best.


Treating erection problems in young men


The expanding definition of erectile dysfunction has big implications for drug manufacturers. Viagra is increasingly being viewed as a lifestyle drug and enhancement tool for sexual performance. Young men are some of the largest consumers of oral ED medications. However, erectile dysfunction in young men has numerous causes, some of which can be treated by modifying lifestyle and habits.

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Nicotine Use Affects Men’s Sexual Health

Nicotine Use Affects Men's Sexual Health
Nicotine Use Affects Men's Sexual Health
Nicotine Use Affects Men’s Sexual Health

Nicotine Affects Sexual Health. It’s a classic scene in a Western: a cowboy swaggers in with a cigarette dangling from the side of his mouth. In the movies, this signifies sex appeal, toughness, and charisma, but in the real world, nicotine does exactly the opposite.

Cigarettes, pipes, cigars, and smokeless tobacco contain more than 40,000 chemicals, some of which are known carcinogens (cancer-causing agents). In addition, smoking has been linked to heart attack, stroke, lung disease, and a laundry list of health problems. But nicotine use takes another terrible toll – it has a significant effect on men’s sexual health.

Smoking affects sexual health in men (and women) of all ages. Nicotine causes direct damage to blood vessels, and blood flow to the penis is critical for achieving and maintaining strong erections. In addition to erectile dysfunction, smoking is associated with several other men’s sexual health problems.

All types of tobacco can cause sexual dysfunction, including second-hand smoke exposure and vaping. The good news is that many of the effects of nicotine are reversible. Quitting smoking can improve vascular health and erectile dysfunction as well as reduce the risk of other health complications. 


Nicotine may be one of the leading causes of erectile dysfunction in young males


Middle-aged and older men often accept erectile dysfunction as part of the physical changes associated with aging. In younger men, however, ED cannot be so easily explained by the effects of age. Traditionally, erection problems in young men were believed to be predominantly related to psychogenic causes. But now there is increasing evidence that nicotine abuse may be one of the lesser known, but significant causes of erectile dysfunction in younger men. Reduced blood flow to the penis from nicotine use and other unhealthy habits can make it difficult for men to get and keep an erection.

Several studies report that smokers have an increased risk of developing ED compared to nonsmokers, irrespective of age. The Massachusetts Male Aging Study [1] found that cigarette smoking almost doubles the likelihood of developing moderate to severe erectile dysfunction in men of all ages. Interestingly, the results of studies [2] that focused on a predominantly young population indicate that smoking is one of the major causes of erectile dysfunction in young males under the age of 40.

One study [3] investigated a possible link between smoking and ED in more than 2,100 men in Minnesota. The researchers found that men who smoked at some point in their lives are more likely to suffer from erection problems regardless of their age. However, the study also found that current smokers in their 40s have the highest likelihood of developing ED, indicating that nicotine is a significant cause of erectile dysfunction in young men. In fact, a study in Finland [4] found that erectile dysfunction is an early indicator of otherwise silent vascular disease in smokers.

It is worth noting that the effects of smoking on men’s sexual health in general and ED, in particular, are dose-dependent and cumulative. In young men between 18 and 44 years old [5], heavy smoking of more than 20 cigarettes per day is associated with a two-fold increase in the risk of developing severe erectile dysfunction compared to men who smoke less.

Heavy smoking causes more severe ED that may not be reversible after quitting. Cumulative smoking history over a man’s lifetime also has an effect on ED risk. Studies show that the association between smoking and ED becomes significant with 20-pack-years of exposure to cigarette smoke [6] (pack-year smoking history is packs per day multiplied by the number of years smoked).


Quitting nicotine can improve your sexual health and your overall health


Smokers tend to have poorer erection quality and other sexual health problems compared to men who have never smoked and never been exposed to Quitting nicotine can improve your sexual healthpassive smoking. Although smoking is being increasingly regarded as one of the most significant erectile dysfunction causes, especially among young men, there is mounting scientific evidence that the damage caused by nicotine is reversible if a man quits smoking and doesn’t restart.

Erection status has been found to improve in up to 25 percent of former smokers [7] one year after quitting, with older men and heavy smokers showing the least improvement. In fact, research [8] has shown that improvement in penile blood flow is almost immediate and occurs within 24-36 hours after cessation of smoking. In heavy smokers, stopping smoking for as little as 24 hours leads to a significant improvement in nocturnal erections [9]. Successfully quitting smoking with 8 weeks of nicotine replacement therapy can lead to sustained improvement in erectile function after one year [7].

