Erectile dysfunction – the inability of a man to achieve or maintain an erection that is sufficient for satisfying sexual performance – has deleterious effects on a man’s quality of life. Most patients with the disorder are depressed and/or have anxiety related to sexual performance.
These symptoms affect the partner and the quality of the relationship.
The erection has two aspects – one, which is a reflex. The other one is affected by the erotic or emotional use of the limbic system of the brain.
The reflex occurs when touch occurs on the penis. This part is under the control of the peripheral nerves and lower parts of the spinal cord.
Causes and Who Gets ED
Erectile dysfunction used to be considered a disorder that had psychological root causes. However, now it’s known that over 80% of cases have another cause that could be endocrine or non-endocrine in nature.
Of the non-endocrine causes, blood supply disorders are the most common cause. Ones affecting the nerves and others caused by medical or surgical treatments also are common.
The condition of erectile dysfunction has reached proportions of 52% in men over the age of 40. However, the percentage varies depending on the location of where the men live.
There’s a strong association between ED and urinary tract symptoms in men with benign prostatic hyperplasia (BPH). Under the age of 40, the percentage is about 22%.
ED has a high prevalence in those who have high blood pressure, heart and blood vessel disease, smoke cigarettes, are obese, have diabetes or metabolic syndrome, exhibit high levels of stress, anxiety, and depression.
Drugs That Cause Erectile Dysfunction
Several drugs are linked with this disorder:
- Luteinizing hormone-releasing agonists and antagonists to treat prostate cancer
- 5-alpha-reductase inhibitors that treat benign prostatic hyperplasia
- Thiazide diuretics
- spironolactone for high blood pressure
- tricyclic antidepressants
- selective serotonin reuptake inhibitors
- H2 blockers that are used for ulcers
The Presence of ED Means Other Health Problems Exist
One of the most important findings so far is that erectile dysfunction is an indication that there are other things happening in the body – specifically systemic endothelial dysfunction.
What this means is the inside of the arteries are affected throughout the entire body, in order for there to be erectile dysfunction.
How Do Researchers and Doctors Tell If A Man Has ED
Erectile dysfunction is rated according to an international index of erectile function questionnaire.
The rating goes from 1 to 25, and 1-7 is considered severe while 22-25 is no erectile dysfunction at all.
This rating scale is still used.
What’s Done Right Now For Erectile Dysfunction
Erectile dysfunction is a condition that until recently had no cure.
There are treatments to relieve the symptoms. These include lifestyle changes, medications, agents that can be injected which are vasodilators, and vacuum devices.
The lifestyle changes are usually ones that are heart friendly. This is as there’s a connection between ED and cardiovascular disease, as well as metabolic dysfunction.
Surgery is only used for patients that can’t use these non-surgical interventions and those with fibrosis of the penis or vascular insufficiency of the penis.
Where Erectile Dysfunction is Headed
The future of sexual medicine lies in regenerative medicine, which is the use of stem cells for the treatment of sexual disorders
One of the most recent medical studies showed that men with severe type 2 diabetes and erectile dysfunction benefited greatly from human umbilical cord blood stem cells.
Although the effects were short-lived, there are seven new stem cell trials that have been registered as large Phase 1-III studies and doctors are awaiting the results.
Between March 2012 and November 2013 stem cell treatment for erectile dysfunction articles hit the medical journals.
More studies appeared in this time frame than for the last 8 years combined, reported Chinese doctors.
At that time researchers were trying different approaches to see what would work the best. Here are the results:
- The doctors could use stem cells by themselves or combine them with the addition of proteins. Genes that stimulate the formation of new blood vessels or genes that cause the growth of the neurological cells derived from stem cells. Of all these types of treatments, the best one was still the single stem cell approach.
- Different types of ways to give the stem cells were also considered. The standard is the injection into the penis. All the new stem cell transplantation methods are more cumbersome and really don’t offer better outcomes so it’s best to stay with the standard method.
Animal studies since 2014 on show that mesenchymal stem cell transplantation works when there has been an injury to the intracavernous nerve that supplies the penis with nerve innervation.
The stem cells allow the production of new supportive cells in the area where the stem cells are injected.
They differentiate into smooth muscle, endothelium, and neurons.
Adipose tissue, which is fat tissue that contains stem cells has been found to be a realistic therapeutic modality for the treatment of erectile dysfunction.
If you have erectile dysfunction, your answer is soon to be found on the medical horizon and it’s without side effects.
Dr. Donna Schwontkowski received a Doctorate in Chiropractic Medicine (D.C.), from the National College of Chiropractic, Lombard, IL, in Dec. 1990. In addition to running a medical practice, Dr Donna has had a long and distinguished career as a medical teacher, both running courses at various universities and also as a published author of several books and as a television presenter on health issues.
Lin, C.S., et al. Stem-cell therapy for erectile dysfunction. Expert Opin Biol Ther 2013 Nov;13(11): 1585-97. https://www.ncbi.nlm.nih.gov/pubmed/24090162
Mangir, N., et al. Mesenchymal stem cell therapy in treatment of erectile dysfunction: autologous or allogeneic cell sources? Int J Urol 2014 Dec;21(12):1280-5. https://www.ncbi.nlm.nih.gov/pubmed/25074479
Gokce, A., et al. Adipose tissue-derived stem cells for the treatment of erectile dysfunction. Curr Urol Req 2016 Feb;17(2):14. https://www.ncbi.nlm.nih.gov/pubmed/26757908
Yafi, F., et al. Erectile dysfunction. Nat Rev Dis Primers. 2016;2:16003. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027992/
About Dr. Donna Schwontkowski
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