Content area
Full Text
Abstract
Chronic low back pain is one of the most common maladies of modem man. Many of these men have accompanying erectile dysfunction (ED). The cause(s) of erectile dysfunction in men with chronic low back pain is multifactorial. This article will review the causes of erectile dysfunction in men with chronic low back pain. We will also review the noninvasive evaluation that can easily be accomplished by most physicians caring for men with chronic low back pain and erectile dysfunction. Finally, we will review the treatment options that are effective in men with chronic low back pain who are affected with erectile dysfunction. The causes of ED in these men include the side effects of medication used to treat back pain, hormone deficiency, depression and other psychological causes, and neurologic causes. Treatment of ED for men with chronic back pain can be very successful.
Keywords: Pain, low back pain, urology, erectile function, ED, opioid use, SSRI, selective serotonin reuptake inhibitors, obesity, cigarette smoking, stress, depression, testosterone, hormone deficiency
Introduction
Back pain is a common problem affecting 80% American men over their lifetime. In the vast majority of cases, low-back pain has no identifiable cause and is termed "non-specific." In most cases, low-back pain is often benign, self-limiting and resolves in six weeks, with or without treatment. However, around 30% of individuals with low-back pain have recurrent or persistent symptoms. As a result, low-back pain is one of the most common reasons for medical visits. Many of these men with chronic low back pain also suffer from erectile dysfunction. Erectile dysfunction (ED) consists of the inability to maintain an erection suitable for sexual intercourse. Men may suffer minimal to severe ED. According to the Massachusetts Male Aging Study, 52% of men between the ages of 40 to 70 experience some degree of ED (1). The incidence of suffering with ED correlates with increasing age and health problems (2). Health problems such as hypertension, diabetes, heart disease, and high cholesterol are all associated with ED (3). The ED associated with back pain is multifactorial. Just 50 years ago the medical textbooks considered ED to be of psychogenic origin in 90% of the men. Later studies demonstrated that in men after age 50, most of the...