ED can be experienced when there are problems with the nerves that are responsible for erections. The nerves are signal carriers, relaying information from the brain to the penile arteries. Alerted, the blood vessels open, allowing enough blood to rush in to cause hardness. If, however, there is a problem with these nerves, either from spinal cord, brain, prostate, or groin injuries, the messages aren’t transmitted correctly. The outcome is an impaired erection—or none at all.

The major nerve problem is produced by diabetes mellitus, a chronic disorder usually caused by a deficient secretion of insulin, the hormonal substance manufactured by the endocrine glands in the pancreas. It is now estimated that the prevalence of ED in men with diabetes is between 35 percent and 75 percent. More than half of them notice the first onset of ED within ten years of developing the disease.

Genetic predisposition, along with obesity, are the most significant factors known to trigger diabetes. In either case, the condition adveresely affects the nerves, making it progressively more difficult for nerve impulses to reach the penis. In some cases, diabetes delivers a double threat: it can also damage blood vessels, causing them to become blocked and interrupt blood flow to the penis.

Multiple sclerosis, a progressive nervous system disorder, and Parkinson’s disease, a degenerative brain syndrome, also create neurological disturbances that can lead to ED. Other nerve disruptions can be brought on by back surgery, as well as disk herniation in the lower back (If a patient tells me his erections were normal before sustaining a back injury, I immediately suspect nerve damage.) Other sources include cancer surgery or any radiation therapy on the pelvic area. If the prostate gland is removed, or an operation is performed to remove cancer in the lower rectum or colon, delicate nerves can also be damaged, leading to erection problems.

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