The Epidemiology and Pathophysiology of Erectile Dysfunction and the Role of Environment-Current Updates

Sarah Collica, Filippo Pederzoli, Trinity Bivalacqua

Research output: Chapter in Book/Report/Conference proceedingChapter


Erectile dysfunction (ED), the inability to attain or maintain a sufficient penile erection for satisfactory sexual intercourse, is a major health issue predicted to affect 322 million people worldwide by year 2025. This chapter reviews well-known risk factors of ED including aging, vasculopathy, neuropathy, neurologic diseases, psychogenic problems, metabolic and endocrine dysregulation, and medications. Commonly consumed toxins such as tobacco, alcohol, and marijuana are also discussed as are environmental factors implicated in ED ranging from chemicals used in agriculture (pesticides and DDT), industrial chemicals, lead, bisphenol A, and 4,4'-diaminostilbene-2,2'-disulfonic acid to arsenic. Although how these compounds cause ED is unclear, this chapter reviews the available research and current theories on how they are thought to be endocrine disrupters with antiandrogenic or estrogenic properties and neurotoxins. The chapter concludes with a discussion of what are believed to be natural solutions for sexual dysfunction (aphrodisiacs) including commonly used cooking ingredients such as honey and potentially lethal plant derivatives such as yohimbine.

Original languageEnglish (US)
Title of host publicationBioenvironmental Issues Affecting Men's Reproductive and Sexual Health
PublisherElsevier Inc.
Number of pages17
ISBN (Electronic)9780128013137
ISBN (Print)9780128012994
StatePublished - Jan 1 2018


  • Aphrodisiacs
  • Erectile dysfunction
  • Nitric oxide
  • Sexual dysfunction

ASJC Scopus subject areas

  • Medicine(all)


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