Erectile Dysfunction Overview
Erectile dysfunction (ED) affects 50% of the world’s population in men starting at an early age of 40.
However, due to unrestricted access to internet pornography, a new generation of young, healthy men are also suffering from erectile dysfunction known as “Porn Induced Erectile Dysfunction” (PIED).
Approximately a whopping 152 million men worldwide are currently suffering from the inability to achieve or maintain a solid and stronger erection enough for successful penetration and subsequent ejaculation.
The current figure is projected to increase to over 320 million men with ED by the year 2025.
In the United States alone, there are about 20-30 million men with ED or approximately 12.5% of the male population.
ED is considered an important public health problem by the National Institute of Health. The World Health Organization (WHO) states that
Sexual health is fundamental to the physical and emotional health and wellbeing of individuals, couples and families, and to the social and economic development of communities and countries.
Despite the adverse impact it has on a man’s self-esteem and quality of life, some men with ED fail to seek medical attention due to the complex nature of sexuality, ignorance, shame, embarrassment, selfishness, cultural restrictions or ethnic beliefs, and acceptance of ED as a normal process of aging.
However, in today’s modern world, it is important for a man to be equipped with knowledge and understanding of basic sex education, health, and nutrition because as demonstrated in a recent study, sexual dysfunction is a major cause of marital problems in the western world. The good news is there are many safe and effective natural treatments for ED available today.
What is Erectile Dysfunction
Erectile dysfunction, also known as impotence, is defined as the persistent inability to achieve or sustain a harder erection for satisfactory sexual activity and intercourse.
ED is a complex male sexual issue involving psychosocial and biological factors. It is also one of the most common sexual disorder in men after premature ejaculation.back to menu ↑
Who is Most Likely Gets ED?
Erectile dysfunction affects men of all races and in all parts of the world. The prevalence and severity of ED increase as they get older. However, growing old is not the main cause of the problem. Though sexual performance may decrease with age, many men enjoy sexual activity well into their senior years.
ED can be an early warning sign of more serious illnesses such as heart problem, hypertension, or type 2 diabetes. Early diagnosing and treating the underlying condition that causes ED can restore your sexual health and overall well-being.
In an American study, ED occurs in
- 39% of men aged 40 to 70 reported moderate or complete impotence
- 52% of the whole group reported having some degree of erectile problem
- 45% of men in their mid-60’s reported having a moderate to compete or severe ED
What are the Risk Factors for Erectile Dysfunction?
Erectile Dysfunction is always been related to both physical and psychological factors. A variety of contributing factors that can develop your risk of erectile dysfunction including:
- Advancing Age -As men get older, erections might take time and most men need direct penile stimulation to get and keep a boner
- Being Over Weight
- Certain Medical Treatments
- prostate surgery
- chemo or radiation treatment for cancer
- Endocrinological or Hormonal Conditions
- low testosterone
- History of Pelvic Irradiation or Surgery, including radical prostatectomy
- Injuries or Physical Trauma
- venous leak or arteries that control erections
- spinal cord injury
- Lifestyle Factors
- smoking cigarettes
- alcohol consumption
- drug abuse can affect sexual function
- bath salts
- Medical Conditions
- cardiovascular disease
- diabetes mellitus
- high blood pressure
- high levels of cholesterol
- multiple sclerosis
- prostate enlargement
- Medications – see the list of meds here which can increase the risk of ED
- appetite suppressants
- ulcer medications
- medications to treat high blood pressure, pain or prostate conditions
- selective serotonin reuptake inhibitors
- Neurologic Conditions
- Alzheimer’s disease
- multiple sclerosis
- Parkinson’s disease
- Peyronie’s Disease
- Prolonged Bicycling
- Psychological Conditions
- anxiety or depression
- fear of sexual failure
- low self-esteem
- sexual abuse
- marital problem
- Sedentary Lifestyle
- Sleep Disorder or Insomnia
Symptoms Of Erectile Dysfunction/Impotence
The symptoms of erectile dysfunction may include:
- lack of sexual desire
- unable to get an erection by command
- difficulty in maintaining an erection and it softens before sexual intercourse
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What Causes ED in Men?
In general, there are many underlying ccauses of ED in men. Understanding the specific types of erectile dysfunction can help a person identify the condition and which therapies may respond better than the others.
(1) Physiologic or Physical Causes of ED
Physiologic also known as organic ED is the result of not enough blood flows into the penis due to damage of the nerves, arteries, and fibrous tissues into the penis.
Many chronic conditions can reduce blood flow into the penis, which cause ED, including:
- atherosclerosis (clogged of the blood vessels)
- diabetes (Type 1, 2 & 3 diabetes)
- heart disease
- high Cholesterol
- hypertension or high blood pressure
- kidney disease (renal failure)
- Peyronie’s disease or penile curvature
- foreskin problems (phimosis, lichen sclerosus)
- priapism or prolong erection
- prostate enlargement
- prolonged smoking cigarettes
- blood diseases (sickle cell anemia and leukemias)
(3) Psychogenic or Psychological Causes of ED
This is another common cause of ED among men. Brain is the largest sex organ. When brain disrupts the normal functioning of the brain cells, it can cause or impair the ability to achieve normal erection quality.
Psychological issues may include:
- anxiety about sexual performance
- depression or schizophrenia
- fear of intimacy
- ambivalence about sexual orientation
- relationship conflicts
- post traumatic sexual experience
- sexual abuse
- stress at home or work
(4) Neurogenic or Neurological Causes of ED
Certain diseases, surgery or injury in the pelvic area can damage nerves in the penis. Therefore, this may disrupt proper communication pathways of the nerve signals from the brain or spinal cord to the penis area.
Here are some of the neurological disease or injury of the blood vessels and nerve supply which cause ED, including:
- Alzheimer’s disease
- Guillain-Barré syndrome
- bicycle seat pressure trauma
- blood clot
- brain or spinal tumours
- chronic alcoholism and drug abuse
- heavy metal poisoning
- multiple sclerosis (MS) – decrease penile sensation
- nerve injury
- Parkinson’s disease
- Surgical procedure in the pelvic area may cause ED include:
- pelvic or prostate surgery
- cryosurgery of the prostate
- abdominal perineal resection
- brachytherapy (seed implants) for prostate cancer
- peripheral neuropathy – seen in people with type 2 diabetes
- spinal cord injury (paraplegia, quadriplegia)
- stroke or cerebral trauma
- temporal lobe epilepsy
(5) Endocrinologic or Hormonal Imbalance Causes of ED
Normal erection is achieved when you have normal levels of testosterone and thyroid, and at the same time low levels of estrogen. Any abnormalities of the endocrine system such as low levels of testosterone can cause not only erectile dysfunction but also the development of breast enlargement or gynecomastia (man’s boob).
Other hormonal disorders that may contribute in the development of ED are:
- Addison’s disease
- type 2 diabetes
- hypogonadism due to testicular failure and decreased secretion of gonadotropin releasing hormone
- lower testosterone levels associated with decreased libido
- decline in nitric oxide synthase activity
(6) Drug Induced Causes of ED
It is important to recall what drugs you’ve been taking as a number of medications are associated with the development of ED. Some of this drugs are used in the treatment of prostate cancer, which can cause loss of libido and erectile dysfunction.
Many prescription drugs can cause debilitating side effects such difficulty of getting an erection, especially among older men.
Some of the medications are known to linked ED are listed below.
- Alpha-adrenergic blockers: tamsulosin (Flomax)
- Antacid or Gastroesophagelal reflux disorder (GERD): Ranitidine (Zantac) and cimetidine (Tagamet)
- Antipsychotic: Phenothiazines (Compazine) and butyrophenones (haloperidol)
- Anticholinergic agents: Disopryamide, anticonvulsants
- Beta-blockers: Carvedilol (Coreg) and Metoprolol (Lopressor)
- Calcium-Channel Blockers: Amlodipine
- Cardiac or cholesterol: digoxin, Gemfibrozil, or Clofibrate
- Chemotherapy drugs: Methotrexate, Ciplatin or Vincristine
- Diuretics: Furosemide (Lasix) and Spironolactone (Aldactone)
- Depressants: alprazolam (Xanax), diazepam (Valium), and codeine
- Immunomodulators: Interferonα
- Stimulants: Cocaine or Amphetamines
- Selective Serotonin Reuptake Inhibitors or SSRIs: (Prozac, Paxil)
- Synthetic hormones: such as estrogens, corticosteroids, and 5-alpha reductase inhibitors; Leuprolide (Eligard)
- Tranquilizers: Butyrophenones, phenothiazines
(6) Vasculogenic Causes of ED or “Venous Leak”
It affects young men as much as 30-70% of the population where the chamber of the penis can’t store blood during an erection.A man with venous leak can’t hold an erection for a longer period of time because blood does not remain trapped inside the penis, thereby, preventing the development of a stronger erection.
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How Does Your Doctor Test & Diagnose Your ED
In order to rule out the cause of your ED accurately, your urologist may obtain the following:
- Medical, Sexual, and Psychosocial Histories. History may reveal underlying causes of ED such as cardiovascular disease, diabetes, depression, previous sexual abuse, and alcoholism.
- Physical Examination
- Genito-urinary: penile, testicular and rectal examination
- Cardiovascular: taking of blood pressure, heart rate, waist circumference, abdominal aortic aneurysm, carotid bruits, foot pulses
- Neurological: focused neurological examination
- Blood Tests can reveal possible causes of ED, such as diabetes, kidney problem, high cholesterol, and low levels of testosterone. Blood tests may include:
- complete blood count (CBC)
- blood glucose
- free testosterone
- luteinizing hormone
- prolactin levels
- sex hormone-binding globulin test
- Doppler Penile Ultrasound Test. It uses a handheld device that is passed over your penis to create images of blood vessels in your penis.
- Intracavernosal Injection Test. Your doctor will inject a medicine into the side of your penis to cause harder erection. If the erection is not hard enough or does not last, you may have a problem with blood flow
- Overnight Erection Test. This involves wrapping a special tape around your penis and must be done before going to bed. It helps to determine the cause of your ED if it is psychological and not physical.
- Nocturnal Penile Tumescence (NPT) Test. This is to check if you are having normal erection during sleep. Normally, a man can have at least 3-5 full erections during deep sleep. If you don’t have any erections during your sleep, you may have nerve damage or the cause of your ED is physical. However, if good erections occur during the night, your ED is more likely psychological cause.
Early Treatment of Erectile Dysfunction (ED)
In the early times, the bible attributed male sexual dysfunction as a divine curse. Over the years, ED has been “treated” by witchcraft, exorcism, and religious counselling.Numerous potions has been use to increase sexual potency and male enhancement with the use of ingesting animal testes and testicular extracts.
Ignorance and superstition about sexual dysfunction were eventually superceded by scientific examination and new approaches to treat ED.
|Historical Dates||Historical Timeline of Erectile Dysfunction & Management|
|Theophrastus (320 B.C. )||A Greek philosopher who discovered a plant called "satyrion" can make a man perform sex up to 70 times in a row.|
|Hippocrates (460–375 B.C.)||The Greek physician and father of medicine, attributed ED to man’s professional preoccupations and the ugliness of the female.|
|Egyptian Civilization (2000 B.C. )||The word "impotence" was first written on Egyptian papyrus scrolls.|
|Chinese, Greek, Roman, and Egyptian (Second Century A.D.)||Literatures mention numerous potions to increase sexual potency. Historical remedies for ED have included the ingestion of animal testes and testicular extracts to treat ED.|
|Pliny the Elder (50 A.D.)||A roman physician shared a comprehensive list of impotence cures and aphrodisiacs, including ginger, truffles, vulture lung, rooster testicles, and goose tongue.|
|India's Ayurvedic medicine (1000 A.D.)||The Ayurvedic medicine make references to erectile dysfunction and suggested an ED remedy: ram's testicle boiled in milk.|
|China (1400s)||Carved jade and ivory cock rings are used to maintain erections.|
|Leonardo Vinci (1452–1519)||Italian artist and inventor who also suffered with erectile dysfunction. He was the first to described the mechanism of erection - the filling of the penis with blood.|
|Constanzo Valorio (1543–1575)||He attributed the Greek physician Galen's first description of erectile dysfunction as the muscle surrounding the penis.|
|William Shakespeare (1564-1616)||He noted that alcohol provokes the desire, but it takes away the performance.|
|Religious Moralists (18th-19th century)||They maintained religious philosophy that it was caused by excessive sexual activities such as masturbation, prostitution, and promiscuity. ED has been “treated” over the years by witchcraft, exorcism, and religious counselling.|
|Vincent Marie Mondat (Early 1800s)||French physician who first invented the “congestor” - a vacuum pump or “exhausting apparatus,” which in drawing blood into the penis was designed to promote erection.|
|William Acton (1813–1875)||British doctor and writer, prescribed strychnine and phosphoric acid with either syrup of orange-peel or syrup of ginger.|
|Charles Edouard Brown- Sequard (1889)||French physiologist injected himself with extracts made of blood from the testicular vein, semen, and a liquid obtained from crushing the testicles of young dogs and guinea pigs. He reported an excellent sexual response to this cocktail, considered by many experts to be the birth of male hormone therapy|
|Frederick Hollick (1818-1900)||American physician and sex educator, used cannabis to cure impotence as well as to restore sexual power and desire.|
|W. Frank Glenn (Late 1800's)||W. Frank Glenn (18th century) He claimed damiana to be the most effective remedy for ED. In cases of complete inability to produce an erection, he employed a combination of phosphide of zinc, damiana, aresenious acide, and cocaine.|
|Sigmund Freud (1856-1939)||An Austrian psychoanalyst, postulates that most cases of erectile dysfunction are caused by neurosis and repressed desires, not physical causes.|
|Alfred Kinsey (1894-1956)||Renowned American sexologist, publishes his first report, Sexual Behavior in the Human Male, which reveals that erectile dysfunction is far more prevalent than previously believed.|
|Masters and Johnson (1957-1990s)||The Masters and Johnson research team published the most cases of sexual disorders and dysfunctions as psychological in origin, setting ED progress back 50 years|
|Dr. Giles Brindley 1983||A British physiologist who demonstrated the efficacy of an injectable penile drug by administering it to himself, then taking off his pants to show the audience his chemically induced erection and invited them to inspect it closely.|
|Pfizer (Viagra) 1998||The first drug of choice approved by the FDA to treat erectile dysfunction. A few years later, other companies developed their own version of erection drugs: Cialis, made by Eli Lilly; Levitra, by Bayer AG and GlaxoSmithKline.|
Treatment for Erectile Dysfunction
Identifying the main root cause of your ED is very important to determine what best treatment option appropriate for you. Always keep in mind that every medical intervention that involves medications or surgeries has its own pros and cons, which you may regret in the long run.
Here are some of the common treatment for ED include:
Healthy Lifestyle Changes
Some men may experience temporary loss of erection due to lifestyle exhaustion or stress. A simple lifestyle modification, can help reverse your ED by:
- managing stress, depression, and other mental issues
- quitting consumption of tobacco, illegal drugs, and alcohol
- eating healthy diet
- exercising regularly to improve blood circulation and lose weight
- sleeping at least 7-8 hours a day
- eliminating certain bad habits and things that unknowingly killing your erections
Medications for ED
(1.) Oral medications for ED
Prescription pills are the most common treatment for ED. It works by increasing blood flow to the penis to get a normal erection when you are sexually turned on. However, pills may not work if the cause of your ED is psychological.
You should never take these ED medications if you are taking nitroglycerine drugs for heart problem because it can cause your blood pressure to drop to a life-threatening level.
These ED drugs can cause a variety of side effects such as nausea, blurred vision, dizziness, headaches, nasal congestion, stomach upset, priapism (prolong erection), etc.
Medications to treat ED include:
- Cialis (tadalafil)
- Levitra, Staxyn (vardenafil)
- Stendra (avanafil)
- Viagra (sildenafil)
(2.) Topical gels for ED include:
- Vitaros – The first prescription cream to treat ED for men who are unable to take oral erection pills. The cream can be applied directly to the tip of the penis to sustain harder erection 15-30 minutes prior to sex.
- AndroGel – It is a synthetic testosterone replacement therapy which can be applied to the skin daily for 24-hour delivery into the body. Possible side effects including dizziness, headache, acne, prostate enlargement, lower sperm count and irritability.
- TriMix-gel®– is an easy to apply gel directly into the penis to achieve an erection before sexual intercourse.
(3.) Injections (Prostaglandins alprostadil)
- Muse Pellet
Vacuum Constrictive Devices (VCDs)
This is another way to treat ED if oral or topical medicines failed to deliver positive results. Basically, you place your penis into the tube that connects to a pump. When air is pumped out of the tube, blood flows into the penis to attain firm erection. Once erection is achieved, a constriction or a tension ring is placed around the base of the penis to keep the blood and maintain an erection until intercourse is finished.
Hormone Replacement Therapy for ED
For some men, abnormal low levels of testosterone is always associated with low libido and ED. Hormone replacement therapy is available in the form of:
- transdermal patches or skin patches
- tablets placed between the cheek and gums
- topical gels
Sex therapy or counselling is recommended for men who are suffering form erectile problem related to emotional or psychosocial issues. Your partner should be involved in this therapy to rule out any miscommunication between the two parties. Counselling therapies include:
- Cognitive Behavioural Therapy (CBT)
- Psychosexual Counselling
- Blood Vessels Repair Surgery
Surgery may be necessary if the cause of your ED is nerve damage or an injury to the penis. It helps to repair arteries that carries blood to the penis.
- Penile Prosthesis (Implants)
This treatment involves the implantation of soft rods into each of the penis’ two erection chambers called the corpora cavernosa and placement of a pump under the skin of your scrotum. This kind of ED treatment is expensive and can lead to infection.back to menu ↑
Alternative Treatment for ED
There are other natural treatments available to help achieve and sustain erection on command that you can explore:
If the cause of your ED is physical, oil essences can help improve your mood and boost your sexual confidence.
Herbs and Food Supplements for ED
Men are exposed to a variety of natural supplements or Superfoods claiming to restore solid erection and vitality. These herbs or Superfoods for ED don’t have an instant effect and may take a day or a week to take effect its efficacy. These natural remedies for ED include:
- Beetroot juice
- Gingko Biloba
- Green tea
- Panax Ginseng
- Pomegranate juice
- Watermelon juice
Best E-books for Natural ED Reversing
If you want to cure your ED without spending thousands on Viagra and other ED treatments listed above, then it is highly recommended to download a copy of these natural ED cures on e-book format. These e-books for ED are all worth the investment and it is exclusively available online and you won’t find them on Amazon or any other bookstore.
Check out the links below and discover how you can actually reverse your ED that your doctors won’t even tell you.
Education is the most powerful weapon which you can use to change the world. – Nelson Mandela
- Carson, Culley C & Dean, John D. (2007), Management of Erectile Dysfunction in Clinical Practice, Springer, London
- Hanash, K. Anthony (2008), New Frontiers in Men’s Sexual Health: Understanding Erectile Dysfunction and the Revolutionary New Treatments, Praeger Publishers, CT, USA
- AUA Foundation: Erectile Dysfunction
- Background on Erectile Dysfunction
- Clinical Review Erectile Dysfunction
- What I need to know about Erectile Dysfunction
- 2015 CUA Practice Guidelines for Erectile Dsyfunction
- Two Millennia of Impotence Cures from Impotence: A Cultural History
- Management of Erectile Dysfunction
- Test for Erection Problem
- Nutrients and Botanicals for Erectile Dysfunction: Examining the evidence
- Timeline of Erectile Dysfunction History