Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for intercourse. Because ED can have a strong psychological component, counseling with a psychotherapist or sex therapist often works. However, more often ED is a symptom of cardiovascular disease and diabetes, both of which can impair blood supply to the penis. In addition, many medications interfere with sexual functioning.
Erectile dysfunction (ED) is a common occurrence in society with a prevalence of about 26 cases per 1,000 patients . This equates to about 150 million cases of ED worldwide. It is a condition where patients are unable to maintain adequate blood flow into their penis to sustain an erection. As a person ages, the probability of having ED grow but no age group is safe from this condition. In a study of Romanian men, it was determined that about 3 percent of males aged 15 to 25, 7 percent of males aged 25 to 45 and 22 percent of males 45 to 65 had ED . Once a man reaches 70, ED can be seen in 84 percent of the elderly. In most cases, ED is a condition that manifests because of a much larger systemic disease. Some of the most common risk factors include cardiovascular disease, hypertension, diabetes mellitus, tobacco use, hyperlipidemia, metabolic syndrome or depression .
Another potential cause of ED is prediabetes and diabetes—35-50 percent of men with diabetes also have ED. Chronically elevated blood sugar damages the arteries (there’s the vascular connection again) and nerves, including those that stimulate the penis. Prediabetes and diabetes are also generally accompanied by excess weight, especially around the mid-section. These excess fat cells convert testosterone into estrogen, negatively altering the testosterone to estrogen ratio. This excess estrogen, independent of prediabetes and diabetes, interferes with the hormonal cascade necessary to produce and maintain an erection. Although many men may reach for a testosterone booster, a more effective means is to improve the body’s metabolism and elimination of estrogen and to lose excess weight around the middle. To support healthy blood sugar balance and estrogen metabolism try:
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Intensive lifestyle changes that include a Mediterranean type diet, circuit-type resistance training, with 15- to 60-second rest between sessions has shown to improve erectile score in a randomized trial. Men in the intervention group had a significant decrease in glucose, insulin, low-density lipoprotein cholesterol, triglycerides, and blood pressure, and a substantial increase in HDL cholesterol.15
Another common cause of ED for many men is stress. When the body is under stress—either mental or physical—the sympathetic nervous system kicks in, releasing a cascade of stress hormones. Chronic stress leads to elevated levels of these hormones, which can lead to weight gain around the middle, and remember, those excess fat cells convert testosterone to estrogen. Stress also reduces sexual drive and leaves very little physical energy for sex. If chronic stress is a problem, try these supplements:
According to the Cleveland Clinic, “because erectile dysfunction is caused by a complex set of psychosocial, neurologic, and vascular factors, a specific cause in a patient may remain ambiguous.” The root causes are often related to a blockage or dysfunction of blood vessels. For example, ED can be due to conditions like atherosclerosis or diabetes, hormonal imbalances or problems related to mental health. It’s been found that common causes typically include one or more of the following factors: (2)
Eastern medicine should be fully exploited, and integrated with modern medicine to combine the advantages of both TCM and Western medicine. More research should be conducted into the efficacy and safety of TCM, and integration of TCM and Western medicine may provide promising breakthroughs in future clinical treatment. This strategy may allow for the development of new therapeutic strategies based on concepts of TCM and integrated medicine. There is a need for multimodal therapy and holistic approach to treat men (and their partners) with ED through complementary use of herbal supplements and modern drug to optimize underlying medical comorbidities; acupuncture, exercise or massage to reduce stress and strengthen the body; introduction and escalation of various medical therapy with use of mechanical therapy to further enhance penile erection; and lastly surgical intervention in suboptimal or refractory ED cases.
