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
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 |
|
Drug-Induced Erectile Dysfunction
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 |
|
|