IMPOTENCE: CAN IT BE CURED WITHOUT DRUGS?

mpotence or erectile dysfunction was once dreaded as man's worst nightmare. Given the advances in medicine and nutrition research, however, it no longer has to be a scary thing. Impotence can be treated - sometimes without drugs. Read on:

What is impotence?
Impotence is defined as the inability to achieve or maintain an erection to perform intercourse or ejaculation.

There are two forms of impotence: primary and secondary. Men with primary impotence have never had sufficient erection for satisfactory intercourse. This form of impotence is rare and is often caused by extreme psychological conditions, such as intense fear of intimacy, extreme feelings of guilt, and severe anxiety.

Secondary impotence, defined as the loss of erectile function after a period of normal function, is more common. Men with secondary erection are typically able to engage in intercourse only 25% of the time. This form of erection typically comes on gradually and is usually more easily treated that primary impotence.

Who becomes impotent?
Although men who have reached middle age and older are more likely to be impotent than younger men, impotence can strike at any adult age. It is estimated to affect between 10 and 15 million men in the United States alone.

What causes impotence?
Diseases
The major cause of impotence is disease. It is estimated that over 70% of all serious impotence cases are the result of diabetes, kidney diseases, multiple sclerosis, endocrine disorders, vascular diseases and high blood pressure, as well as neurological diseases. It is estimated that between 50% and 60% of diabetic men are impotent.

Here, it's important to realize that impotence may be a symptom of a more serious problem with your health - so if you're impotent, don't be ashamed of seeking professional medical help.

Medication
Prescribed drugs used to treat high blood pressure, ulcer, depression, prostate cancer, as well as drugs to prevent baldness or to aid dieting, can have side effects that include impotence. In this case, the impotence lasts as long as you are taking the drugs.

Surgery
Surgery on the spinal cord, prostate, bladder, or pelvis can lead to impotence by damaging essential nerves, tissues, muscles, or arteries needed.

Cigarette smoking, alcohol and narcotics use
One of the most underestimated causes of impotence is actually cigarette smoking (as if you need yet another reason to quit ...) It is ironic that even though cigarette smoking long has the projected aura of coolness or sexiness, in reality it is anything but.

The same goes for alcohol and narcotics such as heroine and cocaine (almost 100% of men who use cocaine regularly are impotent). If you use these recreational drugs, however, you have bigger health problems than just impotence ...

Hormonal imbalance
As testosterone and other male sex hormone levels start to drop after reaching middle age, it is thought that low testosterone level is the culprit of most intermittent impotence problem, especially in older men. Furthermore, studies have shown that lack of testosterone leads to a range of other sexual performance problems, including premature ejaculation and low sex drive.

Psychological factors
It is estimated that about 10 to 20% of impotence cases are the direct result of some sort of psychological factors, such as low self-esteem, depression, and especially stress and anxiety (general and performance anxieties). Here, all the plumbings are A-OK, yet the otherwise healthy man is unable to achieve an erection.

The man's comfort level is also often a factor, especially in maintaining an erection. Boredom, marital problems, or negative feelings against his partner may contribute toward an impotence problem.

Impotence caused by psychological factors is often temporary: it lasts as long as the underlying factor is still there. If you suspect this may be the cause, you can perform a simple test to see if impotence is just in your mind ...

The stamp test: not just for the mail anymore ...
So, how do you distinguish between impotence caused by problems with your body and that caused by psychological factors? A lowly, regular stamp can help ...

Turns out that during sleep, a man often gets multiple erection throughout the night. This involuntary erection means that everything is fine with the nerves, muscles, and arteries involved in the erection process and signals that the cause of impotence lies elsewhere.

To determine this, a man can simply wet and "affix" a small stamp on his flaccid penis before going to bed. If the stamp is no longer in place by the morning, it means that a nocturnal erection occurred.

Medical treatment for impotence
Sildenafil citrate
The invention of Viagra (sildenafil citrate) spotlights the problem of impotence, and made it all right to talk about this once taboo subject. Once designed for heart medication, it was soon discovered that sildenafil can cause quite potent erection (actually, the scientists suspected something when the clinical test subjects were very reluctant to return their pills after the study was over ...)

Sildenafil works by causing the smooth penis muscle to relax, which lets blood to flow into the penis. This, in turn, causes the penis tissue to be engorged by blood and becomes erect (with the proper sexual stimulation) within 20 to 40 minutes after taking the drug orally.

While it works very well, it should be noted that sildenafil is a prescribed drug, and should only be taken on advise of your health care professional as it has serious side effects in some men. The side effects of sildenafil include minor vision problems, headaches, heart attacks, and even death.

Injection therapy
Here, drugs that cause the widenings of blood vessels are injected into the penis to cause erection. This therapy is falling out of favor, because of the obvious (imagine injecting your penis, guys), and because of the side effects, which include persistent erection, scarring, and sudden low blood pressure.

These injection drugs are not recommended for men who are taking prescribed medicine for high blood pressure or who are at risk for blood clots. Furthermore, since the drugs are toxic to fetuses, men are not recommeded to use this method if their partner is pregnant.

Insertable drugs
Instead of injection, there are also drugs in pellet form that can be inserted into the penis about an inch deep with an applicator. Erection will then occur about 8 to 10 minutes after application, and lasts between 30 minutes to an hour.

