| | | | Other Names | | | Impotent, Erectile Dysfunction.
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| | | IMPOTENCE refers to the inability to perform the sexual act. It may
be partial or complete, temporary or permanent. Of the many
classifications of this quite common condition, the most satisfactory is
probably that which divides it into two main groups: organic and
psychological. Among organic causes are lesions of the external genitalia,
e.g. a tight foreskin; disturbances of the endocrine glands, such as
diminished activity of the gonads, thyroid gland or pituitary gland;
diseases of the central nervous system, e.g. tabes dorsalis; any severe
disturbance of health, such as diabetes mellitus, addiction to alcohol and
the like. Psychological factors are the commonest cause and these are
anxiety, ignorance, fear, guilt, weakness of sexual desire or abnormality
of such desire. Counseling or sex therapy, preferably with the partner,
has a 50% chance of helping to cure long-term impotence of psychological
origin.
An oral drug for treating erectile function has recently
been approved by the USA's Food and Drug Administration. Sildenafil
citrate (tradename Viagra) is the first in a new class of drugs called
phosphodiesterase type 5 inhibitors. They work by improving blood flow to
the penis. The pill can be taken an hour before intercourse. The drug is
not an aphrodisiac, and it comes with side-effects including headache,
facial flushing and indigestion. In addition, there are some suggestions
that it may affect retinal function.
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.1 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 of erectile dysfunction? ED is defined by the symptoms
listed above. Symptoms may also include loss of sexual desire (libido),
premature ejaculation, or inability to achieve orgasm.
Conventional
treatment options: Depending on the cause, conventional therapy may
include psychological and behavioral counseling, treatment of underlying
cardiovascular disease, and avoidance of certain medications (such as
cimetidine, antihypertensives, and MAO inhibitors). Drug treatments for ED
include male hormone replacement therapy (testosterone, DHEA), sildenafil
(Viagrar), and medications inserted or injected into the penis
(alprostadil). 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.
Lifestyle changes that may be
helpful: Men who smoke have been shown to have an increased incidence of
ED.2
Nutritional supplements that may be helpful: Low blood levels
of the hormone dehydroepiandrosterone (DHEA) 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.3 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.4 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.5 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.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects
or interactions.
Herbs that may be helpful : Yohimbine (the primary
active constituent in yohimbe) has been shown in several double-blind
trials to help treat men with ED;6 7 negative results have also been
reported, however.8 9 Yohimbe dilates blood vessels and may help,
regardless of the cause of ED. A tincture of yohimbe bark is often used in
the amount of 5 to 10 drops three times per day. Standardized yohimbe
extracts are also available. A typical daily amount of yohimbine is 15 to
30 mg. It is best to use yohimbe and yohimbine under the supervision of a
physician.
Asian ginseng (Panax ginseng) has traditionally been
used as a supportive herb for male potency. A double-blind trial found
that 1,800 mg per day of Asian ginseng extract for three months helped
improve libido and the ability to maintain an erection in men with
ED.10
Ginkgo biloba may help some men with ED by increasing blood
flow to the penis. One double-blind trial found improvement in men taking
240 mg per day of a standardized Ginkgo biloba extract (GBE) for nine
months.11 A preliminary trial, involving 30 men who were experiencing ED
as a result of medication use (selective serotonin reuptake inhibitors and
other medications), found that approximately 200 mg per day of GBE had a
positive effect on sexual function in 76% of the men.12
Damiana
(Turnera diffusa) is a traditional herbal treatment for men with ED.
However, no modern clinical trials have confirmed its
effectiveness.
Are there any side effects or interactions? Refer to
the individual herb for information about any side effects or
interactions.
Other integrative approaches that may be helpful: ED
that cannot be linked to physical causes has been successfully treated by
hypnosis.13 In one trial, three hypnosis sessions per week, later
decreased to one per month over a six-month period led to improvement in
75% of men in the trial.
