Can degenerative arthritis of the lumbar spine and Intervertebral Disc Syndrome (IVDS) cause erectile dysfunction?

From the Guidelines

Degenerative arthritis of the lumbar spine and IVDS can indeed cause erectile dysfunction due to nerve damage or compression affecting sexual function, as well as psychological factors and potential side effects from pain medications. The relationship between spinal conditions and erectile dysfunction is complex, involving both direct neurological impacts and indirect effects such as chronic pain leading to depression, anxiety, and stress [ 1 ]. These psychological factors can significantly contribute to the development or exacerbation of erectile dysfunction.

Causes and Mechanisms

• Nerve compression or damage from degenerative arthritis or IVDS can disrupt normal nerve signals necessary for erection.
• Chronic pain from these spinal conditions can lead to psychological issues like depression and anxiety, which are known to contribute to erectile dysfunction.
• Medications used to treat spinal pain, including opioids, muscle relaxants, and certain antidepressants, may have sexual side effects, including erectile dysfunction.

Treatment Considerations

• Addressing the underlying spinal condition through physical therapy, appropriate pain management, and possibly surgical intervention for severe nerve compression can be beneficial.
• For erectile dysfunction, medications like sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) may be prescribed, typically starting at lower doses and adjusting as needed, as recommended by guidelines for the management of erectile dysfunction [ 1 ].
• It's crucial to evaluate both the spinal condition and erectile dysfunction by appropriate specialists, as treating the spinal condition may sometimes improve erectile function.

Importance of Recent and High-Quality Evidence

The management of erectile dysfunction, especially in the context of other health conditions like degenerative arthritis and IVDS, should be guided by the most recent and highest quality evidence available. This ensures that treatment recommendations are based on the best possible outcomes in terms of morbidity, mortality, and quality of life [ 1 ].

From the Research

Degenerative Arthritis of the Lumbar Spine and IVDS

• Degenerative arthritis of the lumbar spine and Intervertebral Disc Disease (IVDS) can have various effects on the body, including potential impacts on sexual function.
• Studies have shown that spinal injuries or conditions, such as those affecting the lumbar spine, can disrupt the connection between the brain's centers for sexual function and the genitals, leading to problems with erection, ejaculation, orgasm, and fertility 2.

Relationship Between Lumbar Spine Disease and Erectile Dysfunction

• A prospective follow-up study found that the incidence of erectile dysfunction (ED) in patients younger than 50 years with non-fracture-related lumbar spine disease undergoing surgery was 34.3% 3.
• The study also found that patients with neurogenic symptoms (NS) > 70 postoperatively were more likely to have ED, suggesting possible permanent nerve damage from lumbar spine pathology 3.
• Another study found that discopathy in the lumbar-sacral segment can influence sexual activity, with patients experiencing a decrease in satisfaction with their sex life due to pain and neurological symptoms associated with intervertebral disc disease 4.

Potential Mechanisms

• The degenerative process in intervertebral discs can lead to neoinnervation and neovascularization, resulting in disc bulging and loss of nucleus pulposus and water content, which can cause chronic low back pain and potentially affect sexual function 5, 6.
• The pain and limitation of mobility associated with discopathy can also contribute to the occurrence of sexual dysfunction, as patients may experience a change in sexual performance, resulting in passivity, discouragement, weakness, or a complete lack of interest in sex 4.

Key Findings

• Degenerative arthritis of the lumbar spine and IVDS can increase the risk of erectile dysfunction, particularly in patients with neurogenic symptoms or permanent nerve damage 3.
• The condition can also affect sexual activity and satisfaction, with patients experiencing a decrease in satisfaction with their sex life due to pain and neurological symptoms 4.