ED Treatment Options by Dr. Richard R. Howard II

Dr. Richard R. Howard II discusses erectile dysfunction and treatment options, in the following article.

To learn more about erectile dysfunction, visit our article – Need an Erectile Dysfunction Cure? Never Suffer from Impotence Again

Erectile dysfunction

Erectile dysfunction treatment may include psychological, medical, nutritional, and PE therapies.

Erectile Dysfunction Treatment Options

There are many options for treating erectile dysfunction (ED). Managing ED may involve psychological, medical (oral, transdermal or injected drugs), nutritional (supplements), and PE therapies. To correct ED, it is essential to address any underlying chronic conditions and modify lifestyle factors such as:

  • Obesity,
  • Smoking,
  • Alcohol consumption, and
  • Lack of exercise.

Psychological therapy, such as counseling and behavioral therapy, can be effective if psychological factors are contributing to erectile dysfunction. Because ED can be a side effect of certain medications, it may be helpful to change drug regimens under a doctor’s care. Finally, it is important for men to remain physically and sexually active for as long as possible.

Viagara

Popularly-advertised drugs, like Viagra, help restore sexual function through dilating blood vessels.

Erectile Dysfunction and Popular Advertised Drugs

Today, aging men are exposed to information and advertisements touting a wide variety of drugs and supplements that may help restore sexual function. The most popular option is a class of drugs called phosphodiesterase type 5 inhibitors. These include Viagra® and Levitra®.

These drugs dilate blood vessels in the genital region, leading to an erection. Unfortunately, they do very little to increase libido (sexual desire). While these medications are valuable tools in the symptomatic treatment of erectile dysfunction, they may produce multiple side effects such as:

  • Headaches,
  • Changes in blood pressure,
  • Irregular heart rhythm,
  • Flushing,
  • Nasal congestion, and others symptoms,

Additionally, their long-term risks are unknown.1

Erectile Dysfunction and Hormones

Men whose blood tests indicate hormonal deficiencies or imbalances can use bioidentical hormones to help manage ED. Replacement of androgens can be crucial in restoring normal sexual function. While testosterone is available by prescription only, over-the-counter hormones such as DHEA and pregnenolone may help boost testosterone levels and thus improve erectile dysfunction.

Korean Red Ginseng may have properties useful in treating ED.

Korean Red Ginseng may have properties useful in treating ED.

Erectile Dysfunction and Herbal Supplements

Owing to a lack of research in this area, the efficacy of some supplements in managing ED is considered moderate to uncertain. The benefits of most of the products available have been described through cultural experience and anecdotal reports. Many herbal “aphrodisiacs” have a positive influence on erectile dysfunction, and some have an effect on hormonal output as well.

Emerging evidence and case reports suggest that naturally occurring agents such as L-arginine,1,2 Korean red ginseng,3 zinc,4 DHEA,5-10 maca root,1,11 and Tribulus terrestris12 may help improve sexual function and thus ED. A naturally occurring alkaloid called yohimbine, derived from the African tree, Pausinystalia yohimbe, has been used for over 70 years as a pharmacological agent in treating ED.,1,13,14

Other herbs that have been reported to improve ED include horny goat weed, oat straw (Avena sativa), damiana, muira puama, and ashwagandha. Studies of these herbal plants have often yielded inconsistent results, and clinical evidence to support herbal agents in managing ED is still minimal. Those who do not benefit from drugs, supplements, or psychological treatment may see improvement with intracavernosal injection (such as prostaglandin and papaverine plus phentolamine),15 vacuum/constrictive devices, and last but not least various PE stamina exercises which has already been extensively discussed in other articles.

References:

1. McKay D. Nutrients and botanicals for erectile dysfunction: examining the evidence. Altern Med Rev. 2004 Mar;9(1):4-16.
2. Chen J, Wollman Y, Chernichovsky T, et al. Effect of oral administration of high-dose nitric oxide donor L-arginine in men with organic erectile dysfunction: results of a double-blind, randomized, placebo-controlled study. BJU Int. 1999 Feb;83(3):269-73.
3. Hong B, Ji YH, Hong JH, Nam KY, Ahn TY. A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report. J Urol. 2002 Nov;168(5):2070-3.
4. Mahajan SK, Abbasi AA, Prasad AS, et al. Effect of oral zinc therapy on gonadal function in hemodialysis patients. A double-blind study. Ann Intern Med. 1982 Sep;97(3):357-61.
5. Reiter WJ, Pycha A, Schatzl G, et al. Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study. Urology. 1999 Mar;53(3):590-4.
6. Reiter WJ, Pycha A. Placebo-controlled dihydroepiandrosterone substitution in elderly men. Gynakol Geburtshilfliche Rundsch. 1999;39(4):208-9.
7. Reiter WJ, Schatzl G, Mark I, et al. Dehydroepiandrosterone in the treatment of erectile dysfunction in patients with different organic etiologies. Urol Res. 2001 Aug;29(4):278-81.
8. Belaisch J. DHEA: desire and resistance. Gynecol Obstet Fertil. 2002 Dec;30(12):961-9.
9. Vakina TN, Shutov AM, Shalina SV, Zinov’eva EG, Kiselev IP. Dehydroepiandrosterone and sexual function in men with chronic prostatitis. Urologiia. 2003 Jan;(1):49-52.
10. Derouet H, Lehmann J, Stamm B, et al. Age dependent secretion of LH and ACTH in healthy men and patients with erectile dysfunction. Eur Urol. 2002 Feb;41(2):144-53.
11. Gonzales GF, Cordova A, Vega K, et al. Effect of Lepidium meyenii (MACA) on sexual desire and its absent relationship with serum testosterone levels in adult healthy men. Andrologia. 2002 Dec;34(6):367-72.
12. Adimoelja A. Phytochemicals and the breakthrough of traditional herbs in the management of sexual dysfunctions. Int J Androl. 2000;23 Suppl 282-84.
13. Vogt HJ, Brandl P, Kockott G, et al. Double-blind, placebo-controlled safety and efficacy trial with yohimbine hydrochloride in the treatment of nonorganic erectile dysfunction. Int J Impot Res. 1997 Sep;9(3):155-61.
14. Ernst E, Pittler MH. Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials. J Urol. 1998 Feb;159(2):433-6.

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