What Causes Erectile Dysfunction in Men?

Generally, erectile dysfunction (ED) in men may result from psychological stress, excessive fatigue, diabetic peripheral neuropathy, atherosclerosis, or venogenic ED. If symptoms persist, it is recommended to consult a urologist at a reputable hospital. A detailed analysis follows:

1. Psychological Stress

Negative emotions such as tension and anxiety inhibit the brain’s erection center and reduce sympathetic nervous system excitatory signaling, thereby impeding relaxation of the smooth muscle in the corpora cavernosa. Adjusting daily routines, enhancing communication with one’s partner, practicing relaxation techniques, and consulting a psychologist when necessary are advised.

2. Excessive Fatigue

Chronic sleep deprivation or physical exhaustion lowers testosterone secretion and impairs nitric oxide synthase activity, reducing vasodilation capacity in the corpora cavernosa. Ensure seven hours of high-quality sleep per day, manage work intensity appropriately, and engage in moderate aerobic exercise.

3. Diabetic Peripheral Neuropathy

Prolonged hyperglycemia damages pudendal and autonomic nerve fibers, disrupting acetylcholine release from nerve terminals and decreasing blood perfusion to the corpora cavernosa. Strict glycemic control is essential; medications such as sildenafil citrate tablets, tadalafil tablets, and vardenafil hydrochloride tablets should be taken as prescribed. Alpha-lipoic acid capsules may be used concurrently to support nerve health.

4. Atherosclerosis

Lipid plaque deposition in the internal iliac artery or dorsal penile artery narrows the lumen, increasing vascular resistance and reducing peak arterial flow velocity during erection. Lipid-lowering and anticoagulant therapy is required: atorvastatin calcium tablets, enteric-coated aspirin tablets, and cilostazol tablets should be taken per medical advice. Smoking cessation and a low-fat diet are also critical.

5. Venogenic Erectile Dysfunction

Dysfunction of the tunica albuginea or dorsal vein valves leads to incomplete venous occlusion after erection, allowing excessive blood leakage via the deep dorsal vein of the penis and preventing maintenance of sufficient rigidity. Surgical options include deep dorsal vein ligation or cavernosal venous repair, followed by vacuum-assisted rehabilitation training postoperatively.

Routine monitoring of blood glucose and lipid levels is essential. Prolonged sitting and straddle injuries should be avoided. Pelvic floor muscle exercises should be performed regularly, and body mass index (BMI) should be maintained below 24.