The chances of regaining erectile function after cessation of smoking are dependent on a number of factors, including:

  • Age (men under 50 are more likely to improve)
  • The severity of erectile dysfunction (men with mild ED at baseline are more likely to improve)
  • Presence of diabetes and hypertension (men without other vascular risk factors are more likely to improve)

There is no doubt that quitting smoking will have a positive impact on overall health and wellness. All study data points to the fact that men who quit nicotine use can, and often do, experience improved sexual performance and a reduction in ED symptoms. Experts advise that quitting cold turkey is not necessarily the best way to go about it. For some smokers, a gradual reduction in the number of cigarettes can be more appealing and just as effective. Abstinence rates are comparable [10] whether someone quits abruptly or gradually and whether they use nicotine replacement therapy or not.

However, it is important to remember that erectile dysfunction is caused due to the nicotine content of cigarettes. Therefore, using a nicotine replacement patch may not be entirely effective in preventing ED. Following widespread criticism, e-cigarette manufacturers such as Juul Labs are reducing the amount of nicotine in their vaping liquids. Nonetheless, vaping liquids, which contain high doses of nicotine, are not recommended as an alternative to smoking for men who are struggling with poor erection quality, possibly due to nicotine effects.


Smoking can affect other areas of men’s health


Smoking can affect other areas of men’s healthAs noted, exposure to nicotine in cigarettes causes direct damage to blood vessels. In addition to the vascular damage, nicotine is believed to have a negative effect on sexual arousal. One study [11] found that young men, average age 21 years, with negligible prior nicotine use, had substantially reduced erectile response to arousal after the use of a single nicotine patch equivalent to one high-yield cigarette.

Smoking has other effects on men’s sexual health as well. Smokers have significantly less number and motility of sperm compared to nonsmokers [12]. Smoking has been linked to devastating effects on sperm morphology (shape and structure) and viability (ability to function properly), thereby resulting in reduced male fertility [13].

There is a striking association between smoking and the risk of bladder cancer among both men and women. Current smokers have three times the risk of bladder cancer compared to never smokers. Tobacco smoking is the causative factor in 50 to 65 percent of bladder cancers in men [14]. During surgery for bladder cancer, the prostate gland is removed along with the urinary bladder (to prevent cancer from recurring in the prostate). This leads to an inability to ejaculate (dry orgasms). Nerve damage during the operation can be one of the causes of erectile dysfunction after surgery [15]. Following bladder cancer surgery, it may be necessary to use oral ED drugs such as Viagra, injections or pellets in the penis, or a vacuum pump to draw blood into the penis in order to obtain normal erections.

Smoking is also associated with an increased risk of prostate cancer. A meta-analysis of more than 21,500 men with prostate cancer showed that smoking increases both incidence and mortality [16]. Both former and current smokers have an increased risk of getting prostate cancer, but current smokers have an increased risk of dying from prostate cancer. Smoking has been linked to a more aggressive form of prostate cancer that is more likely to spread throughout the body.

There is sufficient data to indicate that nicotine use affects men’s sexual health in more ways than one. If you’re a smoker looking for a reason to quit, consider this: in addition to raising your risk of cardiovascular complications, lung disease, and cancer, tobacco use could be causing erectile dysfunction and other sexual problems. The time to quit is now. The sooner you stop smoking, the less likely it is to cause severe, irreversible damage.


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5 Possible Psychological Causes of Erectile Dysfunction

5 Possible Psychological Causes of Erectile Dysfunction

It is a well-known fact that erectile dysfunction (ED) is more common among older men. According to the Massachusetts Male Aging Study [1], the prevalence triples between ages 40 and 70 years old. However, this is a condition that can affect men of all ages. In fact, studies [2] have found that one in four men seeking medical help for new-onset erectile dysfunction is younger than 40, and those erection problems are severe in almost half the young men. Psychological causes of ED should be considered.

In older men, underlying health conditions such as diabetes and high blood pressure are known causes of erectile dysfunction. But what causes ED in younger men who are in perfect physical health?

Psychological factors are a major contributing factor in many men with ED. In fact, they may be the culprit in up to 20 percent of men [3] experiencing trouble with erections. The psychological reasons for erectile dysfunction can be wide-ranging and may not be obviously apparent to the man and/or his partner.

Common subconscious and emotional causes of ED include stress, depression, loss of interest, and performance anxiety. In addition, the recreational use of ED drugs can lead to sexual dysfunction. Fortunately, erectile dysfunction caused by psychological issues is reversible and can often be treated by addressing the underlying cause. Here’s a guide to the common psychological causes of erectile dysfunction and what can be done to overcome them.


Stress or Anxiety


The fast-paced, technology-driven lifestyle most people lead nowadays can cause a great deal of stress and anxiety. Financial strain, problems in the workplace, and relationship issues can all affect a man’s ability to achieve and maintain an erection. This is because, during periods of stress, the brain becomes focused on essential functions for survival such as blood flow and heart rate rather than non-essential functions such as libido and arousal.

