The role of ethanol, while classically thought to impede erectile function, has been less clear in the literature. Despite the association of alcohol consumption and sexual activity, very little objective evidence exists on the effect of acute ethanol intoxication on erectile function. The data on chronic ethanol exposure is also mixed. Ethanol exposure in an animal model showed histologic evidence of both endothelial damage and metabolicdysfunction.

Impairment of smooth muscle relaxation due to endothelial dysfunction was pronounced while neurogenic smooth muscle relaxation remained intact. Age and Chronic Illness There is no consensus as to whether ED is a nonpathologic, natural aspect of aging in healthy males, though older males do have higher rates of ED. The association between naturally declining testosterone level in older males, socalled andropause, and ED, is complex, but no clear association is found to date.

Interestingly, penile vibrotactile sensation of the penis decreases significantly with age, but this has not been directly linked with ED.

Approximately 82% of men with chronic renal failure (CRF) on hemodialysis have some degree of erectile function, with 45% having severe ED. Additionally, regardless of treatment, patient with CRF have significantly decreased mean nocturnal penile tumescence when compared to both normal and chronically ill controls. The pathophysiology of ED in patients with CRF is complex. A majority of men with CRF have hyperprolactinemia. Uremia also interferes with the HPA such that oligospermia, azoospermia, and impaired steriodogenesis with elevations in LH are common in uremic men.

Zinc deficiency has also been postulated as a potential cause of ED in uremic men and has been targeted for possible therapeutic interventions.

Comments are closed.