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    Erectile Dysfunction and Male Fertility (Part 1)

    “Impotence” – The word a lot of men worldwide dread to be associated with in their health and lifetime. This is the term that is currently referred to as “Erectile dysfunction” in today’s world.

    [Fun fact: “Impotence” was changed to the word “erectile dysfunction” in 1992 (BJUInternational)s]

    Simply put, erectile dysfunction is the inability to achieve and/or maintain a penile erection so that a satisfactory sexual performance can occur (Medscape). It is often associated with a feeling of shame, embarrassment, insecurity, and fear which makes men delay in seeking appropriate medical care. This condition can greatly affect a man’s quality of life (Medline).

    Erectile dysfunction is a complex problem because it emanates from multiple pathways in the body. It can arise from the Central Nervous System, peripheral nervous system, blood vessels, or the hormonal system. An abnormality in any of these systems can significantly impact a man’s ability to get an erection, sustain an erection, ejaculate, or even experience an orgasm. This means that when a man is diagnosed with erectile dysfunction, it can serve as a pointer to a medical condition that requires immediate treatment.


    Sexual function entails a combination of biological, psychological, and sociocultural factors which make it difficult to define the cause of a sexual dysfunction. Therefore, before the diagnosis of any sexual dysfunction is made, all other possible causes that can be explained by a non-sexual stressor needs to be addressed first. Some of these underlying stressors that could be involved but can also be easily ignored are:

    • Partner factors: His partner has some sexual problems or health issues
    • Relationship factors: different levels of desire for sexual activity, communication problems, any form of physical, emotional, or verbal abuse or violence from his partner
    • Vulnerability factors: History of sexual abuse or emotional abuse, existing mental health conditions from stressors like a job loss or even a clinically diagnosed depression
    • Cultural factors: clashing cultures regarding how sexual issues should be handled
    • Religious factors: conflicting beliefs concerning sexuality
    • Medical Factors: an existing medical condition or the effects of certain medications.

    In some men, it can be attributed to psychological concerns, anxiety, depression, tobacco abuse, trauma, diabetes mellitus, hypertension, stroke, thyroid disease, high lipid or cholesterol levels in the blood and especially cardiovascular diseases such as the coronary artery disease. Diseases of the blood vessels is a very common and important cause of erectile dysfunction because sometimes when a man presents to a health professional with this dysfunction, it could be one of the earliest signs of a vascular disease.


    Erectile dysfunction based on duration

    1. Lifelong erectile dysfunction: has been present since first sexual experience and it is mostly associated with psychological factors.
    2. Acquired erectile dysfunction: developed after a period of normal sexual functioning and it is often related to biological factors.

    Erectile dysfunction based on the context it occurs

    1. Generalized erectile dysfunction: occurs all the time irrespective of the stimulation, situation or sexual partner involved.
    2. Situational erectile dysfunction: limited and only occurs in specific types of stimulation, sexual situations or depending on the partner involved.

    Want to learn how erectile dysfunction affects fertility? Watch out in the Part 2!

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    Information source: Medscape, Medline

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