Erectile Dysfunction as Dysautonomia

[Pyrrhus]

The more you know!​

So, the parasympathetic branch of the autonomic nervous system is responsible for producing a penile erection (or vaginal lubrication) in response to stimulation.

This means that if there is a problem with this part of the autonomic nervous system, one might experience erectile dysfunction, and that would be a form of dysautonomia.

Specifically, autonomic nerves stimulate the endothelial cells of blood vessels in the penis to produce nitric oxide (NO), which causes the blood vessels to dilate, greatly increasing blood volume in the penis.

Of course, people love to attribute other causes to erectile dysfunction, especially psychological ones...

Besides dysautonomia, a problem with the endothelial cell production of nitric oxide could also cause erectile dysfunction, and this would be a form of endothelial dysfunction.

Hormonal disruptions such as testosterone deficiency or excessive prolactin, which could be related to hypothalamic dysfunction, can also lead to erectile dysfunction as these hormones affect the autonomic nervous system.

...Just FYI...

 

[Pyrrhus]

Does anyone know of any studies that asked about erectile dysfunction in ME?

All I can find is this one from Taiwan:

Increased risk of organic erectile dysfunction in patients with chronic fatigue syndrome: a nationwide population-based cohort study (Chao et al., 2015)
https://doi.org/10.1111/andr.12052

Chronic fatigue syndrome (CFS) is a complex disorder characterized by profound and persistent fatigue and several comorbidities. CFS was previously reported to be associated with female sexual dysfunction. We propose that CFS might also be associated with organic erectile dysfunction (organic ED).

We conducted a retrospective cohort study by using data from the National Health Insurance (NHI) Research Database. We identified 2156 male patients who were newly diagnosed with CFS between January 1, 2003 and December 31, 2006. After excluding those younger than 20 years and prevalent cases, 1976 patients were subjected to analysis, and 7904 people served as healthy controls. All study subjects were followed up from the index date to the date of organic ED diagnosis, withdrawal from the NHI program, or the end of 2011.

Compared with the non-CFS cohort, the incidence density rate of organic ED was 1.88-fold higher than that in the CFS cohort (3.23 vs. 1.73 per 1000 person-years) with an adjusted hazard ratio (HR) of 1.88 (95% CI = 1.26–2.81) when adjusting for sex and comorbidities.

The combined impacts of patients with CFS and cardiovascular disease (CVD), diabetes mellitus (DM), chronic kidney disease (CKD), depression, and anxiety showed a significant by joint association with organic ED risk compared with patients with no CFS and no counterpart comorbidity. The greatest magnitude of adjusted HR of ED for CFS was observed in individuals without any comorbidity (3.87, 1.95–7.66).

The incidence of organic ED is higher among males aged 40 years and over for both CFS and non-CFS cohorts. As the number of comorbidity increases, the incidence of organic ED increases in males without CFS. Higher incidence of organic ED was observed in males with CVD, DM, CKD, depression, or anxiety for both CFS and non-CFS cohorts.

(spacing added for readability)


I would now link to all the discussions here on Phoenix Rising about erectile dysfunction, but they are all private discussions...

 

[SNT Gatchaman]

Just as an aside, for male physiology, the first year med school mnemonic for which part of the autonomic system was responsible for which aspect was:

Point (parasympathetic)
and
Shoot (sympathetic)

 

[Marylib]

I was remembering how at one point people were trying meds like viagra for ME/CFS.

 

[Pyrrhus]

Just as an aside, for male physiology, the first year med school mnemonic for which part of the autonomic system was responsible for which aspect was:
Point (parasympathetic)
and
Shoot (sympathetic)

I guess that's, er, more to the point than:
"Rest-and-digest" (parasympathetic)
and
"Fight-or-flight" (sympathetic)

 

[nerd]

Different regions of the stem brain, explain different manifestations of ME.

 

[kangaSue]

I was remembering how at one point people were trying meds like viagra for ME/CFS.

If if it's not contraindicated on a personal level, it's worth a shot for any condition that involves having chronic pain at least. Cialis (tadalafil) can be a better one to try though as it has longer period of efficacy than viagra. There is a small body of research work to support tadalafil being effective for pain in Chronic Regional Pain Syndrome, Pelvic Pain Syndrome and Loin Pain Hematuria Syndrome.

Interesting brief mention of tadalafil aiding with improved cognitive impairment in this article though;
https://wjmh.org/DOIx.php?id=10.5534/wjmh.200027

 

[Pyrrhus]

On a related note:

Many people here on Phoenix Rising, of different genders, have reported severe PEM after orgasm. They report that the severity of the PEM is not related to any exertion related to the orgasm, but seems to be a direct effect of the orgasm itself.

I would now link to all the discussions on this topic, but they are all private discussions, except one:

Post-sex exhaustion
https://forums.phoenixrising.me/threads/post-sex-exhaustion.80438/

 

[kushami]

Dr Svetlana Blitshteyn is conducting a research survey titled “Sexual dysfunction in patients with postural orthostatic tachycardia syndrome (POTS)”.

The research is under the auspices of the University at Buffalo Jacobs School of Medicine, New York, USA.

Link to Patient Scout website for more info

 

[kushami]

Tadalafil Treatment Improves Inflammation, Cognitive Function, And Mismatch Negativity Of Patients With Low Urinary Tract Symptoms And Erectile Dysfunction

(Mismatch negativity is a type of cognitive test.)

So it seems to do more than just increase blood flow (or perhaps the increased blood flow leads to other good effects).

 

[pattismith]

Tadalafil Treatment Improves Inflammation, Cognitive Function, And Mismatch Negativity Of Patients With Low Urinary Tract Symptoms And Erectile Dysfunction

(Mismatch negativity is a type of cognitive test.)

So it seems to do more than just increase blood flow (or perhaps the increased blood flow leads to other good effects).

interesting to note that Mirabegron (beta3 agonist and alpha1 antagonist) is a drug designed to relax detrusor (bladder muscle) to treat bladder over activity, also has some vasodilating activity (with NO released).

So beside it's medical indication, Mirabegron also showed interesting properties to improve women sexual activity and erectile function.

Mirabegron has also positive effect on muscle and brain and showed beneficial effect on depression and anxiety in treated patients.

More about Mirabegron here:

https://forums.phoenixrising.me/thr...e-cfs-aging-rapidly.62075/page-2#post-2461503

The effect of mirabegron, used for overactive bladder treatment, on female sexual function: a prospective controlled study 2018​

The effects of mirabegron used for overactive bladder treatment on female sexual function. 2023​

Mirabegron improves erectile function in men with overactive bladder and erectile dysfunction: a 12-week pilot study 2021​

Effect of Mirabegron in Men With Overactive Bladder and Erectile Dysfunction: A Prospective Observational Study 2024​

Effects of Mirabegron on Anxiety and Depression in Female Patients with Overactive Bladder 2019​

https://link.springer.com/article/10.1186/s12894-018-0377-9

https://openurl.ebsco.com/EPDB:gcd:...co:plink:scholar&id=ebsco:gcd:162860473&crl=c

https://www.nature.com/articles/s41443-021-00455-2

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089587/

https://karger.com/uin/article-abst...ts-of-Mirabegron-on-Anxiety-and-Depression-in