Erectile Dysfunction

Erectile dysfunction (ED) refers to the inability of men to attain and maintain an erect penis with sufficient rigidity to allow sexual intercourse. It occurs in middle-aged men and is common after the age of 65. Patients need to discuss this matter frankly with their doctor.

Erectile dysfunction, also known as impotence, is characterized by difficulty in maintaining an erection for satisfactory sexual activity. Impotence refers to the state of being impotent, which is an abnormal physical or psychological condition where a male cannot copulate due to the inability to have or maintain an erection. Sometimes, the term impotence is also used for a condition where a man can have an erection but cannot ejaculate semen.

Erectile dysfunction is a complex multi-system disorder with a variety of vascular, neurogenic, hormonal, pharmacological, or psychogenic causes.

Causes: Causes of erectile dysfunction are divided into psychological and physical categories.

With Reduced Libido:

• Hypogonadism: Functional incompetence of the gonads, especially in males, with subnormal or impaired production of hormones and germ cells.
• Depression

With Intact Libido:

• Psychological problems, including anxiety
• Vascular insufficiency (atheroma)
• Diabetes mellitus
• Alcohol excess
• Multiple sclerosis
• Drugs like β-blockers and diuretics (Thiazide)

If the patient has erections upon waking in the morning, vascular and neuropathic causes are less likely. Stress and strain can also contribute to erectile dysfunction.

A variety of mechanical/prosthetic devices and surgeries have been used for erectile dysfunction, but drug therapy has made a significant impact recently.

Symptoms: Absence of the urge to engage in sex, and failure to achieve an erection.

Herbs Useful for Treating ED:

• Panax Ginseng: Effective for erectile dysfunction, particularly red ginseng, often called "Herbal Viagra." Side effects include insomnia.
• Pinus pinaster: Requires long-term administration. Side effects include mouth ulcers, dizziness, and headache.
• Safed Musli (Chlorophytum arundinaceum): Prescribed for impotence and debility. Acts as a aphrodisiac tonic, refrigerant, and anti-fatigue. It provides strength and vigor (Ref: Wealth Of India, rev Vol 3, 1992,482; Materia Medica based on Ayurveda, Saukhyam of Todarananda, commentary by Vaidya Bhagwan Dash et al., 1980, 50; Indian Herbal Therapies – C.P. Khare).
• Nutmeg (Myristica fragrans): Treats debility and impotence (Ref: Dravyagun Vigyan, Indian Materia Medica).
• Salabmishri (Orchis latifolia): Acts as a vitalizer, nervine, and brain tonic. It is restorative, invigorating, and aphrodisiac, used in diseases related to weakness or sexual powers (Ref: Indian Materia Medica, Charak Samhita).
• Konch (Mucuna prurita seeds): Aphrodisiac, prescribed for impotence (Ref: Dravyagun Vigyan).
• Yohimbe: Found in the bark of an African tree. Studies show promising results for erectile dysfunction, but side effects include kidney failure and heart attack. It should be taken only with a doctor’s prescription.
• Saw Palmetto: Used for erectile dysfunction due to an enlarged prostate. However, clinical trials show it is not effective for dysfunction due to an enlarged prostate.

Consult a doctor before taking these herbs.

Natural Home Remedies

1. Garlic (Allium sativum): Take 2 to 3 crushed garlic cloves with honey three times a day. Garlic acts as a powerful aphrodisiac, increasing hydrogen sulfide production, which helps relax blood vessels. Allicin in garlic stimulates blood flow. Remove the outer layer of garlic, boil 5 to 6 de-skinned cloves in a cup of milk, add sugar, and take twice daily.
2. Papaya (Carica papaya): Advisable as it contains arginine, which is also present in Viagra.
   
3. Black Gram with Onion (Allium cepa) juice: Take once a day.
   
4. Dried Dates: Have aphrodisiac properties.
   
5. Black Raisins: Advisable.
   
6. Herb Mixture: Take a mixture of Bala, Ashwagandha, Vidari, and Safed Musli twice a day with lukewarm milk (for quantity, contact the author).
   
7. Saffron Milk: Add a pinch of saffron to a cup of hot milk and drink before bed.
   
8. Garlic Paste: Crush garlic, make a paste, and add one-fourth of the paste to hot milk. Drink twice a day. Garlic increases blood supply.
   
9. Garlic and Honey: Make a paste of garlic, add honey, and take one teaspoon twice a day.
   
10. Pomegranate Juice: Drink twice daily.
    
11. Herbal Mixture: For psychological issues, mix Shankhapushpi (Convolvulus pluricaulis), Brahmi (Bacopa monnieri), and Jatamansi (Nardostachys jatamansi). Take 1 teaspoon of this mixture in 2 cups of water, boil until reduced by half, filter, and drink once a day.

Use flaxseed oil for cooking. It has been observed that individuals with erectile dysfunction often have low levels of zinc. Foods rich in zinc include dairy products, pumpkin seeds, sunflower seeds, peanuts, and brown rice. Ashwagandha (Withania somnifera) churna (1 teaspoon) taken twice daily with milk is advisable.

L-Arginine: An amino acid found in dairy products and fish that helps expand blood vessels. Side effects include nausea, vomiting, diarrhea, and stomach cramps. Contraindicated for people taking Viagra or blood pressure medication.

Additional Tips

• Give a gap of four days after each intercourse.
• Include ghee in your meals.
• DHEA: A steroid hormone naturally produced by the body, helps in conditions with low testosterone levels, which are rare and unlikely to cause erectile dysfunction. DHEA can produce side effects like acne and reduced HDL (good cholesterol).

What to Do (DO’s)

• Take Abhyanga (bath) with medicinal herbs after consulting an Ayurvedic doctor.
• Proper physical exercise followed by relaxation is advisable.
• Perform certain yoga postures after consulting a yoga teacher.
• Massage the body with Shree Gopal oil (Ayurvedic oil), including the pubic area.

What to Avoid

• Avoid oily and spicy food.
• Prevent indigestion and constipation.
• Avoid working in a stressful atmosphere.
• Avoid exercise before sexual performance.

Partner's Role

A sympathetic partner can help overcome this problem and may increase the confidence level of the person affected by erectile dysfunction.

Granthokta Preparations

• Dhatupoushtic Churna
• Musali Pak
• Ashwagandha Lehyam
• Shilajit Capsule
• Manmath Ras

Though I have mentioned the quantity of ingredients in some natural home remedies, it is advisable to consult an Ayurvedic physician before use.