Herbal Remedies, Natural Treatment and Herbs for Erectile dysfunction

Erectile dysfunction is sometimes very embarrassing condition which can be devastating to self esteem as well as relationships. Erectile dysfunction is sometimes called as “impotence”. The term "erectile dysfunction" can be defined as inability to achieve erection, an inconsistent ability to do so, or the ability to achieve only brief erections or not able to maintain an erection for satisfactory sexual relations. For many years patients have been trying various methods to overcome the erecitle dysfunction and now a days there is a growing number of effective herbs and supplements, providing a natural alternative to erectile dysfunction remedies in modern medicine.

Causes of Erectile Dysfunction

Generally cirulatory problems, heart problems, diabetes and blood pressure are associated with condition.

People with such problems alongwith erectile dysfunction even if they don't have any cardiac or other symptoms should undergo medical evaluation, detailed cardiac assessment, blood pressure measurement, lipid profile and blood sugar test, as well as lifestyle advice regarding weight, diet, and exercise. There are so many herbs being sold through internet but most of them can be extremely dangerous, especially they are made by manufacturers without research and development facilities or doctors in their product development team. Herbal Remedies for erectile dysunction containing Ashwagandha should be preferred. Ashwagandha is also useful in diabetic neuropathy, weakness of nerves because of any other reason, weight loss, fatigue, erectile dyfunction, premautre discharge and low sperm count.

According to Ayurveda

Ayurveda - ancient healing science has explained Erectile dysfunction (ED) in Sanskrit language as:-

Sankalpapravano nityam priyaam vashyaamapi sthreeyam |
na yaathi lingashaithilyaath kadaachidyaathi vaa yadi ||
Shwaasaarthaha swinnagaatrshcha moghasankalpacheshtitaha |
mlaanashishnashcha nirbeejaha syodetat klaibyalaxanam||

Although a man has a strong desire to perform sexual act with a cooperative partner, he cannot perform sexual act because of looseness (absence of erection) of his penis. Even if he performs sexual act with his determined efforts he does not get erection and gets afflicted with tiredness, perspiration and frustration to perform sex.

There are various factors responsible for many types of physiological, psychological and organic erectile dysfunction. Most of the Male Performance Enhancing drugs are chemical based and even some herbal supplements cause side effects.

There are some of the really excellent herbal supplements which proved to be an effective Natural Treatment for erectile dysufnction and one among those herbal remedies for erectile dysfunction is Tribulus Power Capsules. There is no doubt in calling it a herbal and Alternative treatment of erectile dysfunction as it is an excellent herbal remedy to enhance sexual stamina and support healthy erectile function.

What is the Natural Process of Erection and What is Erectile dysfuncion?

The two chambers of penis (corpora cavernosa), which run throught the organ are filled with spongy tissue and blood vessels. The corpora cavernosa are surrounded by a membrane, called the tunica albugineaor the covering membrane. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra-which carries urine and semen runs through the corpora cavernosa.

The natural erection begins because of sensory or mental stimulation, or both,. Due to impulses from brain and local nerves the muscles of corpora cavernosa relax and allow blood to flow in and fill the spaces of spongy tissue. There can be problem

The flow of blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the chambers, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection recedes.

According to Ayurveda erection and ejaculation takes place as explained below-

Vrishunow basthimedram cha naabhyuuru vankshnow gudam |
Apaanasthaanamantrasthaha shukra mootra shakrunti cha ||
(Verse from Ancient Ayurvedic text)

The “apaanavayu” one of the five types of vayu or the kinetic energy of the body is located in the testicles, urinary bladder, phallus, umbilicus, thighs, groin, anus and colon. Its functions are ejaculation of semen, voiding of urine and stools”.

This is purely an Ayurvedic explanation of erectioin and ejaculation. The five types of Vayu (The Air Element) is responsible for all nervous controls of our body.

According to Shushruta (500 BC text on Ayurveda) explains the process of erection and ejaculation as “When a man has desire to have sex, his response to touch increases. (Vayu located in skin causes flow of signals from skin to brain, thus causing sensation of touch). This causes arousal or “harsha” . Arousal or Harsha intensifies actions of vayu and at this moment highly active vayu liberates the “teja “or heat of pitta. Thus tejas and vayu increase body temperature, heart beat and blood flow causing erection.

Herbal Remedies for Erecitle Dysfunction

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Tribulus Power is not only useful in premature ejaculation or erectile dysfunction but also beneficial for people suffering from weakness due to diabetes, prostate enlargement, urinary tract obstructions or weakness due to any other reason as this herbal supplement nourishes the entire system as well as male reproductive system.

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How much time it takes for the Tribulus Power Capsules to work?

Tribulus Power Pack for Male Support provides results within first few hours, and continue to improve in the coming days. More than 90% of the users confirm the action happens within 2-3 hours of its use.

Tribulus Power capsules are useful in:-

  • Low Libido or Low sex drive
  • Erectile dysfunction and premature ejaculation
  • Prolonged and controlled orgasms
  • Increased sexual Energy and stamina
  • Low Sperm Count




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Atirasadi Churna

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How To Use

  • Atirasadi Churna: 1 teaspoonful twice daily with plain water or milk, 1/2 hr. after meals
  • Tribulus Power: 2 capsules twice daily with plain water after meals,1/2 hr. after meals
  • Chander Prabha Vati: 2 tablets twice daily, with plain water, 1/2 hr. after meals
  • Shilajit Capsules: 1 capsule twice daily, with plain water, 1/2 hr. after meals
  • Tri-bull Oil: As per instructions on the packaging. Once every alternate day.
  • Penis Massage Cream (Himcolin): Take small quantity on top of index finger, rub it for 1 minute all over the organ. Once every alternate day.

Although science has developed a lot of medicines for erectile dysfunction and other sexual problems but ancient remedies for sex are the best for long term use as they achieve excellent results with no side effects at all. Whereas the prescription drugs cause a lot of problems.

Tribulus Power Pack for Male Support contains herbs that support normal erectile and cures erectile dysfunction naturally. It is the best alternative to viagra and other synthetic drugs used in sexual problems.

1. Ashwagandha (Withania somnifera)

An effective herb for erectile dysfunction and premature ejaculation is a major ingredient in Atirasadi Churna. Ashwagandha is known as " Indian Ginseng" worldwide and has been used as an aphrodisiac for the past 3000 years. It is also Recommended in the ancient Kama Sutra as best Aphrodisiac. Ashwagandha enhances strength, energy and vitality in the body. Ashwagandha enjoys the reputation in the West also as an aphrodisiac, a use supported by a recent study in which more than 70 percent of men reported increased libido and sexual function after taking the herb. This is the best among all types of ginseng. It provides physical and mental happiness, as it also has stress busting properties and anxiolytic effect without causing any drowsiness or sleepiness. Ashwagandha is very effective alone but the results are remarkably improved if used with herbs like Tribulus, Avena Sativa, Asparagus, Mucuna. Atirasadi Chruna is a unique herbal formulation to enhance male performance, which can be used with Tribulus Power Pack for Male Support capsules. Mucuna pruriens in Atirasadi churna is the main ingredient for increasing sperm count and semen quantity along with Ashwagandha.

2. Shilajit

"Shila" literally means Rock and Jit means - Juice or extract from the rocks. So it is a kind of extract that comes out of the Himalaya rocks and gets deposited on them. Shilajit is a source of natural minerals and is found in the Himalaya rocks. It contains contains plenty of iron, and 48 other valuable minerals. It is rich in natural minerals. Shilajit increases the internal energy responsible for your sexual and spiritual power. People from Himalayan region consume this mineral extract regularly to maintain their health and youth.Shilajit helps a lot in erectile dysfunction and is popular in India as ED herbal medicine.

