Getting to the root of erectile problems

Problems with being able to get or maintain an erection sufficient for penetrative sex is a common concern for males. When it is consistent or recurrent for at least 3 months it is defined as “erectile dysfunction”, and affects 10-20% of males worldwide.

The reasons why this happens are many and complex. A combination of blood flow changes to and from the penis, problems with the nerves supplying the penis, hormonal changes such as low testosterone or thyroid problems, and psychological reasons such as depression, stress and worries about sexual performance, or simply inadequate stimulation can all be involved in varying combinations. Ageing also results in changes to the blood vessels and structure of erectile tissue in the penis, affecting its function. Whilst older males are more likely to have erection problems, younger males can also be affected.

A number of health conditions are known to cause the changes in penis structure and function that can result in erectile problems. These include heart disease, diabetes, high blood pressure, obesity and kidney disease. Medications, particularly some used to treat depression, may also be involved. Problems with erections are also common after surgery and radiotherapy treatment for prostate cancer.

As such, erectile function could be described as a barometer for male health. In fact, the presence of erectile dysfunction is now known to be a warning sign for future heart disease, with males who have erectile dysfunction having a 62% higher chance of a heart attack then those without it. For this reason, it is important that any problems with erections are treated seriously, and thoroughly investigated with a health practitioner. Any identified underlying health problems, properly managed, can then help to reduce future health risks.

Treatment options are diverse. Popular medications such as Viagra and Cialis, which work by improving blood flow to the penis, have an important role to play, as most people who take them (around 70%) will be able to have penetrative intercourse. Some people however experience unwanted side effects (such as headaches and flushing), or simply do not get adequate improvement. For this reason, lifestyle and dietary approaches, the use of appropriately recommended herbal or nutritional medicines, and sex therapy can play an important role in helping address problems with erections, supporting the effectiveness of conventional treatment, and addressing underlying causes.

Changes to lifestyle and diet that aim to improve general health, and support a healthy heart and blood sugar levels are likely to be of benefit to male sexual function. For example, aerobic exercise training for at least 2 months was shown to result in significant improvements in erectile function, and for those who were using medications such as Viagra, aerobic exercise was shown to make it more than twice as effective.

The Mediterranean Diet, rich in vegetables, legumes, whole grains, fruit, nuts, and fish; and low in red meat, poultry and dairy, is well known for its benefits on heart health. Not surprisingly, it has also been shown to protect males against developing erectile problems, and in those who already have erection problems, following this style of diet in combination with exercise and weight loss, has been shown to result in improvements.

Including nuts and seeds regularly in the diet is another way to support both heart, and sexual health. Research has consistently shown that just eating around 30g of nuts daily lowers risk of dying from heart disease by close to 40%, is able to help better control blood sugar levels, and can protect against erectile problems. One small study actually demonstrated that males who ate 100g a day of pistachio nuts for 3 weeks could improve their erections. Improvements in blood flow to the penis was also shown to occur in this study.

Smokers are for obvious reasons more likely to develop problems with their erections, due to the damaging effects on blood vessels, restricting blood flow to the penis. The good news is that for smokers who have erectile problems, quitting is likely to help. Studies have shown that more than half experience significant improvements in erections within 6 months of quitting. These benefits may even be seen within 4 weeks according to one study!

So the key message for males experiencing erectile difficulties, is there is likely to be identifiable, treatable, underlying reasons for the problem. Diet and lifestyle changes, such as following a Mediterranean diet, increasing exercise, incorporating nuts (especially pistachios) and quitting smoking are all likely to benefit, whether or not medications such as Viagra are being used. Most importantly these lifestyle changes can alter the health conditions that may be the root cause. Various herbal and nutritional supplement approaches can also complement these changes, which are best discussed with a Naturopath knowledgeable in their use. Of course, Sex Therapy also serves an important role in helping improve sexual function, by exploring the psychological or relationship reasons that may be contributing to the problem, and helping people develop practical ways to incorporate sexual function changes into a persons sexual life.

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