Analysis of the causes of erectile dysfunction: multiple factors including mental and psychological factors, diseases, and lifestyle.

Causes of erectile dysfunction

(1) Psychological reasons

For example, marital discord, hostility towards the woman, or an unsuitable sexual environment.

(2) Causes of the disease

① Anatomical abnormalities: such as congenital malformations, scrotal hydrops, testicular fibrosis, etc.

② Nervous system lesions: Amyotrophic lateral sclerosis (ALS), myasthenia gravis, Parkinson's disease, spinal cord tumors, multiple sclerosis, and other brain and spinal cord lesions, as well as peripheral neuritis, can also lead to impotence to varying degrees.

③ Endocrine system disorders: There are many endocrine diseases, among which pituitary damage, hypopituitarism, diabetes, hyperthyroidism, and Cushing's syndrome are common causes of erectile dysfunction. Other conditions that can cause erectile dysfunction include hypothyroidism, craniopharyngioma, anorchia, infantile disorders, hyperprolactinemia, oral estrogen use, and feminizing interstitial testicular tumors.

④ Diseases of the urogenital system: Diseases of the male urogenital organs are closely related to erectile dysfunction, such as cystectomy, perineal prostatectomy, Peyronie's disease, phimosis, prostatitis, urethritis, cryptorchidism, and cryptorchidism-induced hypoplasia.

⑤ Hematologic disorders: Hodgkin's disease, leukemia, pernicious anemia (with other systemic diseases), sickle cell anemia.

⑥ Infections: scrotal elephantiasis, genital tuberculosis, gonorrhea, mumps, penile skin infection, etc.

⑦ Vascular lesions: arteritis, lipoma, arteriosclerosis, abdominal aortic bifurcation thrombosis.

⑧ Other conditions: cirrhosis, chronic renal failure, obesity, poisoning (lead, herbicide poisoning), rheumatic fever, pulmonary insufficiency, etc.

(3) Other reasons

① Mental labor: According to statistics, the proportion of intellectuals suffering from erectile dysfunction is higher than that of those engaged in physical labor. This is because mental laborers are more prone to cardiovascular disease and diabetes than physical laborers. People with higher levels of education generally have a fast pace of life, intense competition, and greater pressure, which makes them more prone to psychological disorders.

② Smoking and drinking habits: Long-term excessive smoking can lead to spasm of penile micro-arteries, resulting in insufficient blood supply and causing impotence; long-term alcohol abuse leads to liver damage, affecting hormone secretion, and the peripheral blood vessels and nerves of patients with chronic alcohol poisoning also suffer from varying degrees of damage.

③ Long-term medication: Long-term use of certain antihypertensive drugs, sedatives, etc. can also cause erectile dysfunction.

Traditional Chinese medicine believes that impotence can be caused by a variety of factors, including: emotional distress; congenital deficiency or excessive sexual activity; frequent masturbation; prolonged illness or serious illness leading to malnutrition; prolonged use of cold and cooling medications; excessive thinking; overeating rich and sweet foods; excessive drinking; exposure to damp-heat; unclean sexual intercourse leading to internal damp-heat; holding back ejaculation; prolonged qi stagnation; falls or injuries to the genitals; a history of weak gallbladder, suspicion, and anxiety; sudden accidents causing panic; failure of intercourse in the first sexual experience leading to fear of future failures; disharmony in sexual intercourse causing fear of female criticism; sudden fright during intercourse causing palpitations, timidity, and lethargy; a constitution with yang deficiency and cold excess; improper lifestyle leading to exposure to cold; and improper diet causing spleen dysfunction. These factors can lead to liver qi stagnation, decline of kidney yang, deficiency of both heart and spleen, damp-heat accumulation, blood stasis, yin deficiency with fire excess, kidney damage from fright, cold stagnation in the liver meridian, liver blood deficiency, and phlegm-dampness obstructing the meridians.

How to self-diagnose erectile dysfunction

The diagnosis of erectile dysfunction should be based on several parameters, including the speed and duration of penile erection response, and the rigidity of the erection. The reference standards are as follows:

(1) No impotence

Normal sexual desire, rapid erection response, erection lasting until ejaculation or disappearing after interruption of intercourse, erection hardness sufficient for free insertion into the vagina, good sexual pleasure, no significant change in the frequency of intercourse, and normal erection response during masturbation.