Shilajit in India, is being used as natural aphrodisiac, since ages.It is also very useful in fatigue and painful legs due to diabetes and other illnesses. It is saying in India that Shilajit would return the libido of people to a level of teenagers. It will  keep  your   Vigor,  Vitality   and  Energy  at  optimum  levels. Shilajit works like Viagra that's why it is also called as "Indian Viagra" or sometimes 'Herbal Viagra' in India. It is widely used in Ayurveda for the treatment of impotence and nervous disorders and as a tonic in genitourinary diseases.

How Common is Erectile Dysfunction?

Massachusetts Male Aging Study data has indicated that the prevalence of erectile dysfunction of any degree is 50% in men between the ages of 40 to 70 years.

The Underlying Causes of Erectile Dysfunction

There are 2 types of Erectile dysfunction

Psychological erectile dysfunction:

This is generally caused by psychological reasons. Fear, Stress, Anxiety can be the reasons for psychological erectile dysfunction.

Organic or phycial erectile dysfunction:

This is due to some form of physical or medical problem. Organic erectile dysfunction becomes more common as men get older. Many diseases may also cause erectile dysfunction, especially diabetes as it cause erectile dysfunction due to neuropathy.

Psychological causes of Erectile Dysfunction

There are so many causes of psychological erectile dysfunction and it is difficult to list them all, but most often erectile dysfunction is related to depression, performance anxiety, marital stress or relationship problems, life crisis, financial difficulties, or some type of mental illness. Improving erectile dysfunction in these cases may require addressing the underlying causes. Herbal supplements containing Ashwagandha help a lot in such cases. Tribulus Power Pack for Male Support is a natural dietary supplement containing Ashwagandha (Indian Ginseng).

Organic causes of Erectile Dysfunction

The major causes of Organic Erectile Dysfunction are - Vascular, Neural, Hormonal, and Drug-induced.

Differnt types of Erectile Dysfunction needs different types of treatments:-

1. Vascular causes of Erectile Dysfunction

Any obstruction in the flow of blood to and from the penis are thought to be a common cause of male erectile dysfunction. For example, conditions such as atherosclerosis (hardening of the arteries), high cholesterol, hypertension, or diabetes reduce blood flow to the penis and genital organs thus leading to difficulty with erection. Erectile dysfunction could be an early indication of extreme stress and vascular dysfunction.

Patients with heart disease or diabetes represent the largest group of patients with erectile dysfunction. Lowering cholesterol through diet, supplements, or medicines improves erectile dysfunction. Arjun tea is another unique herbal supplement which can reduce cholesterol naturally and also helps in erectile dysfunction.

Metabolic disorders can increase inflammatory markers in blood and can cause injury to innermost lining of blood vessels which results in poor vasodilation and a higher incidence of erectile dysfunction.

There are many additional factors that can impede blood flow like penile injury and surgery in the pelvic and abdominal area. Smoking can reduce genital blood flow and enhance the process of hardening of the arteries. Some men with erectile dysfunction may have an underlying vascular disease such as atherosclerosis.

2. Neural causes of Erectile Dysfunction

Many nervous disorders can cause neural Erectile dysfunction. Nerve damage from disorders such as multiple sclerosis, Parkinson’s disease, diabetes, and stroke affect the brain’s ability to respond to sexual stimulation and cause erectile dysfunction. Supplements like Tribulus Power Pack for Male Support and Chander Prabha Tablets help a lot in such cases. Erectile dysfunction is common in men undergoing surgical treatment for prostate enlargement or cancer.

3. Hormonal causes of Erectile Dysfunction

Low levels of androgens, such as testosterone, are sometimes a component of erectile dysfunction. Natural supplements containing Tribulus terrestris (Atirasadi Churna) can help a lot in these kind of conditions. Testosterone levels decline about 1 percent each year in men, which may contribute to erectile dysfunction with aging. Tribulus contains natural precusor of DHEA, which gets converted into Testosterone in the body naturally.

Testosterone declines with age in women leading to a decrease in female libido. Replacement of hormones by natural supplements can sometimes be helpful in those with age related erectile dysfunction. Testosterone is available by prescription only, so herb powder like Atirasadi Churna- which has herbs like Tribulus terrestris contain natural protodioscin which gets converted into DHEA, which converts into testosterone and thus has a positive influence on erectile dysfunction.

Many herbal remedies for erectile dysfunction like atirasadi churna have a positive influence on many other sexual problems as well as health problems. Routine hormone blood studies for erectile dysfunction evaluation are not needed during the initial evaluation but perhaps later if treatment modalities are not successful.

Many diseases of the endocrine system, such as diabetes mellitus, hypogonadism, and hyperprolactinemia, may cause erectile dysfunction. Such Erectile dysfunction really responds well to herbs.

4. Drug or Medication-induced Erectile Dysfunction

There are so many drugs that interfere with erectile function include some anti-hypertensives, sedatives, and beta-blockers. Drugs used for depression like Prozac many also cause erectile dysfunction mostly due to their effect on serotonin metabolism. Serotonin is a neuro-transmitter found in our brain. Serotonin has an inhibitory effect on erectile function and sexuality. Beta blockers such as propranolol, atenolol, and others, are some of the most common medications that cause erectile dysfunction. So blood pressure is sometimes the cause of erectile dysfunction.

There are common drugs like ibuprofen and naproxen which may also cause erectile dysfunction. It is the likelihood that middle-aged and elderly men will develop erection difficulties.

Dopamine, acetylcholine, and nitric oxide are the chemicals which are involved in the human sexual response and natural erection. The imbalance in their levels is the cause of erectile dysfunction sometimes.

Alcohol can also have a very negative effect on sex drive and it increases with age. Smoking can also lead to obstruction in the blood vessels and can be a reason for erectile dysfunction.

Erectile Dysfunction causes According to Ayurveda

Disturbed relationship with partner can be the one of the causes of ED. Disliking towards sexual partner can also be one of the causes of Erectile dysfunction. Ayurveda describes this as "naarinaamarasamjnatwaat..." means disliking for women.

Over Exertion- Working for long hours in office, mental stress at office and home, short temperedness, insufficient sleep cause erectile dysfunction. These causes are explained in Ayurveda as "shoka chintaa, bhaya, traasaat .... " which means that erectile dysfunction or Impotence occurs due to grief, fear, anxiety and terror.

Other Diseases- Diseases that cause Erectile dysfunction: Neurological disorders, hypothyroidism, Parkinson's disease, anemia, depression, arthritis, endocrine disorders, diabetes, diseases related to cardiovascular system also become reasons for erectile dysfunction..

According to ayurveda the diseases which cause erectile dysfunction are "Hritpaandurogatamakakaamalashrama..." - Heart diseases , anemia , asthma , liver disorders , tiredness .Apart from these the imbalance in tridoshas also cause impotence or erectile dysfunction.

In classical Ayurvedic texts these causes have been said in brief as "rukshamannapaanam tathoushadham" - "dry food, drinks and medicines" cause impotence or erectile dysfunction.

Trauma to pelvic region: accidental injury to pelvic region and surgeries for the conditions of prostate, bladder, colon, or rectal area may lead to erectile dysfunction. These causes are mentioned as abhighata (trauma), shastradantanakhakshataha (injury from weapons, teeth and nail.) in Ayurveda.

