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admin | Category: Ed Treatment San Antonio | 04.08.2015
Erectile dysfunction is quite a common problem that plagues all men at some time or the other.
There is also a belief that going to quacks or getting treated by taking over-the-counter medicines like Viagra will cure erectile dysfunction. The most important thing in treating any condition is to first find out the cause for the condition. Erectile dysfunction (ED) is not a popular topic among men although it affects many men across the world.
I am going to blame the leading physical cause of ED on inflammation, which is the root of all-evil in the body.
Another common cause of ED is low testosterone, which transcends both the psychological and physical roles. Limit stress with breathing exercises, meditation, yoga, or other relaxation techniques (read my Mind-Body Blog which discusses Adrenal Dysfunction).
Reduce inflammation with the proper lifestyle (nutritious foods, beneficial exercise, and limiting alcohol). As many men already know, ED medications can become expensive, and they can limit the spontaneity of a physical relationship. Though the holidays often seem romantic, all of this eating and drinking combined with short days and low temperatures can turn down the heat in the bedroom for a lot of men.
The holidays are often a stressful time of the year and stress can make your blood vessels contract, leading to difficulty sustaining an erection.
The passing of years brings about changes both in the sexual rhythm and in the quality of sexual intercourse.
See related patient information handout on erectile dysfunction, written by the author of this article. Erectile dysfunction is defined as the persistent inability to attain or maintain penile erection sufficient for sexual intercourse. However, the problem isn’t openly discussed or even medically reported because of the social embarrassment that it carries. Most men think that talking about erectile dysfunction will cast doubts on their virility and manhood.
This belief stems from the fact that not many men are aware of the root cause of the problem although they might be suffering frequently from it. In most cases the condition can be treated at home easily by introducing some healthy changes in your diet and lifestyle. Use the simple remedies given below to treat erectile dysfunction naturally.
The herb is taken by men who suffer from erectile dysfunction caused by use of anti-depressants. The heat from the dry fruits is known to facilitate proper flow of blood to all body parts including the penis.
You must take two teaspoons of this mixture every day or you can add the mixture to a glass of warm milk and drink at night time. Take almonds and grind them to a fine powder. Some prescribed as well as over-the-counter medicines have temporary erectile dysfunction as one of the side effects. Alcohol muddles the brain and numbs the body which affects in erectile dysfunction at times. Smoking releases large amounts of nicotine in the blood which decreases the flow of blood circulation. Many times the fear of children or other family members walking in on you during sex can cause anxiety which can also case erectile dysfunction. Inflammation causes poor blood flow by damaging the microscopic layer of cells that line every blood vessel. Testosterone affects a male’s desire and psychological status in order to properly stimulate erections.
I usually recommend that my patients continue taking their medication while we work on natural ways to improve their erections.
Up to 39 percent of men in their 40s have experienced trouble getting or maintaining an erection, and almost all men over 70 are affected. If you would rather spend the morning tending to your partner than your hangover, it’s best to keep your alcohol consumption to a minimum. Kinsey?s statistics -which may have become out of date- show that there is an inevitable, rapid increase in men?s erectile dysfunction as of 55 years of age. You should not rely on this information as a substitute for personal medical attention,  diagnosis or hands on treatment. The majority of cases have an organic etiology, most commonly vascular disease that decreases blood flow into the penis. The corpora cavernosa are composed of a mesh-work of interconnected cavernosal spaces lined by vascular endothelium. Normal erectile function requires a complex set of dynamic neural and vascular interactions. Most causes of erectile dysfunction were once considered to be psychogenic, but current evidence suggests that up to 80 percent of cases have an organic cause.1 Organic causes are subdivided into vasculogenic, neurogenic and hormonal etiologies.
Aging is an independent risk factor, and although the incidence of erectile dysfunction increases steadily with age, it is not an inevitable consequence of aging.


Information from references 7 and 8.Excessive and long-term use of a number of substances may also cause erectile dysfunction. In all instances, medical conditions having an impact on erectile function should be corrected or their progression controlled. You should have copper supplement along with zinc supplement as copper helps the body absorb zinc better.
