Vasculogenic conditions

This refers to diseases or disorders of the vascular system. The vascular or circulatory system is comprised of a network of veins arteries, veins and blood vessels: these enable blood to be circulated around the body.

But there a number of vasculogenic conditions which affect this blood flow, either by weakening or causing a blockage in these blood vessels. This results in damage to the part of the body which is supplied by these blood vessels.

Examples of vascular conditions include:

  • High blood pressure
  • Diabetes
  • Heart disease
  • Arteriosclerosis
  • Kidney disease

These cause a range of symptoms which include impotence.

High blood pressure

High blood pressure or hypertension occurs when excessive force is applied to the artery walls as blood flows through them. Blood pressure rises when we are stressed, anxious or after exercise but returns to normal afterwards. But if this remains above normal, even at rest then it is classed as high blood pressure.

Uncontrolled high blood pressure can cause serious health problems which include stroke, heart disease, kidney failure and erectile dysfunction.

High blood pressure damages the arteries to the penis which causes them to narrow over time. This restricts blood flow to the penis which impairs the ability to achieve or sustain an erection.

Treatment for high blood pressure involves taking medication on a regular basis and making a few lifestyle changes, e.g. reducing salt intake.

However, there is concern about impotence as a side effect of certain forms of medication, for example beta blockers and diuretics. These are effective at controlling high blood pressure but they do have side effects although these do not occur in every patient. Erectile dysfunction is one possible side effect although this uncommon. If you experience problems with erections as a result of your medication then speak to your GP. He or she will change your dosage or recommend an alternative.


This occurs when the body is unable to produce any insulin or cannot regulate the amount of insulin that is already present. This results in either Type 1 or Type 2 diabetes.

High blood sugar levels over a long period of time can cause serious health problems which include hardening of the arteries, kidney failure, nerve damage and impotence. These and other conditions depend upon how high someone’s blood sugar levels are.

The nearer your blood sugar levels is to normal the less likely you are to develop these conditions.

High blood sugar levels can, over time, damage the nerves and blood vessels which supply blood to the penis. This prevents an erection.

So, even if you have a healthy libido and normal amounts of testosterone you may not be able to achieve or sustain an erection due to this damage.

There is a strong correlation between erectile dysfunction and diabetes. Around 50% of diabetic men experience this and/or other sexual problems as a result of their diabetes.


Heart disease

Heart disease is one of the leading causes of death in the UK and other parts of the world.

Heart disease is used as an umbrella term to describe a range of diseases which include arteriosclerosis/atherosclerosis, left ventricular hypertrophy (enlarged heart), cardiomyopathy and valvular heart disease.

Arteriosclerosis is discussed separately.

Basically, any condition which causes the arteries to become weakened and restricts blood flow through them is likely to trigger a form of heart disease as well as erectile dysfunction.

That’s correct. Erectile dysfunction is a warning sign of heart disease and both of these are caused by the same problem “ a build up of fatty deposits (called ‘ plaques’) within the arteries which cause them to narrow and harden. This is known as atherosclerosis ( ‘ furring of the arteries’).

This obstructs blood flow to various areas of the body which include the brain, heart and penis. Although the arteries which supply blood to the penis are smaller than those which supply the heart, early signs of atherosclerosis may present as erectile dysfunction.

Athesclerosis is a warning sign for other disease such as peripheral artery disease, stroke and aneurysm.

How is erectile dysfunction a precursor of heart disease?

The main reason is a chemical called nitric oxide which is released during into the blood vessels of the penis during an erection. This causes them to expand which enlarges and stiffens the penis.

Nitric oxide is released by the inner lining of these blood vessels “ the endothelium. The endothelium (layer of flat cells) lines the inside of all blood vessels within the body. This helps to regulate blood flow within these vessels.

But, nitric oxide also acts as an ‘ anti-arteriosclerotic’ drug which means that it prevents these vessels from hardening, thereby preventing the risk of arteriosclerosis.

Erectile dysfunction can be caused by low levels of nitric oxide which also indicates that blood vessels are not working as normal in other parts of the body. In other words, narrowed arteries within the penis suggest that there are narrowed arteries in other parts of the body, e.g. those which supply the heart.

This is why erectile dysfunction is seen as a warning of heart problems such as cardiovascular disease.


This is the medical name for hardening of the arteries. It is caused by a variety of factors which include high blood pressure, diabetes, smoking and high cholesterol.

Hardening of the arteries occurs over a long period of time which is why it tends to appear in middle age. The arteries thicken and lose their elasticity which can lead to serious health conditions such as heart disease or stroke.

If this hardening occurs in the arteries within the arms and legs it is called peripheral vascular disease. But it can also develop in the smaller arteries which supply blood to the penis which affects the man’s ability to get an erection. This is known as impotence or erectile dysfunction.

Treatment involves certain lifestyle changes such as eating a low fat diet, taking exercise and stopping smoking (if applicable). Medication will be prescribed which helps to widen the arteries and enable blood to flow through as normal.

Kidney disease

Kidney disease is defined as a loss of function over a period of time which can lead to chronic kidney failure. Basically, the kidneys are less capable of filtering out urine and other fluids from the blood which are normally diverted to the bladder for excretion. In some cases, protein is present in the urine which is an indication of kidney disease.

Kidney disease can cause a range of sexual problems which include a loss of libido, failure to ejaculate and erectile dysfunction.

Men with kidney disease find that they are unable to sustain an erection for as long as they are used to. Eventually, they lose the ability to achieve an erection at all which is both upsetting and frustrating.

This impotence is caused by a variety of factors related to kidney disease which include leaking blood vessels within the penis, hormonal imbalance, excess tiredness caused by anaemia and the stress of dialysis.

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