Erectile dysfunction causes

Erectile dysfunction Treatment of erectile dysfunction caused by neurogenic, vasculogenic, psychogenic, or mixed etiology. 

Medication Classes That Can Cause Erectile Dysfunction... 

The biochemical cause(s) of erectile dysfunction is not known but one possibility is a low concentration of cyclic GMP in the smooth mnscle. On the basis of the principle of the regulation of second messengers see Chapter 12 and Box 12.2, the following might be responsible for a low... 

Erectile dysfunction Diagnose and treat underlying treatable medical causes of erectile dysfunction prior to initiation of therapy. 

Erectiie dysfunction Undertake thorough medical history and physical examination to diagnose erectile dysfunction, determine potential underlying causes, and identify appropriate treatment. 

B. The only time testosterone is indicated for the treatment of erectile dysfunction is if the cause is clearly related to hypogonadism. In other situations, the adverse effects related to testosterone and its limited effectiveness preclude its use. 

A combination of phentolamine with the nonspecific smooth muscle relaxant papaverine, when injected directly into the penis, may cause erections in men with sexual dysfunction. Long-term administration may result in fibrotic reactions. Systemic absorption may lead to orthostatic hypotension priapism may require direct treatment with an -adrenoceptor agonist such as phenylephrine. Alternative therapies for erectile dysfunction include prostaglandins (see Chapter 18), sildenafil and other cGMP phosphodiesterase inhibitors (see Chapter 12), and apomorphine. 

Yohimbine Blocks k2 elicits increased central sympathetic activity increased norepinephrine release Raises BP and HR Male erectile dysfunction hypotension May cause anxiety excess pressor effect if norepinephrine transporter is blocked... 

Impotence, the inability to maintain an erection sufficient for intercourse, is more properly called erectile dysfunction. Up to 20 million men in the United States have this problem to some degree. Another way of stating the problem is that for normal men living in the community who are between 40 and 70 years old, only about half do not have some degree of erectile dysfunction (Fig. 14—8). The problem worsens with age (Fig. 14—9), since 39% of 40-year-olds have some degree of impotence (5% are completely impotent), but by age 70 two-thirds have some degree of impotence (and complete impotence triples to 15%). The multiple causes of erectile... 

FIGURE 14—14. Some antidepressants such as serotonin selective reuptake inhibitors (SSRIs) may inhibit nitric oxide synthetase (NOS) and thereby reduce NO and cause erectile dysfunction. 

There is a higher incidence of impaired sexual function in men who take finasteride compared with placebo (58,59). The incidence of erectile dysfunction has been estimated at 5% (60), but it is difficult to estimate, since in many users of the drug other causes are present, including advanced age, heart disease, diabetes, hypertension, smoking, and hypercholesterolemia. Benign prostatic hyperplasia itself can also aggravate or even induce erectile dysfunction. A questionnaire study in New Jersey... 

The relation of prolactin concentrations and certain adverse events has been explored by using data from two large randomized, double-blind studies (n = 2725 813 women, 1912 men) (1018). Both risperidone and haloperidol produced dose-related increases in plasma prolactin concentrations in men and women, but they were not correlated with adverse events such as amenorrhea, galactorrhea, or reduced libido in women or with erectile dysfunction, ejaculatory dysfunction, gynecomastia, or reduced libido in men. Nevertheless, in five patients risperidone (1-8 mg/day) caused amenorrhea in association with raised serum prolactin concentrations (mean 122 ng/ml, range 61-230 ng/ml reference range 2.7-20 ng/ml) (1019). 

In a 1995 study published by the British Journal of Urology, researchers found that khat chewing inhibits urine flow, an effect caused by blood vessel constriction, which also causes erectile dysfunction. This constriction also affects blood pressure and heart rate however, further studies are needed to determine the possible long-term cardiovascular damage associated with regular khat use. 

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