Erectile dysfunction

Erectile Dysfunction is the inability to achieve and/or
maintain an erection for satisfactory sexual performance at least
25 percent of the time.

DESCRIPTION

Erectile Dysfunction (ED) is a common medical problem in men
between 40 and 70 years of age, but may occur in any male capable
of having an erection. As many as 100 million men worldwide
experience some degree of Erectile Dysfunction.

CAUSE

An erection is the result of a number of physiological
processes. Arousal may begin in the brain (from something seen,
smelt or thought) or by stimulating the penis. The nerves along the
spine send signals to release certain chemicals into the body,
which make the blood vessels in the penis dilate and more blood to
flow into the penis. This blood is trapped in the penis to maintain
the erection. Once the chemicals subside, blood vessels return to
normal and the penis loses the erection.

Any physical or psychological condition that affects the nerves,
blood vessels or hormones may affect the ability to produce and
maintain an erection .

PHYSIOLOGICAL

• Vascular (blood vessel) disorders, e.g. atherosclerosis.
• Diabetes.
• Diseases of the nervous system, e.g. multiple sclerosis,
  Parkinson’s Disease.
• Trauma including spinal cord injury or other nerve damage.
• Medications including antihypertensives (for high blood
  pressure), antidepressants, antihistamines, tranquillisers,
  cimetidine (for ulcers) and appetite suppressants. Medication is
  thought to be the cause of up to 25% of Erectile Dysfunction
  cases.
• Alcohol, tobacco, narcotics and marijuana are other substances
  that may contribute to Erectile Dysfunction.
• Hormonal disorders, e.g. low testosterone levels.
• Surgery, e.g. prostate surgery may injure nerves or blood
  vessels necessary for an erection.
• Renal (kidney) Failure can cause Erectile Dysfunction due to
  vascular and endocrine changes and the effect of medication.
• Ageing can result in decreased testosterone levels and a loss
  of sensitivity in the penis. .

Erectile Dysfunction with a physiological origin usually
affects all erections (intercourse, masturbation, nocturnal or
early morning erections, or response to erotic stimuli).

PSYCHOLOGICAL

• Stress, anxiety, guilt, depression, self-esteem issues, fear of
  failure (sexually).

There are a number of risk factors and characteristics which
increase your chances of developing permanent Erectile Dysfunction.
These include:

• Being of caucasian decent with fair complexion
• Sperm count in excess of 300 million
• Medium to low body weight (being slightly overweight has an
  unexplained protective effect)
• Premature balding i.e significant hair loss before 40 years of
  age

TREATMENT OPTIONS

As with all conditions, your Doctor should be consulted to
diagnose and treat this condition. 

Treatment options vary and may include:

• Changing existing medication that may be the cause.
• Counselling.
• Vacuum devices.
• Surgical implants.
• Surgery.
• Drug therapy, e.g. sildenafil, alprostadil, yohimbine.

Discuss your treatment options with your Doctor.

DIET HINTS

• The diet should revolve around wholesome foods to make the body
  as healthy as possible.
• Limit the intake of coffee and alcohol.
• Always buy fresh green, leafy, vegetables. Cook lightly to
  retain nutrients.
• Raw seeds, nuts and wheatgerm are good sources of vitamin E,
  which is needed to maintain good blood circulation. 
• Avoid fatty, high calorie and low nutrient foods. Include
  plenty of fibre in the diet e.g., wholemeal breads and cereals,
  whole grains such as brown rice, vegetables and beans. 
• Have at least 6 to 8 glasses of fresh, filtered water each
  day.

VITAMINS/MINERALS/HERBS

• Traditional Chinese medicine associates kidney function with
  sexual function. Poor kidney function may be associated with low
  libido. Kidney tonic herbs such as Rhemania glutinosa or Schisandra
  chinensis may be used.
• Ginseng (Panax)may be effective in the treatment of impotence
  and poor sperm count. Ginseng may also improve mood in some
  individuals and has been used to assist in improving the symptoms
  of depression. 
• Zinc is an important nutrient in maintaining the health of the
  prostate. Zinc may be of assistance if Erectile Dysfunction is
  associated with prostate problems.
• Ginkgo biloba is known to improve circulation to the periphery
  and may help prevent vascular damage associated with peripheral
  vascular disease. 
• Damiana has been used as a traditional remedy for
  impotence.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

1. Follow the Diet Hints.
2. Your Pharmacist can advise on any medication prescribed.
3. Avoid or learn to manage stress more effectively. 
4. Exercise regularly.
5. Ask your Pharmacist about the range of products available to
   help you stop smoking. Tobacco may be a cause of erectile
   dysfunction.
6. Drink alcohol in moderation.
7. If your diet is inadequate, consider some nutritional
   supplements.