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Erectile dysfunction (ED) affects the lives of many middle-aged men and their partners. The term erectile dysfunction covers a range of disorders, but usually refers to the inability to obtain an adequate erection for satisfactory sexual activity. Although erectile dysfunction, formerly called impotence, is more common in men older than 65, it can occur at any age. An occasional episode of erectile dysfunction happens to most men and is normal. As men age, it's also normal to experience changes in erectile function. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections. Erectile dysfunction may also be a sign of a physical or emotional problem that requires treatment.

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Erectile dysfunction was once a taboo subject, but more men are seeking help. Doctors are gaining a better understanding of what causes erectile dysfunction and are finding new and better treatments.

This Website discusses all about erectile dysfunction, physiology of the normal erection and the pathophysiology, and treatment of ED.

What is Erectile Dysfunction?

Erectile dysfunction or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. There are various underlying causes, such as diabetes, many of which are medically reversible.

The causes may be physiological or psychological viagra price comparison. Psychological impotence can often be helped by almost anything that the patient believes in; there is a very strong placebo effect.

Due to its embarrassing nature and the shame felt by sufferers, the subject was taboo for a long time, and is the subject of many urban legends. Folk remedies have long been advocated, with some being advertised widely since the 1930s. The introduction of perhaps the first pharmacologically effective remedy for impotence, sildenafil (trade name Viagra), in the 1990s caused a wave of public attention, propelled in part by the news-worthiness of stories about it and heavy advertising.

The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. It is now mostly replaced by more precise terms.

Signs and symptoms:

Erectile dysfunction is characterized by the inability to maintain erection. Normal erections during sleep and in the early morning suggest a psychogenic cause, while loss of these erections may signify underlying disease, often cardiovascular in origin. Other things leading to erectile dysfunction are diabetes mellitus (causing neuropathy) or hypogonadism (decreased testosterone levels due to disease affecting the testicles or the pituitary gland).

Here are some causes of Erectile Dysfunction:

* Arousal: The first step is sexual arousal, which men obtain from the senses of sight, touch, hearing and smell, and from thoughts about viagra price comparison.

* Nervous system response: The brain communicates the sexual excitation to the body's nervous system, which activates increased blood flow to the penis.

* Blood vessel response:. A relaxing action occurs in the blood vessels that supply the penis, allowing more blood to flow into the shafts that produce the erection.

Physiology of normal erections:

Penile erections involve an integration of complex physiologic processes involving the CNS, peripheral nervous system, and hormonal and vascular systems. Any abnormality involving these systems, whether from medication or disease, has a significant impact on the ability to develop and sustain an erection, ejaculate, and experience orgasm. Tumescence, the vascular filling of the cavernous bodies, relies on neural and hormonal mechanisms operating at various levels of the neural axis. This is unique among visceral functions because it requires central neurological input.

Andersson et al viagra price comparison summarized some of the information related to the pathways involved in erectile function. The degree of contraction of corpus cavernosal smooth muscle determines the functional state of the penis. The balance between contraction and relaxation is controlled by central and peripheral factors that involve many transmitters and transmitter systems. At the cellular level, smooth muscle relaxation occurs following the release of acetylcholine from the parasympathetic nerves.

Pathophysiology of erectile dysfunction:

Erectile Dysfunction is essentially a vascular disease. It is often associated with other vascular diseases and viagra price comparison conditions such as diabetes, hypertension, and coronary artery disease. Other conditions associated with Erectile Dysfunction include neurologic disorders, endocrinopathies, benign prostatic hyperplasia, viagra price comparison, and depression. Conditions associated with reduced nerve and endothelium function, such as aging, hypertension, smoking, hypercholesterolemia, and diabetes, alter the balance between contraction and relaxation factors. These conditions cause circulatory and structural changes in penile tissues, resulting in arterial insufficiency and defective smooth muscle relaxation. In some patients, sexual dysfunction may be the presenting symptom of these disorders.

Treatment:

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Ayurveda Remedies for Erectile Dysfunction

Author: Dr.Savitha Suri

Article source: http://www.hotlib.com/. Used with author's permission.

