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Erectile Dysfunction 

Erectile Dysfunction  is quite common affecting about 22% men over age 40 and 50% men over age 70. About 10-15% younger men below age 40 also have this condition. 

Causes of ED:

Treatment of ED (Erectile Dysfunction) largely directed at symptom relief. This includes medications such as viagra, levitra and cialis. However, before starting such medications, it must be understood that ED is often a tell-tale sign of an underlying disorder. 

Erectile dysfunction can be due to a dysfunction in any of the following systems,

  1. Vasculogenic - problems with circulation caused by heart disease, cholesterol, and high blood pressure

  2. Neurogenic - problems with neve supply such as occurs diabetes and many other metabolic conditions or direct nerve injury 

  3. Hormonal - problems with testosterone, thyroid and prolactin

  4. Veno-occlusive - problems with venous return which often occurs with heart disease and disorders of circulation

  5. Psychogenic - problems related to stress and many psychiatric conditions

  6. Pharmacogenic - several medications including antidepressants, anti-hypertensives and others can cause erectile dysfunction 


Above disorders lead to alterations in the nitric oxide/cyclic guanosine monophosphate (cGMP) or cyclic aminophosphate (cAMP) pathway or other regulatory mechanisms including gap junction or ionic channel resulting in an imbalance in corporal smooth muscle contraction and relaxation.In simple terms, it is a problem of relaxation of smooth muscles in the blood vessels supplying to penile area. 

Diagnosing ED:

Following IEF (Index of erectile function) questionnaire is used to diagnose presence and severity of ED


Prevention and Treatment of ED:

So what can be done about it?

Depending upon the root cause, following non-pharmacologic strategies can help.

  1. Control of cardiovascular risk factors 

    • Maintaining a healthy body weight ​

    • Blood Pressure control

    • Cholesterol control

    • Smoking cessation

  2. Prevention of diseases which lead to neuropathy

    • Prevention and treatment of diabetes​

    • Avoidance of alcohol use

    • Avoidance of toxins which may cause neuropathy 

    • Chronic diseases such as liver and kidney disease 

  3. Achievement of hormone balance

    • Testosterone balance​

    • Thyroid balance 

    • Prolactin balance 

  4. Stress reduction 

    • Meditation​, yoga, mindfulness

    • Daily Exercise 

    • Work life balance 

  5. Understanding mechanisms and side effects of prescription medications and supplements which may potentially cause ED

Balanced Objects
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Foods and Supplements:

Based upon research studies, following foods and supplements have shown to improve symptoms of ED. 

  1. Nitrate rich green leafy vegetables 

  2. Flavonoids rich sugar free dark chocolate 

  3. Phytonutrient containing watermelon  

  4. Nuts such as Pistachios 

  5. Zinc containing foods such as vegetables and beans

  6. Red Ginseng (600 mg 3x/day) for moderate ED (IEF > 5)

  7. Arginine (1500 - 5000 mg daily) for mild ED (IEF score > 10)

What not to do?

  • Taking medication only and ignoring root cause 

  • Continuing with unhealthy lifestyle 

  • Ignoring red flag or alarm symptoms such as symptoms suggestive of heart disease, hormone imbalance, dysfunction in major organs and worsening depression and anxiety

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