To understand the physiology of erectile dysfunction, we need to know erection first. An erection occurs when impulses from the brain and genital nerves cause blood to fill the two chambers known as the corpora cavernosa in the male penis. This causes the penis to expand and stiffen. Anything that blocks these impulses or restricts blood flow to the penis can result in ED. This block may be caused by psychological, neurologic, hormonal, arterial, or cavernosal impairment or even from a combination of all these factors.3
I developed joint and muscle pain, periods of extreme fatigue, skin reactions, sun sensitivity, my blood pressure became above normal for the first time in my life, I have developed metabolic syndrome, high blood sugar (as in pre-diabetes), erectile dysfunction, recurring welt-like mouth and cheek sores, lots of gum loss, and bone thinning! I struggle with energy and motivation issues, and I often feel like my lungs burn when I workout or do aerobic exercise.
10 ways of knowing that you are properly squeezing your pelvic floor muscles (PFM): 1) The base of your penis retracts inwards towards the pubic bone as you contract your PFM. 2) The testes rise towards the groin as you contract your PFM. 3) When you place your index and middle fingers in the midline between the scrotum and anus you feel these muscles tighten as you contract your PFM. 4) You can pucker your anus (not the gluteal muscles) as you contract your PFM. You feel the anus tighten and pull up and in, known as “anal wink.” 5) You get the same feeling as you do when you are ejaculating when you contract your PFM. 6) When you touch your erect penis, you feel the erectile cylinders surge with blood as you contract your PFM. 7) You can make your erect penis elevate (lift and point) as you contract your PFM. 8) You can stop your urinary stream completely when you contract your PFM. 9) You can push out the last few drops of urine that remain after completing urination when you contract your PFM. 10) After pursuing PFM training, you notice improvements in erectile rigidity and durability as well as better quality ejaculations, ejaculatory control and improvement in urinary control.
In contrast to Chinese ginseng, Korean ginseng is divided into three types, depending on how it is processed. Red Ginseng is harvested at the sixth year of cultivation and is steamed and dried. In addition to the effects mentioned regarding the effects of ginsenoside, red ginseng has been repoted to improve erectile function in a rat model of metabolic syndrome and it was also found to inhibit fibrosis of the corpus cavernosum of the penis (39). As with most herbal medicines, the concentration of ginsenoside are distributed unevenly throughout the ginseng plant and the concentrations in individual supplements can vary. Common side effects include headaches, insomnia, gastric upset, rash and constipation.
There is no single cause for erectile dysfunction. Achieving an erection involves a complex series of physiological events; in order for an erection to occur, the body is required to coordinate nervous system responses with tactile sensations, emotional triggers, and signals from certain hormones. If any of these events are disrupted, impotence is likely to occur.
The use of shock wave therapy has revolutionized the treatment of many aspects of medicine. High intensity extracorporeal shockwave therapy has been used for the treatment of nephro-urolithiasis while medium intensity shockwave therapy is used by orthopaedic surgeons to treat joint pain as well as tendinitis. Low intensity shockwaves therapy was first noted to improve ischaemia-induced myocardial dysfunction in animal studies when low intensity shockwaves were applied to porcine myocardium (13). Shockwaves induces a localized stress on cell membranes in the same way that shear stress affects endothelial cell membranes (14) and this triggers the release of angiogenic factors, such as increased NO production through increased activity of endothelial NO synthase (eNOS) and neuronal NO synthase (nNOS), platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) (15). These shockwaves also cause membrane hyperpolarization (16), activation of the Ras signaling pathway, non-enzymatic synthesis of NO and induction of stress fibers and intercellular gaps (17).
Opioids are used for chronic pain or for recreational use, and there is currently an epidemic of opioid addiction in the United States. Opioids induce ED by inhibiting gonado-tropin-releasing hormone (GnRH), which leads to a decrease in the production of luteinizing hormone (LH). Decreased levels of LH, in turn, inhibit production of testosterone, which – in both men and women – can cause depression and sexual dysfunction.9
Erectile dysfunction (ED) is commonly called impotence. It’s a condition in which a man can’t achieve or maintain an erection during sexual performance. Symptoms may also include reduced sexual desire or libido. Your doctor is likely to diagnose you with ED if the condition lasts for more than a few weeks or months. ED affects as many as 30 million men in the United States.