Herbs and Natural Alternatives to Erectile Dysfunction Drugs

Male erectile dysfunction is defined as the consistent inability to obtain or maintain an erection for satisfactory sexual relations. For many years patients relied on medications for erectile dysfunction treatment, but now there is a growing number of effective herbs and supplements, providing a natural alternative to erectile dysfunction drugs.
Note: There is a higher rate of heart disease in men with erectile dysfunction. All men, particularly older men, with erectile dysfunction and no cardiac symptoms need a medical evaluation, detailed cardiac assessment, blood pressure measurement, lipid profile and blood sugar test, as well as lifestyle advice regarding weight, diet, and exercise. For more erectile dysfunction information.

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How Common is erectile dysfunction?
Data from the Massachusetts Male Aging Study has indicated that the prevalence of erectile dysfunction of any degree is 50% in men between the ages of 40 to 70 years. At least 20 million American men have some degree of erectile dysfunction, and about one in 10 adult males suffers from erectile dysfunction long-term. About 40% of men in their 40s report at least occasional problems getting and maintaining erections. So do more than half (52%) of men aged 40 to 70, and about 70% of men in their 70s. Hardening of the arteries alone accounts for 50% of erectile dysfunction cases in men 60 and older. Between 35% and 50% of men with diabetes have erectile dysfunction
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Erectile dysfunction and age
Erectile dysfunction is part of normal aging in men, while urinary or bowel function doesn't necessarily decline with age.

Understanding the Causes of Erectile Dysfunction
Erectile dysfunction can be classified simply under two headings. Psychological erectile dysfunction: that is, mental; or Organic erectile dysfunction: that is, due to some form of physical or medical problem. Organic erectile dysfunction becomes more common as men get older.

Psychological causes of Erectile Dysfunction
The causes of psychological erectile dysfunction are numerous, and it is difficult to list them all, but most often erectile dysfunction is related to depression, performance anxiety, marital stress or relationship problems, life crisis, financial difficulties, religious repression, or some type of mental illness. Improving erectile dysfunction in these cases may require addressing the underlying causes. Psychotherapy may help some individuals overcome psychological erectile dysfunction.

Organic causes of Erectile Dysfunction
There are four major causes of organic erectile dysfunction: Vascular, Neural, Hormonal, and Drug-induced. The type of erectile dysfunction determines the treatment approach.

1. Vascular causes of Erectile Dysfunction
Alterations in the flow of blood to and from the penis are thought to be a common cause of male erectile dysfunction. For instance, medical conditions such as atherosclerosis (hardening of the arteries), high cholesterol, hypertension, or diabetes reduce blood flow to the penis and genital organs thus leading to difficulty with erection or genital swelling. Erectile dysfunction could be an early indication of oxidative stress and vascular dysfunction. A vascular problem in the penis may precede a wider, systemic problem in other blood vessels in the body. Patients with cardiovascular disease and patients with diabetes represent the largest group of patients with erectile dysfunction. Lowering cholesterol through diet, supplements, or medicines improves erectile dysfunction.
Metabolic syndrome can increase inflammatory markers in blood and negatively influence endothelial function resulting in poor vasodilation and a higher incidence of erectile dysfunction.
Additional factors that can impede blood flow include penile injury and surgery in the pelvic and abdominal area. Smoking can reduce genital blood flow. Some men with erectile dysfunction may have an underlying vascular disease such as atherosclerosis.

2. Neural causes of Erectile Dysfunction
Nerve damage from disorders such as multiple sclerosis, Parkinson’s disease, diabetes, and stroke affect the brain’s ability to respond to sexual stimulation and cause erectile dysfunction. In women, abdominal or pelvic operations can occasionally lead to nerve damage. Erectile dysfunction is common in men undergoing surgical treatment for prostate enlargement or cancer.

