Erectile dysfunction can cause a considerable amount of emotional distress by negatively impacting intimate relationships, self-esteem, and overall quality of life.
Frequently Asked Questions
- 1What causes Erectile Dysfunction in men?
- 2How does one reach an erection?
- 3What are the biological causes of erectile dysfunction (ED)?
- 4What are the psychological causes of erectile dysfunction?
- 5What are the symptoms of Erectile Dysfunction?
- 6How is ED managed at Health Renewal?
- 7What are the risks and complications of this condition and its management?
- 8How do I get started?
- 9How often should I see the integrative Doctor?
- 10Why should one not self-medicate?
- 11What integrative supplements are recommended for Erectile Dysfunction?
- 12What in office treatments can be done at Body/Health Renewal?
- 13Is a consultation with a doctor necessary for Sexual Rejuvenation/Erectile Dysfunction/ED?
- 14Health Renewal tip: What lifestyle modifications can significantly improve male sexual function?
Erectile Dysfunction(ED) is the inability to achieve or sustain an erection that allows satisfactory sexual performance. Erectile Dysfunction is not a disease, but a symptom of an underlying problem such as physical, psychological or a mixture of both.
The condition is dependent on one's age and affects up to 60% of men over 40. Erectile dysfunction can cause a considerable amount of emotional distress by negatively impacting intimate relationships, self-esteem, and overall quality of life.
An erection is triggered by a complex interplay between the sympathetic and parasympathetic nervous system. Using visual, tactile, auditory, olfactory or imaginative input may result in local sensory stimulation of the genital area and/or central psychogenic stimulation.
The endothelial cells that line the blood vessels of the penis produce vasoactive factors that dilate the blood vessels, one of which is nitric oxide.
Nitric oxide generates a biochemical force leading to expansion (vasodilatation) of penile blood vessels and allows for increased blood flow into the corpus cavernosum, the two columns of spongy tissue that run along the top length of the penis. As the corpus cavernosum fills with blood it stretches, compressing the primary site where blood exits in the penis. This compression causes resistance to blood flow out of the penis, producing and maintaining an erection.
- Vascular, Neurologic and Hormonal disorders.
- Cardiovascular disease and hypertension contribute to endothelial dysfunction which is the most common contributing mechanism to erectile dysfunction overall. 80% of erectile dysfunction cases are due to cardiovascular disease. Atherosclerosis, the most common vascular disease, delays blood flow to the penis.
- Aging and decline in hormone levels such as testosterone and dehydroepiandrosterone (DHEA) and decline in penile elastic fibers are associated with ED.
- Diabetes may interfere with penile blood flow as well as damage the nerves in the penis.
- Medication including several drugs such as antihistamines, benzodiazepines and tricyclic antidepressants can cause ED. Prescription medications for testing high blood pressure (beta-blockers), depression (Prozac® and Zoloft®), insomnia (Stilnox), heart disease (Statins), prostate enlargement (Proscar®) or cancer drugs to name a few, have side effects that include inducing. Excessive alcohol consumption can affect sexual function especially with aging.
Depression, anxiety, stress, low self-esteem and various other psychological conditions can lead to erectile dysfunction. Psychological problems are often to blame for intermittent erectile dysfunction especially among young men. Older men generally have a mixture of both psychological and biological causes.
Erectile dysfunction itself has been shown to independently increase the risk of cardiovascular disease (CVD), stroke, and all-cause death. Erectile dysfunction often leads to some cardiovascular events, by 2 to 5 years; erectile dysfunction is seen as a potential early warning sign for cardiovascular disease.
It is important for men suffering from erectile dysfunction to discuss their symptoms with their Health Renewal physician. In addition to recommending an effective treatment for the primary complaint of erectile dysfunction, your Health Renewal doctor should also screen for cardiovascular disease. This is because erectile dysfunction and CVD share similar risk factors such as hypertension, aging, obesity and an inactive lifestyle.
Certain pharmacologic treatments given to men for erectile dysfunction such as Viagra® and Cialis® are available however these medications provide a temporary benefit and can cause minor to severe side effects. These include headaches, indigestion, visual disturbances and even blindness.
At Health Renewal, in addition to prescription and neutraceuticals, we offer non invasive treatments which will be incorporated into your treatment plan.
At Health Renewal we also prescribe Intracavernous penile injections. These injections are compounded medications which offer physicians the flexibility to prescribe the appropriate strength, route of administration and combination of active ingredients. This allows us to determine the optimum approach for each patient. Compounding offers a solution when commercially available drugs are not appropriate, or not available. This can improve your health and better quality of life.
At Health Renewal we can also provide carboxytherapy treatments for ED.
The underlying function of erectile dysfunction is tied closely to cardiovascular health. This means that men who wish to perform at their sexual peak must take the necessary steps to optimize their blood vessel health. Studies show that improving cardiovascular risk factors through lifestyle modifications and pharmacologic treatment can improve male sexual function significantly.
A medical consultation with one of the Health Renewal medical doctors is mandatory to ensure a complete medical evaluation before any treatment is started. In addition, certain blood tests may be ordered to exclude medical conditions. Testosterone is best measured in the morning hours and you should have your sample drawn at a pathology laboratory before 9am. For certain conditions, prescription medications may need to be combined with nutraceuticals, penile injections and Carboxytherapy. If indicated, the patient may be referred to a specialist for further evaluation.
