Más factores de riesgo para la disfunción eréctil.

Para proseguir con los principales factores de riesgo, el sistema endocrino tiene un papel relevante siendo las enfermedades más importantes: la diabetes, los bajos niveles de testosterona y la hiperprolactinemia, que es un aumento de una hormona de la hipófisis llamada prolactina.

La diabetes mellitus es la enfermedad de mayor relevancia endocrino-metabólica (por el elevado número de casos en la población) y es una causa de DE en el 50% de los enfermos diabéticos. La repercusión de esta enfermedad sobre el sistema nervioso y las arterias de la pelvis y el pene son los principales factores causantes, por lo que el tratamiento más eficaz es el correcto control metabólico y los fármacos que potencien la erección.

La deficiencia de testosterona se incrementa con la edad, se acompaña de una disminución del deseo sexual y del número de erecciones nocturnas, aunque no todos los pacientes con déficit de testosterona manifiestan DE. El tratamiento con testosterona intramuscular o transdérmica aplicada diariamente en pacientes con este déficit puede propiciar un aumento del deseo sexual, de la potencia sexual, de la rigidez nocturna del pene y de la sensación de bienestar; además podría mejorar su respuesta a los medicamentos para la erección. Los pacientes tratados con testosterona deben someterse a controles periódicos de valores sanguíneos, tacto rectal y marcadores prostáticos (Antígeno Prostático Específico).

Otras causas como pueden ser medicamentos como los antidepresivos tricíclicos o medicamentos digestivos tipo metoclopramida, que se utilizan para evitar el vómito o las náuseas, pueden alterar la producción de una hormona llamada Prolactina que anula la producción de hormonas sexuales. En estos casos, al retirar el fármaco, siempre que sea posible, puede mejorar la función sexual.

Las enfermedades del hígado y la insuficiencia renal crónica pueden asociarse a un descenso del deseo sexual y de los caracteres sexuales secundarios, DE y ginecomastia, puesto que no se produce de forma correcta la secreción de testosterona.

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