They come in different flavors so you can choose your favorite
Common Causes and Contributors: From Vascular to Medication Effects When I assess ED, I use a structured framework: Vascular (vasculogenic) Atherosclerosis, endothelial dysfunction, impaired NO signaling Diabetes-related microvascular disease Hypertension-related vascular remodeling Neurogenic Peripheral neuropathy (diabetes, B12 deficiency, chemotherapy) Post-surgical or post-radiation nerve injury (e.g., radical prostatectomy) Spinal stenosis, discopathy, or pelvic nerve entrapment Hormonal Low testosterone (hypogonadism): impacts libido and PDE5 responsiveness Thyroid dysfunction, hyperprolactinemia, cortisol dysregulation Aromatization and unfavorable T:E2 ratios Psychogenic Depression, anxiety, relationship stress, sexual trauma history Performance anxiety and maladaptive autonomic patterns Drug-induced Antihypertensives (e.g., beta blockers, thiazides) SSRIs/SNRIs, antipsychotics Opioids and androgen suppression Iatrogenic and trauma-related Pelvic surgeries, radiation fibrosis Pelvic fractures, lumbar/pelvic injuries Lifestyle and sleep Sedentary behavior, obesity, poor diet, alcohol use Sleep apnea (major factor in testosterone and endothelial dysfunction) Biomechanics and pain Pelvic floor hypertonicity or dyssynergia SI joint dysfunction, lumbar facet syndromes, hip pathology This framework helps us prioritize diagnostics and personalize treatment
ArgovZBank WJMarisJEleffSKennawayNGOlsonREet al
A.SullivanK
