Hello, aquamango-ga!
The fact that you are still so young, healthy and only experiencing
periodic episodes of erectile insufficiency should not provoke much
worry, especially compared to those who suffer from chronic erectile
dysfunction. I understand that this occasional inability to maintain
an erection is of concern to you, but there are several lifestyle
changes you might consider before resorting to Viagra. Actually, I am
a bit surprised that your doctor suggested you try Viagra for
occasional problems at your age, especially since you might come to
believe that Viagra or one of it's counterparts is necessary all the
time, "just in case."
I have compiled some basic background information on occasional
impotence versus chronic erectile dysfunction before I get to your
specific questions. I think it is important to stress the difference
between serious erectile difficulties compared to the occasional
problems that you are encountering. (I know even occasional problems
take on large proportions when they affect you, individually, but if
you can take a step back for a moment, I think you will relax a bit!)
Some of the articles I have linked to are from the Medscape website,
which can only be accessed once you have established a free
subscription. If you are interested in signing up, please register at
www.medscape.com . Then you will be able to click on the Medscape
articles I have referenced.
Also, please excuse me if some of the information I have provided is
included under one heading rather than another. You have asked five,
separate questions, some with multiple parts. Many of these questions
are inter-related and merit references that can appear in several
places.
Hopefully, I have kept some semblance of order here and not made your
head spin!!! You have asked so many questions that I have had to
include a lot of information to try to cover all the bases!
An Overview of Impotence/Erectile Dysfunction and it's Causes
==============================================================
Erectile dysfunction involved a ** persistent inability ** to attain
and/or maintain an erection sufficient for satisfactory sexual
activity.
** Occasional, temporary erectile failure due to tiredness, stress or
excessive alcohol consumption is not the same as chronic erectile
dysfunction.
ED does not necessarily correlate with a lack of sexual interest or
desire and ejaculation and orgasm may still occur
* Erectile dysfunction can occur at any age.
Again, erectile dysfunction is very different from the occasional
difficulty in achieving or maintaining an erection that all men
experience at some time.
In the absence of serious medical disorders such as diabetes,
cardiovascular problems, circulatory problems, and actual physical
injury, the main factors that can exacerbate erectile problems are
* smoking
* being inactive and overweight
* alcohol and/or drug abuse
* abnormally high cholesterol levels
* certain medications (for high blood pressure, diabetes, depression, heart
disease, etc)
* hormonal imbalance
* stress, fatigue and psychological factors.
See the following articles:
"Erection Problems (Erectile Dysfunction." WebMD
http://my.webmd.com/hw/impotence/hw112770.asp
From "Absolute Answers to Erection Dysfunction." 4Men's Health
http://www.4-men.org/impotence.html
==
"According to the Massachusetts Male Aging Study, the prevalence of
erectile dysfunction is approximately 40% in men aged 40 years and
67% in those aged 70 years. The same study reveals that up to 30
million American men suffer from ED. Globally, the numbers reach 150
million. These numbers included those with partial erectile
dysfunction as well as men who have no function at all. Existing and
investigational treatments for ED are also addressed."
From "Issues in the Assessment and Treatment of Erectile Dysfunction:
Individualizing and Optimizing Therapy for the "Silent Majority."
Author: Gerald B. Brock, MD, FRCS. Medscape. April 30, 2002
http://www.medscape.com/viewprogram/1826?src=search
=
One determination of Erectile Dysfunction can be found in the
following article, which utilizes five questions and a scoring value.
This is not a foolproof indicator for all men, however.
See the question chart in "Diagnostic tool for erectile function." Bandolier.
http://www.jr2.ox.ac.uk/bandolier/band90/b90-6.html
"Men without erectile dysfunction had a mean score of 23 and men with
erectile dysfunction had a mean score of 11. Let us assume that there
is a 50% chance of men visiting their GP about erectile dysfunction
truly suffering from it. If such a man scored 21 or less, then their
chance of truly having erectile dysfunction rises to about 93%. If
they score 22 or more, then it falls to 2% or less."
=
Evaluating the existence of nighttime erections can indicate whether
the problems is physical or psychological in nature.
------------------------------------------------------------------------
"One way to know if the cause is physical or psychologic is to
determine if you are having nighttime erections. Normally, men have 3
to 5 erections per night, each lasting up to 30 minutes. Your doctor
can explain a test to find out if you are having the normal number of
nighttime erections."
