If you’re like most men, the very word impotence suggests a whole range of emotions that you’d rather deny, situations you’d prefer to forget, and issues you’d rather not face. Translated, that means fear, anxiety, and humiliation. Here’s a less loaded term, then—erectile dysfunction. It means the same thing but doesn’t have quite the same negative connotation that seemingly threatens the very fabric of manhood.
An estimated 10 to 15 million American men regularly suffer from erectile dysfunction, defined as the inability to achieve and maintain an erection long enough to have satisfactory sexual intercourse. Of those men, 15 to 25 percent are over age 65.
The most common cause of erectile dysfunction in men over 50 is clogged arteries in the penis. Frequently, what’s behind this clogged-up situation is a buildup of cholesterol and fatty deposits inside artery walls. For other men, there are other possible causes. For those in their teens, twenties, and thirties, stress, depression, anger, fatigue, and performance anxiety are the most common triggers. Among the medical problems associated with erectile dysfunction are diabetes, thyroid problems, stroke, heart disease, and multiple sclerosis.
Otherwise helpful or beneficial medicines can also extract a hidden cost. Sometimes, erection problems are a reaction to blood pressure medications, tranquilizers, antidepressant drugs, or antihistamines.
Because erectile dysfunction could be a side effect of prescription drugs or a symptom of other health problems, see a doctor before you take any nutritional supplement. If you’ve been having trouble achieving or maintaining an erection during a period of more than 90 days, let your doctor know.
Alternative medicine practitioners believe that there are dietary and other natural measures that men can take to restore the ability to achieve erections. For starters, experts suggest that you get at least 30 minutes of aerobic exercise several days a week. Improving your heart health will boost your sexual virility.
Experts also say that you should eat a low-fat diet, including lots of fruits and vegetables, whole grains, and legumes. Moreover, they say that men who smoke will just have to quit. Puffing just two cigarettes a day causes blood vessels throughout your entire body to constrict, reducing blood flow to the penis.
Alcohol is another roadblock to satisfying sex. Drink no more than two alcoholic beverages a day, says E. Douglas Whitehead, M.D., associate clinical professor of urology at Albert Einstein College of Medicine in the Bronx and co-founder and director of the Association for Male Sexual Dysfunction in New York City.
Once you’ve adopted these changes, some practitioners believe that a combination of nutritional supplements can speed your progress toward sexual health and that certain herbs are potent enough to dramatically increase blood flow to the penis and boost your sex drive, says Thomas Kruzel, N.D., a naturopathic doctor in Portland, Oregon. Additionally, some vitamins and minerals provide the building blocks for sexual health.
Yohimbine: Charge Up Your Sex Life
For centuries, people have used yohimbe, the bark from a West African tree, to boost sex drive. It is said to increase blood flow to the penis, which makes it possible to attain and sustain an erection. The drug companies took notice. After finding a way to extract the active ingredient from yohimbe, they received approval for yohimbine (Yocon, Yohimex), which is now available by prescription.
In an unusual reversal, herbal experts recommend the prescription drug yohimbine over the over-the-counter herb yohimbe. "Yohimbe is not an herb that you want to mess around with," says James A. Duke, Ph.D., botanical consultant, former ethnobotanist with the U.S. Department of Agriculture who specializes in medicinal plants, and author of The Green Pharmacy. Just a few of its nasty side effects are anxiety, increased heart rate, and hallucinations.
In contrast, side effects of the prescription drug are mild, and one may even be pleasing. Men who have used it report having pleasant tingling sensations along their spines and in their genitals.
Yohimbine is powerful, concludes Ian Bier, N.D., a naturopathic doctor and licensed acupuncturist at the Institute for the Advancement of Natural Medicine in Portsmouth, New Hampshire. In a study conducted at the University of Exeter in England that analyzed results from several clinical trials measuring yohimbine’s safety and effectiveness, researchers found that the benefits of using it far outweigh the risks. They concluded that serious side effects were infrequent and reversible and that yohimbine should be considered the first line of defense for the treatment of impotence.
You shouldn’t take yohimbine if you have certain health conditions or with certain foods and drugs. Be sure to discuss possible interactions and side effects with your doctor.
