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Erectile dysfunction is the inability to achieve or maintain an erection during sexual intercourse. While older men are at higher risk of developing ED, this condition can happen to anyone. In fact, in the United States, ED affects over 18 million men ages 20 and older. ED can lead to decreased self-esteem, depression, anxiety, and distress for both men and their partners. 

ED is a complex issue that involves both physical and mental aspects. ED is primarily an issue with vascular function and can be caused by underlying medical conditions like cardiovascular disease, high blood pressure, or diabetes. ED can also be caused or worsened by mental health issues like depression, anxiety, or chronic stress. Neurological disorders can also cause or worsen ED. Lifestyle choices can also impact ED. Smoking, overuse of alcohol, and sedentary lifestyle are all associated with higher risk of ED.

Fortunately, there are a lot of options for improving erectile function.

Exercise and ED

One of the best ways to improve erectile function is to move your body! Several studies have shown positive impacts of exercise on both erectile function and overall sexual function. Exercise improves vascular function, reduces blood pressure, and overall quality of life. One study found that men who spend more than five hours per day using TV or computers were almost three times more likely to report ED than men who spend less than one hour per day doing the same activities. 

Stress and ED

One of the most common causes of ED that I see in my practice is stress. We live in a high-stress world and in general, we do not do a great job managing our stress in healthy ways, instead often turning to alcohol or sedentary activities to numb the stress. 

Managing stress can have significant impacts on erectile function. In order to achieve an erection, the nervous system must be in “rest and digest” mode. In men with high levels of stress, the body runs in “fight or flight” mode and often has a tough time resetting the nervous system. Additionally, cortisol, our stress hormone, inhibits sex drive. Together, these influences make achieving erection difficult. 

Research has shown that stress management programs or mental health interventions in addition to conventional pharmaceuticals are more effective treatments for ED than medications alone. One recent study focused on mindfulness for men with situational ED and found positive results. Mindfulness can be easy to incorporate into your daily routine with apps like Headspace, Calm, or Insight Timer. 

L-arginine and ED

L-arginine is an amino acid found in higher levels in lean meats, pumpkin seeds, peanuts, chickpeas, and lentils. In the body, l-arginine is converted into nitric oxide, a compound that helps dilate blood vessels. A recent review found that l-arginine supplements can be an effective treatment option for men with mild to moderate ED. 

Ginseng and ED

Korean ginseng, Panax ginseng, has been studied as a treatment for ED. This herb has been used traditionally as an adaptogen to help people adapt to stress. Researchers believe the herb may increase nitric oxide but the mechanism for how this herb impacts ED is still not fully understood. A review article found that in seven clinical trials, ginseng improved erectile dysfunction. Interestingly, many participants who reported psychogenic ED, or ED caused by anxiety, depression, or stress, also reported improvements in symptoms. 

Mediterranean Diet and ED

The Mediterranean diet is the most studied in the world. This dietary pattern focuses on vegetables, whole grains, and healthy fats, and limits intake of red meat, processed foods, and sugar. This diet has been recommended for people with cardiovascular disease, diabetes, and even erectile dysfunction. In one recent review, the Mediterranean diet was shown to contribute to preventing ED because of its positive impact on cholesterol and blood sugar, as well as increased amounts of antioxidants and nitric oxide from fruit and vegetables. 

In addition to natural treatment options, our physicians are also comfortable managing pharmaceutical medications to treat ED. Erectile dysfunction affects millions of men but there are many options for prevention and treatment. Don’t suffer needlessly. Schedule a visit to discuss options for improving erectile function!

References

  1. https://www.amjmed.com/article/S0002-9343(06)00689-9/fulltext
  2. https://www.urologyhealth.org/urologic-conditions/erectile-dysfunction (ed)
  3. Hehemann MC, Kashanian JA. Can lifestyle modification affect men’s erectile function?. Transl Androl Urol. 2016;5(2):187–194. doi:10.21037/tau.2016.02.05
  4. Bossio JA, Basson R, Driscoll M, Correia S, Brotto LA. Mindfulness-Based Group Therapy for Men With Situational Erectile Dysfunction: A Mixed-Methods Feasibility Analysis and Pilot Study. J Sex Med. 2018 Oct;15(10):1478-1490. doi: 10.1016/j.jsxm.2018.08.013.
  5. Rhim HC, Kim MS, Park YJ, et al. The Potential Role of Arginine Supplements on Erectile Dysfunction: A Systemic Review and Meta-Analysis. J Sex Med. 2019 Feb;16(2):223-234. doi: 10.1016/j.jsxm.2018.12.002.
  6. Jang DJ, Lee MS, Shin BC, Lee YC, Ernst E. Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol. 2008;66(4):444–450. doi:10.1111/j.1365-2125.2008.03236.x
  7. Di Francesco S, Tenaglia RL. Mediterranean diet and erectile dysfunction: a current perspective. Cent European J Urol. 2017;70(2):185–187. doi:10.5173/ceju.2017.1356

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