A cause deserving more research.

To state what should now be obvious: the causes of erectile dysfunction are many and varied. This makes it difficult for any physician to pinpoint the exact cause of your problem without performing an extensive range of tests. Unfortunately, this would be time-consuming and expensive. Thus, still wearing my physician's hat, we have to look at the most likely possibilities given your medical profile and concentrate our efforts on those areas. Only when we have eliminated the most common, should we begin spending money on the less common.

In balancing cost-effectiveness against your safety, there's one thing we never overlook. Assuming we can rule out heart disease or another condition where it might be dangerous for you to resume full sexual activity, we will always look to relieve your immediate erectile dysfunction (ED) by prescribing one of Viagra, Cialis or Levitra. Your own emotional health and the quality of your relationship with your partner should be protected wherever possible. If you're alarmed by the prospect of going into your neighborhood pharmacy to collect a prescription, we can look at how to buy Levitra online with reasonable safety.

Endocrine disorders

So, in this article, we're going to focus on one of the endocrine disorders. Most people know that diabetes can affect sexual performance and the ability to reproduce. But we're going to look at thyroid dysfunction as a cause of erectile dysfunction. To give you an idea of its incidence, thyroid problems affect 2% of the total population, and about 10% of men over the age of 60 years. Because it's relatively straightforward to treat, this makes the associated ED reasonably simple to "cure".

Let's start by clarifying the terminology. The "thyroid" describes the endocrine gland located near the bottom of your neck. The "parathyroids" to refer to the four to eight hormone-producing glands found behind and inside the thyroid gland itself.

An over-productive thyroid causes hyperthyroidism. An underproductive thyroid causes hypothyroidism. Both extremes cause ED. As we age, the thyroid gland often slows down and produces less than we need. Many men just think they are getting older, and so don't ask for their thyroid function to be tested. Whether you're young or old, thyroid dysfunction can upset the hormone balance between testosterone and the allied estradiol. This reduces sperm production, makes you less interested in sex and causes ED. The diagnosis of thyroid problems is not always straightforward. If you have any combination of these symptoms, it may indicate hypothyroidism:

• you feel tired most of the time no matter how much sleep you get;
• you begin to feel the cold more than usual;
• you find yourself increasingly constipated;
• you find that your thinking process are slowing down and you are growing a little forgetful;
• you find yourself waking at night with muscle cramps - this affects you during the day but less commonly;
• your libido falls and you begin to suffer from premature ejaculation and ED;
• your hair begins to thin and fall out; and
• you are depressed.

The following symptoms may indicate hyperthyroidism

• you eat more but lose weight - not always present in older men;
• you are full of energy, always busy and highly productive - you friends and colleagues may think you hyperactive;
• despite the level of mental activity, you can often feel physically weak;
• you feel warm even though those around you think it is quite cool;
• you often feel that your heart is racing even though you have not been physically exerting yourself;
• if you hold your hands out, you can see a slight trembling in the fingers, hands or arms;
• you find yourself more nervous and anxious, sometimes quite irritable;
• your libido is affected and you have problems of erectile dysfunction; and
• you have problems in getting to sleep or staying asleep for long periods of time.

All these symptoms can have many causes. Only a blood test can confirm the diagnosis. The simplest test relies on the fact that the thyroid regulates the balance of calcium and phosphorous in your blood stream. We therefore draw a little blood to look at both the calcium and thyroid hormone levels. If the test confirms a thyroid problem, there are relatively inexpensive medications available to correct the balance. In more serious cases of hyperthyroidism in younger men, surgery may be considered.

If you are older, the treatment to balance your hormone levels should be done gradually. Older hearts may find the changes stressful. The beats may temporarily grow irregular and you may experience chest pains. And to dismiss one other possibility that may be lurking in your mind, the incidence of thyroid cancer is rare and, even if you are unlucky, these tumors are often easier to treat successfully than other kinds of cancer.

Study

In a recent study* Italian researchers examined the relationship between thyroid problems and sexual performance.
The study looked at 48 adult men, 34 with hyperthyroidism and 14 with hypothyroidism. The majority experienced some sexual dysfunctions, most of which were reversed when the thyroid hormone levels were normalised. The most common dysfunction affected ejaculation. That almost all these problems were immediately resolved suggests that the thyroid hormones regulate the physiology of ejaculation and are closely associated with ED.

*The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 12 6472-6479