Erectile dysfunction (ED) is a common complaint in general medicine and urology consultations. The causes of ED are often mixed: they can be somatic (vascular, neurological, endocrine, tissue, iatrogenic) or psychogenic. Management usually involves reducing cardiovascular risk factors (FRCV), then vasodilator drug support by inhibiting phosphodiesterase 5.
In case of organic erectile dysfunction resistant to medical treatment, penile implants is a reliable, effective, and long-lasting third-line option. However, new findings around ED might change future treatment approaches.
COVID-19 Linked to Erectile Dysfunction
Getting infected with COVID-19 increases the risk of erectile dysfunction; if someone has it already, they could also be at risk of getting infected with Coronavirus.
The survey was conducted online in spring 2020 by Italian researchers. The percentage of men who reported having COVID and erectile dysfunction was 28 percent.
Their findings were published in Andrology.
Erectile dysfunction is often associated with other factors, such as hypertension, smoking, diabetes, and obesity, which also raise the risk of COVID and complications in men.
The association between Coronavirus and erectile dysfunction may take many months, if not years, of research to confirm. Still, the Italian research offers at minimum another reason to pay attention to Coronavirus.
The author of the study, Doctor Emmanuele A. Jannini, issued a serious warning: “mask up so you can keep it up.”
There Could Be Gene for Erectile Dysfunction
In the past, erectile dysfunctions were considered linked to overweight, smoking, or even hormonal problems, until now. According to the recent discovery by researchers published in the American Academy of Sciences (PNAS) proceedings, ED can also be caused by genetic variation.
By analyzing the data of 36,649 Californian patients, they indeed detected a specific place where a variation was linked to erectile dysfunction on the human DNA chain.
According to the results obtained, men with a copy of this mutated gene in their DNA have a 26% increased risk of having erection problems than the average population. And if they have two, the risk climbs to 59%.
These results were subsequently validated by studying a second database in the United Kingdom.
With more powerful and cost-effective methods to interrogate the genome, epigenome, transcriptome, and proteome, we expect the accelerated development of new biomarkers and drug targets for ED.
Although current understanding of the genetics of ED is limited, we foresee a therapeutic revolution for ED similar to findings in other disease processes such as diabetes, with the discovery of zinc transporter antagonists as a new treatment for type II diabetes.
Since their introduction, PDE5 inhibitors have remained the cornerstone of non-invasive therapies for erectile dysfunction, but an “omic” revolution is poised to change this paradigm.
Stem Cell Transplant is the Future of ED Therapy
Erectile dysfunction can be combated through stem cell therapy, a new therapeutic option that is still in the experimental stage.
Animal models have been used most often in published studies, but a case series has also been conducted with seven Korean men.
All the patients in this study, aged 57-87, had diabetes who received intracavernous stem cell injections from the umbilical cord. After six months of injections, six of the seven men had morning erections. There was no reported side effect.
Stem cell transplants are the future of medicine. There will need to be more human studies to demonstrate stem cell effectiveness in treating erectile dysfunction.
Excess Porn Harms Erections
By distributing a questionnaire to more than 300 women and men between the ages of 20 and 40 consulting in a urology clinic, doctors realized three surprising things.
First, 3.4 % of these men said they would rather masturbate while watching porn than having sex with a partner. Worrying, knowing that it was a population aged 20 to 40 years, three quarters consume X at least once a week (and at least three times a week for 40% of them).
Then a significant number of these X users encountered erectile dysfunction when they had a relationship with someone. “The rate of organic causes (physical cause, Editor’s note) of erectile dysfunction is extremely low at this age, underlines Dr. Mattew Christman, one of the researchers who carried out the study, so we had to look for what could explain the increase observed in recent years in this group.”
And to add: “We think that pornography can be the explanation.” No disorder was noted among women who watched pornography (less than a third of the women surveyed).
The mechanism of porn addiction was already known to neuroscientists. In his book “All addicts!”, Professor David Linden, from Johns Hopkins University (United States), describes what happens in the brain when we look at pornographic images: “Male and female subjects show a strong activation of certain key elements of the pleasure circuit.”
Our brain loves it and wants more. “Internet pornography, in particular, is a super stimulant of this reward circuit, probably because of the possibility of instantly and uninterruptedly finding ever more sexually exciting images,” says Dr. Christman.
A study conducted among students and published in 2015 had already shown that the risk of suffering from a lack of libido dropped from 0% for those who did not watch porn to 6% for those who consumed it less than once per week and 16% for those who watched more than once a week.
One explanation, supported by another Kinsey Institute study, is that heavy X users tend to seek out new stimuli and turn to unusual or extreme sexual practices, which would make sex “vanilla” (classic, Editor’s note) boring, even if it’s real sex (with a partner) and not lonely.
References
https://pubmed.ncbi.nlm.nih.gov/33742540/
http://www.pnas.org/content/early/2018/10/02/1809872115
https://www.researchgate.net/publication/44689905_Treatment_of_diabetic_impotence_with_umbilical_cord_blood_stem_cell_intracavernosal_transplant_Preliminary_report_of_7_cases
https://www.prnewswire.com/news-releases/results-vary-by-gender-on-whether-pornography-use-leads-to-sexual-dysfunction-300456647.html