Erectile Dysfunction & Its Causes

Erectile dysfunction is one of the most common and distressing problems affecting the adult population. It is also a condition that is increasing worldwide. Epidemiological studies show that approximately half of men over 40 years of age suffer from erectile dysfunction, and according to some statistical projections, by 2025 there will be over 300 000 000 in the world of men with erectile dysfunction.Before 1973 the treatment options for erectile dysfunction were limited to psychotherapy and intramuscular injections of testosterone, but since then, with the emergence of new alternatives, has significantly improved its handling.

Epidemiology

Erectile dysfunction, defined as the persistent inability to obtain or maintain an erection sufficient to carry out a
satisfying sexual relationship, is a common condition among men around the world. In 2005, more than 25 million men aged between 40 and 70 years had this condition in the United States.In Latin America it is estimated that between 40 and 46% of the population in that age range have some form of erectile dysfunction. Specifically, in 2001 a study in Mexico showed that 55% of the sample of 1200 men between 40 and 70 years of age, and 9.7% of men between 18 and 39, suffered from some degree of erectile dysfunction.

Risk Factors

There are a number of factors associated with erectile dysfunction, the most common are diabetes mellitus, hypogonadism, hypertension, peripheral vascular disease, hypercholesterolemia, use of certain drugs, neurological disease, Peyronie's disease, alcoholism, smoking, depression and kidney's failure.

Diabetes mellitus

In these patients the vascular causes of erectile dysfunction can be prevented by reducing or eliminating risk factors including smoking, hypertension, obesity, hypercholesterolemia and sedentary, the prevalence in these patients increases with age, but there is no statistical correlation between duration of diabetes and erectile dysfunction

Hypercholesterolemia

In a study conducted in 3250 men showed that  when they exceeded 60 mg / dl of HDL there is a 30% chance of suffering erectile dysfunction, and it increases to 80% when the HDL is less than 30 mg / dl, This demonstrates the importance of the levels of HDL cholesterol in the pathophysiology of the disease.

Hypertension

Systemic arterial hypertension leads to a deterioration of erectile function in most patients, which is aggravated by the association of factors such as diabetes and smoking.Erection also significantly decreased by antihypertensive drugs while in response to vasoactive drugs useful in the treatment of erectile dysfunction.

Smoking

Smoking is a risk factor for the development of atherosclerosis in the pudendal and penile arteries, common in young patients with erectile dysfunction. Strong smokers or heavy smokers have more atherosclerosis with hemodynamic alterations than that of light smokers. Arterial damage occurs by acceleration of the sclerosis of the intima and by changes in cholesterol levels associated with smoking.

Hormonal disturbances

Alterations of the hypothalamic-pituitary-gonadal axis may be related to erectile dysfunction. At age 70 testosterone levels are 30% below the lower limit in younger patients. With increasing age, there is also a reduction in the production of prolactin.

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