Other Herbs to Turn You On
Other herbal supplements are recommended by naturopathic doctors to treat erectile dysfunction. Ginkgo, a medicinal plant with a long tradition, is mainly used to improve blood circulation to the brain. It may also aid mental alertness and memory and even relieve depression. Because it can improve blood flow throughout arteries and veins, it’s been successfully used to treat many men whose impotence is caused by poor blood circulation, says Dr. Kruzel.
In a study, 60 men with erectile dysfunction who didn’t respond to injection treatments with a prescription medication were given 60 milligrams of ginkgo daily for 12 to 18 months. Every four weeks, penile blood flow was evaluated. The first signs of improvement in blood circulation occurred after six to eight weeks. When the men were evaluated again after a six-month period, 50 percent of those who took the ginkgo reported that they had regained potency.
"You can try 60 to 240 milligrams a day, but don’t go any higher than that," says Dr. Duke. High amounts of ginkgo may cause side effects.
Asian ginseng, also called panax, Korean, or Chinese ginseng, tops the list of herbs used to restore vitality, boost energy, reduce fatigue, and improve physical performance. It protects the body from the negative effects of stress. Traditionally, it’s been used as an aphrodisiac, and research seems to back up its reputation, showing that it can increase blood flow to the penis, says Dr. Kruzel.
In a study conducted in Korea, 90 men with erectile dysfunction were divided into three groups. Thirty men were given Korean red ginseng, 30 were given the drug trazodone (Desyrel), and 30 were given an inactive substance (placebo). Sixty percent of the men who took the ginseng experienced improvements in the rigidity of their erections and their sex drive, compared to improvement in only 30 percent of those who received the drug or placebo.
The amount of ginseng you should take for erectile dysfunction depends on the species you buy and how much of the active ingredients is in the product. Dr. Kruzel recommends that most of his patients take 500 milligrams daily, but he says that it’s best to consult your doctor for the optimum dose.
For Prostate-Related Impotence
In rare cases, an enlarged prostate gland, known as benign prostatic hyperplasia (BPH), causes impotence. Located below the bladder and surrounding the urethra, the prostate gland is normally no bigger than a walnut. At some point in your late forties or fifties, it starts growing, and what was once walnut-size can balloon to the size of an orange, causing all sorts of problems.
If you’ve been diagnosed with BPH and it happens to be causing impotence, the herb horsetail may be what you need, says Dr. Kruzel. Although it hasn’t been proven effective in clinical studies, he’s seen it work in his practice.
Horsetail’s anti-inflammatory properties can shrink the prostate gland to normal size and restore potency in some men, he says. "Horsetail is best used in men over age 60 who have BPH. For them, it can work very well," he comments.
The amount of horsetail you should take depends on how much your prostate gland has enlarged. After a doctor examines you, he may prescribe a dose ranging from 400 to 800 milligrams of horsetail daily, Dr. Kruzel says. Be sure to take the prescribed amount, and ask your doctor about possible side effects. Horsetail may cause thiamin deficiency, and you shouldn’t take it if you have heart or kidney problems.
Zinc and Other Vitamin Basics
The most important nutrient for overall sexual health is zinc. This trace mineral is vital for a number of functions. It enhances the production of testosterone, the male hormone that’s required for sexual development and potency. It also influences sperm motility—that is, the speed and mobility of sperm—which can be a factor in fertility.
Zinc has antibacterial and antiviral properties, says Dr. Kruzel. "The prostate has the highest concentration of zinc of any tissue in the body. It’s abundant in semen and in the thin, milky fluid that the prostate gland secretes into the urethra just before ejaculation to prevent infections," he says.
Certain forms of zinc are better-absorbed than others. Zinc picolinate, zinc citrate, and zinc monomethionine are the most absorbable. If you’re experiencing impotence, Dr. Kruzel says that you can take 15 to 30 milligrams of zinc daily, but he advises that you talk to your doctor if you’re considering taking more than 20 milligrams. If you don’t see results after four to six weeks, Dr. Kruzel recommends that you see your doctor for a re-evaluation.
He also recommends taking a high-potency multivitamin and mineral supplement in addition to the zinc to help keep your urinary tract in good working order and to lay the foundation for sexual health. "Vitamins C and E are also found in high concentrations in the prostate gland, so they can help speed your recovery from impotence," says Dr. Kruzel. He recommends 2,000 to 4,000 milligrams of vitamin C with meals and 400 to 800 international units of vitamin E daily.