Erectile Dysfunction due to Old Age

Old age can be a reason for erectile dysfunction. The reson is generally decreased circulation in male sex organ. Diseases associated with age like blood pressure, diabetes, parkinsonism and others can also be physiological as well as psychological reason for erection dysfunction.

Ayurveda describes the cause of impotence or erectile dysfunction due to old age as follows. " diminution of - tissue elements, strength, energy, span of life, inability to take nourishing food, physical and mental fatigue lead to impotence"

Other Health Concerns and Erectile Dysfunction

Many health concerns like hypertension, diabetes, high cholesterol, cardiovascular disease, obesity, peripheral vascular disease, neurologic disorders, and insomnia can be the reason behind erectile dysfunction, reduced libido, or low sex drive.

Erectile Dysfunction and Cardiac Problems

Smoking, hypertension, hyperlipidemia and diabetes mellitus can be the reason behind Erectile dysfunction.Sexual activity is not unduly stressful to the heart and, providing patients are properly assessed using established guidelines, sexual intercourse can be enjoyed without increased risk.

Erectile dysfunction in asymptomatic patients may be a diagnostic tool of silent vascular disease or increased vascular risk factors and physician should go for cardiac evaluation tests if not done previously.

Exercise and Sexual health

Moderate exercise may help boost sexual function in men with heart failure. The results may be good news for some men with erectile dysfunction, because Viagra and other similar erectile dysfunction drugs can have dangerous interactions with medications commonly prescribed to treat heart failure.

Erectile Dysfunction and Heart Disease

Erectile dysfunction can be a sign of heart disease in fact. As erectile dysfunction is generally due to blockage in arteries and the blockage of arteries is a phenomenon which happens in whole body rather than one organ. Men with erectile dysfunction were more likely than other men to experience chest pain, a heart attack or a stroke during the next seven years, the study found. The results suggest that men who see their doctors for erectile dysfunction drugs also should consider getting screened for heart disease.

Viagra, Cialis, Herbal Remedies and Erectile Dysfunction

Sildenafil is the chemical that makes Viagra. Viagra works by dilating the blood vessels in the genital organs. It has a slight effect on the sex drive or sexual arousal. The effects starts within half an hour after taking this pill and the erection may last upto 10-12 hours. However there are a lot of side effects on cardiovascular system associated with this drug for erectile dysfunction. Side effects of Viagra include headache, flushes, nasal congestion or runny nose, malaise, nausea, changes in blood pressure, irregular heart beats, visual disturbances including rare cases of blindness, and chest pain. Viagra may cause stickiness of blood platelets. Trimetazidine, a drug that prevents heart-related chest pain, is a better choice than "nitrate" drugs, such as Nitro-DUR and Isordil, for men with heart disease who are taking Viagra (sildenafil) for erectile dysfunction treatment. So Viagra should be avoided for treating eretile dysfucntion. There have been concerns about dangerously low blood pressure when Viagra is combined with nitrates, yet many men with heart disease are currently seeking treatment for erectile dysfunction with Viagra.

Viagra (sildenafil), approved by the FDA in 1998, has been the most popular medicine for the treatment of erectile dysfunction. New drugs like Cialis may last longer than Viagra but the side effects are almost the same. Natural sex boosters are quite effective and preferable to pharmaceutical erectile dysfunction drugs.

A Houston man filed a lawsuit in June 2005 in federal court against Pfizer, claiming he suffered blindness after taking its best-selling erectile dysfunction drug Viagra. James Thompson filed the civil suit against Pfizer in the U.S. District Court for the Southern District of Texas on Tuesday and is seeking more than $75,000 for his vision loss. He is also seeking class-action status because it has been estimated that since 1998, 23 million people have taken the erectile dysfunction drug Viagra, (Containing Sildenafil)

Herbal Remedies for Erectile Dysfunction include Ashwagandha, Shilajit, (Ingredients of Tribulus Power Pack for Male Support), Mucuna pruriens, Tribulus terrestris, Asparagus, Musli, Danshen, Crocus sativus (Ingredients in Atirasadi Churna). These herbs have no side efffects and are highly beneficial in curing the problem of sexual weakness from the root.

Alcohol and Erectile Dysfunction

Alcohol addiction or regular consumption of Alcohol not only creates social or behaviour problems but also cause physical problems, which not only affect the liver but also affect the blood vessels and hormonal disturbance. Researchers in India found that men being treated for alcoholism had lower testosterone levels and more sperm abnormalities than non-drinkers did. They also had a far higher rate of erectile dysfunction (ED) - 71 percent, versus 7 percent of abstainers. Alcohol must be avoided in all circumstances to get rid of erectile dysfunction problem.

E-Mails about Erectile Dysfunction

(We have not displayed the e mail addresses of our customers to maintain secrecy)

Question.1. I have been using Viagra for erectile dysfunction (50 mg ) on and off. My age is 52 years. Can I use it with herbal supplements like Saw Palmetto or Tribulus for erectile dysfunction ? Steven - Ohio, USA.

A. Our experience say that if you consume herbs like Tribulus, Saw Palmetto, Ashwagandha (Indian Ginseng), Shilajit, Asparagus combinations regularly for 2 to 3 months, you will not suffer from erectile dysfunction problem anymore. These herbs act on the root cause rather than just dilating the blood vessels for some hours. We have a lot of patients worldwide who consumed our herbal supplements like Tribulus Power Pack for Male Support and Atirasadi Churna.

Question.1.I have significant erectile dysfunction, as well as prostate enlargement. I am 61 and have been using Viagra and Prozac for my depression. Are there any herbal atlernatives to Viagra and Prozac. I have a history of coronary artery disease and I am afraid of using Viagra. Edward-Birmingham, UK

A. There are a lot of effective herbal remedies for erectile dysfunction, prostate enlargement as well as heart supporting herbs. Herbs like Ashwagandha are useful not only in erectile dysfunction but also in depression, anxiety, blood pressure, fatigue, stress and general weakness. Shilajit is another rare rock mineral found in Himalaya rock, which is useful in erectile dysfunction as well as enlarged prostate gland.

Question.3. My testosterone level is testosterone level is low (about 20 % low than normal). I am aged 54. I am experiencing erection problem and recently I have started testosteron injections. I do not want to use injections of testosterones. I have been looking for natural care for erectile dysfunction for a while. Are there any herbal remedies for erectile dysfunction ? Andrew jones- Fresno, USA

A. Yes, there are so many herbs which can increase the testosterone levels. Infact Tribulus contains a precursor - protodioscin of of DHEA - which gets converted into testosterone in the body. Herbal supplements like Tribulus Power Pack for Male Support and Atirasadi Churna contain herbs that help in erectile dysfunction. You can try them for one month and see the results by yourself. These are natural care for erectile dysfunction. There number of natural herbs and minerals that can make a significant difference in improving erection.

Question 4. Is it safe to use Levitra as a remedy for erectile dysfunction. I am a cardiac patient taking nitrates.

A. We would advise you not to take Levitra with nitrates, since you are already a cardiac patient. There are a lot of herbal alternatives for erectile dysfunction. So you can try them. Although there are so many treatment options available for erectile dysfunction but a herbal apporach is better.Medications like Viagra, Levitra and Cialis are a temporary solution for erectile dysfunction.

Question 5. What is a common symptom of erectile dysfunction? What erectile dysfunction solution do you recommend?