In addition to side effects that include those listed for injection drugs, insertable drugs can also cause a burning sensation, redness, spotting or bleeding, and aching of the penis and testicles. Furthermore, the man must remain in an up-right position when the erection is forming, so the blood flow is not inhibited. If he lies down too early, then the erection may be lost.

Hormone replacement therapy
Since one of the most common causes of impotence, especially intermittent impotence in older men is low testosterone level, it is obvious that testosterone replacement therapy can help.

Testosterone replacement therapy, however, should only be done under careful administration by doctors, since overdose of testosterone carries serious side effects, including enlargement of the prostate.

Surgery
There are a couple of surgeries available, including repairing blocked or damaged arteries and veins, as well as tying the veins to prevent blood to flow out of the penis during an erection.

Other types of surgeries include implanting erection devices. These devices include a bendable rod which allows a man to (manually) place the penis into the erection position, and an inflatable implant. The inflatable implant consists of cylinders, a fluid reservoir, and a pump that is placed under the skin in the scrotum. When the man presses the pump, fluid flows from the reservoir into the cylinders, which become inflated and cause the penis to be erect. This device causes the penis to become longer and wider while erect. It also has an advantage over the rod, since it allows the flaccid penis to appear more natural.

Besides expensive, remember that surgeries are invasive procedures that can cause potentially serious side effects.

Pump it up. Literally.
Vacuum tube and penis ring - oh, what men go through for a good erection, and natural
Pump it up. Literally!
A vacuum device, composed of a plastic cylinder, pump, and elastic ring or band, can be used to effect an erection.

The way it works is as follows: the cylinder is placed onto the penis and the pump is then used to draw air out of the cylinder. The vacuum causes blood to be forced into the penis, which in turn causes an erection. Once erection is achieved, the man places the elastic ring on the base of the penis, which keeps blood from draining from the penis back into the body. The ring remains on the penis until intercourse is finished.

This device works quite well, although some men complained about the discomfort of the elastic ring, in addition to the hassle of ... er, pumping up.

Herbs: the natural answer for impotence?
Although they are often dismissed as ineffective solutions to impotence, more and more clinical research studies have found that herbs can help impotent men.

Some of the most popular herbs available on the market today include tribulus, yohimbe, ginkgo biloba, and others. Although they are generally safe and without side effects (unlike chemical drugs), it is important to know that the quality of their extraction and preparation processes vary widely.

Tribulus terrestris
One of the most promising herbs is the purified extract of Tribulus terrestris. To date, its effects on treating impotence and other sexual dysfunction problems have been extensively studied.

Tribulus has been used as traditional medicine to treat sexual dysfunction and male infertility in Europe and Asia for many decades, before improvement in scientific extraction techniques allowed identification of its active ingredient called protodioscin.

Clinical studies performed on this purified extract have confirmed the herb's beneficial effect. These studies showed that Tribulus helps treat impotence caused by low testosterone level or an imbalance in the body's level of sex hormones. The active ingredient of Tribulus acts as a natural precursor to these hormones, and is converted into its final forms by the body's own natural enzymes.

Other studies have suggested that Tribulus also acts by increasing the level of dehydroepiandrosterone (DHEA), a naturally occuring substance in the body believed to be important for a healthy sex drive.

In all, these studies proved that Tribulus works very well in curing sexual dysfunctions and in maximizing sexual performance when taken regularly (it does not work immediately, however, Tribulus shows positive effects only after two to three months). There is no known side effect to this herb.

A note of caution: although there are many Tribulus extracts available over the counter today, almost all of these have been found not to contain any significant amount of the active ingredient. Be sure to select a Tribulus extract that contains at least 45% protodioscin (we recommend the Libilov for Men brand).

Yohimbe
Yohimbe is an extract of a bark of the evergreen yohimbe tree, and was traditionally used in Africa as an aphrodisiac. Yohimbine, a chemical substance derived from the Yohimbe extract, is actually a prescribed medicine for sexual dysfunctions. Studies on yohimbine have shown that it may help men achieve erection by increasing blood flow to the penis and acting as a stimulant.

A survey of yohimbe extracts available as dietary supplements, however, have suggested that most do not have significant amount of yohimbine and therefore are not effective. Moreover, there are some side effects of yohimbe that you should be aware of. These include increased anxiety, sleeplessness, and mood swings.

Ginkgo biloba
Best known as an herb to boost memory and mental acuity, recent studies have suggested that ginkgo extracts can help impotent men by increasing peripheral and microcirculation of blood. Clinical studies on impotence caused by antidepressant medications show marked improvement in erection.

L-arginine
L-arginine, while not an herb, is a naturally occurring amino acid present in food. Studies on L-arginine have shown mixed result, and since it can affect insulin and carbohydrate metabolism, men with diabetes (a leading cause of impotence, by the way) are not recommended to take it.

Ginseng
Used for thousands of years in Chinese medicine to treat "old man's disease" of impotence and sexual problems, Ginseng is one popular herb. Not surprisingly, studies have suggested the positive effects of this root on the biochemical mechanism of erection. A substance in the panax subspecies of ginseng, called ginsenosides, have been thought to work by causing the release of nitric oxide, a natural substance responsible for the increased blood flow into the penis.

Moreover, it seems that Ginseng has an overall beneficial effect on health. For some (especially older men), this may just be the boost they need for a healthier sexual life.

You no longer have to suffer from impotence
The fear of impotence, stemming from the belief that there is nothing you can do for it, is slowly diminishing. Admitting being impotent is the first step toward treating impotence.