Acupuncture might be of some benefit for
men with ED. Electroacupuncture, which is acupuncture accompanied by
electrical stimulation, was performed on various acupuncture points in men
with ED in a preliminary trial of men with this condition.14 Two
treatments were administered every week for one month. An improvement in
quality of erection was observed in 15% of the participants and an
increase in sexual activity was reported by 31% of the men. Another
preliminary trial15 found good results in over half of the men treated,
but the only controlled trial of electroacupuncture for ED16 found that
placebo also produced a large improvement in sexual function-an effect
similar to that of acupuncture. Controlled trials with larger groups of
men are necessary to better test the efficacy of acupuncture therapy for
men suffering from ED.
References:
1. Hern ndez-L˘pez
C. Drugs do not only relieve male menopause. BMJ 2000;321:451
[letter].
2. Condra M, Morales A, Owen JA, et al. Prevalence and
significance of tobacco smoking in impotence. Urology
1986;27:495-8.
3. Reiter WJ, Pycha A, Schatzl G, et al.
Dehydroepiandrosterone in the treatment of erectile dysfunction: a
prospective, double-blind randomized, placebo-controlled study. Urology
1999;53:590-5.
4. Zorgniotti AW, Lizza EF. Effect of large doses of
the nitric oxide precursor, L-arginine, on erectile dysfunction. Int J
Impot Res 1994;6:33-6.
5. Chen J, Wollman Y, Chernichovsky T, et
al. Effect of oral administration of high-dose nitric oxide donor
L-arginine in men with organic erectile dysfunction: results of a
double-blind, randomized study. BJU Int 1999;83:269-73.
6. Ernst E,
Pittler MH. Yohimbine for erectile dysfunction: A systematic review and
meta-analysis of randomized clinical trials. J Urol
1998;159:433-6.
7. Carey MP, Johnson BT. Effectiveness of yohimbine
in the treatment of erectile disorder: Four meta-analytic integrations.
Arch Sex Behav 1996;25:341.
8. Kunelius P, H„kkinen J, Lukkarinen
O. Is high-dose yohimbine hydrochloride effective in the treatment of
mixed-type impotence? A prospective, randomized, controlled double-blind
crossover study. Urol 1997;49:441-4.
9. Mann K, Klingler T, Noe S,
et al. Effect of yohimbine on sexual experiences and nocturnal tumescence
and rigidity in erectile dysfunction. Arch Sex Behav
1996;25:1-16.
10. Choi HK, Seong DH, Rha KH. Clinical efficacy of
Korean red ginseng for erectile dysfunction. Int J Impotence Res
1995;7:181-6.
11. Sohn M, Sikora R. Ginkgo biloba extract in the
therapy of erectile dysfunction. J Sec Educ Ther 1991;17:53-61.
12.
Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual
dysfunction. J Sex Marital Ther 1998;24:139-43.
13. Aydin S, Ercan
M, €askurlu T, et al. Acupuncture and hypnotic suggestions in the
treatment of non-organic male sexual dysfunction. Scand J Urol Nephrol
1997;31:271-4.
14. Kho HG, Sweep CG, Chen X, et al. The use of
acupuncture in the treatment of erectile dysfunction. Int J Impot Res
1999;11:41-6.
15. Yaman LS, Kilic S, Sarica K, et al. The place of
acupuncture in the management of psychogenic impotence. Eur Urol
1994;26:52-5.
16. Aydin S, Ercan M, Caskurlu T, et al. Acupuncture
and hypnotic suggestions in the treatment of non-organic male sexual
dysfunction. Scand J Urol Nephrol 1997;31:271-4.
Source: NOW Foods
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Please Note: This Traditional Use information is provided as a courtesy only. The products indicated above may be listed in error. This information is based on Traditional and Folklore Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA and is not based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
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Impotence (Erectile Dysfunction) - Health - Glucosamine Sulfate - 500 mg
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Impotence (Erectile Dysfunction) - Health - MSM / Glucosamine - 1000 mg
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Impotence (Erectile Dysfunction) - Health - Glucosamine Sulfate - 500 mg
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Impotence (Erectile Dysfunction) - Health - Glucosamine Sulfate 225 mg - Devil's Claw 225 mg
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