Erectile Dysfunction (ED): Natural Ways to Address Its Complexities By Erika Dworkin, BCHN®
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id you know that erectile dysfunction (ED) is very common among American men of all ages and that the risk of its development increases with age? Understanding its causes and adopting natural ways to address its complexities can help tackle its power to undermine self-confidence, quality of life, and intimate relationships. Erection Physiology A penile erection is essentially a spinal reflex that is generated through the complex interplay of the sympathetic and parasympathetic nervous systems (reflex aspect), combined with local genital stimulation and/or stimulation from erotic or emotional stimuli that involves the limbic system of the brain (psychological aspect). Various neurotransmitters released from the endothelial cells and excitatory nerves in the penis: • facilitate erectile function, including nitric oxide (NO), dopamine, glutamate, ATP, acetylcholine, oxytocin, ACTH (stimulates cortisol production), and MSH; • inhibit erectile function (noradrenaline, enkephalins, GABA, and endocannabinoids); or • both facilitate and inhibit erectile function (serotonin). The balance among these molecules controls the degree of contraction of the smooth muscle of the corpora cavernosa (CC)—the two columns of spongy tissue that run through the penile shaft—and in turn controls overall penis function.
Erectile dysfunction is a multidimensional but common male sexual dysfunction that involves an alteration in any of the components of the erectile response, including organic, relational and psychological…. [It] can have deleterious effects on a man’s quality of life; most patients have symptoms of depression and anxiety related to sexual performance. These symptoms, in turn, affect his partner’s sexual experience and the couple’s quality of life. —Erectile Dysfunction, Nature Reviews Disease Primers
By initiating production of another chemical messenger called cGMP (cyclic guanosine monophosphate), NO triggers a biochemical cascade leading to vasodilatation (relaxation and expansion) of penile blood vessels, This allows for increased blood flow into the CC, which then stretches, compressing the primary site where blood exits the penis (the subtunical venules) and causing the resistance to blood flow out of the penis, thereby producing and maintaining an erection. What Is ED? ED is the inability to achieve or sustain a penile erection for satisfactory sexual performance. According to the Cleveland Clinic, the failure to get an erection less than 20% of the time is not abnormal and generally does not require treatment. However, such failure more than 50% of the time is generally diagnosed as ED and can be a symptom of a more serious underlying problem, including: 1. vascular disease, including cardiovascular disease (CVD) and blocked blood flow from various factors such as atherosclerosis (note also that hypertension, a risk factor for CVD, may damage blood vessels and disrupt blood flow to the penis);
2. neurological disorders resulting from multiple chronic conditions, including diabetes, MS, lupus, Parkinson’s disease, and the aftermath of stroke; 3. psychological problems such as severe stress/PTSD, depression, low libido, relationship problems, and performance anxiety; 4. male hormone deficiencies (testosterone, DHEA); 5. physical injury to the penis, including that causing Peyronie’s disease, or prostate, bladder, or colon conditions and surgeries; and 6. obesity and metabolic syndrome. Many common medications can also cause ED, including those prescribed for cholesterol (statins); pain/inflammation (NSAIDs); blood pressure (including diuretics); acidrelated conditions (Zantac, Tagamet, Pepcid); allergies; depression; irregular heart function (antiarrhythmics); anxiety (tranquilizers, opiates); muscle tension (muscle relaxants); hormonal imbalance; cancer (chemotherapy prescriptions); seizures; and recreational drugs (alcohol, nicotine, illicit drugs such as marijuana and cocaine). www.NaturalNutmeg.com
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