You can take vitamin A in the form of a supplement or include vitamin A rich foods like carrots and papaya in your daily diet. To treat erectile dysfunction at home drink a glass of warm milk with ? teaspoon turmeric added to it. The herb has a relaxing and soothing effect on the muscles which allows better circulation of blood to the penis.
To treat erectile dysfunction with dry fruits combine 100 gms walnuts, almonds, cashew nuts, prunes, raisins, figs, dried apricots, zest of two lemons in an electric mixer and grind all the ingredients to a coarse powder form.
A man who has been drinking alcohol an hour before sex will find himself difficult to perform. When the penis does not receive enough blood it cannot effectively become hard to allow penetration. These cells, called endothelium, create nitric oxide, which sustain a healthy environment and dilate blood vessels. Low testosterone is usually a symbol of inflammation, and low testosterone itself contributes to inflammatory conditions. By taking the medication consistently, you can improve your confidence and remove the psychological block. The ball may be dropping in Times Square, but there’s no reason for others things not to stay up. Stick to heart-healthy foods such as fish, berries and veggies and steer clear of fatty and fried dishes. As men grow older, they experience a decrease in their libido and are less inclined to sexual gratification. Regardless of the primary cause, erectile dysfunction can have a negative impact on self-esteem, quality of life and interpersonal relationships. An estimated 10 to 20 million American men have some degree of erectile dysfunction.1,2Increased understanding of the male erectile process and the development of several agents to improve erectile function have generated great public interest among men and their sexual partners. Penile erection can be elicited by at least two distinct mechanisms, central psychogenic and reflexogenic,3 which interact during normal sexual activity. Vasculogenic etiologies represent the largest group, with arterial or inflow disorders being the most common. Several studies have indicated that patients and providers are reluctant to address sexual topics. If you do not suffer from zinc deficiency you are highly unlikely to suffer from erectile dysfunction. If this is the case then request your healthcare provider to change the medication and recommend something that does not cause erectile dysfunction. A routine position can make your bed room life pretty boring which lead to erectile dysfunction. After this single event, he will always worry that this will be another occasion that he is not able to step up to bat. Without the appropriate nitric oxide, blood vessels cannot bring enough pressure into the penis to make it erect and firm. In order for this psychological impulse to create an erection, the blood vessels of the penis must be healthy enough to create nitric oxide (physical).
Fortunately, there are steps you can take to make sure it’s truly the happiest time of year.
Nevertheless, they can maintain their erectile capacity until they are 80, provided their health is good.
The initial step in evaluation is a detailed medical and social history, including a review of medication use. These advances are expanding the treatment options available to primary care physicians in the management of erectile dysfunction. 3 Blood flow is provided primarily by the cavernosal branches of the internal pudendal artery. Psychogenic erections are initiated centrally in response to auditory, visual, olfactory or imaginary stimuli. Consideration should be given to discontinuation of any medication suspected of contributing to the erectile problem or, if required, switching to an alternative medication less likely to interfere with erectile function.
This additional worry on top of an already strained psyche leads to further erectile dysfunction.
Each branch divides into numerous terminal branches that open directly into the cavernous spaces. Reflexogenic erections result from stimulation of sensory receptors on the penis which, through spinal interactions, cause somatic and parasympathetic efferent actions.3On arousal, parasympathetic activity triggers a series of events starting with the release of nitric oxide and ending with increased levels of the intracellular mediator cyclic guanosine monophosphate (cGMP).
Regardless of the primary etiology, a psychologic component frequently coexists.5The severity of erectile dysfunction is often described as mild, moderate or complete, although these terms have not been precisely defined.


As you can see, it becomes a snowball effect and erections become weaker and more difficult to sustain over time. Increases in cGMP cause penile vascular and trabecular smooth muscle relaxation.3,4 Blood flow into the corpora cavernosa increases dramatically.
First, provide information about conditions that are commonly associated with sexual dysfunction, then follow with a question about the individual's concerns. Laboratory tests are useful to screen for common etiologic factors and, when indicated, to identify hypogonadal syndromes.
The rapid filling of the cavernosal spaces compresses venules resulting in decreased venous outflow, a process often referred to as the corporeal veno-occlusive mechanism. The male sexual response cycle consists of four major phases: (1) desire, (2) arousal (erectile ability), (3) orgasm and (4) relaxation.
