Erectile Dysfunction: In Your Jeans AND In Your Genes
By The Rex MD Editorial TeamAugust 31, 2020
We've known for quite some time that men with many common chronic health conditions or habits – like diabetes, smoking, high blood pressure, heart disease, and obesity – are at greater risk of suffering from erectile dysfunction (ED).
But newer research also suggests genetics matter to ED. Your issue might be in your jeans, but it could be in your genes too.
Is ED Genetic?
A paper published in 2018 details the findings of researchers at Kaiser Permanente Health Center, who found a specific genetic cause for erectile dysfunction. This tiny little piece of DNA, located on chromosome 6, may actually control whether guys will struggle to get it up – or not.
This specific locus is not quite a gene, but rather an "enhancer" that helps to turn on the SIM1 gene. This gene is partly responsible for hormones that get things moving in your jeans, and the researchers suggest that the rs17185536-T (risk) allele or other erectile dysfunction-associated alleles in this region lead to differential enhancer activity. This enhancer activity may in turn regulate the expression of SIM1 and then ED further down the line.
To identify this new source of discomfort for men, author Eric Jorgenson, Ph.D. and the Kaiser team looked at 36,649 men in the multiethnic Kaiser Permanente Northern California Genetic Epidemiology Research in Adult Health and Aging cohort plus 222,358 men from the UK Biobank. Their analysis identified a single locus (a specific position on a chromosome) on chromosome 6 that was associated with ED across the Kaiser Permanante group. They then looked at the larger UK Biobank dataset to confirm their findings.
Most importantly, their findings are independent of any other known risk factors. The concern here would be that this same gene is related to obesity or hypertension, for example, and that the researchers are identifying a different risk factor. They believe that's not the case, and this important discovery around erectile dysfunction and genes could lead to more breakthroughs.
New Treatments For ED
Since the splashy debut in the '90s of sildenafil and its relatives tadalafil and vardenafil, the landscape for new ED treatments has seen few advancements that have been embraced so widely. Now, these kinds of genetic findings could change how we treat ED someday in the future.
These new findings are important not only for their potential causal implications, but also for the potential to identify and create new, effective ED treatments. A significant portion of men suffering from ED don't respond to widely available medications like sildenafil, and this new genetic marker could serve as a new target for future medications.
Until now, there were no confirmed genetic risk factors for ED, and this new understanding may provide powerful insights into the future of ED therapy.
What Causes Erectile Dysfunction?
What causes erectile dysfunction in men isn't always clear, and this genetic discovery is just a milestone on our journey to understanding ED. In a letter to the authors of the above research, a few other researchers highlighted some concerns with the findings around genetic causes of erectile dysfunction. These researchers point out first that "ED is highly susceptible to environmental factors, social relationships, or spousal relationships, while less impacted by genetic factors." They point out that the questionnaire used in the genetics study may not have identified the predominant mechanism:
For instance, “honeymoon ED,” defined as the failure of successful sexual intercourse in newly wed males, is primarily an environmental and psychological disorder that could not be explained by organic factors.
Ultimately, these letter authors write that they're greatly interested in the Jorgenson study, and that this study provides strong evidence that rs17185536 in SIM1 is related to ED risk. When it comes to genes and ED, there's a lot we have left to learn.
Do genetics affect erectile dysfunction? It certainly looks like it.