Causes of and treatments for erectile dysfunction

Erectile dysfunction, or impotence, is the most commonly reported sexual problem for men and has a significant impact on the quality of life and well-being of the patient. Erectile dysfunction is defined as the inability to maintain a penile erection for successful sexual intercourse. Erectile dysfunction mainly affects men above 40 years of age, although up to 30% of men younger than 40 years are estimated to suffer from occasional or chronic erectile dysfunction.

Male sexual arousal is a very complex process that involves the brain, hormones, emotions, muscles, nerves and blood vessels, and a problem in any of these may be enough to cause erectile dysfunction. Hence, this condition can be caused by several physical disorders, such as cardiovascular disease, hypertension, diabetes and obesity; or emotional disorders like stress, depression, anxiety or relationship problems. Lifestyle factors can also facilitate the onset of impotence, mainly drug or alcohol abuse, smoking or lack of physical exercise. Erectile dysfunction may also be the consequence of damage caused by surgery, namely radical prostatectomies to treat prostate cancer, or the side effect of common medications such as anti-hypertensives, non-steroidal anti-inflammatory drugs and antacids.

Several treatments for erectile dysfunction are available today, including medication, surgery and non-surgical aids. Mechanical treatments include penile implants, where inflatable or maleable implants are inserted surgically into both sides of the penis. There are also external aids, such as penile prostheses, penile sleeves, penile support devices and vacuum erection devices, or penis pumps, which create a vacuum to pull blood into the penis.

The most popular treatment for impotence is phosphodiesterase type 5 inhibitors, such as sildenafil (also known as Viagra), tadalafil (Cialis), and vardenafil (Levitra). These medications facilitate the relaxation of the penile muscles, increasing blood flow and allowing penile erection. However, recent studies suggest that these oral therapies may increase the risk of melanoma or the recurrence of prostate cancer after radical prostatectomy. Other medicated treatments for this condition include alprostadil, a vasodilator that increases blood flow into the corpus cavernosum of the penis.  It is administered directly into the penis by injection or with a urethral suppository. Testosterone administration is also an option when the patient has low levels of this hormone.

Stem Cells – Can They Help Improve Your Sexual Health?

Umbilical cord stem cells, obtained from the umbilical cords of healthy newborn babies, are known to have a great capability for self-renewal and for being able to differentiate into different types of cells, making them excellent candidates for repairing different types of tissues. Because of these qualities, umbilical cord stem cells have been proposed as a possible solution for erectile dysfunction. They have been studied in animal models for addressing different types of impotence, including bilateral cavernous nerve injury or diabetes and obesity-associated erectile dysfunction, and were shown to successfully improve erectile function. Umbilical cord blood stem cells have likewise shown positive effects on diabetes-associated erectile dysfunction in humans. These encouraging results suggest that umbilical cord stem cells could be a good alternative for addressing erectile dysfunction, and several clinical trials are ongoing with positive results.

Resources:

Shamloul, R; Ghanem, H. 2013. Erectile dysfunction. Lancet 381(9861):153-65.

Zhu, JQLu, HKCui, ZQWang, YCLi, YHZhao, WFu, QXu, YMXu, YSong, LJ. 2015. Therapeutic potential of human umbilical cord blood mesenchymal stem cells on erectile functionin rats with cavernous nerve injury. Biotechnol Lett. 37(7):1515-25.

Nguyen, HMT; Gabrielson, AT; Hellstrom, WJG. 2017. Erectile Dysfunction in Young Men-A Review of the Prevalence and Risk Factors. Sex Med Rev. 5(4):508-520.

Yiou, R. Stem-cell therapy for erectile dysfunction. 2017. Biomed Mater Eng. 28(s1):S81-S85.

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