Erectile dysfunction (ED) is the inability of a male to attain or sustain an erection sufficient for sexual intercourse. It can be a persistent condition; however, almost half of all men experience ED only occasionally. ED can have physical, psychological, or drug-induced causes. Although some doctors used to believe differently, most researchers and doctors now believe that physical factors are responsible for the majority of ED cases.
Several conditions may contribute to ED by impairing blood flow to the penis. These include atherosclerosis, diabetes, hypothyroidism, multiple sclerosis, and chronic alcohol abuse.
What are the symptoms?
ED is defined by the symptoms listed above. Symptoms may also include loss of sexual desire (libido), premature ejaculation, or inability to achieve orgasm.
Lifestyle changes that may be helpful
Men who smoke have been shown to have an increased incidence of ED. In a study of obese men with erectile dysfunction, a two-year lifestyle program consisting of a low-calorie diet plus regular exercise resulted in a significant improvement in erectile function, which became normal in 31% of the participants.
Other therapies
Depending on the cause, therapy may include psychological and behavioral counseling, treatment of underlying cardiovascular disease, and avoidance of medications such as cimetidine, antihypertensives, and MAO inhibitors. Penile vacuum devices and surgical options, such as penile implants and vascular repair, are usually limited to those who have not responded to other treatments.
Testosterone therapy may be given to treat medical conditions like (ED) Erectile Dysfunction, including female (but not male) breast cancer hypogonadism (low gonadal function) in the male, cryptorchism (nondescent of the testis into the scrotum), and menorrhagia (irregular periods).
Supplements that may be helpful
Low blood levels of the hormone DHEA (dehydroepiandrosterone) have been reported in some men with ED. In one double-blind trial, 40 men with low DHEA levels and ED were given 50 mg DHEA per day for six months. Significant improvement in both erectile function and interest in sex occurred in the men assigned to take DHEA, but not in those assigned to take placebo. No significant change occurred in testosterone levels or in factors that could affect the prostate gland. Experts have concerns about the safe use of DHEA, particularly because long-term safety data do not exist.
Dilation of blood vessels necessary for a normal erection depends on a substance called nitric oxide, and nitric oxide formation depends on the amino acid arginine. In a preliminary trial, men with ED were given 2,800 mg of arginine per day for two weeks. Six of the 15 men in the trial were helped, though none improved while taking placebo. In a larger double-blind trial, men with ED were given 1,670 mg of arginine per day or a matching placebo for six weeks. Arginine supplementation was found to be particularly effective at improving ED in men with abnormal nitric oxide metabolism. Although little is known about how effective arginine will be for men with ED or which subset of these men would be helped, available research looks promising and suggests that at least some men are likely to benefit.
In a double-blind study, supplementing with the combination of propionyl-L-carnitine (a form of L-carnitine) and acetyl-L-carnitine (2 grams of each per day) for six months significantly improved erectile function in elderly men with erectile dysfunction associated with low testosterone levels. Propionyl-L-carnitine and acetyl-L-carnitine were significantly more effective than testosterone treatment.
In a double-blind study of men with erectile dysfunction, supplementing with 120 mg per day of Pycnogenol®, an extract of the bark of a certain tree (Pinus pinaster), improved erectile function, whereas placebo treatment had no effect.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions..
