Abstract

It has been recently proposed that human sexual behavior, which is usually triggered by external stimuli or endogenous factors, is a multidimensional experience comprising closely interrelated components. Sexual behavior is a complex series of psycho-neuro- vascular events. Thus, the physiologic mechanism of normal sexual response includes a combination of neurogenic, psychogenic, vascular, and hormonal factors that are coordinated by the hypothalamus, limbic system, and cerebral cortex centers. Accordingly, the erectile dysfunction (ED) is a biopsychosocial process and there should be related with stress. This lecture will be covered the cutting edge findings in stress and ED. Through extensive literature review, clinical experience, and several functional imaging researches, the comprehensive approach for understanding in stress and ED was performed. The relationship with stress and ED may be grouped into patients with functional or psychogenic ED, patients with mixed, organic, psychogenic ED, and patients with ED and active psychopathology. Our neuroimaging results using functional magnetic resonance imaging definitely suggested the involvement of the brain is crucial in ED. Factors associated with stress may be perpetuating, aggravating, and accompanying factors in ED. The major psychiatric disorders as well as the psychopharmaceutical drugs interfere erectile mechanism. The complicated association between psychological factors, organic involvement, the proper understanding and management should be considered in the treatment of subjects with ED. Although many studies have suggested that, for the majority of middle aged and elderly men with ED, the primary etiology is vascular, comprehensive and multidimensional understanding for ED with an emphasis on stress is important. (Korean J Str Res 2005;13:77∼81)

• Keywords: Stress, Erectile dysfunction, Sexual behavior, Neuroscience