Men represent about 90% of my practice with Helix Mobile wellness and many of them report their erections are not what they used to be. We have good success improving erections with testosterone therapy, but it’s not always that simple. Erectile health is multifactorial and requires a systemic approach. The causes usually include a combination of psychological, pharmacological, vascular, neurological, and hormonal factors. The National Institutes of Health Consensus Development Conference on Impotence (December 7-9,1992) defined erectile dysfunction as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance for at least 3 months. It’s estimated about 30 million men in the US struggle with erectile dysfunction1. Healthy erections are dependent on healthy circulation, healthy nitric oxide release, healthy hormones, healthy diet, and a sufficient amount of exercise. When evaluating why your erections are not healthy three factors must always be considered:
Medications: The Major Players
- Antidepressants: Prozac
- Blood pressure medications: Hydrochlorothiazides, Metoprolol
- Anti-seizure medications: Gabapentin
- Antihistamines: Cimitidine, Benadryl, Zantac.
- Muscle relaxants
- Pain medications: Oxycodone, Codeine, Gabapentin
- Non-steroidal anti-inflammatory (NSAIDs): Naproxine, Ibuprofen
- Other medications: Estrogen, Propecia
- Drugs: nicotine, cocaine, alcohol
There are many other medications in these classes that cause ED, these are the most commonly prescribed.
Arteriosclerosis, damage to arteries, or narrowing of the vessels can lead to poor circulation. Poor circulation can interfere with erections becoming fully erect. Often erectile dysfunction is an early sign of cardiovascular disease. In my practice I work with two different cardiovascular labs that do extensive testing to evaluate the health of my patients cardiovascular system. We can pin point what, where and why there are imbalances in the cardiovascular system. For more information on these labs and getting yourself tested see: Boston Heart and Singulex.
Diabetes Type II
Diabetes Mellitus is a health condition where blood sugar levels are too high for too long, and is largely effected by diet. These chronically elevated blood sugar levels cause damage to arteries, vessels and tissues, leading to lack of blood flow and erectile dysfunction. Have your fasting blood sugar, insulin and HbA1C checked.
What can you do?
Improve your Diet
Cut the carbs. Avoid all simple carbs, refined carbs, and sugars such as cookies, pastries, pastas, breads, cereals, quick oats, white rice, packaged foods. Whole grains like quinoa or wild rice are fine in moderation.
Increase Anti-oxidant rich foods: berries, pomegranate, dark leafy greens, greens powder. Foods rich in color are rich in anti-oxidants!
Chose organic meats and dairy to avoid adding extra harmful hormones to your body. Keep red meat lean and no more than 3x per week, remove skin from chicken. Chose more wild fish like salmon, cod, and halibut.
Cut the caffeine. Watch out for those energy drinks, pre-workout drinks and other caffeinated beverages. Caffeine increases estrogen in men, as men age they already have a tendency to make too much estrogen. Too much estrogen is not good for your erections, your testosterone levels, your cardiovascular health or your prostate! Keep coffee to no more then 3 cups per week.
Ask your doctor about your medications.
Be pro-active, know what you’re taking, is it working for you, and what are the safe alternatives. Be sure to consult with your doctor before discontinuing any medications, as rebound effects can be harmful if you’re not weaned off properly.
Natural Herbs & Nutrients
- Gingko biloba: Increases circulation to body, brain and penis.
- Tribulus terresteris: Increases vasodilation and testosterone.
- Lepidium peruvianum (Maca): Useful for those on SSRI anti-depressants, Lepidium increases testosterone release.
- Garlic: Improves cholesterol, cardiovascular health and increases circulation.
- L-Argenine + L-Citruline: increases nitric oxide causing vasodilation and better erections, like a natural viagra. Dosing is important: 1.5 grams of each daily for at least 6 weeks.
- DHEA: can help optimize free testosterone and support healthy hormones.
- Zinc + Copper: Helps to boost testosterone and sperm production
- Omega 3 & 6: fish oil, flaxseed oil, olive oil all help to build testosterone, improve cardiovascular health and keeps the blood viscous thus helping circulation.
Balance your hormones
Have your sex hormones (testosterone, DHT, DHEA, estrogen) tested. If they come back low have a qualified doctor treat and monitor you on a well rounded bio-identical hormone replacement therapy (bHRT) program. Including testosterone therapy. For more on testosterone health see my men’s health blog here.
Evaluate your thyroid and adrenal health. Stress and thyroid play a big role in overall hormone health.
(1) Nunes KP, Labazi H, Webb RC. New insights into hypertension-associated erectile dysfunction. Current Opinion in Nephrology and Hypertension. 2012;21(2):163–170.