Good circulation of blood is essential for sex. Erection and sexual performance in both sexes is a function of adequate blood flow to the genitals. When the blood supply to the external genitals is impaired, problems of arousal, lubrication and erection may arise.
On arousal, the muscles of the penis relax to accommodate large volumes of blood. This makes the penis to gain erection. After ejaculation, the entrapped blood is released back to the body.
Functionally, women also experience increased blood flood to the genitals during sex. This is responsible for the lubrication and engorgement of the external genitals. The clitoral erection is similar to penile erection.
Blood disorders can affect the penis in two opposite ways: inability to attain or maintain erection and prolonged erection (priapism). Erectile dysfunction can arise from a number of causes. It can arise from impairment of the blood supply of the penis by atheroma (plaques formed along the inner walls of the blood vessels). This condition is called atherosclerosis. Also, persistent/ excessively prolonged erection (priapism) may arise in sickle cell anemia, leukemia or as a side-effect of some drugs. Low blood level (anemia) may cause low-sex drive in both sexes and poor exercise tolerance (even during sex). Excess iron in the body on the other hand may cause similar symptoms.
Atherosclerosis and Erectile Dysfunction
Atherosclerosis of the penile arteries is primarily responsible for the erectile dysfunction noted by many hypertensive patients. Later introduction of antihypertensive further worsens this condition by reducing the blood pressure/flow to the penis. Atherosclerosis of the penile arteries is not an isolated event. It may indicate that the heart, brain and legs are also at risk of reduced blood flow from atherosclerosis. A study found that 64 percent of men with previous heart attack had erectile dysfunction before the attack.
The other risk factors for atherosclerosis are diabetes, obesity, smoking and high blood cholesterol.
For help on erectile dysfunction, consult your doctor.
Priapism is a condition in which penile erection persists beyond or is unrelated to sexual stimulation.. It is common between 20 to 50 years of age. It is also seen commonly in boys 5-10 years. It can arise in certain blood disorders like sickle cell anemia, leukemia and thalassemia. Blood disorders account for 8% of priapism. In boys, sickle cell anemia is the most common. In fact, a source states that 42% of adults with sickle-cell disease will eventually develop priapism.
The other causes of priapism include
- Injury to the penis or the pelvic area, spinal cord injury
- Used for erectile dysfunction (e.g. aprostadil, Cialis –tadalafil, Viagra-sildenafil)
- Some antihypertensives, antidepressants, omeprazole, metoclopramide, chlorpromazine and blood thinners, although rarely
- Excessive alcohol
- Carbon monoxide poisoning
- Venom from black widow spiders or scorpions
- Rarely, in cancers of the penis.
A lot of times, priapism resolves on its own. Ice packs may help to reduce the associated swelling. If it is accompanied with unbearable pain or if it persists over 4 hours, prompt visit to the doctor is advised. Longer duration of priapism may cause erectile dysfunction and/or penile disfigurement. There are many treatment options available for priapism in the emergency room. Sometimes, surgery may be done. The underlying cause is also treated simultaneously.
Anemia and Iron Overload
Anemia (low blood level) is a known cause of low sex drive in women. In both men and women, it can deprive individuals of the required stamina/ strength for sex. Tiredness and inability to tolerate exercise experienced by anemic people may be the cause of this. Anemia can also predispose to recurrent chest pain, heart attack, heart failure, and kidney failure, all of which can lead to poor sexual activity. Beyond sexual enjoyment, anemia is linked to infertility in men. In women, prematurity, low-birth weight and bleeding following delivery complicate pregnancy in anemic mothers.
Similarly, excess iron in the body can affect sex by also reducing the sex drive and erectile dysfunction. This can also lead to tiredness.
Iron overload can result from:
Excess intake of iron (in foods or supplements)
Repeated blood transfusion
Dialysis for kidney disease may also have excess iron.
Hematochromatosis (a condition in which iron is deposited in the organs; inherited most of the times)
Iron overload can lead to damage of the heart, liver, pancreas and joints.
Anemia can be treated by adequate intake of food rich in iron, folic acid and vitamin B12. Iron, folic acid, vitamin B complex and vitamin C supplementation is usually required. In severe cases, blood transfusion may be offered.
Iron overload is commonly treated by periodic removal of blood (phlebotomy). Drugs to bind/chelate the iron are available.