You might try to determine this on your own by using the "stamp test."
"For the stamp test, you take a strip of stamps (such as Easter Seals)
and make a ring around the nonerect shaft of the penis, moistening and
sealing the stamp overlap before going to sleep. (Do not use postage
stamps because the glue is too strong.) If an erection occurs during
sleep, the stamp ring will break, waking you, and allowing you to feel
the degree of erection. Awakening the next morning with the ring
intact means you did not have an erection while you were sleeping.
Repeat the test the next two nights. If you have the same negative
result three times, you probably have impaired circulation in your
penis."
From "Dealing with Impotence Medically." Health Journal
http://www.bodyandfitness.com/Information/Menhealth/impotence1.htm
=
It is also of vital importance that a thorough medical exam rules out
all other serious medical causes for erectile problems. Please see the
lengthy list of Medical History questions and potential tests that can
detect the origin of erectile dysfunction in the following article:
From "Erection Problems." Medline Plus
http://www.nlm.nih.gov/medlineplus/ency/article/003164.htm
How Serious is it?
-------------------
If impotence:
* Is transient or appearing only occasionally, the problem is not
likely to be serious; all men experience problems with erections at
some time in their lives.
* Develops gradually and persistently, there is probably a physical
cause; this is generally the case with chronic impotence.
* Develops abruptly but you still have early-morning erections and are
able to have an erection while masturbating, the problem is likely to
have a psychological cause.
From "Impotence." http://www.health-hippo.co.uk/malezone/impotence.htm
==
What's normal?
"In younger men who consult the doctor, the initial problem is often
anxiety over the reliability of an erection. However, occasional
episodes of ED are common and do not mean there will be persistent
problems in the future."
From "Erectile dysfunction." July 2003
http://hcd2.bupa.co.uk/fact_sheets/Mosby_factsheets/Impotence.html
YOUR QUESTIONS
================
1. How well does Viagra work? Can you provide me with quotes on basic effects?
*******************************************************************************
There are currently three primary medications approved and available
in the US for erectile dysfunction:
Viagra (Sildenafil)
Levitra (Vardenafil)
Cialis (Tadalafil)
All three are highly specific inhibitors of type 5 phosphodiesterase
and work basically in the same manner.
** The success rate is about 80% for improvement in erections and 75%
for improvement in intercourse.
** Common side effects include headaches, facial flushing, rhinorrhea
(runny nose), dyspepsia (upset or pain in the stomach) and visual
disturbances. Less common side effects are myalgia (muscle pain) and
back pain.
All three medications begin to work approximately 30 minutes after
ingestion. Duration of action is approximately 4-6 hours for Viagra
and Levitra, and 36 hours for Cialis.
** Duration of action should be taken into account in relation to an
individual's pattern of sexual activity.
** The longer duration of Cialis (Tadalafil) is an advantage for
individuals who desire sexual activity more than once in a 36-hour
period.
If angina is a concern, Cialis may be inappropriate since
nitroglycerine (and similar substances) is contraindicated for 24
hours after the use of any of the above medications.
The information above is summarized from "New Therapies for Erectile
Dysfunction" on Medscape Urology (08/06/2003). Medscape articles are
available by free subscription.
http://www.medscape.com/viewarticle/459656
==
The latest research shows that nightly ingestion of Viagra "may"
restore normal erections.
Read "Nightly Viagra May Restore Normal Erections," by Paula Moyer.
WebMD Health. May 2004
http://my.webmd.com/content/article/87/99321.htm?action=related_link
"When men with erectile dysfunction take Viagra every night, rather
than just when the mood strikes them, they may experience a return to
normal erections, say researchers at a meeting of men's health
specialists. "Nightly treatment may help promote erectile function as
the result of this drugs' beneficial effect on endothelial cells,"
Frank Sommer, MD, said in a news conference."
(This news is based on a small research study group and is not
currently a recommendation for the general population!)
==
A table of Side Effects can also be found in the article, "Male Sexual
Medicine -- What's New?" by Wayne J. G. Hellstrom, MD, FACS (2004)
also available on Medscape at http://www.medscape.com/viewarticle/480673
Side Effects of the 3 PDE-5 Inhibitors
Sildenafil Vardenafil Tadalafil
Headache 20% 17% 12%
Dyspepsia 6% 6% 5%
Rhinitis 7% 6% 4%
Flush 16% 10% 7%
Myalgia/back pain < 1% < 1% 3%
Visual disturbance/eye pressr 6% 3% 1%
==
Remember that these medications are for serious cases of erectile
dysfunction -not the occasional episodes of impotence.