Depending on which form of hormone supplementation you and your Health Renewal Doctor have decided on, one could expect to follow up with your physician from anything between every 2 weeks to once every 6 months. All men receiving testosterone therapy must be evaluated at least annually by an ECG and blood pressure test.
For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. Please do not self-medicate. Self-Medicating is done when a person takes prescription medication or neutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified medical practitioner, you could be missing vital deficiencies or conditions such as elevated blood pressure and high sugar levels. In addition, there is no single supplement given to clients as there is no magic bullet that can support all the essential nutrients that one's body needs.
It is important to remember that every patient is treated individually and according to their needs. Please do not self medicate as there is no single supplement given to all clients.
A variety of natural modalities may improve erectile function and male sexual health:
- Pycnogenol, a bioactive compound derived from French maritime bark with vasodilatory properties, has been tested in 5 independent clinical studies and been shown to improve male sexual function.
- Ginseng belongs to the genus Panax, which is a group of slow-growing perennial plants with distinctively fleshy roots. Ginsenosides, the principle active constituents in ginseng, have cardio-protective, immune-stimulatory, anti-fatigue, hepato-protective, and antioxidant effects. In addition, they also increase the synthesis of nitric oxide.
- Ginkgo biloba– Extracts of leaves from the Ginkgo biloba tree have been used in the treatment of asthma, fatigue, circulatory problems, and vertigo. It has more recently been associated with enhanced sexual desire, excitement, orgasm, and resolution, as well as neuroprotective properties.
- Chrysin: The bioflavonoid chrysin is a natural aromatase inhibitor that helps minimize the conversion of testosterone to estrogen.
- Carnitine (including acetyl-L-carnitine [ALC] and propionyl-L-carnitine [PLC]) are natural amino acid compounds. Studies have linked carnitines to a variety of positive effects among men with low testosterone, including improved erection quality/function, orgasm, and general sexual well-being. Carnitines may improve endothelial function by acting as antioxidants in these cells. For this reason, carnitine supplementation may be generally beneficial for cardiovascular health.
- Vitamin D3 deficiency may be a risk factor for erectile dysfunction, since it contributes to arterial stiffness and vascular dysfunction. Vitamin D has also been shown to stimulate the production of nitric oxide.
- B vitamins – Inadequate intake of B vitamins, especially folate, B6, and B12, can contribute to elevated levels of homocysteine. Homocysteine is a metabolic amino acid derivative that can damage endothelial cells and contribute to cardiovascular disease.
Carboxytherapy uses micro injections of Carbon Dioxide (CO2) in the affected area to stimulate the tissues to grow new capillaries. This then replenishes the blood supply, improves circulation to the area and restores the function of the tissues as well as increasing the amount of tissue in the treatment area. The effects of each treatment are accumulative. Skin /Health Renewal are a leading provider of Carboxytherapy in South Africa. Skin /Health Renewal offer well-priced, safe Carboxytherapy treatments administered by qualified and highly trained doctors.
A single session of Carboxytherapy for sexual rejuvenation takes around 5-15 minutes and is tolerated well. This highly sensitive procedure is done by one of our trained doctors at Skin/Health Renewal.
With Carboxytherapy the following conditions are improved;
- Cosmetic appearance as tissues regain plumpness
- Functionality i.e. tissue turgor
- Sensation of the area
- Strength & Size
Usually after 8 to 10 treatments and depending whether the patient is satisfied with the results, a maintenance treatment once every 4 to 6 weeks is recommended in order to maintain results.
A medical consultation with one of the Health Renewal medical doctors is mandatory to ensure a complete medical evaluation before any treatment is started. In addition certain blood tests may be ordered to exclude medical conditions. For certain conditions, prescription medications may need to be combined with Carboxytherapy or Penile Injections. In certain instances the patient may be referred to a specialist for further evaluation.
There are certain modifiable conditions and behaviors that increase the chances of developing this condition. These mainly include lack of physical activity, obesity, use of alcohol, tobacco and illicit drug use. Eating an unhealthy diet low in antioxidants is also linked to erectile dysfunction.
The following lifestyle modifications may improve erectile function:
Regular physical exercise: Studies have shown that exercise can improve erectile function, sexual response, and overall cardiovascular health.
Weight control and diet: Obesity nearly doubles the risk of erectile dysfunction. Obesity affects insulin sensitivity and can eventually lead to Non Insulin dependent diabetes. Raised sugar levels together with hypertension and high cholesterol levels contribute to erectile dysfunction. The Body Renewal Medical Weight loss program which uses hCG off label to safely reduce weight -especially dangerous abdominal fat. 10 to 12 kgs of resistant fat can be safely lost in 4 to 6 weeks if this program is strictly followed.
Weight control and adoption of a healthier diet (such the Mediterranean diet) may reduce this risk. The principles of a Mediterranean diet include high intake of fruits, vegetables, nuts, whole grains, and fish, with low intake of refined grains as well as red and processed meats. In combination with physical activity, a Mediterranean diet may be especially beneficial for men with erectile dysfunction who also have metabolic syndrome. Furthermore, diets rich in antioxidants have been shown to improve penile blood flow, erectile activity, smooth muscle relaxation, and fibrosis.
Stop Smoking: Both smoking and erectile dysfunction have often been associated–individually–with plaque build-up in the arteries, called atherosclerosis. The plaque obstructs blood flow through vessels, causing a host of circulatory problems throughout the body, such as erectile dysfunction.