Diminished or ineffective erection in man causing inability to have a successful intercourse 75 percent of the time is medically termed erectile dysfunction or ED for short. This condition affects between 18 to 30 million in the United States, some as early as age 40, according to the Massachusetts Male Aging Study. Others have reported ED to affect some in their mid-20s, mostly due to psychological or medical reason.
Is poor libido same as ED?
No, diminished or absent libido is the lack of sexual desire. This and problems with ejaculation are also forms of male sexual dysfunction, but ED is the actual physical inability to have an effective and sustained erection to achieve ejaculation. Men with ED have normal libido, but have ineffective erection. Usually, there is a physical or medical (hemodynamic) reason for it.
What is the normal mechanism?
When a man is sexually stimulated, the normal hemodynamic is initiated by the brain (the largest sex organ, contrary to what some people erroneously think), which sends electrical impulses to the genital nerves in the male organ, causing the smooth muscles inside the two longitudinal sausage casing-like chambers (tubular balloons called cavernous spongiosa) inside the penis to dilate (open up and expand), allowing them to fill up with blood, to engorge, distend, and stiffen the penis. Any condition that prevents the transmission of the nerve impulses or restricts the flow of blood to the penis results in ED.
What are the symptoms of ED?
The obvious ones are the penis does not harden enough, too limp, for penetration, or it stiffens but lasts only briefly, and the worst is when erection does not even happen. The less obvious symptoms is the adverse psychological ED has on the confidence of the man, his frustration, embarrassment, poor self-esteem, and unhappiness, which are also felt by the partner. ED has caused broken marriages and termination of relationships. Some men with ED shy away from the opposite sex and have poor social life.
What are the causes of ED?
The commonest cause is unhealthy lifestyle, like smoking, alcohol abuse, use of illegal drugs, obesity, and lack of daily physical exercise, all of which may injure the blood vessels and reduce blood flow to the penis. Smokers have 200 percent risk for ED compared to non-smokers. Those who exercise daily have tremendously lower risk for ED. Medications for the treatment of high blood pressure, tranquilizers, antidepressants, and sleeping pills are among the common drugs that could cause ED. Surgery for prostate cancer, enlarged prostate, bladder cancer, can sometimes injure the nerves and blood vessels to the penis and cause ED. Some nerve damage could be permanent but in others the condition improves spontaneously within a year and a half. Stress and psychological factors can also cause ED, and these are temporary and reversible with treatment. This accounts for about 15 percent of erectile dysfunction, usually seen in younger men as stated above. Psychiatrists state that performance anxiety, poor self-esteem, depression, stress, can “short-circuit the process that leads to erection.”
Does bicycling cause ED?
Avid cyclists are more prone to suffer from ED compared to other athletes, according to some studies. The danger appears to be in the contour of the bicycle seats that applies pressure on the perineum (area between scrotum and anus) which contain nerves and arteries vital to sexual arousal.
Can fatty diet cause ED?
Yes, those who eat a lot of red meat and other high cholesterol/fat food items, processed foods, are at a higher risk for ED. Their arteries are clogged by hardening of the arteries from this unhealthy diet, which results in restricting the flow of blood to the penis. As we have alluded to in previous columns, eating red meat is also associated with higher risk for the development of cancer, heart disease and stroke, and higher risk of death at younger ages.
Does ED signal heart disease?
No, but high cholesterol and hardening of the artery can cause blockages in the coronary artery and in the arteries to the male genitalia. Therefore, ED could also (but not always) be a warning of a more serious ailment. A study in 2010 suggests erectile dysfunction as a strong predictor of heart attack, stroke and death from cardiovascular diseases (CVD) as a whole. Males with ED should also be examined for CVD as a precaution, but this does mean all men with ED will develop CVDs.
What is the treatment for ED?
This depends on the cause or causes. For lifestyle-related factors, obviously alteration in this regard and adoption of a healthy lifestyle are the needed regimen. Quitting cigarette, disciplined alcohol intake, daily exercise, staying away from red meats and processed foods, enjoying life and managing stress with simple wholesome pleasures with the family, preventing obesity, are changes that will improve ED and sexual performance and stamina. For those with blockages in the arteries to the penis due to aorto-iliac artery blockage in the lower abdomen, an arterial bypass may be needed. The attending physician may also opt to prescribe pills, like Viagra, Cialis, Levitra, Stendra, and Staxyn (which dissolves in the mouth). All these act to improve circulation of blood to the male organ.
Are herbals effective for ED?
Not really, except perhaps for their placebo or psychological effect, for those who do not know any better. Ginseng, ginkgo biloba, and other herbal preparations, “for sexual enhancement” have been disappointing to most men. And they are expensive and a waste of money, in the end. The preparation DHEA has even been feared to cause cancer in the long run. The following at the other options which the physician might discuss with the patient with resistant ED: vacuum devices, direct injection to penis, penile implant, psychotherapy, and surgery to blocked arteries, which is also common among diabetics. There are so many scams out there, with claims, including increasing the length and circumference of the penis, and stiffness. More often than not, these are fraudulent claims to get your money. So, buyers be wise and beware! Stick to science and evidence-based medicine.
What natural foods help?
A more reasonable, safer, and more economical, approach is to eat a lot of vegetables, of all colors, the more colors, the better, and a lot of spices and nuts. The spices, which are also good in boosting our immune system to ward off illnesses, including cancer, include pepper, garlic, cilantro, ginger, onions, cinnamon, cumin, curry, chili, lemongrass, thyme, mustard, oregano, fennel, turmeric. All these pep us up and improve our circulation, and together with a healthy lifestyle, they can enhance man’s virility, stamina, and overall performance, not only in bed but in life in general.
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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]