"Before you ask your doc for any new sex drug, let's clear up what
'impotence' (or erectile dysfunction) actually is. It means that over
a period of weeks or months you consistently cannot get or keep a
stiffy that's hard enough to have sex that satisfies you or your
partner, or prevents you from being able to masturbate on your own.
Certain health problems (such as diabetes or MS and depression) are
linked to it, as are some medications, or unhealthy practices like
smoking, drinking, or recreational drug use.
* It's normal to have problems getting hard occasionally, especially
if you are stressed, tired, or nervous.
These drugs are not aphrodisiacs, they won't make you better lovers,
and unless you're psychologically prepared for sex, they may not even
give you an erection. They are designed for people with a chronic
medical problem."
From Men's Health:
http://www.menshealth.co.uk/news/story.phtml?id=1540
=
Another warning about the efficacy and unwarranted use of Viagra follows:
"Sildenafil (Viagra) is an oral medication for mild to moderate
erection difficulties of either physical or psychological origin.
Sexual stimulation (visual, verbal, or tactile) is usually required to
initiate an erection. Although sildenafil has become extremely
popular, it is not a "cure-all," it is not an aphrodiasiac (that is,
it does not enhance sexual desire) nor does it enahnce erections if
you are not impotent, and it DOES have side effects. DO NOT order it
online or otherwise use this medication without having seen a doctor
in person. Sildenafil should not be used at the same time as certain
other medications."
From "Erection Problems." Medline Plus
http://www.nlm.nih.gov/medlineplus/ency/article/003164.htm
==
Other Side Effects of Viagra
** Note, once again, that Viagra is NOT for men with normal sexual functioning.
Risk of Priapism
----------------
The drug poses a very low risk for priapism in most men. (Priapism is
sustained, painful, and unwanted erection.) *** Exceptions are young
men with normal erectile function who take Viagra.
Risk of Urinary Tract Infections in Female Sexual Partners
----------------------------------------------------------
One medical center reported an unusually high incidence of urinary
tract infections in female sexual partners of men who were taking
sildenafil
COMPARISON TABLE OF TREATMENTS FOR ERECTILE DYSFUNCTION
========================================================
Please refer to the following table:
"Impotence Treatment Comparison Table."
http://www.impotence-guide.com/comparison-table.html
2. Does Viagra produce any long term effects? Is it addictive?
***************************************************************
There is little information concerning the long-term side effects of
Viagra since it has not been on the market long enough. There have
been a few references to possible reduced fertility, but so far these
studies have only been done in mice.
Other warnings surround concerns about psychological dependency,
especially since so many young men who really do not suffer from
erectile dysfunction are begging for the medication.
The following article highlights such concerns:
"More younger men are turning to Viagra to enhance sexual
performance," by Helena Oliviero.
http://www.strangecosmos.com/content/item/25310.html
"Hundreds of patients asking Dr. Scott Parry for Viagra at his
Virginia-Highland clinic are young, healthy and virile. They don't
suffer from diabetes, hypertension or any other medical cause of
impotence. Instead, some complain about performance anxiety. Others
say their marriage is in need of a spark. Partygoers are looking for
something to offset the effects of alcohol."
"They are part of a new wave of men in their 20s, 30s and 40s who look
nothing like Viagra's first spokesman five years ago -- former
presidential candidate Bob Dole, who famously used the term, erectile
dysfunction or ED. Instead they mirror the drug manufacturer's new
spokesman homerun slugger Rafael Palmeiro who has reportedly said he
has tried Viagra but didn't need it."
"Unfortunately, experts say some of these guys suffer from unrealistic
expectations for performance or are masking more deep-rooted problems,
such as relationship conflict, poor self-image or drug addiction."
"There seems to be growing interest in having a 24/7 erection and
perform sexually without looking at the context or meaning," said Dr.
Gail Wyatt, a sex therapist, professor of psychiatry at UCLA and
author of the book, "No More Clueless Sex." Other times, it's even
more superficial: men simply want to be impressed with how they
function."