Definition of Erectile dysfunction

Erectile dysfunction (ED) is the inability of a man to achieve or maintain an erection sufficient for his sexual needs or the needs of his partner. Erectile dysfunction is sometimes called as "impotence".

The term "erectile dysfunction" can mean the inability to achieve erection, an inconsistent ability to do so, or the ability to achieve only brief erections.

Ayurveda defines Erectile dysfunction or ED as follows.

Sankalpapravano nityam priyaam vashyaamapi sthreeyam ||
na yaathi lingashaithilyaath kadaachidyaathi vaa yadi |
Shwaasaarthaha swinnagaatrshcha moghasankalpacheshtitaha ||
mlaanashishnashcha nirbeejaha syodetat klaibyalaxanam |

This means even though a man has a strong desire to perform sexual act with a cooperative partner , he can not perform sexual act because of looseness (absence of erection ) of his phallus ( penis). Even if he performs sexual act with his determined efforts he does not get erection and gets afflicted with tiredness, perspiration and frustration to perform sex Physiology of erection

The two chambers of penis (corpora cavernosa,) which run throught the organ are filled with spongy tissue. 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 semen runs along underside of the corpora cavernosa.

Due to sensory or mental stimulation, or both, the erection begins. Due to impulses from brain and local nerves the muscles of corpora cavernosa relax and allow blood to flow in and fill the spaces of spongy tissue.

The flow of blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the chambers, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection recedes.

In ayurveda physiology of erection and ejaculation is described as follows

Vrishunow basthimedram cha naabhyuuru vankshnow gudam|
Apaanasthaanamantrasthaha shukra mootra shakrunti cha||

The "apaanavayu" one of the five types of vayu is located in the testicles, urinary bladder, phallus, umbilicus, thighs, groin, anus and colon. Its functions are ejaculation of semen, voiding of urine and stools".

Shushruta explains the process of erection and ejaculation as " When a man has desire (iccha) to have sex, his response to touch increases ( Vayu located in skin causes flow of signals from skin to brain, thus causing sensation of touch). This causes arousal or "harsha" . Arousal or Harsha intensifies actions of vayu and at this moment highly active vayu liberates the "teja "or heat of pitta. Thus tejas and vayu increase body temperature , heart beat and blood flow causing erection. "

Causes of ED

Erection requires a sequence of events. Erectile dysfunction can occur when any of the events is disturbed. Nerve impulses in the brain, spinal column, around the penis and response in muscles, fibrous tissues, veins, and arteries in and around the corpora cavernosa constitute this sequence of events. Injury to any of these parts which are part of this sequence ( nerves, arteries, smooth muscles, fibrous tissue ) can cause ED.

Lowered level of testosterone hormone: The primary male hormone is testosterone. After age 40, a man's testosterone level gradually declines. About 5% of men that doctors see for erectile dysfunction have low testosterone levels. In many of these cases, low testosterone causes lower sexual interest, not erectile dysfunction.

The whole male body responds to testosterone.

Even sushruta has illustrated about this response of body to the element "Shukra" . He has said

"yatha payasi sarpistu goodashchekshow raso yatha shareereshu tatha shukram nrinaam vidyaadhbishagwara"

This means " The shukra ( the element which helps in reproduction) is present all over the body .

This can be explained with the following examples:

1. The ghee is present in milk in an invisible form. This is extracted from milk using many processes.

2. The sugar is present all over the sugarcane. It is extracted by subjecting the sugarcane to number of processes.

Same way shukra is present all over the body. But the cream of shukra (semen) comes out of the body only during the process of ejaculation. But this process of ejaculation needs a joyful union of mind and body.

Decrease in production of "Shukra" causes erectile dysfunction.

Over exertion - physically and mentally : Working for long hours in office, mental stress at office and home, short temperedness ,insufficient sleep cause erectile dysfunction.

These causes are explained in ayurveda as "shoka chintaa, bhaya, traasaat .... " which means that erectile dysfunction or Impotence occurs due to grief, fear, anxiety and terror.

Strained relationship with sexual partner: Erectile dysfunction also occurs when there is a disliking towards sexual partner.

