Erectile Dysfunction

Many men will experience impotence at some point in their lives. While most episodes are temporary, chronic impotence requires medical attention. This month’s alive discusses conventional medical treatments and herbal supplements for impotence.

Impotence, or erectile dysfunction (ED), is defined as the inability to achieve or maintain an erection sufficient to engage in or to complete sexual intercourse. No matter a man’s age, impotence is not a normal condition.

The Canary in the Mine Shaft

An unhealthy lifestyle–obesity, smoking, too much alcohol or stress–can cause occasional ED. However, impotence more than 50 percent of the time may indicate more serious medical conditions such as diabetes, kidney disease, atherosclerosis, neurological disease, vascular disease, prostate enlargement or cancer, or depression. Additionally, many prescription medications can contribute to ED.

Conventional Treatments

The three prescription ED medications–tadalafil (Cialis), vardenafil hydrochloride (Levitra), and sildenafil citrate (Viagra)–are effective when prescribed and used properly. Nevertheless, these medications can have serious and potentially life-threatening side effects.

They may be inappropriate for patients with heart problems who use nitrates, those with liver or kidney problems, or men with uncontrolled high blood pressure. Sudden hearing loss has also been reported by a small number of patients using these drugs.

Searching for a Natural Option

Many men turn to natural products with the hope of avoiding the side effects of prescription ED medications. Consumers have many choices and may find an experienced herbalist or reputable retailer helpful in understanding the various herbal mixtures and in choosing a safe product.

Health authorities in the US, Canada, and Europe have issued warnings about supplements that have been marketed as “natural,” which later have been found to contain prescription levels of sildenafil, tadalafil, or vardenafil. Taken by an unsuspecting cardiac patient or someone with high blood pressure, these supplements could cause a fatal drug interaction.

Most herbal supplements for ED claim to increase blood flow or improve muscle tone. Commonly, these products contain at least some combination of Asian ginseng, yohimbe extract, and horny goat weed (Epimedium).

Of these herbs, Korean red ginseng (Panax ginseng) seems to provide the greatest help for ED. A well-designed 2003 study showed a clear therapeutic effect on erectile function compared with a placebo. These results were supported in 2007 by researchers who concluded that Korean red ginseng“can be an effective alternative” for treating ED.

Derived from the bark of a tree native to western Africa, yohimbe is used traditionally as an aphrodisiac and to treat sexual dysfunction. However, herbal yohimbe should not be confused with yohimbine hydrochloride, a standardized form used to treat ED available only by prescription.

There are few studies on herbal yohimbe, but considerable research on the prescription form has been done. Most recent work seems to indicate that it is no better than a placebo when used alone and only moderately effective when combined with the amino acid L-arginine. There is even less research on the effectiveness of horny goat weed.

The various herbs found in natural supplements may have beneficial properties, but the evidence does not yet verify their effectiveness for ED. Furthermore, negative side effects from these herbal products can vary based on the amount ingested and the user’s overall health.

Trust Your Physician to Treat ED

To gain an erection, blood must flow to the penis to engorge the tissue. Whether synthetic drug or herbal, an anti-impotence compound must facilitate this mechanism in some way. These treatments can be a problem for menwith circulatory, pulmonary, cardiac,or blood pressure problems, especiallyif undiagnosed.

Men who experience occasional, temporary impotence may find that lifestyle changes such as losing weight and exercising improve their sexual function. Those with more serious causes of ED must rely on their physicians.