In addition, stress impacts a mans basic mood for sex. The underlying problems causing stress take up all the mind space and distract him from enjoying sex and pleasing his partner. Hormones also play a role in sexual dysfunction. During a stressful period, the levels of cortisol, the main stress hormone, are high, whereas the levels of testosterone, the male hormone, may drop.

This can lead to problems with penile erection, orgasm, libido, and sexual satisfaction. Techniques to counter chronic stress can help prevent ED. These include relaxation through deep breathing, meditation, yoga, and Tai-Chi, engaging in physical activity, and relying on social support.

Another cause of ED is the pressure to perform during sex, commonly referred to as performance anxiety. It is not unusual for a man to be a little nervous about sex when the relationship is new. However, this anxiety usually abates as the couple becomes familiar with each other. If it persists, performance anxiety can become a self-perpetuating cause of erectile dysfunction.

For example, a single episode of premature ejaculation or trouble achieving and/or maintaining an erection may lead to anxiety about sexual performance at the next encounter. Overthinking and worrying about achieving an erection feed the fear of sexual failure. In addition, some men develop feelings of guilt about not being able to pleasure and satisfy their partner.

All this focus on performance impacts the psyche and distracts a man from being able to relax and enjoy the experience. The more anxious a man is, the less he is able to perform, the more anxious he becomes, leading to a vicious cycle of worrying and being unable to perform.


Depression or Low Self-Esteem


Depression manifests in many ways: fatigue, change in appetite, erratic sleep patterns, hopelessness, apathy, and loss of self-esteem. In addition to these well-known symptoms, depression is commonly found in men with sexual disorders such as erectile dysfunction and premature ejaculation.

Studies [4] show that in the majority of men, depression and anxiety pre-date the onset of erection problems, suggesting that the psychological issues could be contributing to the sexual dysfunction. The relationship between depression and ED is complex but is known to be independent of other factors [5].

This means that depression can cause erectile dysfunction in men of all ages regardless of their lifestyle habits, the medications they are on, and their hormone levels.

The inability to perform in the bedroom can affect a man’s confidence, leading to low self-esteem. But the reverse is also true. Low self-esteem, which is a common symptom of depression, can become the driving force in causing erection problems. Feelings of inadequacy can create a negative view of one’s worth and abilities, which in turn can create a concern for sexual failure.

Once a man becomes caught up in a poor perception of himself, he may begin to project it onto his partner. For instance, loss of confidence and low self-worth may lead a man to believe he cannot satisfy his partner, which could have an effect on sexual performance.

Another potential link between the two conditions is that some of the medications used to treat depression can lead to erectile dysfunction. A number of psychiatric medications are known offenders in causing ED, failed ejaculation, and decreased libido. Men who are suffering from ED and depression both should talk to a health care provider about appropriate antidepressants that do not cause worsening of sexual dysfunction.


Indifference or Loss of Interest


Loss of interest, indifference, or loss of sexual desire is one of the most common psychological causes of erectile dysfunction. Men who are not interested in sex are more likely to have ED. Men who have ED are more prone to experience low libido. What causes ED due to loss of interest in sex?

Age: As men get older, their sex drive decreases due to a natural reduction in testosterone levels.


Relationship problems: Erectile dysfunction can cause problems in a relationship, but conversely, relationship problems can easily spill over into sex life.


Over-familiarity: In longstanding relationships, sex can begin to feel boring or routine.


Depression or stress: Loss of sex drive can occur as a result of chronic stress and/or depression.


Medication side effects: Sometimes the loss of libido may be caused by a physical cause, for example, as a side effect of certain prescription medications.


Good communication is essential to cultivate and maintain a healthy interpersonal and sexual relationship. Trying new things and stepping out of the comfort zone can help ignite sexual desire and lead to more fulfilling sex. Getting treatment for depression can sometimes restore desire and reduce the likelihood of ED. Speaking to a doctor is important to identify whether any medications may be causing reduced sexual desire and/or inability to orgasm.


Unrealistic Expectations


Unrealistic ExpectationsA number of factors affect a couple’s ability to have healthy, fulfilling sex. Reading cues correctly, establishing a connection, and mixing things up to avoid falling into a routine are all important. Having sex often is another key factor. A reduced frequency of sexual intercourse can set up an expectation that sex when it happens, must be riveting [6]. More frequent sex helps a couple understand how to handle occasional failures, discuss anxiety, and learn to be intimate in more ways than one.

Another lesser-known cause of ED is masturbation. Some men masturbate with rough strokes and become accustomed to being aroused with that level of stimulation. When this cannot be duplicated with a partner, they are unable to achieve an erection. Similarly, masturbating to unrealistic scenarios or watching material that cannot be recreated in real life can set a man up for disappointment when attempting to have intercourse with a partner [7]. Limiting the amount of masturbation may help. Sometimes, looking at images rather than videos can lead to desensitization with better arousal and erectile function during sex with a partner.

