Vasculogenic Erectile Dysfunction: What It Is and How to Treat It

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Vasculogenic Erectile Dysfunction: What It Is and How to Treat It

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Vasculogenic erectile dysfunction occurs as a result of circulatory problems and may precede heart disease.

Vascular erectile dysfunction is associated with preventable cardiovascular risk factors.

This condition may be linked to an increased cardiovascular risk, as described in scientific studies, especially when other metabolic risk factors are also present.

Learn more about the vascular causes of erectile dysfunction.

What is vasculogenic erectile dysfunction

Vasculogenic erectile dysfunction is caused by changes in penile blood flow.

According to an article published in the American Journal of Medicine, 80% of erectile dysfunction cases have an organic origin and affect 15% of men between 40 and 49 years of age.

Reduced testosterone levels, neurological problems, the use of certain medications and vascular issues are among the main causes.

According to the authors, vasculogenic erectile dysfunction is currently considered the main cause of organic erectile dysfunction.

They highlight smoking as one of the factors that impair blood circulation in the penis, since the toxic substances in cigarettes damage the arteries, hinder blood flow and may result in insufficient penile rigidity.

Causes and risk factors

Heart disease is a risk factor for vasculogenic erectile dysfunction, as are unhealthy habits, older age and the use of certain medications.

Below, learn more about cardiovascular health and impotence.

1. Atherosclerosis

Atherosclerosis is the build-up of fat inside the arteries that causes them to clog and compromises blood circulation throughout the body.

This reduces penile blood flow and can make it more difficult to achieve or maintain a healthy erection.

2. Hypertension, diabetes and high cholesterol

Hypertension, diabetes and high cholesterol increase the risk of vasculogenic erectile dysfunction, because they make blood vessels narrower and stiffer, interfering with adequate blood flow.

In addition to these vascular changes, diabetes may also damage the nerves involved in sexual function.

This is why regular medical follow-up and adherence to treatment are so important to keep these conditions under control.

3. Smoking and physical inactivity

Smoking interferes with the relationship between nitric oxide and erection. Nitric oxide is a substance that relaxes and dilates blood vessels, facilitating blood circulation.

When the body produces less nitric oxide, cavernous blood flow can be impaired, which makes the erection process more difficult.

If smoking is associated with a sedentary lifestyle, the impact on erectile function may be even greater.

Lack of exercise lowers testosterone levels and makes blood vessels less elastic, which also affects circulation.

Physical inactivity may further reduce testosterone levels, a hormone that plays an important role in male sexual function.

4. Obesity and metabolic syndrome

Obesity is a risk condition for erectile dysfunction because it is associated with high blood pressure and abnormal cholesterol — findings that characterize metabolic syndrome.

These conditions may contribute to reduced penile blood flow, which can make the erection process more difficult in some men.

5. Advanced age and endothelial dysfunction

Aging may be accompanied by erection difficulties due to decreased testosterone levels, cardiovascular disease and even the use of medications.

Another issue that may appear over the years is endothelial dysfunction.

Endothelial dysfunction results from low levels of nitric oxide in the vessel walls.

This condition makes blood vessels narrower, which increases the risk of cardiovascular disease and may contribute to vasculogenic erectile dysfunction.

6. Long-term use of certain medications (antidepressants, antihypertensives)

Antidepressants and antihypertensive drugs may trigger or worsen vasculogenic erectile dysfunction in some patients.

Antidepressants tend to affect neurotransmitters associated with sexual desire and response.

This may reduce the ability of blood to reach and remain in the penis, resulting in insufficient penile rigidity.

In the case of blood pressure medications, the vasodilation and relaxation they promote can reduce penile blood flow.

Symptoms and when to suspect vasculogenic erectile dysfunction

Below are some signs that may indicate you are dealing with a weak erection:

Infographic explaining the symptoms of vasculogenic erectile dysfunction.

Infographic explaining the symptoms of vasculogenic erectile dysfunction

Diagnosis of vasculogenic erectile dysfunction

The diagnosis of erectile dysfunction is essential to identify the cause and guide the most appropriate treatment. See how it is usually performed:

  • Clinical examination and detailed medical history: during the consultation, the urologist examines the patient to identify anatomical changes and reviews the medical history.
  • Penile Doppler ultrasound with pharmacologic stimulation: the penile Doppler ultrasound is an imaging test in which a medication induces erection to assess penile blood flow.
  • Hormone level assessment: blood tests to measure sex hormones and prolactin levels may also be requested when investigating vasculogenic erectile dysfunction.
  • Additional cardiovascular tests: because cardiovascular disease is a risk factor, the doctor may also request tests to screen for diabetes and hypertension.

 

Infographic with tests for the diagnosis of vasculogenic erectile dysfunction

Infographic with tests for the diagnosis of vasculogenic erectile dysfunction

Treatment of vasculogenic erectile dysfunction

The treatment of vasculogenic erectile dysfunction is defined according to the degree of compromise of erectile function and the associated conditions. See the main options:

  • Lifestyle changes: balanced diet and regular exercise to help maintain adequate weight, blood pressure control and good glycemic control.
  • Medication therapy: use of phosphodiesterase type 5 inhibitors, such as sildenafil and tadalafil, when indicated by the physician.
  • Shock wave therapy: in selected cases and under medical guidance, shock wave therapy may be used as a complementary approach.
  • Injectable treatments: some vasoactive therapies may be prescribed by a specialized urologist, when appropriate, after individual evaluation.
  • Penile revascularization: penile revascularization is a surgical procedure that aims to improve penile circulation in carefully selected cases, usually in younger men with good urological and vascular status.

Infographic with treatment options for vasculogenic erectile dysfunction

Infographic with treatment options for vasculogenic erectile dysfunction

Frequently asked questions

What is vasculogenic erectile dysfunction?

It is the difficulty in maintaining a firm erection due to inadequate blood circulation in the corpora cavernosa of the penis.

How is vascular erectile dysfunction treated?

Treatment options may include medications, vascular therapies and, in advanced cases, penile prosthesis implantation, always according to medical evaluation.

How can penile vascularization be improved?

Through healthy eating, regular physical activity, cholesterol control and ongoing medical follow-up.

Which vitamins support cavernous blood flow?

Vitamins C, E and B-complex, as well as zinc and L-arginine, may contribute to overall vascular health.

Questions about vasculogenic erectile dysfunction? Contact Dr. Paulo Egydio

Vasculogenic erectile dysfunction requires evaluation of the underlying cause and individualized therapeutic strategies focused on erectile health.

Dr. Paulo Egydio is a urologist with more than 25 years of experience in men’s health and sexual medicine.

If you wish, you can fill out the pre-assessment form so that our team can contact you with general information and guidance.

Paulo Egydio, M.D.

PhD in Urology from USP, CRM 67482-SP, RQE 19514, Author of Geometric Principles (known as “Egydio Technique”), as well as other articles and scientific books in the area. Guest professor to teach classes and live surgeries at conferences in Brazil and abroad.

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