A. Basically, the inability to have an erection strong enough to penetrate the vagina and sustain intercourse.

Erectile Dysfunction Research Update

Effect of nonsteroidal anti-inflammatory drug use on the incidence of erectile dysfunction. J Urol. 2006 May;175(5):1812-5; discussion 1815-6.

Tampere School of Public Health, University of Tampere, Tampere, Finland.

The target population consisted of men 50, 60 or 70 years old residing in the study area in Finland in 1994. Questionnaires were mailed to 3,143 men in 1994 and to 2,864 men 5 years later. The followup sample consisted of 1,683 men who responded to baseline and follow up questionnaires. We estimated the effect of NSAIDs on the incidence of ED in men free from moderate or complete ED at baseline (in 1,126). Erectile dysfunction was assessed by 2 questions on subject ability to achieve or maintain an erection sufficient for intercourse. Results: The incidence of erectile dysfunction was 93 cases per 1,000 person-years in men who used and 35 in those who did not use NSAIDs. Among men with arthritis, the most common indication for NSAID use, erectile dysfunction incidence was 97 cases per 1,000 in those using and 52 in men who did not use NSAIDs. Conclusion: The use of nonsteroidal anti-inflammatory drugs increases the risk of erectile dysfunction and the effect is independent of indication.

Drugs to treat erectile dysfunction need stronger warnings on their packaging about the risk of blindness, U.S. consumer group Public Citizen said in October, 2005, in a petition filed with health regulators. The U.S. Food and Drug Administration should "immediately add a black box warning regarding the risks of drug-induced blindness for the three phosphodiesterase 5 (PDE5) inhibitors that are prescribed for the treatment of erectile dysfunction," Public Citizen's Health Research Group wrote. Pfizer Inc.'s pulmonary hypertension drug Revatio, which has the same active ingredient as its impotence drug Viagra, should also carry a similar black box warning -- the strongest warning the agency can require, the advocacy group said. Earlier in 2005 drugmakers agreed to put information on their impotence drug labels about the possible vision loss, called non-arteritic anterior ischemic optic neuropathy. Viagra, Cialis, sold by Eli Lily & Co. and Icos Corp., and Levitra, sold by GlaxoSmithKline , Bayer AG and Schering-Plough Corp., now carry the new labels, which say the condition "has been reported rarely.

In diabetic men with erectile dysfunction, the severity of their sexual performance problem increases as control of blood sugar levels worsens.

Erectile dysfunction may serve as an early warning of heart disease down the road, even in men without traditional risk factors for heart trouble. In a study of 143 middle-aged men, Italian researchers found that those with vascular erectile dysfunction (ED) were nearly four times as likely as those without the condition to show high levels of calcification in the heart arteries. Calcium deposits, along with fat and other substances, are part of the artery-clogging "plaque" that accumulate in atherosclerosis, a "hardening" and narrowing of coronary arteries that can lead to heart attack and stroke. Computed tomography (CT), a specialized X-ray technique, can detect these calcium deposits, and it is sometimes used to screen for heart disease before symptoms are apparent. In the new study, CT scans revealed that arterial calcium deposits were more common and more extensive in men with erectile dysfunction -- even though traditional heart risk factors, like high blood pressure and high cholesterol, were not.

Exercises that focus on strengthening the muscles at the base of the penis, known as the pelvic floor, appear to be a useful treatment for erectile dysfunction. The findings, which appear in the medical journal BJU International, are based on a study of 55 men with erection difficulties who were randomly selected to receive lifestyle advice, such as quitting smoking, with or without training in pelvic floor exercises. After three months, subjects in the non-exercise group who showed no response were treated with the exercise intervention. The exercise training was provided by a physiotherapist who instructed the men to tighten their pelvic floor muscles as if they were trying to prevent gas passing. In addition, emphasis was placed on the ability to retract the penis and lift the scrotum using pelvic muscles. After three months of training, the men were encouraged to continue the exercises at home for three additional months. At that point, erectile function, based on a standard scoring system, was significantly better in the pelvic exercise group than in comparison subjects. The men who crossed over to the intervention displayed a significant improvement in erectile dysfunction three months later.

Smoking may raise the risk of erectile dysfunction, particularly in younger men. Researchers found that among the more than 1,300 men they followed, those who smoked were at greater risk of erectile dysfunction than either former smokers or non-smokers. Smokers in their 40s, the youngest group in the study, showed the highest smoking-related risk. Compared with other men their age, they were nearly three times more likely to have erectile dysfunction. Smoking was also linked, to a lesser extent, to erectile dysfunction among men in their 50s and 60s, but not among those in their 70s. This age difference is not surprising, according to Drs. Naomi M. Gades and Steven J. Jacobsen of the Mayo Clinic College of Medicine in Rochester, Minnesota, two of the authors of the study. Older men often have a number of risk factors for erectile dysfunction, including diabetes, heart disease and high blood pressure. In younger men, the association between smoking and erectile dysfunction is less likely to be "masked" by these other medical conditions.

Tadalafil may increase the blood pressure-lowering effects of doxazosin, which is commonly prescribed for the treatment of enlarged prostate, or benign prostatic hyperplasia (BPH), researchers report in the Journal of Neurology. Patients and physicians and patients should be aware that there might be interactions between alpha blocker drugs, which are often used to treat BPH and high blood pressure, and drugs used to treat erectile dysfunction, phosphodiesterase 5 inhibitors, which include drugs such as tadalafil.

Erectile dysfunction is sometimes more than just an issue that negatively impacts a man's quality of life -- it can also be an early sign of heart or blood vessel problems. Consequently, men need to tell their doctors as soon as they develop erectile dysfunction, so their doctors can order additional tests to make sure their heart and blood vessels are healthy. Erectile dysfunction is a barometer of a man's overall cardiovascular health. Erectile dysfunction is often caused by problems in the body's blood vessels, Billups explained. If blood vessel problems are causing high blood pressure or cholesterol -- so-called "silent" conditions -- men may not know it. But if those impaired blood vessels also impact erections, men will know.

The Food and Drug Administration on 11/04 warned consumers not to buy or use Actra-Rx or Yilishen for erectile dysfunction treatment because the supplements contain an ingredient that could lower blood pressure to unsafe levels. The FDA also instructed employees to block imports of the supplements, calling them “dangerous ... and even life-threatening.” Actra-Rx and Yilishen are promoted for erectile dysfunction treatment that enhance men’s sexual performance. Despite an all-natural label, Actra-Rx capsules contain prescription strength levels of sildenafil, the active drug ingredient in Viagra. Viagra, produced by Pfizer, was approved by the FDA to treat erectile dysfunction.

Erectile dysfunction as a sentinel symptom of cardiovascular autonomic neuropathy in heavy drinkers.

J Peripher Nerv Syst. 2004 Dec;9(4):209-14.

Because autonomic neuropathy (AN) is not routinely assessed in chronic alcoholism, its features and relationship with other disease parameters remain undefined. The very existence of true alcohol-related autonomic dysfunction, in the absence of alcoholic hepatopathy, is even controversial. We aimed this study at evaluating the frequency and pattern of AN in a population of heavy drinkers without liver dysfunction. We also investigated the putative risk factors for AN as well as its relationship to peripheral neuropathy (PN). PN was found in 74% and AN in 26%; abnormalities in at least one autonomic test were found in 62%. All patients with PN were symptomatic, mainly due to sensory disturbances. In line with this, ENG abnormalities were more evident at sural nerves. AN was symptomatic in 10 of 18 patients, and its sole clinical expression was erectile dysfunction: indeed, the pattern of autonomic involvement was mainly parasympathetic. Among symptomatic patients (55%), erectile dysfunction seems to be the sole symptom, in line with the higher degree of parasympathetic damage.