3. Hormonal causes of Erectile Dysfunction
Low levels of androgens, such as testosterone, are sometimes a component of erectile dysfunction. Testosterone levels decline about 1 percent each year in men, which may contribute to erectile dysfunction with aging. Testosterone also declines with age in women leading to a decrease in female libido. Replacement of androgens can sometimes be helpful in those with age related erectile dysfunction. Testosterone is available by prescription only. An over the counter hormones, such as DHEA, converts into testosterone and thus has a positive influence on erectile dysfunction. Pregnenolone is another over the counter hormone that may increase testosterone levels and thus improve erectile dysfunction. Many herbal aphrodisiacs also have a positive influence on erectile dysfunction. Routine hormone blood studies for erectile dysfunction evaluation are not needed during the initial evaluation but perhaps later if treatment modalities are not successful. Prominent diseases of the endocrine system, such as diabetes mellitus, hypogonadism, and hyperprolactinemia, may cause erectile dysfunction. Sometimes erectile dysfunction treatment with hormones such as DHEA or testosterone can be effective.

4. Drug or Medication-induced Erectile Dysfunction
Drugs that interfere with erectile function include some anti-hypertensives, SSRIs (like Prozac), sedatives, and beta-blockers. SSRIs - treatment for depression - cause erectile dysfunction mostly due to their effect on serotonin metabolism. Serotonin has an inhibitory effect on erectile function and sexuality. Beta blockers such as propranolol, atenolol, and others, are some of the most common medications that cause erectile dysfunction.
Surprisingly, NSAIDs such as ibuprofen and naproxen also cause erectile dysfunction. Regardless of the reason for taking them, painkillers classified as non-steroidal anti-inflammatory drugs (NSAIDs) apparently increase the likelihood that middle-aged and elderly men will develop erection difficulties. A study involved 1126 men, between 50 and 70 years of age, without erectile dysfunction in 1994 when they completed a questionnaire that included, among other things, questions about erectile function and medication usage. The questionnaire was then re-administered five years later. The investigators found that the erectile dysfunction rate was 93 cases per 1000 persons per year among NSAID users compared with just 35 cases among nonusers.
Some chemicals involved in the human sexual response include dopamine, acetylcholine, and nitric oxide. All these three natural chemicals and others can be manipulated n the treatment of erectile dysfunction. Alcohol's negative affect on sex drive increases with age. Heavy smoking is an important risk factor for erectile dysfunction in men.. erectile dysfunction therapy

Erectile Dysfunction and Medical conditions
Certain medical conditions cause erectile dysfunction or reduce libido, performance, or enjoyment. These include hypertension, diabetes, high cholesterol, cardiovascular disease, obesity, peripheral vascular disease, neurologic disorders, and insomnia. Erectile dysfunction  is almost twice as common in men with symptoms of overactive bladder as it is in men without overactive bladder. Sitting on a bicycle too long. Men who log several thousand miles a year on their mountain bikes suffer scrotal damage that could reduce their fertility or cause erectile dysfunction.

Erectile Dysfunction and Cardiac Patients
Erectile dysfunction is common in cardiac patients and shares the same risk factors - smoking, hypertension, hyperlipidemia and diabetes mellitus. Sexual activity is not unduly stressful to the heart and, providing patients are properly assessed using established guidelines, sexual intercourse can be enjoyed without increased risk. Erectile dysfunction in asymptomatic patients may be a marker of silent vascular disease or increased vascular risk factors and should alert the physician to the need for cardiac risk screening.
Physical fitness positively influences sexual desire and performance. Moderate exercise may help boost sexual function in men with heart failure. The results may be good news for some men with erectile dysfunction, because Viagra and other similar erectile dysfunction drugs can have dangerous interactions with medications commonly prescribed to treat heart failure.

Basic facts about erectile dysfunction
Overweight men are more likely to have erectile dysfunction
Common causes of erectile dysfunction include nerve diseases, psychological conditions and diseases that affect blood flow. A number of prescription drugs and over-the-counter drugs may also cause ED by affecting a man's hormones, nerves or blood circulation
Tobacco, alcohol and recreational drugs can all damage a man's blood vessels and/or restrict blood flow to the penis, causing erectile dysfunction
Regular exercise can reduce the risk of erectile dysfunction
Stress and anxiety are leading causes of temporary erectile dysfunction


Erectile Dysfunction and Heart Disease
A large study of men age 55 and older adds to evidence that erectile dysfunction can be a warning sign for heart disease. Men with erectile dysfunction were more likely than other men to experience chest pain, a heart attack or a stroke during the next seven years, the study found. The results suggest that men who see their doctors for erectile dysfunction drugs also should consider getting screened for heart disease.