Pornography addiction is another potential cause of erectile dysfunction that many men fail to consider. The availability of free-streaming high-definition porn has made this problem worse, especially among young men. When a man spends a considerable amount of time watching pornography, he gets used to being aroused by something that is not always rooted in reality.

This can train the brain to expect and need that kind of experience to achieve arousal and climax. In addition, it can lead to a loss of desire for romantic-sexual interactions. Men who are compulsive viewers of porn become accustomed to being fully in control of the experience without having to deal with a partner, who is a real, complicated human being with their own needs and insecurities. All of this can set up a man for failure during real-world sexual intercourse with a partner [8].


Reliance on ED treatment


Medications such as Viagra and Cialis are a viable treatment option for men who are experiencing erectile dysfunction as a result of short-term anxiety or stress. These drugs can help overcome the problem and restore confidence until the troublesome period is over. However, there is a danger that the use of these medications can lead to an over-reliance on drugs to achieve an erection.

Based on new research [9], experts caution that the recreational use of ED drugs can lead to psychogenic erectile dysfunction in healthy young men. It is believed that regular use of these medications leads to reduced confidence in achieving and maintaining erections unaided. Also, ED medication users may become over-sensitive and develop unreasonable standards of erectile performance.

If the problem with obtaining and sustaining erections is persistent (occurs more than half the time) and is a source of distress for you or your partner, it’s important to seek medical advice and treatment. The best practice is to always determine what is causing erectile dysfunction before doing something about it.

If performance anxiety, stress, or other psychological issues are the cause, short-term treatment with PDE5 inhibitors such as Viagra may be recommended to provide a confidence boost without leading to dependence. If it is determined that physical causes such as poor blood flow to the penis are the underlying reason, regular and continued use these medications may be indicated.

However, some men experience side effects with these drugs, and vacuum erection devices (VEDs) or penis pumps offer a simple, inexpensive, and safe alternative.


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What medications can cause erectile dysfunction?

Are you having trouble achieving and maintaining an erection and wondering what’s going on? The answer could lie in your medicine cabinet. Many prescription and over-the-counter drugs can cause erectile dysfunction (ED). In fact, some of the most commonly prescribed medications in the U.S. list ED as a side effect. It is worth remembering though that every person is different, and a medication that leads to sexual dysfunction in one man may not cause a similar problem in another man.

Erections occur as the result of a complex interaction between nerves, hormones, blood circulation, and sexual arousal. A medication that is given to treat a particular medical condition could also have an undesirable effect on one or more body systems, resulting in ED or increase the risk of developing it.


For example, if a drug interferes with normal blood flow or reduces nerve sensitivity, it could result in sexual performance issues. However, this does not mean that one must either live with erectile dysfunction symptoms or discontinue treatment for a medical condition.


What medications can cause erectile dysfunction? And what should you do if you think medication might be causing problems with sexual performance? Read on to find out.

Is my prescription drug causing my erectile dysfunction?


The list of medications that can cause or contribute to erectile dysfunction is a long one. A physician is the best person to decide whether a particular drug could be causing ED as a side effect. However, the most common culprits are known and include blood pressure medications, antidepressants, and allergy meds.

Here’s some information about the main types of medications that can lead a man to seek erectile dysfunction treatment:


Diuretics and Antihypertensives


These drugs are used to treat high blood pressure. They include thiazides, beta blockers, and water pills. High blood pressure and erectile dysfunction share an intimate relationship.  

Men with ED are more likely to have high blood pressure. Erection problems are common in men who smoke and/or are overweight, both of which are known risk factors for hypertension. In addition, erectile dysfunction drugs such as Viagra affect blood pressure.

Further complicating matters is the fact that studies show that there is an important psychological component to ED. One study found that when men were made aware that Tenormin (atenolol), a commonly prescribed blood pressure drug, can potentially cause erectile dysfunction, more than 30 percent reported experiencing trouble with sexual performance after hypertension treatment was begun.

However, among the men who were not informed of this potential side effect, only about 15 percent experienced trouble with erections [1] while on atenolol. Therefore, it is believed that knowledge about the potential sexual side effects of a blood pressure medication can lead to anxiety-induced ED.


Psychiatric Medications


Many antidepressants, antipsychotics, anticonvulsants, and anti-anxiety drugs are known offenders in causing ED. Erectile dysfunction is listed as a side effect for medications such as Prozac, Zoloft, Elavil, Valium, and Ativan. These drugs are believed to cause problems with erections through their action on nerve signaling and neurotransmitters as well as by lowering testosterone levels.

Men taking these psychiatric medications may experience decreased libido, failed ejaculation, and/or erectile dysfunction.


