Erectile Dysfunction Associated with Psychoactive Substances

Psychoactive substances are believed to be aphrodisiac; but in reality they have deleterious effects on all the aspects of sexual function. The purpose of this article is to review and summarize the available sci- entific literature on the impact of psychoactive substances, including alcohol, tobacco and illicit drugs on erectile dysfunction (ED) in men. Almost all of them have been reported to be associated with ED. These substances may exert their inhibitory effect on erection through their effects on central neurotransmitter pathways (serotogenic, adrenergic or dopaminergic). Besides, some also may exhibit vasoconstricting prop- erties (cocaine), impair endothelium function (nicotine) or suppress the release of luteinizing hormone from the pituitary, resulting in hypogonadism (morphine) to induce ED. The relationship between ED and psycho- active substances is attributed not only to pharmacological effects, but also to psychological and social re- actions to substance dependence. Whether withdrawal from the substances could restore erectile function remains unknown. However, human and animal studies demonstrated that the effects of neurological dam- age from chronic substance abuse are long-lasting. This information of sexual consequence of the sub- stances will be of great general interest and may serve as a powerful tool to healthcare providers.