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PSA levels: PSA (prostate specific antigen) blood levels and prostate examination to exclude prostate cancer is important before starting testosterone treatment since testosterone can aggravate prostate cancer.
The researchers were scheduled to present their work Sept. 24 at the American Heart Association's conference on high blood pressure research in Chicago.
To add to the problem, the penis contains much smaller blood vessels than the ones that carry blood to the heart and the brain, which is why men who have early heart disease may see the effects first in their penis and then in larger blood vessels.
For people who are at risk of developing ED due to personal behavior, such as drinking too much alcohol, steps may be taken to prevent its occurrence. However, other causes of ED may not be preventable.
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The use of exogenous androgens suppresses natural androgen production. Elevating serum androgen levels has the potential to stimulate prostate growth and may increase the risk of activating a latent cancer. Periodic prostate examinations, including digital rectal examinations, prostate-specific antigen determinations, and blood counts (ie, CBC counts), are recommended in all patients receiving supplemental androgens. Obtaining a testosterone level while on therapy is also suggested to optimize the dosage.
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As with all bodily functions, erections depend on signals from the brain that say when to start and when to stop. The inability to get an erection can sometimes result from a problem with the nerves carrying signals from the brain to the penis.
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Tests that assess erectile function examine the blood vessels, nerves, muscles, and other tissues of the penis and pelvic region.
Almost all antihypertensive medications have been implicated in erectile dysfunction.23 The mechanisms vary from central-acting sympatholytics, depression of libido as well as higher blood pressure requirement to achieve erection in atherosclerotic patients taking diuretics and vasodilators. The role of smoking in causing erectile dysfunction remains a source of controversy. A recent consensus group analysis failed to document a direct link to erectile dysfunction. However, smoking seems to amplify other risk factors, such as hypertension and coronary artery disease.24 Martin-Morales and colleagues25 have shown an increased risk of erectile dysfunction among smokers (odds ratio [OR] 2.5). Systemic diseases are also associated with erectile dysfunction. This is often multifactorial, as in diabetes and renal failure.26 Given the role of androgens in the physiology of erections, it is not surprising that many hypogonadal men do not experience erectile dysfunction per se. Low serum testosterone levels may be primary or secondary to another condition, such as hyperprolactinemia or hypothyroidism. Regardless of the mechanism, the result is primarily a loss of libido, although many hypogonadal men retain their ability to obtain erections.27
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