Excellent article by Tom F. Lue on psychogenic ED
Posted: Fri Jan 24, 2020 4:08 pm
Thanks to Mattbg7, I came across this wonderful article by top urologist Tom F. Lue on psychogenic ED:
http://tau.amegroups.com/article/view/9503/10291
This confirmed much of what I said previously about sexual performance anxiety and the role of the sympathetic nervous system, as well as the efficacy of alpha blockers in the treatment of ED.
What has been excluded entirely from all recent discussions of ED in young men is a concept presented many years ago—the concept of increased sympathetic tone as an organic etiology of “psychogenic” erectile dysfunction in young men
the stimulation of sympathetic nerves or systemic infusion of epinephrine causes detumescence of the erect penis
Multiple authors have demonstrated that anxiety, depression, and stress clearly produce major neurochemical and neuroendocrine changes in the brain (10,11). Changes in neurobiology would be expected to contribute to impaired erectile function. Stress and anxiety lead to increased epinephrine production, and heightened sympathetic tone leads to exaggerated cavernosal smooth muscle contraction, inability of smooth muscle to relax, and subsequent erectile dysfunction (6,7). Failure to achieve a fully rigid erection may aggravate performance anxiety leading to a vicious cycle.
http://tau.amegroups.com/article/view/9503/10291
This confirmed much of what I said previously about sexual performance anxiety and the role of the sympathetic nervous system, as well as the efficacy of alpha blockers in the treatment of ED.
What has been excluded entirely from all recent discussions of ED in young men is a concept presented many years ago—the concept of increased sympathetic tone as an organic etiology of “psychogenic” erectile dysfunction in young men
the stimulation of sympathetic nerves or systemic infusion of epinephrine causes detumescence of the erect penis
Multiple authors have demonstrated that anxiety, depression, and stress clearly produce major neurochemical and neuroendocrine changes in the brain (10,11). Changes in neurobiology would be expected to contribute to impaired erectile function. Stress and anxiety lead to increased epinephrine production, and heightened sympathetic tone leads to exaggerated cavernosal smooth muscle contraction, inability of smooth muscle to relax, and subsequent erectile dysfunction (6,7). Failure to achieve a fully rigid erection may aggravate performance anxiety leading to a vicious cycle.