What causes inability to have an erection?

Erectile dysfunction may be caused by psychological stress, vascular disease, hormone imbalance, nerve damage, drug side effects, etc.

1. Psychological pressure:

Chronic anxiety, depression, or partner tension can inhibit the conduction of sexual arousal. Excessive work pressure may cause sympathetic nerve overactivity, resulting in the inability of the smooth muscles of the corpus cavernosum to fully relax. Some patients have post-traumatic stress disorder from sexual experiences, which manifests as normal morning erections but the inability to maintain erection during sex.

2. Vascular disease:

Atherosclerosis reduces penile blood perfusion, and diabetes-induced microvascular disease can lead to impaired endothelial cell function. In patients with hypertension, the elasticity of blood vessels decreases, and the cavernous sinus of the penis cannot be effectively filled with blood. Such patients are usually accompanied by peripheral vascular symptoms such as chills in the lower limbs and pain in the lower limbs after exercise.

3. Hormone imbalance:

Testosterone levels below 300ng/dl will affect sexual desire and erection quality, and the increase in prolactin caused by pituitary tumors will inhibit the function of the hypothalamic-gonadal axis. Patients with hypothyroidism have a reduced metabolic rate and may experience decreased sexual desire and delayed erection initiation, often accompanied by systemic symptoms such as fatigue and intolerance to cold.

4. Nerve damage:

Compression of the sacral nerve plexus by lumbar disc herniation will affect the erectile reflex arc, and damage to the nerve myelin in patients with multiple sclerosis may lead to signal conduction disorders. Pelvic surgery such as radical resection for rectal cancer may damage the pelvic nerves, and these patients are often accompanied by urinary dysfunction.

5. Drug side effects:

Antidepressants inhibit sexual function through the serotonin system, and beta-blockers in antihypertensive medications reduce blood flow to the penis. Long-term use of proton pump inhibitors may reduce testosterone levels, and some allergy medications have anticholinergic effects that interfere with erectile neurotransmitter release.

It is recommended to increase the intake of arginine-rich foods such as deep-sea fish and nuts, and to perform aerobic exercise such as brisk walking and swimming regularly to improve vascular endothelial function. Avoid staying up late and excessive drinking, and smokers should quit smoking as soon as possible to reduce blood vessel damage. Strengthen emotional communication between partners, and conduct behavioral therapy under the guidance of a doctor if necessary. Men over 40 years old are recommended to test fasting blood sugar and testosterone levels every year. If there are three high symptoms, underlying diseases must be controlled simultaneously.