Old-fashioned beliefs suggested erectile dysfunction to be psychological in origin. While anxiety and stress are factors that can cause ED, scientific advances now provide proof that in a majority of cases, it is traced back to physical conditions which interrupt nerve functioning and restrict blood flow.¹ Diabetes, arthrosclerosis, cardiovascular conditions, as well as some types of prostate disease and their treatments are responsible for most cases of ED.³ This article will focus on how prostate diseases have impacted erections and sexual activity.

Erection is a matter of synchronous body function, which fills the penile tissue with blood, allowing it to swell and stand erect. This process requires an orchestrated mechanism, lead by blood vessels, endocrine system, and the nervous system, and obviously, any interference can affect the quality of an erection.² Nitric oxide promotes vasodilatation while neurotransmitters such as norepinephrine and acetylcholine increase the production of chemicals such as guanosine monophosphate, prostaglandins, and polypeptides which initiate the erection process by shifting chemical gradients in the muscles and capillaries of the corpora cavernosa, which runs along the shaft, causing inflation and swelling of the penis.¹

It is important to understand how conditions such as prostate disease can interrupt the above mentioned process, leading to abnormal erections or inconsistency in the erectile functioning. It is also helpful to realize limited erections for one or two nights does not mean you have ED.

Prostate Cancer

Sudden and frequent erectile problems can be a symptom associated with prostate cancer, so a prostate-specific antigen, PSA test, accompanied by a rectal exam is performed to assess the situation.

Prostate surgery to remove tumors is often associated with the high risk of nerve damage or cardiovascular complications due to the site specificity of such surgeries. Many choose radical prostatectomy, which only 25% to 80% of men can regain their abilities to maintain any erection.¹ Patient’s medical background and the surgeon’s experience are often taken into consideration when evaluating the chances to regain sexual abilities after a surgical procedure.⁴ Rehabilitation takes up to eighteen months, and that alone takes away from the sexual functioning of men in many cases. Radiation therapy very often harms erectile mechanisms, as both the radiation beam and the radiation-emitting seeds implanted in the prostate can severe the nerve and the muscle cells.²

Hormone therapy is another treatment option which men with prostate cancer opt-in for, but such medication such as goserelin and leuprolide may also translate to ED symptoms, since interference in the endocrine system can greatly impact the erectile mechanism.⁶

Benign Prostate Hyperplasia

BPH is a non-cancerous enlargement of the prostate, which can greatly impact erectile and ejaculatory function. An enlarged prostate, does not lead to ED, rather some of the treatments used for this condition can lead to ED. Finasteride is an example of an anti-testosterone which is used to treat BPH, can cause reduction in libido, and in turn switch off the erectile engine in men. Transurethral resection, a surgical procedure used in the reduction of the prostate gland has also failed to skip ED as one of its side-effects.⁶

Prostatis

Simply known as the inflammation of the prostate gland, prostitis can be acute, or chronic, which is either caused by an infectious agent or not respectively, can trigger ED in many men. Aside from pain, frequent urination, and discharge from the penis, this condition can directly cause ED. It can also be accompanied by painful ejaculation and lack of sexual pleasure for men. The infection can clear in several weeks if treated, but the chronic form can be a permanent problem for some men.⁷

However, there is no need to panic. Every failed attempt to maintain an erection is not ED. When the male genitals don’t get hard enough, or it loses the rigidity and softens soon after an erection, there might be some speculations about ED. It might take longer to get an erection, and in other occasions, the erection might not be as firm or last as long. With such conditions witnessed regularly, it would be time to contact your doctor, and figure out a way to stop this condition in its tracks. With all the new medical discoveries and pharmaceutical advances, a right solution for you might be easier to access than you might imagine.

Diagnosis Methods*

In order to confirm a case of erectile dysfunction, a visit to your primary care physician, urologist or ED specialist would be required. Below is a table from Harvard Health Publishing which summarizes the procedure followed by doctors for each possible cause of erectile dysfunction: