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Erectile dysfunction (ED), frequently labeled “impotence,” is a
concern of virtually every man over the age of forty. It
is defined as either an inability to reach sufficient
penile hardness for vaginal penetration or inability to
maintain an erection long enough to achieve satisfactory
sexual intercourse.
A man’s erection results from a complex
combination of physical conditions, hormonal balance,
nerve function, circulatory and overall health, as well
as external stimuli to the brain and penis. In addition, to
achieve an erection and have satisfactory intercourse,
the prostate must function properly. Anything that
interferes with any of these pathways, including
prescription or over-the-counter medications, can cause
a problem, either temporarily, or permanently in the
case of a severe imbalance, chronic illness, or
long-term drug use. Many drugs (especially
antidepressants) can cause or exacerbate erectile
dysfunction.
A large study done a little more than a
decade ago used a self-administered sexual activity
questionnaire to determine the incidence of erectile
dysfunction in 1300 male subjects between the ages of
forty and seventy. The report concluded that the
combined incidence of erectile dysfunction ranging from
minimal to total impotence was 52 percent of all men in
this age range. Additionally, the prevalence of complete
impotence tripled from 5 to 15 percent as subject ages
neared seventy years. From this and other studies, it is
estimated that the number of American men suffering from
this condition is from twenty-five to well over thirty
million, depending on the source.
Most men have few problems with erectile dysfunction in
their youth and expect such youthful vigor to continue
forever. However, as the years advance, the health and
vitality of the body deteriorates, and the level of
sexual vigor drops accordingly. Unfortunately, many men
suffering from erectile dysfunction or loss of libido,
cannot (or will not) admit to a connection between their
overall health and their sexual problems. Fortunately,
most such problems can be corrected.
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Many cases of erectile dysfunction are due to impaired
blood circulation resulting from an underlying health
condition. All body organs and tissues depend on
circulating blood to provide necessary nutrients and
remove waste products. An organ lacking good blood
circulation cannot maintain peak health. The prostate is
no exception. It is well supplied with blood vessels and
capillaries, and dependent on them to maintain its
function. The overall health of the prostate and the
nerve bundles that surround it are crucial to sexual
performance and satisfaction.
The penis is also dependent on good blood circulation.
Like the prostate, it needs an ample blood supply for
nourishment. However, aside from general tissue health,
the penis requires unimpeded blood circulation to
produce an erection for sexual activity. Thus, while
some cases of erectile dysfunction are related to
hormone imbalances, the problem is more often a direct
result of poor health or vascular insufficiency. Any
health condition, medication, or physical injury that
impedes blood circulation in a man often results in some
degree of prostate problems or erectile dysfunction.
Many chronic conditions are also a result of decreased
blood flow in the body. Thus, erectile dysfunction can
be the first symptom of a compromised vascular system,
and is often an early symptom of other cardiovascular
problems.
There are many health conditions that contribute to
vascular problems, and any one of them can cause or
exacerbate erectile dysfunction. For many years,
impotence was thought to be a side effect or
complication of other vascular problems like diabetes,
cardiovascular disease, high blood pressure, high
cholesterol or high trigliceride levels. However, it is
more likely that impotence is the earliest indicator of
impaired circulation problems from one of the above
conditions. Thus, by resolving problems with erectile
dysfunction early and naturally, one may also be
preventing or ameliorating other cardiovascular
problems.
Several studies have found erectile dysfunction to be
prevalent among men with high total cholesterol and low
HDL/LDL ratios. High cholesterol and triglyceride levels
are well known as strong risk factors for numerous
cardiovascular problems. Reducing their levels can help
correct erectile dysfunction while also lowering the
risk of other problems. These elevated levels can be
reduced with prescription medication or herbal remedies.
However, since they usually result from a poor diet and
lack of exercise, lifestyle and dietary changes are
significantly more effective and should be the first
choice.
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Often, high cholesterol and trigliceride levels are
accompanied by or result in high blood pressure
(hypertension), hardening of the arteries
(arteriosclerosis), or arteries clogged by cholesterol
deposits (atherosclerosis). These conditions all inhibit
blood flow in the body, and can be grouped under the
general term of vascular or cardiovascular dysfunction.
Diabetes can also cause serious problems. It exacerbates
erectile dysfunction by making blood vessels less
elastic. Such blood vessels cannot dilate fully and thus
restrict blood flow during an erection. Diabetes also
deteriorates nerve viability, thus decreasing the
sensitivity of the penis. Both effects are magnified
when the condition has been present or poorly controlled
for many years.
Approximately fifty percent
of men with diabetes have erectile dysfunction, and the
percentage increases with age.
Diabetes also has profound effects on the endocrine
system, and thus, on hormone levels. A recent study in
The Journal of Clinical Endocrinology and Metabolism
measured testosterone levels of 103 men with type-2
diabetes and found that 33 percent of them had low free
testosterone levels. The median age of these men was
54.7 years. In this study, the men seemed to have
lowered levels of the pituitary hormones that control
testosterone production. This is interesting because it
suggests that diabetes lowers free testosterone levels
by a process unrelated to aging. Essentially, this means
that age-related declines in testosterone levels are
magnified in the presence of diabetes. This is another
good reason for any diabetic to monitor his condition
carefully and keep it under control.
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The blockage of veins and arteries due to
arteriosclerosis and atherosclerosis can also cause or
exacerbate impotence by physically diminishing blood
flow to the penis. Hypertension is frequently the result
of clogged arteries from either condition. When the
body’s circulation system is clogged with deposits, the
heart must pump harder to move blood around the body,
thus raising blood pressure. And even though the heart
is pumping harder, blood flow is still diminished from
normal.
The obvious conclusion is that conditions that impair
blood flow throughout the body affect all organs,
including the prostate and the penis. As mentioned
before, when the blood supply to any organ in the body
is diminished, the health of the organ deteriorates.
And, when blood flow to penile arteries is impeded,
erectile dysfunction is inevitable.
Typically impotence is caused by a combination of
several factors, none of which may by itself, be serious
enough to warrant a man to seek medical treatment.
Erectile dysfunction can be quite debilitating to a
sexually active man and his partner. But it is often the
first symptom of a more serious problem—one of clogged
arteries and poor blood circulation. Many studies have
confirmed this, including a recent article published in
the Journal of the American Medical Association (JAMA).
According to its authors, data from this large study
(9457 men) provides evidence of a strong association
between erectile dysfunction and subsequent development
of cardiovascular problems. The simple truth is that
when blood circulation is poor in one area of the
body—the penile arteries—it is very likely deficient in
many other parts of the body as well, including arteries
that supply the heart (and the brain).
There are many nutrients, herbs and natural products
that may help with of erectile dysfunction. See the
Supplements section.
Also, my book
Your Prostate, Your
Libido, Your Life has two chapters on
erectile dysfunction, one discusses its causes, and the
other some natural techniques that can help resolve it.
Erectile dysfunction or impotence is a major problem
affecting many aging men but by improving your health
and with some natural techniques, you can overcome it.
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