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Erectile Dysfunction or Impotence
Causes of Impotence, Part I When the precise sequence of events in the physiology of erection is disrupted, one experiences ED. Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of ED. Reduced blood flow to the penis and nerve damage are the most common physical causes of ED. Diabetes Mellitus Chronic high levels of blood sugar associated with diabetes mellitus often damage small blood vessels and nerves throughout the body, which can impair nerve impulses and blood flow necessary for erection. About 60% of men with diabetes experience impotence. Drugs Long-term use of alcohol and illicit drugs may affect the vascular and nervous systems and are associated with erectile dysfunction. Over 200 commonly prescribed drugs are known to cause or contribute to impotence, including drugs for high blood pressure, heart medications, antidepressants, tranquilizers, and sedatives. A number of over-the-counter medications also can lead to impotence. Surgery and Radiation Therapy Trauma to the pelvic region or spinal cord can damage veins and nerves needed for erection. Surgery of the colon, prostate, bladder, or rectum may damage the nerves and blood vessels involved in erection. Prostate and bladder cancer surgery often require removing tissue and nerves surrounding a tumor, which increases the risk for impotence. Temporary impotence is also associated with these procedures, even those in which nerve-sparing techniques were used. Vascular Disease Arteriosclerosis, the hardening and narrowing of the arteries, causes a reduction in blood flow throughout the body and can lead to impotence, is associated with age and accounts for 50% to 60% of impotence in men over 60. Risk factors for arteriosclerosis include Diabetes mellitus, High Blood pressure and High Cholesterol. Smoking, which can lead to any of the above risk factors, is perhaps the most significant risk factor for impotence related to arteriosclerosis. For more causes of Erectile Dysfunction, see the next page.
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