Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health problems can cause or worsen erectile dysfunction. Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical problem that slows your sexual response may cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.

In most cases, erectile dysfunction is caused by something physical. Common causes include:

• Heart disease
• Clogged blood vessels (atherosclerosis)
• High blood pressure
• Diabetes
• Obesity
• Metabolic syndrome, a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
• Parkinson’s disease
• Multiple sclerosis

• Low testosterone
• Peyronie’s disease, development of scar tissue inside the penis
• Certain prescription medications
• Tobacco use
• Alcoholism and other forms of substance abuse
• Treatments for prostate cancer or enlarged prostate
• Surgeries or injuries that affect the pelvic area or spinal cord

Symptoms include trouble getting an erection, trouble keeping an erection, and reduced sexual desire.

Even though it may seem awkward to talk with your doctor about erectile dysfunction, go in for an evaluation. Problems getting or keeping an erection can be a sign of a health condition that needs treatment, such as heart disease or poorly controlled diabetes. Treating an underlying problem may be enough to reverse your erectile dysfunction.

If treating an underlying condition doesn’t help your erectile dysfunction, medications or other direct treatments may work.

• Depression, anxiety or other mental health conditions
• Stress
• Fatigue
• Relationship problems due to stress, poor communication or other concerns

So if you feel any of these can be affecting your ability to get or maintain an erection, talk to your doctor about treatment options.

A tendency toward inflammatory arthritis of the spine, sacroiliac and other joints of the body

A condition called enthesopathy, which is an inflammation where the ligaments attach to the bone

A tendency to occur in more than one family member

The absence of physical signs or testing markers that are found in other types of arthritis, such as sub-cutaneous nodules (or lumps under the skin) and a positive blood test for the rheumatoid factor.

The disease starts with low back pain that comes and goes. Pain and stiffness are worse at night, in the morning, or when you are not active. It may wake you from your sleep. The pain typically gets better with activity or exercise.

The cause of psoriatic arthritis is not known, but genes may play a role. In general, people who have psoriasis have a higher rate of arthritis than the general population.

Once diagnosed, your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDS) or salicylates to reduce pain and inflammation of the joints.

More severe arthritis requires treatment with more powerful drugs called disease-modifying antirheumatic drugs (DMARDs).

Unfortunately there is nothing you can do to prevent the condition. Repeated episodes often occur, so if you believe you have psoriasis, make sure you talk to your doctor immediately so that you can talk about treatment and your possibility of developing arthritis.

The tendency to develop ankylosing spondylitis is believed to be genetically inherited, and a majority (nearly 90%) of people with ankylosing spondylitis are born with a gene known as the HLA-B27 gene. Getting tested for this gene is the most accurate way to diagnose ankylosing spondylitis in patients. The gene appears only to increase the tendency of developing ankylosing spondylitis, while some additional factors, perhaps environmental, are necessary for the disease to appear or become expressed.

How inflammation occurs and persists in different organs and joints in ankylosing spondylitis is a subject of active research.

It’s not entirely clear why the immune system turns on healthy tissue, but it seems likely that both genetic and environmental factors play a role. Many people with psoriatic arthritis have a family history of either psoriasis or psoriatic arthritis. Researchers have discovered certain genetic markers that appear to be associated with psoriatic arthritis.

Physical trauma or something in the environment — such as a viral or bacterial infection — may trigger psoriatic arthritis in people with an inherited tendency.

No cure for psoriatic arthritis exists, so the focus is on controlling symptoms and preventing damage to your joints. Without treatment, psoriatic arthritis may be disabling.

AS can also cause inflammation, pain and stiffness in other areas of the body such as the shoulders, hips, ribs, heels and small joints of the hands and feet. Sometimes the eyes can become involved (known as Iritis or Uveitis), and rarely, the lungs and heart can be affected.

The severity of AS varies greatly from person to person, and not everyone will experience the most serious complications or have spinal fusion. Some will experience only intermittent back pain and discomfort, but others will experience severe pain and stiffness over multiple areas of the body for long periods of time. AS can be very debilitating, and in some cases, lead to disability

Psoriatic arthritis can affect joints on just one side or on both sides of your body. The signs and symptoms of psoriatic arthritis often resemble those of rheumatoid arthritis. Both diseases cause joints to become painful, swollen and warm to the touch. Symptoms include swollen fingers and toes, foot pain, and lower back pain.

Joint pain, stiffness and swelling are the main symptoms of psoriatic arthritis. They can affect any part of your body, including your fingertips and spine, and can range from relatively mild to severe. In both psoriasis and psoriatic arthritis, disease flares may alternate with periods of remission.

No cure for psoriatic arthritis exists, so the focus is on controlling symptoms and preventing damage to your joints. Without treatment, psoriatic arthritis may be disabling.

• Alcohol. Alcohol acts as a bladder stimulant and a diuretic, which can cause an urgent need to urinate.
• Overhydration. Drinking a lot of fluids, especially in a short period of time, increases the amount of urine your bladder has to deal with.
• Caffeine. Caffeine is a diuretic and a bladder stimulant that can cause a sudden need to urinate.
• Bladder irritation. Carbonated drinks, tea and coffee — with or without caffeine — artificial sweeteners, corn syrup, and foods and beverages that are high in spice, sugar and acid, such as citrus and tomatoes, can aggravate your bladder.
• Medications. Heart medications, blood pressure drugs, sedatives, muscle relaxants and other medications may contribute to bladder control problems.