Ayurveda describes this as "naarinaamarasamjnatwaat..." means disliking for women.

Diseases that cause Erectile dysfunction: Neurological disorders, hypothyroidism, Parkinson's disease, anemia, depression, arthritis, endocrine disorders,diabetes, diseases related to cardiovascular system also become reasons for erectile dysfunction..

According to ayurveda the diseases which cause erectile dysfunction are "Hritpaandurogatamakakaamalashrama..." - Heart diseases , anemia , asthma , liver disorders , tiredness .Apart from these the imbalance in tridoshas also cause impotence or erectile dysfunction.

Consumption of medicines, drugs and tobacco: Using antidepressants, tranquilizers and antihypertensive medicines for a long time, addiction to tobacco especially smoking, excessive consumption of alcohol, addiction to cocaine, heroin and marijuana cause erectile dysfunction.

In ayurveda texts these causes have been said in brief as "rukshamannapaanam tathoushadham" - "dry food , drinks and medicines" cause impotence or erectile dysfunction.

Trauma to pelvic region: accidental injury to pelvic region and surgeries for the conditions of prostate, bladder, colon, or rectal area may lead to erectile dysfunction.

These causes are mentioned as abhighata (trauma), shastradantanakhakshataha (injury from weapons, teeth and nail.) in ayurveda.

Other reasons: Obesity, prolonged bicycle riding, past history of sexual abuse and old age also cause Erectile dysfunction.

Ayurveda describes the cause of impotence or erectile dysfunction due to old age as follows. " diminution of - tissue elements, strength, energy, span of life, inability to take nourishing food, physical and mental fatigue lead to impotence" Remedies for ED

ED is treatable at any age. The total treatment in for impotence is called as " Vajikarana therapy" in ayurveda. As this therapy increases the strength of a man to perform sexual act, like a horse, it is called 'Vaajikarana'. ( ' Vaaji'=Horse.)

Vaajikarana therapy leads to

• Happiness.
• Good strength.
• Potency to produce healthy offspring.
• Increased span of erection.

Eligibility for vajikarana therapy.

1. The vajikarana therapy should be administered to persons who are between 18 to 70 years of age.

2. These therapies should be administered only to a self controlled person. If this therapy is administered to a person who does not have self control, he becomes nuisance to society through his illegitimate sex acts.

Psychotherapy

Decreasing anxiety associated with intercourse, with psychologically based treatment helps to cure ED. 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.

Same treatment is illustrated in ayurveda. It has been said "A woman who understands a man and is liked by him, along with erotic environment act as best aphrodisiac."

Drug Therapy

Numerous herbal preparations are mentioned in Ayurveda to treat ED or impotence. It has been said that people who have strong sexual urge, who want to enjoy sex regularly have to consume these preparations regularly to replenish the energy, vigor, stamina and strength. These preparations also supply the nutrients which are necessary for production of semen.

Ayurveda tips to overcome ED

1. Consuming herbal preparations to rejuvenate the reproductive organs.

2. Massaging the body with a herbal oil which gives a relief from physical exertion and also acts as aphrodisiac.

3. Practicing Yoga and Meditation to overcome mental exertion and to cope up with stress.

4. Sleep at least for 8 hours a day.

5. Avoiding the consumption of alcohol, tobacco, heroin etc.

6. Exercise regularly.

7. Avoid hot, spicy and bitter foods.

8. Favor sweets, milk products, nuts and urad dal.

9. Add little ghee in your diet.

10. Give a gap of four days between two consecutive intercourses

Biography of Dr. SavithaSuri
Dr. SavithaSuri has done her graduation in Ayurvedic Medicine and Surgery (B.A.M.S) from Government college of Indian Medicine in 1988, Mysore University. Mysore, Karnataka, India. She is practicing Indian System of Medicines since 16 YRS and she has also contributed health related articles and articles about ayurveda in state level newspapers, magazines and, health related web sites. Dr. SavithaSuri is a regular health columnist to a regional newspaper.

Website http://www.ayurhelp.com/

Email mailto:doctor@ayurhelp.com


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