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Source: Lee M. Erectile Dysfunction. In: DiPiro, JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach. 8th edition. Accessed July 10, 2012.

  • Impotence

  • Failure to achieve penile erection suitable for sexual intercourse

  • Abnormality in system necessary for penile erection
    • Organic erectile dysfunction (ED): Vascular, nervous, or hormonal systems—80% of patients
    • Psychogenic ED: Psychological etiology

  • Interconnected sinuses in two corpora cavernosa in penis fill with blood to produce erection.
  • Acetylcholine works with other neurotransmitters (i.e., cyclic guanylate monophosphate, cyclic adenosine monophosphate, and vasoactive intestinal polypeptide) to produce penile arterial vasodilation and ultimately erection.
  • Organic ED associated with diseases that:
    • Compromise vascular flow to corpora cavernosum (e.g., peripheral vascular disease, arteriosclerosis, and essential hypertension)
    • Impair nerve conduction to brain (e.g., spinal cord injury and stroke)
    • Impair peripheral nerve conduction (e.g., diabetes mellitus)
  • Secondary ED associated with hypogonadism.
  • Psychogenic ED associated with:
    • Malaise
    • Reactive depression
    • Performance anxiety
    • Sedation
    • Alzheimer’s disease
    • Hypothyroidism
    • Mental disorders
  • Social habits (e.g., cigarette smoking and excessive ethanol intake) and medications (Table 1) can also cause ED

Table 1. Medication Classes that Can Cause Erectile Dysfunction

  • Incidence increases as men age
  • Often associated with concurrent medical conditions
    • Diabetes mellitus
    • Hypertension—medications may contribute to ED
    • Arteriosclerosis
    • Hyperlipidemia
    • Psychiatric disorders

  • Peripheral ...

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