Specific aspects of erectile dysfunction in endocrinology.

Int J Impot Res. 2004 Oct;16 Suppl 2:S10-2.

Prominent diseases of the endocrine system, such as diabetes mellitus, hypogonadism, and hyperprolactinemia, may cause erectile dysfunction. Erectile dysfunction affects about 50% of male diabetic patients possibly due to the vascular and neuropathic complications. Metabolic control and selective phosphodiesterase type 5 inhibitors are therapies of choice for controlling erectile dysfunction. By correcting hypogonadism, testosterone levels are restored. This, and the use of dopaminergic drugs, which normalize prolactin levels in male hyperprolactinemia, may be effective in reversing erectile dysfunction in these endocrine disorders. Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes.

Curr Med Res Opin. 2004 Sep;20(9):1377-84.

To investigate the efficacy and tolerability of oral propionyl-L-carnitine plus sildenafil in men with erectile dysfunction and diabetes unresponsive to sildenafil monotherapy. Patients with medically documented erectile dysfunction of organic or mixed aetiology and diabetes (type 1 and 2) were randomised to receive oral propionyl-L-carnitine (2 g/day) plus sildenafil (50 mg twice weekly) (20 patients, Group 1) or sildenafil alone (20 patients, Group 2), in a double-blind, fixed-dose study. All patients had been previously treated unsuccessfully with a minimum of eight administrations of sildenafil. CONCLUSIONS: Salvage therapy with propionyl-L-carnitine plus sildenafil was more effective in erectile dysfunction than sildenafil in the treatment of erectile dysfunction in patients with diabetes refractory to sildenafil monotherapy.

Erectile dysfunction: a significant health need in patients with coronary heart disease.

Scott Med J. 2004 Aug;49(3):97-8.

Erectile dysfunction is a common condition, which negatively affects quality of life, and shares similar risk factors with Coronary Heart Disease (CHD). Studies from the pre - sildenafil era confirm a higher risk of Erectile dysfunction in patients with cardiovascular disease. The high profile and success of sildenafil therapy has made it easier for some men to discuss erectile difficulties with healthcare professionals. Our aim therefore was to estimate the prevalence of Erectile dysfunction in our cardiac rehabilitation patients . We surveyed 150 random male cardiac rehabilitation patients using the International Index of Erectile Function questionnaire. 61% of all respondents had erectile difficulties, rising to 75% in the over 55 age group. 48% of respondents indicated their wish to discuss erectile problems with the healthcare team. CONCLUSION: Erectile dysfunction and CHD commonly co-exist. A large proportion of our respondents wished further discussion of erectile insufficiency. We recommend that cardiac rehabilitation programs should adopt a proactive approach to detection and treatment of erectile dysfunction.

Erectile dysfunction rates and requests for treatment in patients attending outpatient urology clinics and those accompanying them.

Int Urol Nephrol. 2004;36(2):223-6.

Erectile dysfunction is a common sexual function disorder in men. The aim of the present study was to determine the rates of erectile dysfunction and requests for treatment in male patients referred to our outpatient urology clinics and those accompanying them who were older than 20 years. The study comprised 2 groups: group 1 included male patients older than 20 years whom attend to the outpatient urology clinics, and group 2 included their companies whom were older than 20 years. Subjects were asked whether they had erectile dysfunction or not, if so whether they had been treated or not, if not then why, and whether they desired treatment or not at present. RESULTS: Erectile dysfunction was determined in 224 subjects (13%) in group 1, and 57 (8%) in group 2. It was found that approximately one half of patients with erectile dysfunction did not complain about this. The main reasons for this were failure to perceive sexual dysfunction as a problem, and shame. Of 281 men who determined to have erectile dysfunction, 71 indicated that they desired treatment. In those who did not desire treatment, the main reasons were failure to perceive it as a problem, and shame. CONCLUSIONS: These findings show that the doctor has a great responsibility in determining erectile dysfunction. Therefore discussions of sexual health should be made a routine part of doctor-patient discussions, and patients, especially those over 50, should be asked whether they have a complaint of erectile dysfunction. Morphologic findings and blood flow parameters of penile vasculature in patients with erectile dysfunction.

World J Urol. 2004 Sep 9

The objective was to study the risk factors in patients with erectile dysfunction in correlation with ultrasound findings of penile vasculature. Patients with erectile dysfunction were classified in four groups according to their risk factors. Group A (37 pts) who were heavy smokers, group B (40 pts) who suffered from diabetes mellitus, group C (30 pts) who suffered from hyperlipidemia and group D (40 pts) with no risk factors. The peak systolic velocity (PSV) was measured after the intracavernous injection of 10 mg alprostadile. Normal values were PSV>35 cm/s and endiastolic venous velocity<4 cm/s. It was found that the mean PSV in group A was 22 cm/s without venous leakage, in group B the mean PSV was 24 cm/s but there was a significant venous leakage (mean end-diastolic velocity 6 cm/s). Patients with hyperlipidemia (group C) had a mean PSV of 26 cm/s and insignificant venous leakage and patients in group D had a normal vascular profile. Patients with erectile dysfunction who are heavy smokers are predisposed to have penile arterial insufficiency, while diabetics have both arterial insufficiency and venous leakage.Erectile dysfunction under age 40: etiology and role of contributing factors.

ScientificWorldJournal. 2004 Jun 7;4 Suppl 1:171-4.

The aim of this study was to evaluate the etiology of erectile dysfunction in patients under the age of 40 years. Eighty one patients were included in this study. All patients underwent a multidisciplinary diagnostic approach by color Doppler ultrasonography, dynamic pharmacocavernosometry (optional), selective pudendal pharmaco-arteriography (optional) and nocturnal penile tumescence monitoring by a Rigi-Scan (optional). Mean age of the population was 32 years. Psychogenic erectile dysfunction was diagnosed in 50% of the patients and organic erectile dysfunction was diagnosed in 45%. After the 3rd decade of life, a vasculogenic etiology was the most common cause of erectile dysfunction. Smoking and hypertension played a major role as chronic contributing factors in the overall study population. Primary erectile dysfunction was diagnosed in 11 patients who were unmarried. The rate of organic causes was 45% in this group (all vasculogenic in nature). Erectile dysfunction in younger patients and in patients with primary impotence is due mainly to organic causes, usually vascular in origin. Saddle pressure can cause temporary erectile dysfunction for men who take part in long distance cycling events, but bike adjustments may decrease the risk. However, bicycle seats with "cutouts" designed to relieve the pressure that may contribute to erectile dysfunction could actually put certain men at greater risk for the problem. Researchers found that among 463 men who'd taken part in long-distance cycling events, just over four percent developed short-lived erectile dysfunction within the following week. And while many of those who reported using a cutout saddle were at lower risk of temporary erectile dysfunction, others -- namely, those who felt numbness in the groin during the ride -- were more likely to develop erectile dysfunction if they used a cutout seat. The researchers also found a greater erectile dysfunction risk among men who used a mountain bike for the road race, and those with handlebars higher than the saddle. The findings are published in The Journal of Urology. cause of erectile dysfunction erectile dysfunction drug. Is routine hormonal measurement necessary in initial evaluation of men with erectile dysfunction?

Arch Androl. 2004 Jul-Aug;50(4):247-53.