How effective are Erectile Dysfunction Drugs?
[Pharmacotherapy of erectile dysfunction]
Urologiia. 2000 Jan-Feb;(1):33-8. Links
Among the drugs used to treat erectile dysfunction most common are prostaglandins El, viagra, iochimbin, vasodilators and desaggregants, vitamins, biogenic stimulators, etc. The comparative analysis of their efficacy was made in 360 patients with erectile dysfunction, primarily at subcompensated stage, aged 17-83 years. Organic and psychogenic erectile dysfunctions were diagnosed in 69 and 31% of the patients, respectively. Intracavernous injections of prostaglandin El (Caverject) were effective in 74%, transurethral alprostadil (MUSE) when adjusting the dose--in 38% of the patients. Iochimbin in patients with organic and psychogenic forms of erectile dysfunctions was effective in 25 and 40% of patients, respectively. In 26.3 and 19% of such patients the response was obtained after use of the combination including xantinol, nicotinate, trental, biogenic stimulators and adaptogens. Viagra was effective in 60 and 77% of patients with psychogenic and organic erectile dysfunctions, respectively.

Biking as a cause of erectile dysfunction
Spending too much time on a bicycle seat can compress the artery and vital nerves leading to the penis and in some men can cause erectile dysfunction. A male cyclist has a significant part of his body weight on his perineum, an area between the scrotum and the anus where the nerves and arteries to the penis pass. This pressure -- and a narrow saddle seat -- can injure the arteries and nerves. Even as little as a few hours a week of cycling can increase the risk for bicycle seat erectile dysfunction. One option while riding is to take frequent breaks to allow the blood vessels an nerves of the perineum to readjust and function normally. The good news is that erectile dysfunction from cycling is almost always temporary and reversible.

Erectile dysfunction questions
Q. I have been confronted with
erectile dysfunction for almost three years now. I taken most of the leading brands of medications, and herbs including the expensive and painful Boston Medical group treatment but no avail. Does Passion RX Yohimbe treat erectile dysfunction challenge and Early ejeculation challenge? I need help. Be honest with me. Any help will be highly appreciated
   A. Passion Rx with yohimbe is a very popular product, and many people also like alternating it with Prostate Power Rx. Please discuss with your doctor regarding the use of these supplements. There is no way to predict any individual person's response. We wonder what the Boston Medical group treatment is.

Q. I am 55 and have erectile dysfunction. I have had this problem for several years. I have been on testosterone therapy and Cialis for about a month. It is not working sufficiently. All it is doing is keeping me preoccupied with what it is not enabling me to do and keeping me awake at night with the desire but no capability. I want to try the Passion Rx but I wanted to get some guidance from you first. I have started to walk and do resistance exercises to lose weight and hopefully restore some blood flow. I am diabetic but not seriously yet. I'd like to be able to satisfy my wife like I did in the old days. Will Passion Rx really help me to any extent for erectile dysfunction?

Q. I am a 55 yr old hetero male with a regular partner. At this age I find that I am suffering from erectile dysfunction and the meds don't help. I have tried oral meds (with little help) and cant tolerate the side effects and the injections are painful and dont help much. My doctors have suggested a prostheses, but before considering that I am interested in alterative measures to solve this problem .
   A. It is difficult to predict which sex enhancing herb will be helpful, or which combination of herbs, or which sex improving product will be effective in any particular person. Sometimes it takes trial and error to find out.

Q. Does CoQ10 improve erectile dysfunction?
   A. Coq10 does not seem to play a major role in erection, at least it does not have a quick effect on sexual enhancement.

Q. I have read a study of using Propionyl L-Carnitine and Acetyl-L-Carnitine coupled with Viagra to combat erectile dysfunction in diabetics. However, has any study results revealed that this treatment is effective with those who suffer high blood pressure and are taking high blood pressure meds. I specifically take Lisinopril, Valsartan, and hydrochlorothiazide.
   A. We are not aware of any studies that have evaluated the combination of acetyl carnitine or other carnitine supplements in the treatment of erectile dysfunction in combination with prescription medications for blood pressure or other purposes. If one is already taking prescription medications and wants to begin taking supplements, it is wise to begin with low dosages.

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