(2) Mild erectile dysfunction (I°)

Sexual desire is generally normal, erection response is rapid, erection duration is unstable, sometimes it cannot be sustained, erection hardness is sometimes insufficient for vaginal penetration, sexual pleasure is generally normal, frequency of intercourse is less than before, and erection response during masturbation is generally normal.

(3) Moderate erectile dysfunction (II°)

Decreased libido, slower erectile response, frequent inability to maintain an erection, insufficient erection rigidity for vaginal penetration, diminished sexual pleasure, significantly reduced frequency of intercourse, and weak erectile response during masturbation.

(4) Severe erectile dysfunction (III degrees)

Sexual desire disappears, erectile response is absent, and there is no sustained penile erection, making vaginal penetration impossible and resulting in no sexual pleasure.

In addition, it is important to understand whether the onset of erectile dysfunction is sudden (often caused by psychological stress, classified as psychogenic erectile dysfunction) or gradually worsening (indicating potential organ damage or disease), in order to help identify the type. Grade I and II erectile dysfunction are primarily psychogenic, but may also be early stages of organic erectile dysfunction. Grade III is more commonly caused by organic factors. Erectile dysfunction caused by disease can also be influenced by psychological factors to varying degrees.

How to prevent erectile dysfunction

Popularizing sex education, correctly understanding the natural physiological function of sex, reducing anxiety about intercourse, eliminating unnecessary worries, and preventing psychogenic erectile dysfunction. Avoiding all types of sexual stimulation and abstaining from sexual activity for a period of time allows the sexual center and organs to regulate and rest, which is beneficial for willpower regulation and disease recovery. Actively treating any diseases that may cause erectile dysfunction, avoiding or discontinuing medications that may cause (or have been verified to cause) erectile dysfunction. The female partner should be understanding and considerate of the male partner, and should never blame or belittle him, helping him build confidence based on understanding and support, which is beneficial for mental well-being. Maintaining a cheerful mood, a calm and balanced lifestyle, paying attention to a reasonable diet, moderate exercise, quitting smoking and limiting alcohol consumption, and psychological balance are all important for strengthening the body and improving disease resistance. When erectile dysfunction occurs, the doctor should be informed of the entire disease and its progression to facilitate early treatment; concealing the condition is strictly prohibited.

Can sexually transmitted diseases cause erectile dysfunction?

Some men who have had sexually transmitted infections (STIs) often report developing erectile dysfunction as a result. One scenario involves being able to have intercourse, but with insufficient erection, shorter duration of intercourse, and less pleasure; another scenario involves being unable to achieve an erection, having a weak erection, or experiencing an erection that is too short to complete intercourse. So, does having an STI actually cause erectile dysfunction?

Generally, if a sexually transmitted disease (STD) is treated properly and cured, it will not cause erectile dysfunction. However, some people, due to a lack of prior knowledge about STDs, contract one and experience physical pain and mental stress. Even after recovery, the memory of the pain remains vivid, creating a heavy mental burden and causing anxiety, self-blame, and guilt. Coupled with criticism from their wives or societal discrimination, fear of the infection entering their reproductive organs, the worry of transmitting the toxin to their wives through sexual intercourse, and reluctance to have sex, they develop psychogenic erectile dysfunction, which can lead to a decline in morale and worsen their erectile dysfunction.

In fact, most sexually transmitted diseases (STDs) are completely curable if treated promptly and systematically at a reputable specialist hospital. From a physiological perspective, they do not affect sexual function or cause erectile dysfunction. Furthermore, it's crucial to have the right mindset, correct unhealthy sexual behaviors, and gain the understanding and sympathy of one's partner. This will remove the burden, bring peace of mind, and naturally lead to a fulfilling sex life. However, a small number of patients with STDs seek treatment haphazardly, use medications indiscriminately, or ignore the condition while indulging in excessive sexual activity, leading to a worsening of the infection and causing conditions such as epididymitis, prostatitis, seminal vesiculitis, balanitis, and fistula formation. These conditions severely affect sexual function and can cause erectile dysfunction. Some STDs still lack a complete cure, and erectile dysfunction can naturally occur in the later stages of these stubborn STDs.