"Everybody has insecurity, and here's this one thing they take and
they can feel they have this power and they look good," said Atlanta
sex therapist Virginia Erhardt."
Some doctors also worry the new Cialis is particuarly attractive to
young party revelers since it stays in the bloodstream for so long.
"You take it at lunch on Friday and you are good all weekend," said
Dr. Bruce Stein, an Atlanta urologist.
"Sex is everywhere," Davis said. "Men see sex and sexual performance
as part of the definition of what a great catch of a guy is. . .I
think this is fed to them by the outside world for the most part. Not
their partners."
Relationship gurus believe many psychological roots to impotence
require counseling instead of medication, or at least a different
mindsight. They recommend drug-free solutions: tenderness, love and
communication. "Women don't want a minute and a half, but they sure
don't want four hours. Most women would like four hours of love-making
that includes hugging and kissing and cuddling but four hours of
intercourse? Give me a break," Erhardt said.
Dr. Wyatt said many men are developing a warped -- and casual -- view
of sex. "Viagra is not the way to a good sex life," she said. "The way
to a good sex life is to make a friend of the person you're with...and
look at sex as an added ingredient."
==
From the Mercola Website:
http://www.mercola.com/2004/apr/24/viagra_infertility.htm
"Often prescribed to older men experiencing erectile problems,
research has released reports of increasing numbers of younger people
taking Viagra for recreational purposes.
"A study involving mice found that mice given equal amounts of human
Viagra fertilized approximately 30 percent fewer female eggs than
normal and many of the fertilized eggs were shown to grow at a slower
pace. *It has yet to be determined how Viagra might disrupt the
sperm?s internal functions."
3. Can you provide me with links to approved, reviewed and popular
websites where I can purchase Viagra-like product but for a much lower
price, possibly without the hassle of going through subscriptions?
*******************************************************************************
I have provided the names of online pharmacies that provide Viagra
with a simple online consultation. They require no doctor's visit but
are more reputable than sites which simply dispense medication from
foreign suppliers with no assurance of medication quality. If you want
to go that route (which I don't recommend) I am sure you can find
cheaper prices.
Online Prescription Portal
--------------------------
http://onlineprescriptionsportal.com/
"At online prescriptions portal we have professional U.S. physicians
that are ready to assist you with your prescription needs. We Are Here
to Help The citizens Of The U.S. Have Easy Access To Needed
Medications And We Will only Prescribe medications To Residents Living
In The United States. All Medications Are held to the highest quality
FDA standards, We Will not compromise your health."
No prescription is needed but requires the consumer to fill out an
online questionnaire.
Buy Online Prescription Drugs Net
---------------------------------
http://www.buy-online-prescription-drugs.net/
"Buy-Online-Prescription-Drugs.Net is one of the largest online
pharmaceutical ordering services, providing medical consultations and
prescription processing. Our team of U.S. board-certified physicians
and pharmacists provide you with professional medical advice and
FDA-approved medications."
"Buy-Online-Prescription-Drugs.Net offers a complimentary medical
consultation with one of our doctors to determine which treatment is
best for you. Using the internet, patients can discuss any concerns
they might have and participate in their own health care. Once your
application is filled out and approved by one of our doctors, the
medication will arrive at your home or office in discreet packaging
within 24-48 hours."
"A large percentage of U.S. physicians currently prescribe medications
by reviewing a client's medical history without an in-person physical
exam. With Buy-Online-Prescription-Drugs.Net, we've created an online
medical consultation to get you the medications you need without the
hassle, embarrassment, and cost of the doctor's office and pharmacy.
Everything is done on-line and confidentially."
IntegraRX
----------
http://www.integrarx.com/about.asp
IntegraRx is an American based company that provides consumers easy
access to FDA approved online prescriptions over the Internet. (Online
consultation)
Alpha Drugs
-----------
http://www.alfadrugs.com/
"Upon approval, our USA physicians will write an FDA approved
prescription medications and the product will be filled and shipped
via FedEx direct to your door, immediately and discreetly."
"Online consultations are a new concept in healthcare, that utilize
the Internet to improve patient access to physician care. The patient
does not receive a traditional physical exam by the physician, but
rather completes information on the questionnaire prepared by medical
professionals and communicates with the physician using our secure on
line communication tool.
USA Pharmacy Online
--------------------
http://www.usa-pharmacy-online.com/
"Our online pharmacy sells FDA approved drugs. We offer patients
throughout the world quick access to the widest range of drugs
available through responsible and secure ordering service.