Before the initiation of testosterone therapy, the patient should be evaluated for the possibility of an occult prostate malignancy, which may be stimulated by supplemental testosterone.
Appropriate evaluation of erectile dysfunction leads to accurate advice, management and referral of patients with erectile dysfunction. This information may help assess the patient's sexual problems as well as identify high-risk behaviors and other concerns affecting the patient's overall health.Once a concern with the patient's sexual function is identified, the next step is to differentiate erectile dysfunction from other sexual problems, such as loss of libido or ejaculatory problems.
The physician should use appropriate vocabulary, avoiding slang or excessively technical terminology. Patients with suspected vasculogenic or neurogenic causes can be considered for a trial of therapy in the primary care setting. Having the patient define the terms in his own words will help the physician and patient communicate more effectively.13 The International Index of Erectile Function (IIEF)14 is a valuable tool for defining the area of sexual dysfunction (Figure 4).
Patients with a suspected psychogenic etiology should be considered for sexual counseling or psychiatric referral as well.Patients requesting a more comprehensive evaluation or those not responding to initial therapy should be referred for further evaluation and treatment. The IIEF is designed to be a self-administered measure of erectile dysfunction, but it also assesses a patient's function in other phases of sexual function. As such, it should be viewed as an adjunct to, rather than a detailed sexual history.Reprinted with permission from Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile dysfunction (IIEF): a multidimensional scale for assessment of erectile dysfunction. Because erectile dysfunction is frequently caused by medication, a review of the patient's drug therapy is essential and should include prescription and over-the-counter medications. Life stressors such as change in social status, divorce, death of spouse, loss of job, or family problems may have an effect on erectile function. Difficulty in erectile function affects the patient and his partner, so it is important to assess whether the erectile problem is troubling one partner more than the other, and if so, who and why.
Finally, the physician should determine the patient's and the partner's level of understanding of sexual anatomy and function, as well as what expectations each has with regard to treatment outcome. Men with erectile dysfunction and their partners often lack a full understanding of sexual processes or have unrealistic expectations regarding sexual performance and satisfaction.5PHYSICAL EXAMINATIONThe physical examination should assess the patient's overall health.
Particular attention should be given to the cardiovascular, neurologic and genitourinary systems, as these systems are directly involved with erectile function.
The cardiovascular examination should include assessment of vital signs (especially blood pressure and pulse) and signs of hypertensive or ischemic heart disease.
Abdominal or femoral artery bruits and asymmetric or absent lower extremity pulses are indicative of vascular disease. Skin and hair pattern evidence of vascular insufficiency should be noted.The patient's demeanor, dress, speech and overall appearance should be noted for signs suggestive of anxiety or depressive disorders. The superficial anal reflex, indicative of normal somatic function of sacral cord levels S2–4, is assessed by touching the perianal skin and noting contraction of the external anal sphincter muscles. It is performed by placing a finger in the rectum and noting contraction of the anal sphincter and bulbocavernosus muscle when the glans penis is squeezed. External anal sphincter tone can be assessed during this maneuver as well.The genital evaluation should assess for local abnormalities, such as hypospadias or phimosis, and evidence of hypogonadism.
The penis should be palpated to determine the presence of local abnormalities such as fibrous plaques of the fascial covering (Peyronie's disease). The prostate gland should be assessed for size, consistency and symmetry.ADDITIONAL STUDIESIf not previously done, some basic studies should be considered to identify unrecognized systemic conditions that may predispose to erectile dysfunction.
The specific testosterone assay to be obtained is debated.15,17 Testosterone is predominately protein-bound and is influenced by a variety of clinical conditions. An age-adjusted, first-morning, free testosterone level is probably the most accurate measure.17 If the initial testosterone level is low, follow-up studies should include luteinizing hormone and follicle-stimulating hormone levels to differentiate testicular from hypothalamic-pituitary dysfunction. These tests are not usually performed in the family physician's office and are not necessary before the initiation of therapy for most patients.
Many of these tests are subject to significant variation in interpretations and are most appropriate for use in refractory cases.



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