Antihistamines and Non-Steroidal Anti-Inflammatory Drugs


Antihistamines are commonly used to treat allergies and many of them are available over-the-counter. Antihistamines block the action of histamine, a chemical involved in allergic reactions, but also necessary for healthy erections [2]. NSAIDs (non-steroidal anti-inflammatory drugs) such as naproxen and indomethacin are used to treat mild to moderate pain due to arthritis, sports injuries, etc.

Studies [3] have shown that men who take NSAIDs regularly are more likely to have erectile dysfunction.


Other Common Drugs Linked to ED


  • Chemotherapy drugs such as Cytoxan and Myleran
  • Prostate cancer medications such as Lupron and Eulexin
  • Parkinson’s disease medications such as Cogentin, Artane, Sinemet, and Parlodel
  • Muscle relaxants such as Flexeril and Norflex


What other substances or drugs may be causing my erectile dysfunction?


In addition to prescription and OTC drugs, a number of other substances are known to cause ED or worsen the risk of developing this condition. The following recreational and frequently abused drugs have been linked to problems with erections:


Alcohol and Nicotine


Alcohol causes dehydration, leading to a reduction in blood volume as well as an increase in angiotensin, a hormone that has been linked to ED [4]. Alcohol is also a nervous system depressant and it suppresses nerve sensitivity. Excessive alcohol consumption can lead to decreased testosterone levels, which can result in reduced sexual drive and function.




Cannabis is the most widely used illicit drug globally, and with many states legalizing the use of marijuana for medicinal purposes, its use is becoming even more widespread. However, research [5] shows that marijuana can have a potentially negative effect on male sexual function through its action on specific receptors in the cavernous tissue of the penis.


Opiates, Cocaine, and Methadone


Erectile dysfunction is common among drug abusers. Studies [6,7] have shown that the prevalence of ED and problems with libido, orgasm, and sexual satisfaction is substantially higher among abusers of prescription medications such as methadone as well as illicit drugs such as heroin and cocaine. In fact, one study [8] found sexual dysfunction in 62 percent of men who were both alcoholics and cocaine addicts.


What can I do about my ED?


The good news is that ED is a treatable and reversible condition. There are several erectile dysfunction treatments that are both safe and effective. Here’s what you can do if you suspect a medication you’re taking may be preventing you from obtaining strong, sustained erections.


Discuss sexual function frankly with your healthcare provider


You don’t have to live with sexual dissatisfaction. Be honest and upfront with your healthcare providers. The more they know, the better they can address your symptoms and help you maintain a healthy, satisfying sex life.


Talk to your doctor about alternatives


If you believe a medication may be causing erectile dysfunction, DO NOT stop taking it without consulting your doctor first. Adjusting the dose may be able to relieve erectile dysfunction symptoms or your physician may switch you to a different medication.


Get treatment for ED


If changing medications is not an option, there are many effective therapies for ED available, the most common of which are PDE5 inhibitors such as Viagra, Cialis, and Stendra.


Try other treatments for ED


Sometimes erectile dysfunction pills cannot be used because of potential interactions with other drugs. Some men may not respond to these medications. Others may be unwilling to take these drugs because of the risk of side effects or lack of spontaneity they entail. Other treatment options for erectile dysfunction are available. Medical vacuum erection devices can help solve many issues that men face when dealing with ED. Check with your doctor to see if a medical penis pump is right for you.



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Are men with psoriasis and psoriatic-arthritis more likely to develop erectile dysfunction?

causes of erectile dysfunction

causes of erectile dysfunction

Erectile dysfunction (the inability to achieve and sustain firm erections) can make sexual intercourse difficult, if not impossible, but it impacts more than just a man’s physical performance in the bedroom. The psychological toll that ED takes can result in permanent damage to a relationship.

It doesn’t help that this is a sensitive topic and many men are embarrassed to discuss it with their partners or seek help.

Fortunately, ED is a treatable condition. Lifestyle changes, medications, injections, vacuum erection devices, and surgery are all viable treatment options. But, the first step in coping with it is identifying the causes of erectile dysfunction.

There are some well-known physical causes, including heart disease, diabetes, high cholesterol, high blood pressure, and obesity. Alcoholism, substance abuse, and tobacco use can also lead to ED. There are certain drugs that cause erectile dysfunction. Surgeries in the pelvic area and treatment for prostate cancer may also cause problems with erections.

However, there is another lesser known cause of ED. There is increasing scientific evidence linking psoriasis and psoriatic-arthritis to erectile dysfunction. What is psoriasis and how is it connected to sexual function in men?


What is Psoriasis?


psychological causes of erectile dysfunction

Psoriasis is a chronic dermatological condition in which the life cycle of skin cells speeds up and they begin to multiply at an abnormally fast rate, up to 10 times faster than normal. This results in a build-up of cells on the skin surface and the formation of red, scaly bumps that are sometimes itchy, burning, or stinging.