To prospectively compare serum hormone levels and the incidence of hormonal pathologies between men with and without erectile dysfunction, and investigate risk factors that might predict hormonal pathologies in men complaining of erectile dysfunction. The study included 262 men with erectile dysfunction and 53 healthy men with no erectile dysfunction as a control group. All men enrolled in the study were evaluated with a detailed history, physical examination, international index of erectile function, and serum hormone measurement. Hypotestosteronemia was considered as serum total testosterone value of <3 ng/mL, and hyperprolactinemia was considered as serum prolactin level of >18 ng/mL. Serum hormone levels and the incidence of hormonal abnormalities were compared between the controls and those with erectile dysfunction. In addition, risk factors for hormonal abnormalities were investigated. There were no significant differences in the mean serum FSH, LH, testosterone and prolactin values between the men with and without erectile dysfunction. Hypotestosteronemia was detected in 29 (11%) of the erectile dysfunction group and in 2 (3.7%) of the control group, revealing no significant difference (p = 0.104). Hyperprolactinemia was detected in 25 (9%) of the erectile dysfunction group and in 2 (3.7%) of the control group, revealing no significant difference. To investigate risk factors that might predict hormonal pathologies, there were no significant differences in the patient age, duration of the erectile dysfunction, smoking history and duration, the presence of chronic disease and the type of erectile dysfunction. Our findings suggest that hormonal measurement should not be routinely performed in the initial evaluation of men presenting with erectile dysfunction, and may be necessary based only on the findings obtained with a careful history and physical examination. Erectile Dysfunction and diabetes.

Int J Clin Pract. 2004 Apr;58(4):358-62.

Erectile Dysfunction is common in men with diabetes. Diabetic men are three times as likely to develop Erectile Dysfunction as non-diabetic men. The cause is multifactorial, but most commonly reflects endothelial dysfunction and autonomic neuropathy. Diabetes and vascular disease often coexist and Erectile Dysfunction may be a marker for silent occlusive arterial disease, for which the patient should be screened. Many men still do not volunteer their problem, hence, routine questioning by health care professionals is an important part of the overall management because of the deleterious effect of Erectile Dysfunction on relationships, self-esteem and quality of life. Treatment is effective in the majority and all options should be considered, beginning with the much preferred oral phosphodiesterase type 5 inhibitors (sildenafil, tadalafil, vardenafil). Female Sexual Dysfunction or Disorder (FSD) is more difficult to define and specific studies in diabetics are limited. Problems with arousal, lubrication and orgasmic dysfunction occur, but the fatigue of diabetes may be influencing these complaints, and in general, psychological issues appear to predominate.

Prevention and treatment of erectile dysfunction using lifestyle changes and dietary supplements: what works and what is worthless, part II.

Moyad MA, et al. Sexual Medicine Society Nutraceutical Committee.

University of Michigan Medical Center, Ann Arbor, MI

Urol Clin North Am. 2004 May;31(2):259-73.

It seems naive to believe that some plants or herbs do not contain specific compounds that could benefit patients with erectile dysfunction. Many supplements have not been investigated in a laboratory or clinical research setting before commercial sale, however, which creates a complex situation. If efficacy is or is not demonstrated through adequate research, then the benefit or lack thereof cannot be mentioned on the label. Furthermore, clinicians and the public cannot be made aware of which compounds or supplements are effective because no general standards for sale exist under the current guidelines. Dietary supplements have received a tremendous amount of publicity. The large and growing market for erectile dysfunction treatment seems to have contributed partly to the promotion of numerous supplements and their apparent benefits. Whether these dietary supplements have merit is questionable. Some supplements may produce results opposite to those advertised. Other supplements may be enjoying the benefits of the placebo effect. Because a placebo response of 25% to 50% has been recorded in clinical trials with effective agents, it is understandable that some supplements enjoy financial success despite the limited research espousing their use. If one to two of four individuals or one of three individuals who try a dietary supplement gain some benefit for their erectile dysfunction, the market for these supplements will remain extraordinary. On a larger scale, of 100,000 men who try a supplement, approximately 25,000 to 50,000 will claim some success. The challenge for clinicians is to discuss the placebo response properly and the need for good research before any intervention, especially supplements, can be advocated for general use. Table 2 summarizes some popular erectile dysfunction supplements and general conclusions that can be drawn from clinical investigations. Some dietary supplements may have an active ingredient that benefits patients with certain types of erectile dysfunction. An exciting area of future dietary supplement research is the ability of certain agents to have a synergistic effect with prescription agents for erectile dysfunction, thereby improving response rates in men that have failed approved erectile dysfunction therapy initially, especially with oral agents. Randomized clinical trials are the best method of determining which dietary supplements will become a part of conventional medicine. Therefore, more randomized trials for dietary supplements are needed so that they may have the opportunity to become a part of the mainstream milieu, which means that more funding needs to be made available for erectile dysfunction research.  male erectile dysfunction.

Erectile dysfunction: symptom or disease?

University of Padua, Italy.

J Endocrinol Invest. 2004 Jan;27(1):80-95. Erectile dysfunction has been defined by the National Institute of Health (NIH) as the inability to achieve and/or to maintain an erection for a sufficiently long period of time so as to permit satisfactory sexual intercourse. Erectile dysfunction affects millions of men throughout the world and could have a negative influence on the individual's well-being as well as on the quality of life of affected subjects. Discordant data have been reported on Erectile dysfunction epidemiology with prevalence ranging from 12% to 52%, probably depending on the different criteria utilized in the different studies for patient selection. Erectile dysfunction is a symptom, sometimes the first, of different pathological conditions. In 15.7% of 45-yr-old patients with vascular Erectile dysfunction a dynamic ergometric test has shown electrocardiographic alterations in the absence of any cardiac symptom. In 15% of the patients with Erectile dysfunction, high fasting glucose plasma levels are discovered for the first time and in patients with ED and normal fasting glucose plasma levels the prevalence of undiagnosed diabetes mellitus is 12% after an oral glucose tolerance test. The different risk factors are often additive in the possible development of systemic vasculopathy, neuropathy and Erectile dysfunction. Erectile dysfunction, underestimated in clinical practice due to archaic prejudice which hinders the patient in spontaneously revealing the problem and the physicians in investigating it, can mark the point where evaluation and prevention of important diseases (such as diabetes, arterial hypertension, atherosclerosis) hitherto unknown by the patients, can begin. The physicians' cultural baggage must include the ability to identify the pathology that can determine Erectile dysfunction and the ability to program a specific diagnostic workup. In this paper the different specialists involved in Erectile dysfunction diagnosis agreed that a clinical approach which allows the identification of systemic pathologies contributing to the development of Erectile dysfunction constitutes an improvement in disease prognosis and may either induce a spontaneous reduction of Erectile dysfunction or facilitate its specific treatment. dysfunction erectile meds.A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report.

Hong B. niversity of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

J Urol. 2002 Nov;168(5):2070-3.

We investigated the efficacy of Korean red ginseng for erectile dysfunction. A total of 45 patients with clinically diagnosed erectile dysfunction were enrolled in a double-blind, placebo controlled, crossover study (8 weeks on treatment, 2 weeks of washout and 8 weeks on treatment) in which the effects of Korean red ginseng and a vehicle placebo were compared using multiple variables. The ginseng dose was 900 mg. 3 times daily. RESULTS: Mean International Index of Erectile Function scores were significantly higher in patients treated with Korean red ginseng than in those who received placebo. Scores on penetration and maintenance were significantly higher in the ginseng than in the placebo group. In response to the global efficacy question 60% of the patients answered that Korean red ginseng improved erection. Among other variables penile tip rigidity on RigiScan showed significant improvement for ginseng versus placebo. Our data show that Korean red ginseng can be an effective alternative for treating male erectile dysfunction.Cessation of smoking rapidly decreases erectile dysfunction.