Our pharmacy staff consists of U.S. licensed physicians and
pharmacists. We are dedicated to help you live a healthy and happy
lifestyle. With our trusted healthcare professionals, dedicated
customer service representatives and simple online ordering system, it
has never been easier to get the drugs you need. We utilize only
licensed and certified U.S. physicians and pharmacies."
4. Are there other alternatives to Viagra like substances that actually work?
*******************************************************************************
Uprima
=======
Uprima is available over the internet and legal in the UK, but has not
yet gotten FDA approval.
"Uprima is a drug that acts on dopamine, a brain chemical central to
sexual arousal. It is taken in pill form, and dissolved under the
tongue, producing an erection in 20 minutes, says Dr. John Mulhall, a
urologist at Weill Medical College of Cornell University and New York
Presbyterian Hospital in New York City. Uprima behaves differently
from Viagra, Pfizer's blockbuster erection drug, which acts by
increasing the blood flow to the penis."
From "Viagra Alternative Seeks Approval Once Again." Meridian Health
http://www.meridianhealth.com/index.cfm/MediaRelations/News/MensHealth/approval.cfm
Also read 2002 Press Release from TAP Pharmaceuticals
http://www.tap.com/npr_2002_10_29.asp
Read more about Uprima on the Remedyfind website
http://remedyfind.com/rem.asp?ID=5860
Testosterone Patch
=====================
A testosterone patch "may" be considered if testosterone levels are
low, but unless true hypogonadism is present, the hormone supplement
won't work.
Read more about Testosterone Patches at NetDoctor:
http://www.netdoctor.co.uk/medicines/showpreparation.asp?id=4307
Read about adverse effects of supplemental Testosterone if it is not truly needed:
"WHAT ARE THE ORAL TREATMENTS FOR ERECTILE DYSFUNCTION?" (scroll down page)
http://www.ucdmc.ucdavis.edu/ucdhs/health/a-z/15Impotence/doc15treatmentoral.html
Yohimbine (this is very controversial)
==========
Yohimbine is another medicine that can work for some men. Yohimbine
"works best for cases of impotence where a physical cause is unknown,
or where the cause is psychological in nature. It acts by stimulating
the nervous system. It has been suggested the medication also raises
libido levels."
"Yohimbine does not boast a particularly high success rate: only ten
to twenty percent of men who have taken it reported an improvement in
their ability to achieve an erection. It does not work fast: yohimbine
must be taken for six to eight weeks before results can be seen. Side
effects may include dizziness, headaches, an increased heart rate and
nausea. When used to treat psychologically based erectile dysfunction,
the drug may be prescribed in combination with the antidepressant
trazodone."
From "Medical Solutions for Erectile Dysfunction."
http://www.treatments-for-erectile-dysfunction.com/html/medicinal-methods.php3
Read more about Yohimbine, including caution about it's use, on the
Remedyfind website:
http://remedyfind.com/rem.asp?ID=5811
Yohimbine does have numerous cautions associated with it.
Maca (Lepidium meyenii)
========================
Maca is an herbal product used as a sexual enhancer with some evidence
that it can help with erectile difficulty.
Read more about Maca on the RemedyFind website:
http://remedyfind.com/rem.asp?ID=5806
Other Alternative Remedies
==========================
The following recommendations are from the article, "Impotence."
http://www.health-hippo.co.uk/malezone/impotence.htm
Counseling
----------
"If the cause is judged to be psychological, it is crucial to review
your relationship with your partner and to examine other possible
sources of stress or tension in your life. A trained therapist can aid
in these matters and may help unearth problems such as unreasonable
guilt, performance anxiety or inhibiting attitudes toward sex that
were learned at an early age.
Acupuncture
-----------
"Men whose impotence has psychological foundations may be helped by
acupuncture, which releases and rebalances the qi, or life force, by
placing needles at specific "meridians" of the body."
Aromatherapy
-------------
"The scents employed in aromatherapy may relax the amorously inclined
and put you in the mood. Some evidence shows aromatherapy may actually
increase blood flow to the penis. No specific scent has been proven to
affect all men, so try several to find one that works for you."
