Diabetes India - Causes and Classification of Erectile Dysfunction

Causes and Classification of Erectile Dysfunction

In most people with diabetes, problems with erection are due to nerve damage. All the same, it would be worthwhile to keep the other causes in mind especially the medications which can lead to erectile dysfunction. Sometimes, your doctor may just change the medication to another similar one which does not cause this problem. Which is also why you msut always tell your doctor the full list of medicines which you are taking, no matter how common these medicines may be and even if some other doctor has prescribed them for an associated condition.

Causes of Erectile Dysfunction
Psychologic causes Young age with abrupt onset associated with specific emotional event Dysfunction in certain settings while normal function in others Persistence of nocturnal erections Previous history of erectile dysfunction with spontaneous improvement Excessive life stressors--work, relationships Mental status findings suggestive of depression, psychosis or anxiety disorder. Penile injury/disease Peyronie's disease Priapism Anatomic abnormalities Medications	Aging Chronic disease Diabetes mellitus Heart disease Hypertension Lipid disorders Renal failure Liver disease Vascular disease Life style Cigarette smoking Chronic alcohol abuse Organic causes Vasculogenic--arterial Persistent interest in sex Older age with gradual onset Impaired function in all settings Presence of chronic disease (particularly diabetes, hypertension) Use of prescription/over-the-counter medications associated with erectile dysfunction. Smoking Elevated blood pressure, evidence of peripheral vascular disease (bruits, decreased pulses, skin and hair changes consistent with arterial insufficiency). Vasculogenic-venous Inability to maintain erection once established Prior history of priapism Local anomalies of thepenis.	Neurogenic History of spinal cord/pelvic trauma or surgery Presence of chronic disease (diabetes, alcoholism) Presence of neurologic condition (multiple sclerosis, stroke) Abnormal neurologic examination of genitals/perineum. Hormonal Loss of interest in sexual activity Small atrophic testis Low testosterone, elevated prolactin.

Causes of Erectile Dysfunction

Psychologic causes
Young age with abrupt onset associated with specific emotional event Dysfunction in certain settings while normal function in others Persistence of nocturnal erections Previous history of erectile dysfunction with spontaneous improvement Excessive life stressors--work, relationships Mental status findings suggestive of depression, psychosis or anxiety disorder.

Penile injury/disease
Peyronie's disease
Priapism
Anatomic abnormalities

Medications

Aging
Chronic disease
Diabetes mellitus
Heart disease
Hypertension
Lipid disorders
Renal failure
Liver disease
Vascular disease

Life style
Cigarette smoking
Chronic alcohol abuse

Organic causes
Vasculogenic--arterial
Persistent interest in sex Older age with gradual onset Impaired function in all settings Presence of chronic disease (particularly diabetes, hypertension) Use of prescription/over-the-counter medications associated with erectile dysfunction.

Smoking
Elevated blood pressure, evidence of peripheral vascular disease (bruits, decreased pulses, skin and hair changes consistent with arterial insufficiency).

Vasculogenic-venous
Inability to maintain erection once established
Prior history of priapism
Local anomalies of thepenis.

Neurogenic
History of spinal cord/pelvic trauma or surgery
Presence of chronic disease (diabetes, alcoholism)
Presence of neurologic condition (multiple sclerosis, stroke)
Abnormal neurologic examination of genitals/perineum.

Hormonal
Loss of interest in sexual activity
Small atrophic testis
Low testosterone, elevated prolactin.

The drugs may have a direct effect or may act indirectly through bringing about nerve, vascular or hormonal imbalance.

As many as 25 percent of cases of erectile dysfunction are related to medication side effects. If you are taking any of these drugs, please tell your doctor. At the same time, many patients only know their medications by their trade names, which is why it becomes so essential for you to tell the doctor all the medications you are on.

The list given below is only that of allopathic, or what is called by many as "Western" medicines. Many people with diabetes, tend to take herbal medications in the hope of "curing" diabetes. Even medicines given by those practicing alternative medicines such as homeopathy, ayurveda, unani branches of medications may have erectile dysfunction as their side effects. It would be much better to discontinue these medications under medical guidance as they may be unknowingly the reason for your erection problems! .

Drugs Causing Sexual Dysfunction
Drug/Drug Class	Possible Alternative
Antiarrhythmics Amiodarone Mexiletine	Procainamide
Anticonvulsants Carbamazepine Ethosuximide Phenytoin	Valproic acid
Antidepressants Amitriptyline Amoxapine Clomipramine Doxepin Maprotiline Protriptyline Trazodone	Imipramine Desipramine * Some patients who experienced sexual dysfunction with amoxapine and clomipramine were successfully switched to imipramine and desipramine, respectively.
Antihypertensives Atenolol Clonidine Hydralazine Labetolol Methyldopa Metoprolol Pindolol Prazosin Propranolol Verapamil Reserpine Guanethidine Penbutolol, Timolol	Captopril Enalapril Diltiazem Nifedipine
Antipsychotic Chlorpromazine Haloperidol Thioridazine Trifluoperazine	Loxapine
Antispasmodic Baclofen	Dantrolene
Diuretics Amiloride Indapamide Thiazide diuretics Spironolactone	Furosemide
Anti-Ulcer Cimetidine Ranitidine Metoclopramide	Famotidine
Antihyperlipidemic Clofibrate	Gemfibrozil
Non-Steroidal Anti-lnflammatory Naproxen Ibuprofen	Diclofenac

Causes and Classification of Erectile Dysfunction

Causes of Erectile Dysfunction

Drug-Induced Erectile Dysfunction

Drugs Causing Sexual Dysfunction

Drug/Drug Class

Possible Alternative