Section of Endocrinology, Lahey Hitchcock Medical Center, Burlington, Massachusetts.

Endocr Pract. 1998;4(1):23-6.

Objective: To assess the relationship between cessation of smoking and rapid improvement in erectile dysfunction as well as the effect of nicotine patches on nocturnal penile tumescence and rigidity. Nocturnal penile erections were studied in 10 smokers with use of the RigiScan portable home monitor. Two nights were monitored: for the first night, the patients had not stopped smoking; for the second night, the patients had stopped smoking for 24 hours. In addition, four men were monitored after cessation of smoking and wearing nicotine patches for 1 month. Results: Multiple variables studied showed a statistically significant improvement in nocturnal penile tumescence and rigidity in the men who had stopped smoking for 24 hours. Continued improvement in erectile dysfunction was noted in the four men who were monitored while not smoking and wearing nicotine patches for 1 month. Conclusion: Stopping cigarette smoking is a factor that rapidly improves penile tumescence and rigidity. Because the improvement continues while the patient is receiving nicotine from transdermal patches, some factor or factors other than the nicotine are responsible for the erectile dysfunction.The etiology of erectile dysfunction and contributing factors in different age groups in Turkey.

Caskurlu T.Sisli Etfal Training and Research Hospital, Istanbul, Turkey.

Int J Urol. 2004 Jul;11(7):525-529.

Abstract Background: The aim of the present study was to determine the pathophysiological factors which cause erectile dysfunction, as well as the risk factors in different age groups in Turkey. Methods: A total of 948 patients with erectile dysfunction who were admitted to three andrology clinics were evaluated in terms of etiological factors. They underwent a multidisciplinary diagnostic evaluation. Erectile dysfunction was classified as primarily organic, primarily psychogenic, mixed or unknown in etiology. Results: Psychogenic erectile dysfunction was diagnosed in 65.4% of the patients and organic erectile dysfunction was diagnosed in 34.6% of patients overall. In patients under 40 years, the rate of psychogenic erectile dysfunction was 83% and the rate of organic erectile dysfunction was 17%, but in the patients over 40 years, the rate of psychogenic erectile dysfunction was 40.7% and the rate of organic erectile dysfunction was 59.3%. The causes of organic erectile dysfunction were identified as arteriogenic erectile dysfunction, 40.5%; cavernosal factor (venogenic) erectile dysfunction, 10%; neurogenic erectile dysfunction, 12.5%; endocrinologic erectile dysfunction, 1.8%; mixed type erectile dysfunction, 11.8%; and drug induced erectile dysfunction, 4.5%. Conclusion: Our data represent a higher ratio of erectile dysfunction in patients under 40, which are mostly psychogenic, This finding potentially results from local social and cultural differences.Improvement in erectile function in men with organic erectile dysfunction by correction of elevated cholesterol levels: a clinical observation.

Saltzman EA. Lahey Clinic Northshore, Peabody, Massachusetts 01960, USA.

J Urol. 2004 Jul;172(1):255-8.

PURPOSE: We determined that use of a statin drug to lower cholesterol would improve erectile function in men who have hypercholesterolemia as the only risk factor for erectile dysfunction. MATERIALS AND METHODS: A total of 18 men were determined to have increased cholesterol as the only risk factor for erectile dysfunction by history, system review, physical examination and laboratory analysis. Nine of these men agreed to participate in the study. Organic erectile dysfunction was verified by abnormal nocturnal penile tumescence and rigidity testing. Subjects were given atorvastatin with a goal decrease of total cholesterol to less than 200 mg/dl and low-density lipoprotein cholesterol to less than 120 mg/dl. RigiScan measurements were compared before and after treatment with atrovastatin. RESULTS: Mean age +/- SD was 49.7 +/- 7.4 years. Mean length of treatment with atrorvastatin was 3.7 +/- 2.1 months. Clinically 8 of the 9 men had improved erection adequate for penetration during sexual intercourse. Mean questionnaire scores improved from 14.2 to 20.7. Mean total and low-density lipoprotein cholesterol decreased significantly after treatment. RigiScan measurements showed an increased average penile rigidity at the base and tip after treatment with atorvastatin. CONCLUSIONS: Erectile dysfunction improves in men with hypercholesterolemia as the only risk factor for erectile dysfunction when treated with atorvastatin. Treating hypercholesterolemia may improve erectile dysfunction, while promoting primary cardiac prevention. dysfunction erectile pump.

Cardiovascular disease and erectile dysfunction are closely interrelated disease processes. Erectile dysfunction reportedly affects 10 million to 20 million men in the United States and more than 100 million men worldwide. Each year, about 500,000 persons in the United States survive a myocardial infarction, and an estimated 11 million have existing cardiovascular disease, making the issue of erectile dysfunction and cardiac disease relevant to many patients. care dysfunction erectile.

Aging and pathogenesis of erectile dysfunction.

Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.

Int J Impot Res. 2004 May 6

The prevalence and the severity of erectile dysfunction increase with advancing age; different pathogenetic factors could contribute to age-related erectile dysfunction. We studied organic, relational and intrapsychic components of erectile dysfunction as a function of patients' age in a consecutive series of 977 patients with erectile dysfunction, using the specifically designed structured interview. A complete physical examination and a series of biochemical, hormonal, psychometric and penile vascular tests were also performed. Relational factors seems to be more relevant in patients aged over 60 y, while intrapsychic disturbances play a major role in younger subjects. Organic factors are the most important determinant of erectile dysfunction in all age groups, but their contribution is more important in older patients. In fact, basal and dynamic peak cavernosal velocity at Doppler ultrasound penile examination was reduced in older patients. Among hormonal factors, the body mass index-dependent reduction of testosterone in older patients does not seem to play a crucial role in the pathogenesis of erectile dysfunction. No significant correlation was observed between testosterone level and the severity of erectile dysfunction, although patients reporting hypoactive sexual desire showed significantly lower testosterone levels when compared with the rest of the sample.  drug dysfunction erectile dysfunction erectile medication.Exercise and weight loss may improve sexual function in obese men, researchers in Italy report. In a new study of more than 100 obese men with erectile dysfunction, nearly a third regained normal sexual function after participating in an intensive weight loss program. If a man with type 2 diabetes also suffers from erectile dysfunction, it strongly suggests that he could well have coronary artery disease that's not causing any symptoms.

U.S. health regulators have accused Vivus Inc. of misleading consumers by downplaying risks associated with its little-used erectile dysfunction treatment called Muse. Vivus failed to include risk information and made false claims about the drug's effectiveness both on its Web site and in television advertisements that ran in 2003. dysfunction erectile help dysfunction erectile vitamin.