Psoriatic patches can appear anywhere on the skin but are most common on the elbows, knees, and scalp. The patches may be restricted to a small area of skin, or in severe cases, involve more extensive parts of the body. Psoriatic patches heal and reappear throughout a person’s life.

Psoriasis is not an infection and it is not contagious, i.e., it cannot be passed on from person to person. Psoriatic lesions usually first appear during young adulthood (age 15-35), but the condition may occasionally be diagnosed in children.

Psoriatic arthritis is a type of arthritis that occurs in people with psoriasis. In fact, up to 30 percent of people with the skin manifestations of the disease eventually develop psoriatic arthritis.

Usually, the skin lesions appear first and joint involvement occurs later, but some people may experience joint problems before they exhibit any skin plaques. Psoriatic arthritis can affect any joint in the body, including small joints such as the fingers and larger joints such as the spine. Symptoms include pain, stiffness, and swelling in the affected joint. The disease flares up and remits periodically. Without treatment, psoriatic arthritis can be disabling.

In addition to the physical manifestations of the disease, psoriasis has a significant psychological component. Not only are the psoriatic lesions unsightly to look at, but a lack of awareness about the disease leads people to perceive the patches as contagious. This makes psoriasis highly stigmatizing. The disease can affect a person’s confidence, self-esteem, and relationships, leading to a negative impact on physical, mental, and sexual health, as well as quality of life.

To make things worse, people with psoriasis are at an increased risk of developing other serious chronic health conditions such as cardiovascular disease, type 2 diabetes, Crohn’s disease, and depression. Psoriasis has also been linked to poor sexual function in women and erectile dysfunction in men.


What causes psoriasis?


Scientists are not quite sure what causes psoriasis, but they believe that the disease is the result of a complex interplay between the immune system, genetics, and the environment.  Psoriasis affects 2-3 percent of the general population. Men and women are equally at risk and the condition occurs in all racial groups. It is an immune-mediated chronic inflammatory condition that runs in families, but can sometimes skip a generation. If both parents have the disease, there is a 50 percent chance their child will also have it. About one-third of people with psoriasis report having at least one relative who also has the condition.

In addition to a genetic predisposition, psoriasis outbreaks may be caused by certain environmental triggers, including:

  • Emotional stress
  • Cuts and scrapes on the skin, bug bites, or bad sunburns
  • Infections like strep throat
  • Cold, dry weather
  • Hot water
  • Itching
  • Heavy alcohol consumption
  • Tobacco
  • Certain medications like prednisone, lithium, antimalarials, quinidine, indomethacin, and hydroxychloroquine

Experts believe that psoriasis occurs due to overactivity of the immune system. In healthy individuals, the immune system protects against bacteria and viruses. In people with psoriasis, the immune system mistakes healthy cells for “intruders” and attacks them, leading to inflammation and other skin and joint symptoms. This overactivity of the immune system also causes more skin cells to be produced at an abnormal rate.

The life cycle of skin cells in healthy individuals is about 30 days. In people with psoriasis, it is only 3-4 days. The body is unable to shed the excess skin cells and they build up into the characteristic red, scaly psoriatic plaques.


If I have psoriasis am I at risk for erectile dysfunction?


What Causes erectile dysfunction

There is mounting scientific evidence linking psoriasis with an increased risk of sexual dysfunction in both men and women. Psoriasis is a highly visible disease and the skin manifestations can cause intense emotional distress. One study in Britain found that the presence of psoriatic plaques significantly affects desire, arousal, and orgasm in women.

In addition, the presence of psoriatic lesions in intimate areas (such as the genitalia, thighs, abdomen, and back) was found to be associated with even more significant sexual dysfunction.

In men, studies show an independent association between psoriasis and erectile dysfunction. The prevalence of ED is substantially higher in men with psoriasis compared to men who do not have the skin condition.

The risk of sexual dysfunction related to psoriasis is higher in men above the age of 60 and in men with psoriatic-arthritis. One Danish study found that the prevalence of ED in the general population was about 9 percent, in men with atopic dermatitis (eczema) was about 7 percent, and in men with psoriasis was nearly 13 percent.

Therefore, men with psoriasis were found to have the highest prevalence of ED compared to the general population and compared to men with other skin conditions. Scientists postulate that the chronic inflammation seen in psoriasis is associated with the presence of inflammatory molecules in the bloodstream which causes damage to blood vessels. Damage to arteries in the penis is one of the known causes of erectile dysfunction.


How does psoriasis cause erectile dysfunction?


The vast majority of men feel unattractive and embarrassed in front of sexual partners during a psoriasis exacerbation. Nearly 50 percent of men with psoriasis have experienced rejection at some point in their life because of skin disease. The disease leads to a negative perception of body image, low self-esteem, loss of confidence, and perceived or actual stigmatization, all of which can lead to depression. Depression is believed to be a critical psychological link between psoriasis and erectile dysfunction. Further complicating the picture is the fact that classic treatments for psoriasis are moderately effective at best.

