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Erectile Dysfunction (or “ED” as it is commonly referred to) is rarely a problem that exists in isolation and nearly always is a result of some other health problem (which may or may not be known to the ED sufferer).  While prescription medications are available to help with ED to varying degrees and with varying rates of side-effects, in most cases it is not only more effective, but healthier overall to address the underlying causes of ED rather than simply attempt to compensate for the problem with pharmaceuticals. 

The causes of ED fall into four main categories:  psychological, circulatory, chemical, and neurological.

Psychological factors are very commonly at least part of the cause of ED.  Stress, depression, anxiety, and/or conflict with one’s sexual partner can all result in erectile dysfunction.  Because of the emotional impact of ED itself, it can become self-perpetuating as one or more episodes of ED can result in “performance anxiety” that in turn causes future episodes of ED.  Depending on the nature and severity of psychological issues, ED may be may be a brief or transient problem, or it can become quite chronic.  One or two episodes of ED are really nothing to worry about, particularly if they occur when a man is under unusual amounts of stress, is fatigued, or is experiencing some temporary emotional upset.  My advice to anyone who experiences ED for the first time is to try to relax and not read too much into it and simply enjoy other sexual activities or aspects of intimacy with your partner.  More chronic problems with psychologically-induced ED may require some type of in-depth stress management or professional counselling.  There are some very effective self-treatment methods that are easy to apply for these purposes as well.  In particular, I recommend Emotional Freedom Technique and/or the Sedona Method. 

Circulatory causes of ED typically involve either heart problems or atherosclerotic narrowing of blood vessels.  Diabetic men often suffer from ED due to plaque formation in the blood vessels all over the body, including the blood vessels of the penis.  Not all circulatory causes for ED can be corrected, but the vast majority can be dramatically improved through diet, exercise, and supplements that help with circulation.  It is also very important to avoid smoking, as this activity greatly reduces circulation.  A diet high in fresh vegetables and fruits and high quality protein (lean meat, fish, and poultry) is best.  Any kind of exercise is better than none, but for those with ED, “cardio” training done for 30 to 60 minutes three or more times per week will dramatically improve circulation and will often greatly reduce difficulties with ED all by itself.  Supplements such as ginkgo biloba, garlic, omega-3 fatty acids, coenzyme Q10 and natural taurine can improve circulation by keeping blood vessels and the heart healthy. 

By far the most common chemical causes of ED are medication side-effects.  As mentioned earlier, depression can cause ED, but in many cases of depression, ED results from depression medication more than from the depression itself.  For this reason, I suggest trying natural depression remedies (such as omega-3 fatty acids, vitamin B-6,  5-HTP, and/or St. John’s wort) before resorting to medication.  Almost any medication can cause almost any side-effect, and ED is actually a common side effect of a wide range of commonly-prescribed medications.  Any time one experiences a sudden onset of ED following the start of taking a new medication, the medication should be considered as a probable cause.  In such situations, it is recommended that you discuss the problem with the prescribing doctor and ask about alternative treatments. 

In addition to medication side-effects, chemical causes of ED can include exposure to “exogenous estrogens”, which are chemicals present in our food and water supply that mimic the effects of the female hormone estrogen.  Thes estrogen-like chemicals can inhibit libido and sexual function in men.  Such chemicals can produce ED as well as other symptoms, such as enlarged breasts in men.  Endogenous estrogens may also result in atherosclerosis which can cause ED due to impaired circulation.  While it is impossible to avoid all exogenous estrogens, you can reduce your exposure by eating organic produce and naturally raised (homone-free) meats and dairy, avoid cooking/heating food in plastic and styrofoam containers, and avoid storing food or beverages in plastic containers marked with recycle codes 3, 6, 0r 7 (the recycle code is found in the triangular symbol imprinted on the bottom of most plastic containers).  It is also a good idea to minimize your use of chemical fertilizers and pesticides around your home and wear rubber gloves whenever handling such chemicals. 

In some instances, ED is one of several symptoms (including breast enlargement, weight gain, and emotional disturbances) which may result from abnormal hormone production - typically either too much estrogen (men produce small amounts of estrogen in the adrenal glands) or too little testosterone.  Such hormone imbalnaces are most common in older men and is now popularly called “andropause”.  With chronic ED, this is one possibility that should be investigated through hormone testing.   

There are various supplements on the market that are reputed to enhance male sexual function.  From what I have seen, products such as yohimbe, horny goat weed (yes, that’s actually what it’s called), MACA, and other products are usually not that effective in and of themselves.  For men with actual ED, there may be some benefit from these products, but really they should be combined with the other recommendations in this article to get the best effects. 

The neurological causes of ED can be due to nerve damage suffered from surgery (especially prostate surgery) or direct trauma to the penis, and they may not always be correctable.  But a large number of cases of ED actually result from altered nerve supply from the spine and these are often treatable through spinal manipulation (from a chiropractor or osteopath) or back exercises.  Most people are aware that drastic spinal injuries that cause paralysis will usually impair or prevent normal sexual function, but the fact that much more subtle spinal problems - even those that don’t produce any significant ongoing pain - can be a major cause of ED is still largely unknown.  Over the years, a few men have reported their ED problems to me that developed in association with a back injury or back pain episode.  Given the relatively large numbers of men who suffer from ED and the high rate of back pain in our society, I suspect that there were many more men who also developed ED in association with a back problem, but who didn’t think to report it or were embarrassed to mention it.  I can’t know how many men developed ED as a result of a back problem, or how many had their ED resolve as a result of treatment for their backs.  What I do know is that, as far as I can recall, EVERY patient I have seen in my 17+ year career who did report developing ED associated with a back issue told me that the ED went away after having the back problem corrected.  So, if you have ED and you have ever had a problem with your back (particularly the low back), even if you are not currently having significant back pain, I think it is well-worth a trial of chiropractic or osteopathic manipulation to see if it will resolve the ED problem.  Back exercises may help as well, but exercises don’t do what spinal manipulation can do and I think the quickest way to get improvement is with the help of a good chiropractor or osteopath. 

As we have discussed, erectile dysfunction is usually the result of one or more underlying health conditions that may or may not be known to the ED sufferer.  By addressing these underlying conditions, the vast majority of cases of ED can be resolved without subjecting oneself to the potentially dangerous side-effects of ED medications. 

Stay tuned to my natural remedies blog for more on male health issues. 

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