Prostate cancer patients underwent an operation called a bilateral nerve-sparing retropubic radical prostatectomy. More than 90 percent of these men who had the operation suffered from erectile dysfunction afterwards. dysfunction erectile male dysfunction erectile impotence.A third of older men have erectile dysfunction and the problem only gets more common with age. The good news is that there are many things men can do to reduce their risk of erectile dysfunction. The figures come from a survey of nearly 32,000 men, 53 to 90 years of age, who participated in the Health Professionals Follow-up Study. The results are reported in the Annals of Internal Medicine. Dr. Constance G. Bacon, from Harvard School of Public Health, and associates found that 33 percent of the men reported erection problems in the previous 3 months. Moreover, for each decade beyond 50 years of age, overall sexual function, desire, and orgasm frequency decreased sharply. Physical inactivity and obesity had a lot to do with erectile dysfunction. Men who ran for at least 3 hours per week or engaged in a similar amount of exercise were 30 percent less likely to have erectile dysfunction than men who barely exercised at all. Similarly, non-obese men were 30 percent less likely to develop these problems than obese men, the researchers note. Other "risk factors" for erectile dysfunction included smoking, drinking alcohol, and watching television. SOURCE: Annals of Internal Medicine August 5, 2003.

Dr. Sahelian adds: Diet also plays an important role in reducing the risk of erectile dysfunction. I recommend eating lots of healthy, organic vegetables and adding fish to the diet.

Effects of icariin on cGMP-specific PDE5 and cAMP-specific PDE4 activities.

Xin ZC, Kim EK, Lin CS, Liu WJ, Tian L, Yuan YM, Fu J.

Department of Urology, the 1st Hospital, Peking University, 8 Xishiku Street, Xicheng District, Beijing 100034, China.

AIM: To clarify the mechanism of the therapeutic action of icariin on erectile dysfunction. METHODS: PDE5 was isolated from the human platelet and PDE4 from the rat liver tissue. RESULTS: Icariin and papaverine showed dose-dependent inhibitory effects on PDE5 and PDE4 activities. The potencies of selectivity of icariin and papaverine on PDE5 (PDE4/PDE5 of IC(50)) were 167.67 times and 4.54 times, respectively. CONCLUSION: Icariin is a cGMP-specific PDE5 inhibitor that may be developed into an oral effective agent for the treatment of erectile dysfunction.

The endocrinologist as the focus in a multidisciplinary approach to management of erectile dysfunction.

Section of Endocrinology, Lahey Hitchcock Medical Center, Burlington, Massachusetts.

Endocr Pract. 1997;3(1):1-8.

Objective: To present an approach to the complete but cost-effective office evaluation and treatment of erectile dysfunction. Methods: The numerous medical, hormonal, and psychologic causes of erectile dysfunction are reviewed, and the various treatment strategies are outlined. Results: Erectile dysfunction, which might also include libido and ejaculatory disturbances, is the most frequently encountered type of sexual dysfunction seen in office practice. Before 1960, the assessment of erectile dysfunction was dominated by psychiatrists; later, urologists assumed a role. More recently, physicians in internal medicine have become involved in the management of erectile dysfunction. Diabetes mellitus, hypertension, and tobacco abuse are the three most common causes of erectile dysfunction in men older than 50 years of age. In addition to optimizing the management of diabetes, the endocrinologist can treat other endocrine problems associated with erectile dysfunction. Conclusion: A multidisciplinary approach to the evaluation and treatment of erectile dysfunction is logical, and the endocrinologist--because of an extensive background in internal medicine and expertise in hormonal diagnosis and treatment--should be the focal point of this diagnostic and therapeutic team. dysfunction erectile medicine diabetes dysfunction erectile.Future options for combination therapy in the management of erectile dysfunction in older men.

Department of Urology, University Medical Centre Cologne, Cologne, Germany.

Drugs Aging. 2004;21(9):555-64.

The prevalence of erectile dysfunction has dramatically increased in parallel with the aging of the Western industrialised population. The estimated prevalence of erectile dysfunction worldwide in 1995 was 152 million men. As the population in industrial nations ages, an estimated 322 million men will be affected by erectile dysfunction by the year 2025. Oral drug therapy with the phosphodiesterase (PDE) type 5 inhibitor sildenafil fails in some patients with erectile dysfunction; however, several different classes of drugs demonstrate efficacy in treating erectile dysfunction, creating the potential for pharmacological combination therapy. Pharmaceutical products that lead to the activation of or an increase in cyclic nucleotides (cyclic adenosine monophosphate and cyclic guanosine monophosphate), with or without nitric oxide donors or nitrates, as well as alpha-adrenoceptor antagonists, have been used to treat erectile dysfunction. Sildenafil has been used in combination with alprostadil (prostaglandin E(1)) and administered via intraurethral or intracavernous route. Successful intercourse using this combination of agents varies from 47% to 100% following failed monotherapy. Various combination therapies for erectile dysfunction are being studied using PDE5 inhibitors, together with other agents, alpha-adrenoceptor antagonists, and testosterone replacement therapy for men with hypogonadism. Preliminary observations of combination therapy for the treatment of erectile dysfunction have been encouraging and provide a scientific rationale for prospective, randomized clinical trials with adequate numbers of patients.

New oral drugs for erectile dysfunction.

Drug Ther Bull. 2004 Jul;42(7):49-52.

In 1998, we concluded that sildenafil (Viagra--pfizer Ltd), a selective phosphodiesterase type 5 inhibitor, appeared to offer advantages over other medical approaches for erectile dysfunction in terms of ease of administration and cost. Oral drug treatment is now widely advocated as first-line therapy for erectile dysfunction, except where the cause is clearly psychological. In the past 4 years, three more oral preparations have been licensed in the UK for the treatment of men with erectile dysfunction. A sublingual preparation of the dopaminergic agonist apomorphine (Uprima--Abbott Laboratories Ltd) is the first centrally acting drug to be licensed. Tadalafil (Cialis--Eli-Lilly) and vardenafil (Levitra--Bayer PLC) are phosphodiesterase type 5 inhibitors. Here we review the place of these preparations for men with erectile dysfunction. dysfunction erectile product dysfunction erectile pill.Characterization of patients in a medical endocrine-based center for male sexual dysfunction

Center for Sexual Function and Section of Endocrinology, Lahey Clinic Northshore, Peabody, Massachusetts.

Endocr Pract. 1999;5(6):314-21.

Objective: To characterize the patient population in a multidisciplinary erectile dysfunction clinic whose focal person is an endocrinologist and to summarize the initial manifestations, the demographics of the study group, and their associated medical conditions. We undertook a retrospective analysis of the medical records of all new consultations in a center for erectile dysfunction during a recent 2-year period. Results: Of the overall study group of 990 men, most (93%) had erectile dysfunction (versus libido or ejaculatory problems), but combinations of problems were common. Most men had organic causes of their erectile dysfunction that correlated with increasing age; however, their erectile dysfunction was more often the result of chronic medical conditions than of advancing age itself. Most men were married (72%) and in long-term relationships. Hypogonadism was the most common medical condition (36%), a finding that reflected an endocrine referral bias. Testosterone treatment alone corrected the complaints in a minority of patients. Hypertension was a more common diagnosis than diabetes (35% versus 23%), and pituitary tumors were rare. Successful outcomes were achieved in about two-thirds of men having a strong organic cause of erectile dysfunction, but treatments were less successful when pronounced psychologic factors were present. Conclusion: Many patients have more than one manifestation of erectile dysfunction, which may have to be addressed separately. In an erectile dysfunction clinic managed by an endocrinologist, referral bias may direct more patients with hypogonadism and fewer patients who have had transurethral retropubic prostatectomy or a radical prostatectomy. Treatment of hypogonadism corrects erectile dysfunction in only a few men, and only when other medical problems are not present. Although the percentage of men with diabetes would be expected to be high in this study, the number of patients with hypertension was higher. Erectile dysfunction treatment.


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