Men who suffer from psoriasis can easily become frustrated with trying one treatment after another and seeing no improvement, which can lead to depression. Another plausible link between the two conditions is atherosclerosis (plaque build-up in the arteries). Men with psoriasis and psoriatic-arthritis are at increased risk of cardiovascular disease, and studies show that the risk is higher in those with severe psoriasis. Atherosclerosis in the blood vessels of the pelvis can affect blood flow to the penis, which is critical for strong, sustained erections.

In addition, diabetes mellitus, metabolic syndrome, and smoking, which are comorbidities of psoriasis (frequently occur together) are known causes of erectile dysfunction. People with severe psoriasis or psoriatic-arthritis are at increased risk of periodontitis (inflammation of the gums), which is a known risk factor for cardiovascular disease. As mentioned, cardiovascular disease (atherosclerosis) is strongly related to erectile dysfunction.

Another link between psoriasis and erectile dysfunction may be hormonal in nature. Men with psoriasis have significantly lower levels of testosterone compared to healthy men. Testosterone, the male sex hormone, is a key component of the male sexual response, including libido and erections.

Finally, medications used to treat psoriasis may cause erectile dysfunction. Topical and systemic psoriasis treatments such as etretinate, acitretin, and methotrexate may trigger problems with erections. Case studies have shown that symptoms of ED developed soon after starting treatment with psoriasis medications and abated when the treatment was discontinued.


How can you reduce the risk of erectile dysfunction when you have psoriasis?


Scientists are still trying to completely understand the connection between ED and psoriasis, but it seems likely that chronic inflammation plays a key role in the development of both conditions. The best way to reduce the risk of erectile dysfunction in men with psoriasis is to minimize inflammation as much as possible. If you have psoriasis, here are some things you can do to reduce the risk of sexual dysfunction:

Psychological Factors

  • Reduce stress levels.
  • Seek help for anxiety and depression to prevent them from spiraling out of control.

Physical Factors

  • Avoid psoriasis triggers, such as cold, dry weather, excess sun, hot water, and itching.
  • Check for food triggers of psoriasis, such as gluten, red meat, dairy, gluten, and alcohol.
  • Certain medications, such as antimalarials and beta-blockers (used to treat high blood pressure) can trigger psoriasis attacks. Antidepressants, antihistamines, high blood pressure medicines, Parkinson’s medications, and chemotherapy and hormonal medicines are known causes of erectile dysfunction.
  • Check your medicine cabinet. Remember, over-the-counter supplements can also have an effect on hormones, nerves, and blood circulation, resulting in new-onset or worsening ED. Talk to a healthcare provider before taking any OTC drugs.

If you have been diagnosed with psoriasis and are having trouble with erections, talk to your doctor. It is important for psoriasis patients to discuss sexual dysfunction with their healthcare providers. ED is often not addressed at dermatology consultations. Your dermatologist should be aware of the connection between psoriasis and erectile dysfunction and the multidisciplinary approach required to treat both conditions.

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Erectile dysfunction linked to Vitamin D deficiency

Vitamin D

vitamin D


Vitamin D is a nutrient sometimes known as “the sunshine vitamin” because direct sunlight produces it naturally in our bodies. It is also known to play a key role in biochemical processes ranging from bone renewal to hormone balance.  So, how is erectile dysfunction linked to a vitamin D deficiency?

Researchers from Johns Hopkins university analyzed data from more than 3,400 American men. Erectile dysfunction linked to Vitamin D deficiency was present in 35 percent of men, compared to 29 without erectile dysfunction.  While the data was compelling, lead investigator Dr. Erin Michos acknowledges that their finding is observational and doesn’t attempt to prove cause and effect as it relates to the link between vitamin D and ED.

At most the 2015 study, which was presented at the American Heart Association’s annual meeting, suggests that if a correlation does exist between vitamin D deficiency and erectile dysfunction, that findings might lead to new treatment approaches.  The question remains.  Does erectile dysfunction lead to a vitamin D deficiency?  Does a vitamin D deficiency lead to erectile dysfunction?  Here are some things we do know.


vitamin D and Diabetes


Vitamin D and Diabetes

There is also growing evidence around vitamin D and Diabetes.   The American Diabetes Associates published a study that concluded that a vitamin D deficiency could be a contributing factor in the development of both type 1 and type 2 diabetes.  According to researcher’s vitamin D treatment improves glucose tolerance and insulin resistance.

