阳痿的病因解析 | Understanding the Causes of Erectile Dysfunction (ED)

阳痿（勃起功能障碍，ED）是男性在性活动中无法获得或维持足够勃起的现象，其病因复杂多样。在新加坡，约20%的40岁以上男性受ED困扰^1。本文以中英双语解析生理、心理及生活方式等综合病因，帮助读者全面理解并科学应对。
Erectile Dysfunction (ED) refers to the inability to achieve or sustain an erection during sexual activity, with causes ranging from physical to psychological. In Singapore, approximately 20% of men over 40 experience ED^1. This bilingual article explores the multifactorial causes of ED and offers practical insights.

1. 生理病因 | Physical Causes

• 血管问题：
  高血压、动脉硬化或高胆固醇会减少阴茎血流量，占ED病例的70%^2。
  Vascular Issues: Hypertension, atherosclerosis, or high cholesterol reduce penile blood flow, contributing to 70% of ED cases^2.
• 神经损伤：
  糖尿病、多发性硬化症或脊髓损伤可能阻断勃起信号传导。
  Nerve Damage: Diabetes, multiple sclerosis, or spinal injuries disrupt nerve signals for erections.
• 荷尔蒙失衡：
  睾酮不足（常见于老年男性）或甲状腺疾病影响性欲与勃起功能。
  Hormonal Imbalance: Low testosterone (common in aging men) or thyroid disorders impair libido and erectile function.

2. 心理病因 | Psychological Causes

• 慢性压力：
  新加坡职场压力全球排名前列^3，长期压力抑制性激素分泌。
  Chronic Stress: Singapore’s high workplace stress ranks globally^3, suppressing sex hormone production.
• 焦虑与抑郁：
  对性表现过度担忧或情绪低落直接影响大脑性兴奋反应。
  Anxiety & Depression: Performance anxiety or low mood disrupts brain signals for sexual arousal.
• 创伤经历：
  过去的性创伤或失败经历可能引发心理性ED循环。
  Past Trauma: Previous sexual trauma or failures can trigger psychological ED cycles.

3. 生活方式因素 | Lifestyle Factors

• 吸烟与酗酒：
  尼古丁破坏血管内皮，酒精抑制中枢神经系统功能。
  Smoking & Alcohol: Nicotine damages blood vessels, while alcohol suppresses nervous system function.
• 缺乏运动：
  新加坡约37%成年男性超重^4，肥胖增加糖尿病和ED风险。
  Sedentary Lifestyle: 37% of Singaporean men are overweight^4, raising risks of diabetes and ED.
• 睡眠不足：
  每晚睡眠<6小时可降低睾酮水平，影响勃起质量。
  Poor Sleep: Sleeping <6 hours nightly reduces testosterone and erection quality.

4. 药物与疾病 | Medications & Medical Conditions

• 处方药影响：
  抗抑郁药、降压药（如β受体阻滞剂）或前列腺药物可能引发ED。
  Prescription Drugs: Antidepressants, blood pressure medications (e.g., beta-blockers), or prostate drugs may cause ED.
• 慢性疾病：
  慢性肾病、肝病或癌症（如前列腺癌）常伴随ED。
  Chronic Diseases: Kidney/liver disease or cancers (e.g., prostate cancer) are linked to ED.
• 手术并发症：
  盆腔手术（如前列腺切除术）可能损伤勃起相关神经或血管。
  Surgical Complications: Pelvic surgeries (e.g., prostatectomy) may damage nerves or blood vessels.

新加坡特殊影响因素 | Local Risk Factors in Singapore

• 高糖饮食文化：
  新加坡糖尿病患病率全球第二^5，长期高血糖加速血管病变。
  High-Sugar Diets: Singapore has the world’s 2nd-highest diabetes rate^5, accelerating vascular damage.
• “怕输”（Kiasu）心态：
  过度追求完美性表现加重焦虑，形成恶性循环。
  “Kiasu” Mentality: Overemphasis on sexual perfection worsens anxiety and ED.
• 数字化生活：
  屏幕时间过长导致运动减少和睡眠质量下降。
  Digital Overload: Excessive screen time reduces physical activity and sleep quality.

预防与管理建议 | Prevention & Management

• 定期筛查：
  40岁以上男性建议每年检测血糖、血压和睾酮水平。
  Regular Screening: Men over 40 should test blood glucose, blood pressure, and testosterone annually.
• 健康饮食：
  遵循新加坡“健康餐盘”指南，控制精制糖和饱和脂肪摄入。
  Balanced Diet: Follow Singapore’s “Healthy Plate” guidelines to limit refined sugars and saturated fats.
• 心理支持：
  利用HealthHub“MindSG”平台或咨询心理医生缓解压力。
  Mental Health Support: Use HealthHub’s “MindSG” platform or seek counselling for stress management.

结语 | Conclusion

阳痿的病因是生理、心理及环境因素交互作用的结果。新加坡男性可通过早期干预（如改善生活方式）有效降低风险。若症状持续，建议咨询泌尿科医生或参加新加坡中央医院的“男性健康计划”。
ED results from interactions between physical, psychological, and environmental factors. Singaporean men can reduce risks through early interventions like lifestyle changes. For persistent symptoms, consult a urologist or join the “Men’s Health Programme” at Singapore General Hospital.