© Erectile dysfunction (ED) is a condition in which the male partner could not obtain or maintain sufficient stiffness of the penis to have satisfactory sexual intercourse.
© Erectile dysfunction (ED) is an important
sexual health problem worldwide and it affects about 50% of men aged 40–70
years.
© Physiological Mechanism of Erection:
© Physical Causes of Erectile Dysfunction include…
Ø Vasculogenic (Conditions
affecting blood flow to the penis) - Atherosclerosis,
Hypertension, Diabetes.
Ø Neurogenic (Conditions
affecting nervous system) – Multiple Sclerosis, Parkinsonism, Spinal injury
or disorder, Stroke.
Ø Hormonal (Conditions
affecting hormone levels) - Hypogonadism,
Hypothyroidism, Hyperthyroidism, Cushing's syndrome.
Ø Anatomical (Conditions
affecting the physical structure of penis) – Peyronie's disease, Penis injuries.
© Psychological Causes of Erectile Dysfunction
include…
Ø Depression
Ø Anxiety
Ø Relationship problems
Ø Lack of sexual knowledge
Ø Past sexual problems
Ø Past sexual abuse
Ø Being in a new relationship
Ø Worry or Fear
© Other Causes of Erectile Dysfunction may
include…
Ø Medicines
(Diuretics, Betablockers, Fibrates, Antipsychotics, Antidepressants, Corticosteroids, H2 blockers,
Anticonvulsants, Antihistamines, Antiandrogens, Cytotoxics)
Ø Excessive Alcohol intake
Ø Smoking
Ø Inadequate physical activity
Ø Obesity
Ø Illegal drugs like Cannabis, Heroin or
Cocaine
Ø Cycling
© Management of Erectile Dysfunction:
Ø Pharmacological Management:
· Phosphodiesterase-5 (PDE-5) inhibitors –
Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra),
Avanafil (Spedra).
· Alprostadil
· Hormone therapy
Ø Non-Pharmacological Management:
· Quit Smoking
· Avoid Alcohol and other illegal drugs
· Exercise regularly & Lose Weight
· Reduce stress
Ø Psychological treatments:
· Sensate focus
· Psychosexual counselling
· Cognitive behavioural therapy (CBT)
Ø Pelvic floor muscle exercises
Ø Vacuum pump
Ø Penile implants - Semi-rigid implants,
Inflatable implants
Ø Surgery
© CAM used for
Erectile Dysfunction include…
Ø Mind and Body Practices:
· Acupuncture
Ø Herbal Supplements:
· Yohimbe bark (Pausinvstalia yohimbe)
· Ginseng (Panax ginseng – Korean Red
Ginseng)
· Ginkgo (Ginkgo biloba)
· Saffron (Crocus sativus)
· Nutmeg (Myristica fragrans)
· Tongkat Ali (Eurycoma longifolia)
· Maca (Lepidium meyenii - Peruvian
Ginseng)
· Kaempferia parviflora (Thai black
Ginger, Thai Ginseng)
· Mondia whitei
· Schisandra chinensis
· Horny Goat Weed (Epimedium)
· Fadogia agrestis
Ø Foods & Juices:
· Water Melon (Citrullus lanatus)
· Dates (Phoenix dactylifera)
· Drumstick (Moringa oleifera)
· Pomegranate (Punica granatum)
· Fig (Ficus carica)
· Groundnuts (Arachis hypogaea)
· Pistachio Nuts (Pistacia vera)
· Onion (Allium Cepa)
· Coffee
· Ginger (Zingiber officinale)
· Flavonoids rich Foods (Blueberries,
Cranberries, Oranges, Grapefruit, Tea, Apples, Pears, Dark Chocolate)
· Omega-3 Fatty Acids rich Foods ((Flaxseed,
Fish (Mackerel, Salmon, Sardines),
Walnuts, Chia seeds, etc.)
· Zinc rich Foods (Beef, Shrimp, Oysters,
Kidney beans, Flax Seeds, Watermelon seeds, Pumpkin Seeds, Spinach,
Nuts, Dark chocolate, Mushrooms, etc.)
· Arginine rich Foods (Meats, Pumpkin
Seeds, Nuts)
Ø Nutritional supplements:
· Arginine
· Dehydroepiandrosterone (DHEA)
· Folic acid
· Zinc
· Vitamin E
© TIPS for Better Sex:
Ø Avoid Stressful situations
Ø Quit Smoking
Ø Avoid Alcohol
Ø Walk at least 30 minutes a day
Ø Eat a balanced Diet rich in fruit, vegetables,
whole grains, and fish.
Ø Maintain blood pressure, blood sugar, blood
cholesterol, and blood triglycerides in normal range.
Ø Get slim and stay slim
Ø Move pelvic floor muscle (Two sets of Kegel
exercises daily)
© Herbal Viagra:
Ø Herbal Viagra products are available as
Over-The-Counter (OTC) herbal supplements to treat Erectile Dysfunction (ED).
Ø The laboratory analysis of such herbal
supplements by US FDA, found to contain hidden ingredients like PDE5 inhibitors
such as Sildenafil (Viagra), Tadalafil (Cialis), etc., which are, approved as
Prescription-only medicines.
Ø Due to the presence of hidden chemicals, Herbal
Viagra can cause dangerous Hypotension and can interact with other prescription
drugs.
Ø The products labeled as “Herbal Viagra”, “All
Natural”, “Free from side effects”, etc. should be avoided.
© TIPS for Smart Use of Herbal Remedies:
Ø Consult with the healthcare professional before
trying any herbal products.
Ø Always look for scientific-based sources of
information.
Ø Beware of commercial claims.
Ø Stop taking the herbal product and notify the
healthcare professional, if there is any side effects such
as nausea, vomiting, rapid
heartbeat, anxiety, insomnia, diarrhea, or skin rashes.
Ø Purchase only the products which contain
details such as herb's common and scientific name, the name and address of the
manufacturer, a batch and lot number, expiration date, dosage guidelines, and
potential side effects.
Ø Discuss with the Doctor or Pharmacist about
possible Herb - Drug Interactions.
© TIPS on choosing Dietary Supplements:
Ø Before considering any dietary supplement,
consult with a Doctor or Pharmacist.
Ø Do not replace scientifically proven drugs with
unproven health products or practices.
Ø Always remember that dietary supplements may
interact with medications or other dietary supplements.
Ø Discuss with the health care providers about
the current use of any CAM approaches.
© Indulge in Healthy activities.
© Beware of “Herbal Viagra” products.
© Use of Herbal products should always be
discussed with the Doctor or Pharmacist.
© Always remember that dietary supplements may
interact with medications or other dietary supplements.
© The patients should discuss with their health
care provider regarding the use of CAM therapy.
© The patients should be advised not to replace
their conventional treatment with an unproven product or practice.