Some doctors believe that there is a link between vitamin D and type II diabetes as studies indicate young people who have the lowest level of vitamin D in their blood have a higher chance of developing type II diabetes as they age.  Diabetes is estimated to reach 322 million cases worldwide by 2025, and it just so happens the third most common complaint is, you guessed it, erectile dysfunction


diabetes and hypertension


The relationship between diabetes and hypertension

Further studies have found that at least 1 in 3 patients with type 1 diabetes also have hypertension.  Diabetes does three things that may increase blood pressure:

  • Decreasing the blood vessel’s ability to stretch
  • Increasing the amount of fluid in the body
  • Change the way the body manages insulin


Vitamin D and Hypertension

According to researchers at the Mayo Clinic, it’s too early to say whether too little vitamin D causes high blood pressure or whether vitamin D supplements may have a role in treatment of high blood pressure.  Regardless, vitamin D deficiency increases the risk of hardening of the arteries (hypertension).  Hypertension leads to High blood pressure and can block blood flow in blood vessels throughout the body. 

Erectile dysfunction caused by Vitamin D deficiency


The relationship between diabetes and hypertension

According to researchers at the Mayo Clinic, it’s too early to say whether too little vitamin D causes high blood pressure or whether vitamin D supplements may have a role in treatment of high blood pressure.  Regardless, vitamin D deficiency increases the risk of hardening of the arteries (hypertension).  Hypertension leads to High blood pressure and can block blood flow in blood vessels throughout the body. 


High blood pressure and erectile dysfunction


High blood and erectile dysfunction go hand in hand.  Men with erectile dysfunction who also have cardiovascular disease are incredibly common.  90% of men with ED have at least one major cardiovascular risk.  Usually high blood pressure, high cholesterol, diabetes, or smoking are risk factors found in men with erectile dysfunction.


vitamin D and cardiovascular disease


The evidence for an association between vitamin D and cardiovascular disease is also strong. Poor vitamin D while linked to obesity, diabetes, and poor mental health, also plays a role in the inner lining of blood vessels. Known as endothelial dysfunction, an aspect of vascular disease, blood vessels in this state have a problem functioning properly without adequate levels of vitamin D.  Endothelial dysfunction is known to be highly correlated with poor vitamin D.  Endothelial dysfunction is a precursor to hardening of the arteries or atherosclerosis also described as the loss of elasticity of artery walls.  We know that hardening of the arteries is a vascular disease that can contribute to, you guessed it, erectile dysfunction.


vitamin D and cardiovascular disease


Penile atherosclerosis

Penile atherosclerosis is medical term for hardening of the arteries in the penis. Healthy erectile function is not able to occur if the blood vessels are inflexible.  Hardened arteries, also known as being the by-product of endothelial dysfunction, prevents the expansion of penile tissues from a flaccid to erect state. Vitamin D3 deficiency seems to occur prior to, or as the result of, penile atherosclerosis.

Vitamin D and Nitric Oxide

Dr. Michos and her colleagues also noted in the 2015 John Hopkins study that men with ED have an increased frequency of endothelial dysfunction, and vitamin D may improve endothelial function. “One mechanism linking low vitamin D levels with ED may be via reduced synthesis of nitric oxide,” they wrote. “Secretion of nitric oxide is needed for relaxation of the smooth muscles of the corpora cavernosa and subsequent penile erection, and vitamin D may be a regulator of endothelial nitric oxide synthase.”

Erectile Function

Healthy erectile function is all about the health of blood vessels and blood flow to the penis.  Men with erectile dysfunction are unable to achieve or maintain adequate amounts of blood in penile tissues. Having established that vitamin D is essential to the health of blood vessels, it is not difficult to speculate that vitamin d deficiency can play a role in diminished blood flow due to endothelial dysfunction (hypertension).

It is clear in various clinical studies published on vitamin D and diabetes, heart disease, and erectile dysfunction, they all have one thing in common.  They are inconclusive around the exact cause and effect relationship between vitamin D and these three conditions. However, there is a relationship between a deficiency of the vitamin D, the health of the vascular system, and the mentioned disease states.

Erectile Dysfunction Pump in ED related Diabetes and Hypertension

An erectile dysfunction pump is the first line treatment of choice for men with either diabetes or hypertension.  However, the reasons this is true is different for both diabetes and hypertension.  Oral medications being very accessible, are often considered as the first line treatment for ED.

Men who take medications that treat hypertension often find that oral ED medications do not mix well with high blood pressure medications that contain nitrates. Possible side effects could include, headache, flushing, indigestion, nasal congestion, muscle aches, back pain, or vision distortion.

50% of men with diabetes type 1 who try oral ED medications report there is no improvement in the erections they achieve.  40% of men with diabetes type 2 who try oral ED medications report there is no improvement in the erections they achieve.

So many men who are taking hypertension medications cannot combine ED medications with certain blood pressure medications.  Men with diabetes type 1 or type 2 have a high probability that oral ED medications will not yield a positive response.


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