Important Facts about Impotence

THE term "Erectile Dysfunction" (ED) or impotence is usually defined as the persistent (lasting at least six months) inability to achieve or sustain an erection, an inconsistent ability to do so, or the ability to keep an erection firm enough to permit satisfactory sexual performance. 

Medical professionals often use the term "Erectile Dysfunction" to describe this disorder and to differentiate it from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.

Most men experience this at some point in their lives, usually by age 40, and are not psychologically affected by it.

Although it's a common disorder affecting at least 10 per cent of men, and may appear to be a male problem, it's something we all have to take seriously.

ED can be caused by physical and psychological reasons. The physical causes includes underlying life threatening conditions such as hypertension, heart disease, clogged blood vessels, diabetes, obesity, and/or dyslipidemia (a disorder of lipoprotein metabolism). It could also be caused by certain prescription medications, heavy smoking, alcoholism, Parkinson's disease, prostate cancer, multiple sclerosis, hormonal disorders and surgeries or injuries that affect the pelvic area or spinal cord.

ED can be your body's way of signaling that more serious health problems such as heart or kidney disease are present - and could in fact save later complications if the warning signs are heeded.

Many studies have shown that 80 per cent of chronic ED cases are related to the physical vascular system and only 20 per cent to psychological problems like stress, anxiety or depression.

Men with diabetes have a higher risk of developing ED. In addition, men treated for diabetes are up to three times as likely to develop serious ED. The causes of ED in men with diabetes involve impairment in nerves, blood vessels and muscle function. Chronic elevated blood sugar can damage the blood vessels and nerves that control erection. Therefore, you may not be able to achieve a firm erection although you have normal amounts of hormone and have sexual desires.

The medications include hypertensive medicines such as beta blockers, diuretics (hydrochlorothiaside and spironolactone), tranquilisers, antidepressants and digoxin may affect sexual function in many ways, not just induced impotence, but also causing diminished libido, inorgasmia, priaprism, premature ejaculation, gynaecomastia and decreased vaginal lubrication.

Most men with ED tend to suffer from a drop in self-esteem, embarrassment, and social stigma and believe they will become the subject of jokes and often seek unorthodox, off-label and over-the-counter methods of treatment. Self-medication for ED is dangerous because of the strong association between ED and Coronary Artery Disease (CAD). On average, ED can present itself two to three years before the symptoms of coronary artery disease occur. So, if a man has trouble having or keeping an erection more than 25 per cent of the time, he should seek medical advice.

A herbal formula containing seven herbs such as Horny Goat Weed, Ginseng, Puncture Vine, Muira Puama, Withania, Damiana and Ginkgo will prove beneficial. They help to enhance sexual performance by increasing blood flow and oxygen to the genital areas. They improve the release of nitric oxide in men, thus relaxing the spongy tissues in the penis and promoting blood flow.

Ginseng is traditionally used for male impotence. It is highly respected and prized as a herb which promotes male or yang energy, improving circulation, boosting vitality and acting as an overall systemic invigorator.

Withania is a traditional remedy for impotence due to fatigue, a tonic to fight stress and for debility and nervous exhaustion.

Ginkgo enhances the effects of nitric oxide, which helps relax the artery walls, allowing more blood flow into the penis. This herb increases the body's ability to achieve and maintain an erection during sexual stimulation. Therefore, a unique combination of herbs formulated to address the causes of low libido and male sexual dysfunction is advisable.

Good nutrition may help improve ED. Eat whole, fresh, unrefined and unprocessed foods. Include in your diet fresh fruits, vegetables, whole grains, soybeans, seeds, nuts, olive oil, and coldwater fish. Specific nutrients the body needs to boost energy levels, to alleviate fatigue or for healing the reproductive organs are vitamin E, vitamin C, bioflavonoids, vitamin B-complex, calcium, magnesium, iodine, zinc, selenium or organic spirulina. These nutrients are best assimilated when taken in food or supplement form. Everyone should consume more vegetables, fruits and whole grains. Not only do these foods clear the arteries and prevent diseases, they will ensure that the male pump is functioning at its best! Avoid excessive sugar, dairy products, refined foods, fried foods, junk foods, and caffeine.

Maintaining blood sugar levels near to the normal is just as important. Other nutrients like alpha lipoic acid may help reduce nerve damage due to chronic elevated blood sugar. It may be helpful in improving ED, too

The treatment options for ED include oral medications, vacuum constriction devices, self-injection therapy with alprostadil, papaverine, intra-urethral alprostadil suppository, penile prosthesis and vascular surgery.

All current available treatments are suitable for a cardiovascular patient and, if used according to the instructions, do not increase the cardiovascular risk.

Oral medications from the phosphodiesterase type 5 enzyme inhibitors (PDE-5) family, such as sildenafil (Viagra, Pfizer), tadalafil (Cialis, Eli Lilly) and vardenafil (Levitra, Bayer) have revolutionised the treatment of ED since 1998.

Despite the lack of head-to-head comparative studies, all three PDE5 inhibitors appear to have equivalent efficacy in the treatment of ED.

Sildenafil has additional efficacy data in the management of ED associated with spinal cord injury and antidepressant medications.

Tadalafil has the longest duration of action (up to 36 hours); this feature can be both beneficial (greater sexual spontaneity) and possibly detrimental (delayed adverse events).

However, the concomitant use of nitrates with PDE5 inhibitors may be hazardous and life threatening. They must be avoided as they can produce significant hypotension and are potentially fatal. No nitrates should be used within 24 hours of PDE5 use.

Patients who have taken PDE5 inhibitors and then taken to the Accident and Emergency section of a hospital with chest pain must inform the physician because the first line treatment for angina pain is nitrates.

Fast Facts on the Serious Diseases

* Coronary disease/heart attack. A long-running study of over 2,000 men found that erectile dysfunction is associated with a more than threefold higher risk of heart attack.

* Damage from smoking - Men with high blood pressure who smoke are 26 times more likely to be impotent than non-smokers. Even former smokers with high blood pressure are 11 times more likely to be impotent than non-smokers.

* Prostate cancer - A cancerous prostate gland may interfere with blood flow and nerve impulses to the penis. That can cause ED; impotence can be one of the first signs of prostate cancer.