High norepinephrine levels (or relatively high norepinephrine levels compared to the other neurotransmitters) can cause erectile dysfunction (chronic or otherwise).
Norepinephrine is the primary signal in the brain for stress. It is a excitatory neurotransmitter. It keeps a person awake. It can help improve attention. It causes an increase in ACTH production, which then drives adrenal hormone production. A spike of norepinephrine triggers orgasm/ejaculation in men. Norepinephrine is the primary chemical messenger of the sympathetic nervous system (the system that responds to fight-or-flight, stressful situations).
When a person has chronically high norepinephrine, it can cause anxiety or irritability. It can eventually cause adrenal depletion, fatigue, or frank adrenal insufficiency. This can then lead to erectile dysfunction, loss of libido, sexual dysfunction.
To keep norepinephrine levels high, the brain may have to lower the production of dopamine, which can lead to loss of libido and erectile dysfunction. Lowered dopamine production, itself, can reduce testosterone production (though high norepinephrine can raise it - causing a wash if the balance is maintained). Lower testosterone can lead to erectile dysfunction. Lowered testosterone production can lead to insulin resistance and further metabolic cascades that can cause erectilve dysfunction and lack of libido.
Chronically high norepinephrine production in the absence of other neurotransmitter, hormone, cytokine problems, can lead to premature ejaculation - since it doesn’t take much to get a higher norepinephrine spike to trigger ejaculation.
Chronically high norepinephrine can raise blood pressure. This leads to long-term consequences, including renal dysfunction and erectile dysfunction.
What can be done is to either directly address the high norepinephrine production (e.g. with a serotonergic, anxiolytic, mood stabilizing, beta-blocking medication or others), or treat the consequences - such as adrenal fatigue (where the higher cortisol levels from treatment can help reduce via a feedback loop in the brain to lower CRH production, to lower norepinephrine levels), or treat the underlying cause of higher norepinephrine levels (which can include psychological stress, trauma, mental illness, thyroid dysfunction, hypogonadism, insulin resistance, infection or other chronic physical illness, etc.). In a way, a global treatment once assessment occurs, needs to be done. I usually don’t see a single substance (drug, hormone, or nutrient, or even herb) working. There are many entrypoints to dysfunction when a single hormone/neurotransmitter is out of whack in function. What I usually see are multiple hormone/neurotransmitter/cytokine problems as a consequence.
Any statement I make on this site is for educational purposes only and will change as medical knowledge progresses. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, please ask your doctor. Thank you.