Erectile Dysfunction in Men with Low Back Pain
Erectile dysfunction is a silent passion extinguisher. It’s an unseen and unheard problem that lives a secretive life. Instead of keeping the problem zipped up, asking questions and getting answers is the only way to undermine the power of this relationship downer. Many people think that ED is just an old person’s problem or that it’s just in a person’s head, but that is not the case especially for those that also have low back problems.
In a recent study of men under the age of 50 years old with lumbar spine disease, 34% also had erectile dysfunction.1 The link between spine disease and sexual potency has long been a subject of speculation, but the mechanisms remain unclear and research enthusiasm is lacking.
Naturally, people assume that low testosterone has something to do with it considering that anyone using long-term opioids will likely have hormonal imbalances. However, low T is rarely a real cause of erectile dysfunction. Lately, the focus has been on the nervous system as the primary culprit leading to impotency in men with low back pain. Erections are under the control of two different nerve centers in the spine: the parasympathetic input from the sacrum and the sympathetic input from the thoracic-lumbar pathway. Thus, any spinal injuries can result in sexual dysfunction.
Unfortunately, that does not necessarily mean that fixing the spine will correct the impotence. In another study of men under the age of 50 years old, those that underwent surgery did not experience much improvement in sexual function.2 That’s not to say that surgery cannot be successful. One case report of a 35 year old man that had erectile dysfunction for 17 years had much improvement after the disc herniation was remedied.3 Most experts agree that the chances of reversing spinal nerve damage are best in the mild cases.
If spinal surgery is not an option or has already been tired, what other solutions exist for men with erectile dysfunction related to low back pain? Interestingly, women with low desire, low arousal, and anoragasmia because of low back problems seem to improve with the use of Viagra.4 Both men and women can benefit from these phosphodiesterase-5 (PDE5) inhibitors that enhance sexual function when one is aroused. Correction of hormonal imbalances is also worth a try too. But the best solution for erectile dysfunction is to find the real cause first.
If you or someone you love is struggling with erectile dysfunction or sexual function in general, remember that it is not necessarily related to age or stress. Real neurologic damage can be the cause of this silent passion extinguisher. So breaking the silence and talking to a professional can be the first step towards a satisfying sexual relationship.
- Spine (Phila Pa 1976). 2012 Apr 20;37(9):797-801
- Spine (Phila Pa 1976). 2013 May 1;38(10):846-50
- Scand J Urol Nephrol. 2008;42(1):91-3
- Int J Urol. 2007 Jun;14(6):566-7
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.