The role of nitric oxide in erectile dysfunction: implications for medical therapy.

Research output: Contribution to journalArticle

Abstract

Erectile dysfunction is a common, multifactorial disorder that is associated with aging and a range of organic and psychogenic conditions, including hypertension, hypercholesterolemia, diabetes mellitus, cardiovascular disease, and depression. Penile erection is a complex process involving psychogenic and hormonal input, and a neurovascular nonadrenergic, noncholinergic mechanism. Nitric oxide (NO) is believed to be the main vasoactive nonadrenergic, noncholinergic neurotransmitter and chemical mediator of penile erection. Released by nerve and endothelial cells in the corpora cavernosa of the penis, NO activates soluble guanylyl cyclase, which increases 3',5'-cyclic guanosine monophosphate (cGMP) levels. Acting as a second messenger molecule, cGMP regulates the activity of calcium channels as well as intracellular contractile proteins that affect the relaxation of corpus cavernosum smooth muscle. Impaired NO bioactivity is a major pathogenic mechanism of erectile dysfunction. Treatment of erectile dysfunction often requires combinations of psychogenic and medical therapies, many of which have been only moderately successful in the past. The advent of oral phosphodiesterase type 5 (PDE-5) inhibitors, however, has greatly enhanced erectile dysfunction treatment; patients have demonstrated high tolerability and success rates for improved erectile function. The efficacy of the PDE-5 inhibitors also serves to illustrate the importance of the NO-cGMP pathway in erectile function since these agents counteract the degradation of NO-generated cGMP. Because not all patients respond to PDE-5 inhibitors, additional therapies are being investigated, such as soluble guanylyl cyclase activators and NO donors, which act on NO-independent and NO-dependent pathways, respectively.

Original languageEnglish (US)
Pages (from-to)53-62
Number of pages10
JournalJournal of clinical hypertension (Greenwich, Conn.)
Volume8
Issue number12 Suppl 4
StatePublished - Dec 2006

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Erectile Dysfunction
Nitric Oxide
Cyclic GMP
Phosphodiesterase 5 Inhibitors
Penile Erection
Therapeutics
Contractile Proteins
Nitric Oxide Donors
Penis
Second Messenger Systems
Calcium Channels
Hypercholesterolemia
Smooth Muscle
Neurotransmitter Agents
Diabetes Mellitus
Cardiovascular Diseases
Endothelial Cells
Depression
Hypertension
Neurons

ASJC Scopus subject areas

  • Internal Medicine

Cite this

The role of nitric oxide in erectile dysfunction : implications for medical therapy. / Burnett, Arthur.

In: Journal of clinical hypertension (Greenwich, Conn.), Vol. 8, No. 12 Suppl 4, 12.2006, p. 53-62.

Research output: Contribution to journalArticle

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