Monthly Archive November 2019

Erectile Dysfunction: Why It Happens and How to Treat It

Erectile dysfunction in Australia and other western countries, sometimes it’s the fault of smoking.
Cigarettes worsen the quality of life, even negatively affecting sexual performance.

Cigarettes worsen the quality of life in many ways, not least by negatively affecting reproductive activity and sexual performance.
In both sexes smoking can reduce fertility, but in humans, as well as altering sperm production, it can also compromise the physiological mechanisms responsible for erection, and thus lead to erectile dysfunction.
In fact, determining an erection is essentially a conspicuous and rapid increase in the flow of blood within the arteries that constitute the main anatomical structures of the penis (cavernous bodies and spongy body).
This influx is allowed by the release of the muscle cells that surround the blood vessels, induced by nerve stimuli that accompany sexual excitement.
Once the maximum level is reached, the swelling of the arterial structures then causes a compression on the veins of the organ, which prevents the blood from flowing out, thus guaranteeing the continuation of the erection until the completion of the coitus.

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Sometimes it’s normal.

Erectile dysfunction, commonly referred to as “impotence” in the past, is due to an interruption of the sequence of events which, involving on one side the central nervous system and on the other the nervous, muscular and vascular structures of the penis, leads to an ingestion. and the elevation of the male sexual organ.
A transient decrease in the efficiency of these mechanisms can be considered a normal phenomenon, just as their reduction in old age is normal. If, on the contrary, the disorder often arises or persists at a young age, it can be traced back to non-physiological conditions.
Being the erection the final result of a series of processes that are activated depending on each other, there are many factors that, intervening in the various phases of the sequence, are able to block it.

Possible defendants.

In addition to factors that interfere with the psychological and hormonal components of sexual arousal, there are some systemic pathologies and some local factors that damage the innervation and vascular structures of the penis, making the hemodynamic changes that produce an erection impossible. These can essentially be traced back to six main groups.

  • Psychological causes: Anxiety, depression, relationship problems
  • Vascular causes: Hypertension, atherosclerosis, diabetes
  • Endocrine causes: Testosterone deficiency, hyperprolactinemia, thyroid dysfunction
  • Neurological causes: Multiple sclerosis, Parkinson’s disease, pathologies or traumas of the spine, traumas or surgery in the pelvic area (for example on the prostate or on the bladder)
  • Iatrogenic causes: (side effect of therapies) Some sedatives, anxiolytics, antidepressants, antihypertensives, anti-inflammatories, hormones, testicular radiotherapy etc.
  • Lifestyles: Cigarette smoking, alcohol abuse, drug use.

The indirect and direct role of cigarettes.

The relationship between smoking and erectile dysfunction has long been the subject of investigation. On the one hand, experimental research has now amply demonstrated the toxic effects of nicotine and some other compounds derived from the burning of tobacco on the tissue that coats the inner walls of blood vessels (endothelium).

On the other hand, epidemiological studies have repeatedly shown an incidence of this disorder higher in regular smokers and in former habitual smokers than in non-smokers. And, although to a lesser extent, non-smokers who are constantly exposed to passive smoking are also at risk of developing erectile dysfunction.

In recent years, clinical investigations have also sought to clarify whether penile deficiency is simply the consequence of smoke-induced atherosclerosis in the blood vessels of the whole organism and is therefore associated with the various cardiovascular disorders in which smokers may incur, such as hypertension , myocardial ischemia and stroke, or is due to a direct effect of smoking on the functioning of the mechanisms of erection.

The latter hypothesis seems to be the most probable today. A series of recent epidemiological studies conducted in different populations (United States, Italy, China, Australia, Brazil, Japan, Turkey etc.) has shown that smoking is associated with erectile dysfunction even in relatively young men (within the age of 50) ) who do not have (or do not yet have) clinical signs of cardiovascular disease and have less risk factors.
Furthermore, according to the Australian study, in this same group of young adults erectile dysfunction is still liable to a significant improvement with smoking cessation.
In addition, the effects on the erection appeared to be “dose-dependent”, meaning that the daily consumption of cigarettes is greater and the duration in years of smoking is the more severe the dysfunction.

Although not all the mechanisms by which smoking damages blood vessels are perfectly known, to explain the impairment of erection even before the vascular alterations of an atherosclerotic nature could be, according to experts, a well-known biochemical mechanism.