Herbs and Supplements
-----------------------
"There's little evidence yet to support the use of herbs for treating
impotence. If you do choose to try herbs and supplements, inform your
doctor and proceed with caution. Gingko has been shown to increase
blood flow, but there is no direct proof that this leads to regained
potency for men. Ginseng and saw palmetto are two other popular herbs
whose claims regarding potency have yet to be well proven. The amino
acid arginine is being studied and may show promise in some cases of
erectile dysfunction, but more research is needed."
Therapies That May Harm You
----------------------------
"Cell therapy (which in the case of impotence involves transferring
cells from pig's gonads into humans) is hardly likely to work, very
expensive and illegal in the United States. Chelation therapy, a form
of chemical purging supposedly good for improving vascular circulation
in men with impotence, is unproven and may be dangerous. Magnetic
field therapy may have some applications, but there is no evidence
that it cures impotence."
** "The herb yohimbe may relieve impotence in many cases, but, due to
potential serious side effects, it cannot be sold over the counter in
the United States. If you choose to obtain yohimbe outside the United
States, be sure to consult a knowledgeable herbalist before using it."
5. What sort of food should I eat, what sort of lifestyle should I
lead, what kind of excersizes should I perform, what sort of vitamins
and nutrients do I need, etc -- to help me keep an erection? (Very
very important, spend the most time researching this)
*******************************************************************************
LIFESTYLE FACTORS
=================
Aside from disease conditions like diabetes or medications that
inhibit blood flow or nerve impulses to the penis, a major factor in
erectile dysfunction is stress and lifestyle. Approximately 10% of
problems are psychological in nature.
Certainly, once an initial episode of erectile dysfunction occurs, it
is not hard to imagine that performance anxiety can lead to increased
stress levels! Fatigue is another issue.
According to the Male Health Centres, the following lifestyle changes
can help to maintain optimum sexual health:
http://www.malehealth.com/HTML/B4f3.html
Quit Smoking
-------------
Smoking can wreak havoc on the nervous, vascular and endocrine
systems, all of which are vital components to erectile function.
According the Massachusetts Male Aging Study (MMAS), erectile function
can often be fully or partially restored in men who have quit smoking.
Get regular exercise and lose weight
---------------------------------------
"A sedentary lifestyle can lead to obesity (which can then lead to
high blood pressure, hardening of the arteries and heart problems). A
sedentary lifestyle may also make it more difficult to cope with
stress."
A study by the American Urological Association has identified both
the above as factors in erectile dysfunction.
From "Diet & Exercise A Better Option For Erectile Dysfunction." June 28, 2004
http://www.altpenis.com/penis_news/20040528035132data_trunc_sys.shtml
"Obese men with erectile dysfunction may be able to improve their
sexual function with exercise and weight loss, according to a study
appearing in The Journal of the American Medical Association."
"Katherine Esposito, of the Center for Obesity Management in Naples,
Italy, and colleagues conducted a study to determine if lifestyle
changes designed to obtain a sustained and long-term reduction in body
weight and an increase in physical activity would improve erectile
function in obese men.
The men involved in the study received detailed advice about how to
achieve a loss of 10 percent or more in their total body weight by
reducing caloric intake and increasing their level of physical
activity. The researchers said, "Our data demonstrate that lifestyle
changes, including a reduced calorie diet and increased exercise,
improve erectile function in obese men and resulted in about one-third
of men with erectile dysfunction regaining sexual function after
treatment."
Quit Drinking or use alcohol in moderation
-------------------------------------------
Short-term effects: In small quantities, alcohol can stimulate
arousal. However, drinking alcohol softens the erection by slowing
down reflexes and dulling sensations, including sexual pleasure.
Maintain healthy cholesterol levels and reduce fat in the diet
----------------------------------------------------------------
"Erectile dysfunction may be the first sign of hardening of the
arteries. Your family doctor should annually check your weight, blood
pressure and cholesterol/triglyceride blood levels."
=
"High cholesterol may also contribute to impotency. A study of 3,250
men aged 26 to 85 demonstrated an increase in erectile dysfunction in
relationship to their serum cholesterol. For every mmol/liter of
cholesterol increase above the normal range (3.63 to 5.18 mmol/liter),
the risk of impotency increased.5 Researchers concluded that high
levels of cholesterol and low levels of HDL were important risk
factors for developing impotency."
