Erectile Dysfunction (ED) and Endocrine Disorders
By pocketpills: January 1, 2021
Erectile Dysfunction (ED) and Endocrine Disorders
Erectile dysfunction (ED) is a widespread condition affecting 50% of Canadian men. While occasional problems with erection are normal, persistent difficulty in getting or maintaining an erection is known as erectile dysfunction. ED may also be a sign of an underlying condition, such as neurological and endocrine disorders.
Many studies have shown a relationship between sexual health and low testosterone levels. Scientists believe that testosterone deficiency is an excellent marker for physical and sexual problems in men.
Moreover, other hormones such as thyroid-stimulating hormone (TSH), prolactin, and luteinizing hormone (LH) are also involved in sexual functioning, and their deficiency may cause ED. If you face persistent difficulty in getting or maintaining an erection, it is best to consult your doctor. They will help find an underlying cause and treat the same to reverse ED.
Table of Contents
How Endocrine Glands Affect Erection?
Normal sexual function is divided into four domains sexual, erection, ejaculation, and subsiding of sexual arousal.
Before we move ahead to the causes, let us first understand the process of erection. The shaft of the penis is surrounded by two chambers and contains the urethra in the center. The surrounding tissues of the chambers include smooth muscle fiber, small blood vessels, and empty spaces.
When sexually aroused, signals from the nerve endings in the penis or brain prompt the blood vessels to dilate and smooth muscles of the chambers to relax. This causes the empty spaces to fill with blood. This increased pressure of blood triggers the release of chemicals such as nitric oxide (NO), which dilates blood vessels that further improve blood supply to the penis.
The pressure of blood flow causes the sheath to press on veins, which drains blood out of the penis. The pressure thus traps the blood inside the penis. With more flow of blood, the penis stiffens and expands, resulting in an erection.
When arousal ends, smooth muscles contract, relieving pressure off the veins, and the penis returns to the original flaccid state.
Testosterone regulates the endothelial (lining of blood vessels) working of penile blood vessels and acts on the function, structure, and nerve supply of smooth muscles. Testosterone deficiency may thus make it difficult to get or maintain an erection.
Endocrine Disrupting Chemicals (EDCs)
Endocrine-disrupting chemicals (EDCs) are estrogen-like or anti-androgenic compounds that can alter normal hormonal balance. Some examples of EDCs include herbicides, pesticides, biocides, plastic contaminants, chemical catalysts, heat stabilizers, dietary components, or pharmaceuticals.
You may come in contact with EDCs through inhalation of dust or contaminated air, contaminated food, or skin contact. Some men are at a higher risk due to cultural and geographical reasons.
While studies have shown a link between EDCs and erectile problems, further studies are needed to be conclusive.
Is Hyperinsulinemia, A Form of Diabetes, Responsible for ED?
If the blood vessels are damaged, the blood flow through the body organs, including the penis, is reduced. This decrease in blood flow may make engorgement of the penis difficult, resulting in ED.
Besides, damaged nerves may alter the processing of sexual stimuli, which may increase or decrease desire, impede arousal, or curb genital engorgement. This is because the alteration of stimuli between the nerves and brain interferes with a climax, genital engorgement, and ejaculation.
Managing blood sugar levels and lifestyle modifications such as being physically active and quitting smoking, may help reverse ED.
Other Endocrine Disorders Causing Erectile Dysfunction
Some other endocrine conditions that may cause erectile problems are mentioned below.
Male hypogonadism is a condition where the body does not produce enough testosterone, a hormone playing a vital role in erection and sperm production. A man can be born with hypogonadism or develop later in life due to infection or injury.
Management of hypogonadism depends on the point of life when it occurs. In some cases, testosterone replacement therapy can help treat this condition.
Thyroid hormones influence the functioning of almost every cell, organ, and system of your body, including your sexual health. It is thus expected that thyroid disorders are associated with erectile problems, including erectile dysfunction.
Besides, thyroid problems may result in low sex drive, fatigue, or low mood, impeding erection.
Studies have shown that both hyperthyroidism (overactive gland) and hypothyroidism (underactive gland) may cause ED. A study showed that almost 80% of men with thyroid disorders also suffered from ED.
But the good news is that managing thyroid disorders with medicines or other treatment options often resolves erectile problems.
While the exact mechanism is not understood, studies have shown that men with adrenal disorders are at a higher risk of erectile dysfunction than the general population.
A study revealed that altered blood pressure associated with Addison’s disease (a type of autoimmune adrenal disorder) increases ED risk.
Another study also indicated that Addison’s disease is linked with various sexual dysfunctions, all reversible after hormonal replacement therapy.
Hyperprolactinemia may cause hypogonadism by altering the secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus.
All this results in low testosterone levels, which is the commonest cause of erectile dysfunction. Dopamine-agonist therapy is the best treatment option for hyperprolactinemia-associated erectile dysfunction.
Multiple Endocrine Neoplasia Syndromes
It is a genetic condition that runs in families. Men with multiple endocrine neoplasia syndromes have a tumor in the pancreas, the adrenal gland, the thyroid gland, or the pituitary gland.
In men with pituitary gland tumors, high prolactin levels result in low testosterone levels and erectile dysfunction. The majority of the cases with multiple endocrine neoplasia syndromes are managed with surgical removal of the tumor, which corrects the hormonal imbalance.
Treatment options for ED depend on the underlying endocrine disorders. For instance, hypogonadism is managed through testosterone replacement therapy and tumors through its surgical removal.
Besides, various treatment options are available to improve erection.
In the majority of the cases, oral pills called PDE5 inhibitors aid in managing ED. These medicines do not increase your sexual desire but increase blood flow to the penis and help get an erection when you are sexually aroused.
Prescription medicines for ED include Sildenafil, Vardenafil, Avanafil, and Tadalafil
However, PDE5 inhibitors are not recommended if you:
- Take nitrate drugs
- Have liver or kidney diseases
- Have an eye disorder known as retinitis pigmentosa
- Had a stroke or heart attack in the past six months
However, do not worry, even if pills are not an option for you. There are other treatment options, as well.
Other Treatment Options
Some other common treatment options include:
- Penis suppository
- Vacuum pump
- Testosterone replacement
- Penile implants
- Vascular surgery
Whether ED has an emotional or a physical cause, some lifestyle modifications can help manage ED.
Some lifestyle modifications that may help are:
- Limiting the intake of alcohol
- Stop smoking
- Eating healthy
- Being active
- Reducing anxiety
The majority of the endocrine problems are long-term diseases. If left unattended, it may hamper the functioning of various body parts, including the penis, increasing ED risk.
Various treatment options are available to manage ED and help you get back your healthy sex life. Besides, if you have an endocrine condition, making certain lifestyle modifications, such as being active and managing stress may help prevent or manage ED.
You can work with your physician to manage your endocrine problem and prevent ED.