While most men want to jump to an immediate treatment plan for erectile dysfunction (ED), true long term success requires that you first identify the cause, and once identified, then proceed to a correct treatment.
Sadly, many physicians will write for a prescription like Viagra or Levitra in the interest of time without giving this critical issue much thought. WARNING! THE MOST COMMON CAUSE OF ERECTILE DYSFUNCTION IS CARDIOVASCULAR DISEASE FROM CLOGGED ARTERIES, which if not diagnosed can result in a heart attack, stroke, or death, plus permanent erectile dysfunction.
After we discuss the causes and you have clarified which might apply to you, then consider solutions, including the supplement recommendations below.
What are the Causes of Erectile Dysfunction?
- Cardiovascular disease (CVD). CVD results in arterial blockage of blood flow to the genitals. Often, the first sign of cardiovascular disease is ED. Viagra, Levitra, and similar drugs might temporarily reverse symptoms as they cause arteries to dilate overcoming the early blockage, but over time you would be at risk for a heart attack, stroke, or death by missing this critical diagnosis. As the blockage worsens, at some point these medications stop working. At the Masley Optimal Health Center, we utilize carotid IMT ultrasound testing (no needles, no radiation, no pain) to clarify your arterial thickness and arterial age. For info on revitalizing your heart and reversing plaque growth in your arteries see “Are you at risk for a heart attack or stroke?”
- Low testosterone levels. Nearly 20% of men between 50-60 have low testosterone function. This is less frequent before age 50 and more frequent after age 60. Low testosterone function does not only cause ED but typically also causes low energy, low drive, low libido, night sweats, poor quality sleep, low exercise interest and difficulty controlling weight. There are two forms of low testosterone function that can cause ED. First is from low total production with low total testosterone levels, and the second is from normal production, but the testosterone is stuck to blood proteins and is not available to stimulate tissues. Because the treatments for the two causes of low testosterone are totally different, it is critical to measure both total and free testosterone levels when evaluating patients with the above symptoms. Initially Viagra, Levitra, and similar drugs work, but eventually if not treated properly, a man will not have enough libido for success, even if the drugs work with erectile function.
- Low Fitness. Some men just are not fit enough to perform. Take my fitness test in the Free Health Evaluation. If you score below the 40th percentile for your age, then you need to get more fit before you should expect normal erectile function. Keep in mind that average fitness for an American (when two thirds of Americans are either obese or overweight) is not such a good thing. In truth, if you want great romantic performance you should aim for aerobic fitness that is in the top 20th percentile for your age group.
- Tobacco use. Every time you smoke a cigarette, it decreases the blood flow to your genitals for at least 4-6 hours, limiting your ability to have an erection. Tobacco use also accelerates arterial plaque growth in your arteries so most smokers will eventually suffer from ED. If you smoke, I strongly encourage you to quit and talk to your medical provider about quitting options that are appropriate for you.
- Excessive Alcohol Intake. Drinking more than one serving of alcohol decreases sports and romantic performance. If you suffer from early signs of low fitness, testosterone deficiency, or cardiovascular disease, extra alcohol just compounds your problems. While the average 20 year old has zero erectile dysfunction and might gain a little confidence after 1-2 drinks, most men after 35 will experience a drop in sexual function.
- Excessive Stress. Too much stress can lead to insomnia and ED. If stress is impacting your romantic performance, please consider these four key steps to stress management: (1) Get enough sleep (2) Execise daily for at least 30-45 minutes to burn away the tension (3)Don’t overuse caffeine or alcohol (4) Add some form of relaxation time such as weekly massages, meditation, prayer, etc. For details, refer to Ten Years Younger Chapter 7. If nothing is working, then seek the help of a professional mental health counselor.
Are There Natural Supplements for ED?
YES. There are natural compounds that increase nitric oxide levels (like Viagra and similar medications) in your blood stream and cause your arteries to dilate, including those to the genitals.
Nitric oxide is made from the amino acid (building block of natural protein) called arginine. Studies have shown that taking 5 grams of arginine daily improves erectile dysfunction. Don’t be surprised then to see many over the counter agents put arginine in their treatments. Very rarely, some men might notice dizziness with this dosage and should contact their physicians.
Clinical studies using zinc, gingko, and ashwaganda (called male ginseng in Asia) often seem to help, but once compared to a placebo, do not seem more effective than the placebo themselves.
What About Yohimbine?
The bark of the west African yohimbe tree is a source of yohimbine, a compound that has been found to stimulate blood flow to the penis, increase libido, and decrease the period between ejaculations.
Yohimbine is not recommended, however, because it is potentially dangerous, even in small doses. Side effects may include dizziness, anxiety, nausea, a severe drop in blood pressure, abdominal pain, fatigue, hallucinations, and paralysis.
Erectile Dysfunction (ED) Summary
If you have ED, first clarify you don’t have any of the reversible causes listed above. Once that is done, talk to your medical provider about treatment options, but do not forget to ask about trying Arginine as well.
























