Stressful life, alcohol, drugs can affect men’s health and cause erectiledysfunction (ED), impotence. It is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word "impotence" may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm.
  • Decreased sexuality, ED is the repeated inability to get or keep an erection firm enough for sexual intercourse.
  • ED affects 15 to 30 million American men. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 2016, that rate had tripled to 25.3.
  • ED usually has a psychological and physical cause. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED.
  • ED is treatable at all ages.Incidence increases with age: About 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED. But it is not an inevitable part of aging. ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED.
How does an erection occur?

The penis contains two chambers called the corpora cavernosa, which run the length of the organ (see figure 1). A spongy tissue fills the chambers. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa and is surrounded by the corpus spongiosum.
Erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed.
How we diagnose sexual dysfunction, ED?

Patient History
Medical and sexual histories help define the degree and nature of ED. A medical history can disclose diseases that lead to ED, while a simple recounting of sexual activity might distinguish among problems with sexual desire, erection, ejaculation, or orgasm. Using certain prescription or illegal drugs can suggest a chemical cause, since drug effects account for 25 percent of ED cases. Cutting back on or substituting certain medications can often alleviate the problem.
Physical Examination
A physical examination can give clues to systemic problems. For example, if the penis is not sensitive to touching, a problem in the nervous system may be the cause. Abnormal secondary sex characteristics, such as hair pattern or breast enlargement, can point to hormonal problems, which would mean that the endocrine system is involved. The examiner might discover a circulatory problem by observing decreased pulses in the wrist or ankles. And unusual characteristics of the penis itself could suggest the source of the problem.
Laboratory Tests
Several laboratory tests can help diagnose ED. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of free testosterone in the blood can yield information about problems with the endocrine system and is indicated especially in patients with decreased sexual desire and chronic pain syndrome.
Psychosocial Examination
A psychosocial examination, using an interview and a questionnaire, reveals psychological factors. A man's sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse.

How do we treat sexual dysfunction, ED?
Our clinic suggests that treatments proceed from least to most invasive.


Cutting back on any drugs with harmful side effects is considered first. If you think a particular drug is causing problems with erection, tell your doctor and ask whether you can try a different class of pain medicine.

Psychotherapy
Our Center works with several psychologists who treat ED using techniques that decrease the anxiety associated with intercourse. The patient's partner can help with the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety when ED from physical causes is being treated.

Special diet
There are many food and food modification that might help with male health. Our Center offers dietary consultation and can create a special diet for you. This is an example of foods that might be helpful for male health and sexual function: scallions, lamb, sea cucumber, shrimp, bitter melon seeds, ginseng, black beans, kidney beans, yams, lycii fruit. Also recommended:
  • Lamb stew with daikon radish and Chinese black dates.
  • Tea made with walnuts, lotus seeds, pearl barley, Chinese black dates and lycii fruit.
  • Roast and grind bitter melon seeds with rice wine.

Herbal and Folk Medicine
Our Center offers several choices of effective herbal recipes for sexual dysfunction. Here's a quick guide to erectile dysfunction herbs:

Testosterone replacement

Testosterone is a male hormone that amps up sex drive, sperm production, bone density, and muscle mass. Many men worry about declining sex drive as they age—and for good reason. The Mayo Clinic reports that testosterone levels peak in early adulthood and drop about one percent each year after age 30. Testosterone therapy can reduce ED in some men with low levels of natural testosterone, and we use oral, topical and injectable Testosterone treatment after checking Testosterone level in blood. Improvements observed following use of these drugs may be examples of the placebo effect, that is, a change that results simply from the patient's believing that an improvement will occur.
Testopelis a method of special Testosterone pellets placement inside the body into the muscles. Of all of the forms of Testosterone replacement therapy in the US, only one is FDA approved and available to help restore testosterone for 3 to 4 months, sometimes as long as 6 months per dose. TESTOPEL® is not a daily treatment, or even weekly, which is good because guys hate remembering things.

Special Drug Therapy (Viagra, Cialis, Levitra)

In March 1998, the Food and Drug Administration (FDA) approved Viagra, the first pill to treat ED. In August 2003, the FDA gave approval to a second oral medicine, vardenafil hydrochloride (Levitra). Cialis is another medication for sexual dysfunction treatment and for benign prostate hypertrophy. Taken an hour before sexual activity, Viagra, Levitra and Cialis work by enhancing the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow.
While oral medicines improve the response to sexual stimulation, they do not trigger an automatic erection as injections do. Important to note that testosterone level should be corrected before taking those meds. Neither Viagra, Cialis, nor Levitra should be used more than once a day. Men who take nitrate-based drugs such as nitroglycerin for heart problems should not use either drug because the combination can cause a sudden drop in blood pressure.


Acupuncture

Acupuncture is an effective way to improve male’s health. It addresses energy and blood flow in the body. In Traditional Chinese Medicine (TCM), energy (Qi) flows in channels called meridians. These channels course the entire body and supply energy and stimulate blood flow to all areas – including the penis. If a meridian is blocked, there will be stagnation and dysfunction. Acupuncture helps increase the circulation of your body’s Qi energy and blood, encouraging your body to do what it should do naturally. Acupuncture is also a balancing therapy, returning the body, mind and spirit to a balanced state. Used for thousands of years to treat ED, Acupuncture, along with Chinese herbs, offer powerful tools. They can be safely used as a replacement for and along with Western therapies. Many people may be concerned about the placement of needles, but they are not placed in or near sensitive private areas. Needles are placed in the extremities, back and stomach, according to whole body treatment principles. Acupuncture does not have any serious side effects, and because acupuncture reduces stress, you will look better and feel more relaxed.

Injections

Drugs for treating ED can be taken orally, but might be injected directly into the penis, or inserted into the urethra at the tip of the penis. Many men achieve stronger erections by injecting drugs into the penis, causing it to become engorged with blood. Drugs such as papaverine hydrochloride, phentolamine, and alprostadil (marketed as Caverject), Trimex widen blood vessels. Botox (Dysport, Xeomin) also help with ED.

Vacuum Devices

Mechanical vacuum devices cause erection by creating a partial vacuum, which draws blood into the penis, engorging and expanding it. The devices have three components: a plastic cylinder, into which the penis is placed; a pump, which draws air out of the cylinder; and an elastic band, which is placed around the base of the penis to maintain the erection after the cylinder is removed and during intercourse by preventing blood from flowing back into the body. One variation of the vacuum device involves a semi rigid rubber sheath that is placed on the penis and remains there after erection is attained and during intercourse.

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