"Treating Impotence Naturally," by Thomas Kruzel, N.D.
http://www.healthwell.com/hnbreakthroughs/oct97/impotence.cfm
Reduce Stress & Anxiety
------------------------
"Stress and anxiety can cause the release of neurotransmitters in the
brain that "steal" an erection. Chronic stress can lead to low energy
levels, poor sleeping habits, irritability and depression. Dealing
better with stress not only improves erectile function but also your
general well being. There are countless books available on improved
coping skills. Stress counselors and your family doctor are available
for added support."
====
In a Nutshell:
"Because impotence is often related to poor blood flow, take steps
that improve your cardiovascular health: control your blood pressure,
cholesterol level and medical conditions like diabetes, and don't
smoke. Avoid alcohol and recreational drugs that may reduce sexual
desire or affect your ability to maintain an erection. Discuss side
effects of medications with your doctor. Try to establish open
communication with your sexual partner as a way to ease tensions that
could be affecting your performance. Remember that occasional problems
with erections are normal. Worrying about past failures can interfere
with present pleasure."
From "Impotence." http://www.health-hippo.co.uk/malezone/impotence.htm
Stress and the "Impotence Domino Effect"
=========================================
From "A Comprehensive Guide to Psychological Impotence."
http://www.impotence-guide.com/psychological-impotence.html
"Recent clinical and doctor-patient studies have conclusively proven
that psychological impotence directly affects only 10% to 20% of men.
However, because of the perceptions men attach to their sexuality and
virility, and the subsequent feelings of frustration, anxiety and
depression caused by impotence, psychological impotence can be the
indirect result of impotence brought about by a physical condition."
"The brain plays an integral part in the physical process of creating
an erection. It can also be equally responsible for preventing one. If
the portion of the brain responsible for sending impulses to the penis
that result in an erection receives negative rather than positive
messages, it will respond by releasing chemicals that constrict the
blood vessels in the penis and inhibit the natural process that causes
an erection."
"Therefore, feelings of inadequacy, anxiety, stress, guilt, depression
or sheer boredom can result in what is called psychogenic impotence
(or psychological impotence) - the inability to achieve or maintain an
erection due to psychological rather than physical causes."
"Most men will experience psychological impotence at least once in
their adult life, so it's important to know that an occasional episode
is not a diagnosis for on-going impotence. In most cases, isolated
episodes are more likely to be due to fatigue, stress or an
over-indulgence in alcohol than an underlying physical cause."
**** "However, many men react to an occasional episode of impotence by
becoming more anxious, which results in further sexual problems, hence
more anxiety. This is called the "impotence domino effect" of anxiety
- failure - more anxiety - more failure."
* Note that stress, fatigue, depression and relationship issues can
all lead to psychological impotence.
===
NUTRIENTS AND SUPPLEMENTS
==========================
From "Natural Treatments for Erectile Dysfunction (Impotence)," by
Cathy Wong, N.D. http://altmedicine.about.com/cs/conditionsetoh/a/erectiledysfunc.htm
L-Arginine
----------
"In a double-blind clinical trial, 50 men with problems achieving an
erection received either 5 g of L-arginine per day or placebo for 6
weeks. More men in the treated group experienced improvement in sexual
performance than the placebo. L-arginine is an amino acid found in
foods such as meat, dairy products, poultry and fish. The body uses
arginine to make nitric oxide, a substance that relaxes the blood
vessels. Arginine appears to be safe at moderate doses of 2 to 3 g per
day, although minor digestive distress can occur." (see cautions)
Gingko
------
"Some research suggests that ginkgo may be useful in erectile
dysfunction, due to their ability to stimulate blood flow to the
penis. In one study of 60 men with impotence due to poor blood
circulation demonstrated a 50% success rate after 6 months. Gingko
appears to be relatively safe. (Beware if you are taking
blood-thinning drugs of any type)
Zinc
-----
"Deficiency of zinc is known to have a negative effect on sexual
function. Zinc is one of the most commonly deficient minerals. A
typical dosage for impotence is 15 to 30 mg daily, taken with 1 to 2
mg of copper, since supplemental zinc interferes with copper
absorption. Too much zinc can be toxic, so do not exceed this dose."
