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Erectile Dysfunction (ED)

Vascular, Neurogenic, Endocrine, and Psychogenic Causes

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Erectile Dysfunction (ED)?

ED is the persistent (>3 months) inability to attain or maintain penile erection sufficient for satisfactory sexual performance.

Causes are multifactorial: vascular (endothelial dysfunction, atherosclerosis), neurogenic (pelvic surgery, diabetes, MS), endocrine (hypogonadism), and psychogenic.

ED is an early sentinel of systemic atherosclerosis, often preceding coronary events by 3-5 years.

Evaluation includes medical and sexual history, testosterone, glycemic, lipid profile, and cardiovascular risk assessment.

Symptoms

Difficulty obtaining an erection
Inability to maintain erection for intercourse
Reduced erection rigidity
Decreased libido with associated hypogonadism
Loss of morning erections (vascular/endocrine)
Performance anxiety and relationship distress

Risk Factors

Cardiovascular disease, hypertension, and atherosclerosis
Diabetes mellitus and metabolic syndrome
Smoking, obesity, and sedentary lifestyle
Pelvic surgery (radical prostatectomy, cystectomy) or radiation
Hypogonadism, hyperprolactinemia, thyroid disease
Medications (antihypertensives, antidepressants, anti-androgens) and substance use

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent ED for more than 3 months
  • ED with chest pain, exertional dyspnea, or other cardiac symptoms
  • Sudden-onset ED after pelvic surgery, trauma, or new medication

Treatment Methods

01
Lifestyle: smoking cessation, weight loss, exercise, and glycemic/BP control
02
PDE5 inhibitors (sildenafil, tadalafil, vardenafil) as first-line oral therapy (nitrate use is contraindicated)
03
Testosterone replacement only in confirmed hypogonadism with low free testosterone and symptoms
04
Intracavernosal injection (alprostadil, combinations) or intraurethral alprostadil for non-responders
05
Vacuum erection device and constriction ring as non-pharmacologic alternative
06
Penile prosthesis implantation for refractory ED with excellent satisfaction rates

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Üroloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.