Erectile Dysfunction

Overview

Erectile dysfunction (ED) affects up to 30 million American men and is defined as "the inability to achieve or sustain a penile erection sufficient for satisfactory sexual performance." It is typically age-dependent and can cause substantial 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 along with local sensory stimulation. The endothelial cells lining the blood vessels produce nitric oxide to trigger a biochemical cascade leading to expansion (vasodilatation) of penile blood vessels and allowing 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 stretches, it compresses the primary site where blood exits the penis. This causes resistance to blood flow out of the penis, producing and maintaining an erection.

Symptoms & Diagnosis

Achieving an erection requires coordination between many body systems, so there are several ways the process can go wrong. The cause of erectile dysfunction can be biological, psychological, or both.

Biological causes of ED include vascular, hormonal, and neurologic disorders. Cardiovascular disease accounts for up to 80% of ED cases. Atherosclerosis, the most common vascular disease, impedes blood flow to the penis. Cardiovascular disease and high blood pressure contribute to endothelial dysfunction, which is the most common contributing mechanism to ED overall.

Age-related decline in hormone levels (testosterone and DHEA) is associated with erectile dysfunction. Diabetes can damage nerves in the penis and interfere with penile blood flow, leading to ED. Imbalances between the sympathetic and parasympathetic nervous systems are also involved. Medication-induced ED can occur from drugs including antihistamines, benzodiazepines, tricyclic antidepressants, and many others.

Medical Treatment

Several pharmacologic treatments for ED are available (Viagra, Levitra, and Cialis), but these medications provide only temporary benefits and may cause minor to severe side effects such as headache, indigestion, visual disturbances, priapism (painful, prolonged erection lasting more than 6 hours), and even blindness. These drugs improve erectile function by blocking certain enzymes, allowing the erection to persist. However, approximately one-third of men with ED do not respond to these drugs due to low testosterone levels and should have a testosterone blood test. The use of these drugs is contraindicated in some men with cardiovascular disease or those who are currently taking medications such as nitrates.

How We Can Help

The underlying physiology of erectile function is tied very closely to cardiovascular and neurological health. Therefore, men who wish to perform at their sexual peak must take steps to optimize their blood vessel health.

Numerous studies show that improving cardiovascular risk factors via healthy lifestyle modifications and nutritional supplementation can significantly improve male sexual function.

A variety of natural modalities can improve erectile function and male sexual health. At Divine Design, we know that lifestyle modifications can drastically improve ED. Regular physical exercise increases sexual response, neurological input, and overall cardiovascular health. Monitoring weight and diet reduces the risk of obesity and its myriad of associated health concerns. Chiropractic adjustments to address neurology and specific nutritional protocols to address antioxidant and hormone levels can often restore erectile function without the inclusion of side effects so common with the drugs used to treat ED.