(See the remainder of the article for other herbal recommendations)
==
Also read "Treating Impotence Naturally," by Thomas Kruzel, N.D.
http://www.healthwell.com/hnbreakthroughs/oct97/impotence.cfm
"Nutrients such as vitamins C, E, zinc and essential fatty acids are
important to a man's normal sexual function.6 All are needed to form
both sperm and seminal fluid and are found in especially high levels
in the prostate gland. (Raw pumpkin seeds are a good source of zinc
and essential oils. Diets high in vitamins, minerals and antioxidants
from fresh fruits and vegetables help maintain vascular integrity and
sufficient blood flow to the penis's erectile tissue (corpus
cavernosum).8 Healthy diets also prevent lipid peroxidation--a result
of free radical formation that in turn decreases the hormones and
neurotransmitters needed for a normal erection."
==
From "Supplement Alternative to Viagra."
http://www.mercola.com/1998/archive/viagra_warning.htm
Dr. Joseph Mercola, known for his alternative therapies, recommends
several nutrients to boost ACH (acetlycholine) levels as well as well
as Yohimbe and yohimbine as natural alternatives to Viagra.
"One way to safely and effectively enhance ACH levels in the body is
to take supplements of choline ( 1000 to 3000 mg) and vitamin B5 (500
to 1500 mg) so that the body will produce more ACH. Vitamin B5, also
known as pantothenic acid, actually seems to enhance endurance by two
routes. The first is by increasing ACH and the second is its role in
the energy producing Krebs cycle. The choline and vitamin B5 are
ideally taken about 20 to 30 minutes before sex in order to get the
full effect.
Yohimbe and yohimbine is from a native tree in West Africa. For
centuries a tea distilled from the inner bark of this tree has been
used to amplify male virility and sexual prowess. Yohimbine?s primary
path of action duplicates a key biochemical role in male erection.
Yohimibine acts upon a specific network of nerve cells called the
alpha-2-adrengeric system. Yohimbine shuts down this system which
increases the flow of blood through arteries into the penis while at
the same time decreasing the blood flow from the penis through veins.
It also results in higher levels of ACH. Several controlled trials
have been done with yohimbine and the response rate is about 40
percent.
=
Please see another perspective on Yohimbe, which cautions against it's use:
"The bark of the west African yohimbe tree is a traditional
aphrodisiac and the source of yohimbine, a prescription drug for
impotence. Yohimbe stimulates blood flow to the penis. Yohimbe has
also been shown to increase libido and decrease the period between
ejaculations. However, yohimbe is not recommended because it has a
very narrow therapeutic index. There is a relatively small dosing
range, below it the herb doesn?t work and above it the herb is toxic.
Side effects of normal dosages include dizziness, anxiety,
hyperstimulation, and nausea. As little as 40 mg a day can cause a
severe drop in blood pressure, abdominal pain, fatigue,
hallucinations, and paralysis."
From "Natural Treatments for Erectile Dysfunction (Impotence)," by
Cathy Wong, N.D. http://altmedicine.about.com/cs/conditionsetoh/a/erectiledysfunc.htm
EXERCISES FOR THE PENIS
========================
I cannot vouch for their effectiveness, but you may follow the various
links associated with the following article:
"Penis enlargement exercise."
http://www.penis-enlargement-exercise.org/
http://www.penis-enlargement-exercise.org/free-penis-enlargement-exercise.html
http://www.penis-enlargement-exercise.org/penis-enlargement-exercise-injuries.html
http://www.abcs-of-penis-enlargement.com/penis-enlargement-exercise.shtml
"Penis enlargement exercise - Do they work?
http://www.penis-enlargement-exercise.org/do-penis-enlargement-exercises-work.html
Also read "Penis Enlargement FAQ
http://www.altpenis.com/penis_news/penis_enlargement_faq.shtml
An Additional Recommendation
=============================
You might be interested in an online, natural health analysis by a
naturopathic doctor. I ran across the following website and it looked
quite interesting, actually. The page I have linked to has an overview
of erectile dysfunction, and you may click on the link at the top for
"Start the Analyst" to view a sample report and read through the
various options. It is worth a try!
http://www.digitalnaturopath.com/cond/C387057.html
===
I believe I have covered all the bases for you. I have been working
on this all day and as it is now close to 2:am, I am getting a bit
bleary-eyed!!! If I have been deficient in any part of my answer,
please let me know.
Otherwise, I truly hope that I have helped by providing you with
accurate and worthwhile information that will allow you to make some
informed choices and lifestyle changes on the pathway to good health
and "more satisfactory function."
Take care!
umiat
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