Category: Erectile Dysfunction

Some men swear by ginseng, particularly Panax ginseng, which is the Asian variety of this gnarled root that has been a mainstay of traditional Asian medicine for centuries. According to the University of Maryland Medical Center, human testing of ginseng’s ability to improve erectile function and fertility has so far been too limited to produce definitive evidence one way or the other.

In its overview of ginseng’s medicinal properties, the medical center cites one small-scale study that produced positive evidence of ginseng’s effect on erectile function. In that study, which had a study group of only 45 men, those who took 900 milligrams of Korean ginseng three times a day had less trouble getting an erection than those who received placebo.

In a somewhat larger study, conducted by South Korean researchers, 119 men were divided into two groups. One group got four 350-milligram tablets of ginseng extract per day, and the other got placebo. At the end of the eight-week study period, those who got ginseng showed improvement in all areas of sexual function.

Happily, the answer to your question is no. Although the incidence of erectile dysfunction increases as men age, many men go through life without experiencing any significant difficulties in getting and keeping an erection. WebMD estimates that roughly 20 million American men experience erectile dysfunction, which leaves a fair amount of the country’s male population unaffected.

That said, it should be noted that most men have an occasional problem achieving an erection, but most such incidents do not persist and can usually be traced to overindulgence in alcohol, extreme stress or fatigue, or to the effects of a medication. In cases where medication appears to be the culprit, substituting another drug or adjusting dosage often alleviates the problem.

The key to staving off ED for most men is to follow the same general advice your doctor offers for healthy living: Eat a well-rounded and nutritious diet and maintain a program of regular physical activity.

Diabetes is one of the leading risk factors for erectile dysfunction. According to the National Diabetes Information Clearinghouse, estimates of the prevalence of ED among diabetic men vary widely, ranging from 20 to 75 percent. And the risk of ED among diabetic men is two to three times what it is for nondiabetics, according to NDIC.

Among all men with erectile dysfunction, men with diabetes tend to develop the problem 10 to 15 years earlier than those who aren’t diabetic. Because diabetes goes untreated in a large number of both men and women, research indicates the ED may be an early indicator of diabetes, particularly in men who are 45 or younger.

As men with diabetes age, the incidence of ED increases fairly sharply, according to WebMD. Among men over the age of 50, ED occurs in 50 to 60 percent of diabetics. Among men 70 and over, ED affects roughly 95 percent of male diabetics.

As macabre — and useless — as it may seem, there have apparently been cases of post-mortem erection, according to Wikipedia. In its entry entitled “Death Erection,” the online encyclopedia points out that most erections after death “have been observed in the corpses of men who have been executed, particularly by hanging.”

Also known as “angel lust” or “terminal erection,” this post-mortem phenomenon is attributed to pressure on the cerebellum that is exerted by the noose. Interestingly, spontaneous erections have been observed among living people who have suffered injuries to the cerebellum or spinal cord.

Death by hanging, whether as a suicide or in an execution, appears to have a traumatic effect on the genitals of both men and women, according to Wikipedia. In women, hanging often causes the labia and clitoris to become engorged with blood.

If by “erection pills” you mean the prescription PDE5 inhibitors, they have proven effective among the vast majority of men who use them. In an overall evaluation of these drugs’ effectiveness published in the July 2013 issue of “P&T Journal,” pharmacology researchers Sharon A. Huang and Janette D. Lie reported that “PDE5 inhibitors have shown consistent improvement in erectile functioning compared with placebo.”

The researchers cited evidence accumulated in multiple clinical trials of specific PDE5 drugs. In 16 clinical trials evaluating the effects of sildenafil, the active ingredient in Viagra, the mean per-patient percentage of successful sexual intercourse was 69 percent with the drug, compared with 35.5 percent with placebo. In 15 trials to assess the effectiveness of vardenafil, the active ingredient in Levitra and Staxyn, the success rate with the drug was 69 percent versus 33 percent with placebo.

Other so-called “erection pills,” widely advertised over the Internet, are mostly of dubious origin and range from ineffective to dangerous, depending on the materials with which they are made. Herbal remedies, such as Panax ginseng and Rhodiola rosea, have proven effective for some users. However, if you decide to try one of these natural remedies, buy the products from a reputable manufacturer of herbal supplements.

Would you believe “it only hurts for a little while?” According to EverydayHealth.com, one study found that about four out of every 10 men reported fleeting pain in the penis after injection. Attesting to the effectiveness and ease of administration of penile injection therapy, that same study found that only a handful of men stopped using the therapy.

Some men on this therapy reported that injecting the medication slowly helps to minimize the discomfort. What generally surprises those who’ve never used this therapy is the fact that it’s self-administered, at least after the first few injections that your doctor or urologist will perform in order to establish the level of medication you’ll need to achieve an erection.

Another way to minimize the pain is to use an auto-injector, a spring-loaded device that inserts the needle (fairly tiny, by the way) very quickly and with a minimum of discomfort.

The first PDE5 inhibitor to hit the market was Viagra, which won FDA approval in 1998. Its active ingredient is sildenafil. Pfizer, the drug’s manufacturer, discovered its ability to facilitate erections by accident while testing a sildenafil compound for the treatment of angina and high blood pressure. While it was only minimally successful at easing the symptoms of angina, the drug readily induced erections in many of the test subjects.

Introduced in 2003, Cialis (tadalafil) was the next PDE5 inhibitor to reach the market. As originally marketed, the pill was longer lasting than Viagra, retaining its effectiveness for up to 36 hours. Five years later, a lower-strength formulation of Cialis came to market. Available in 2.5- and 5-milligram tablets, Cialis for Daily Use is taken daily so that users can achieve an erection whenever the time is right.

Rounding out the family of PDE5 inhibitors are Levitra (vardenafil), which also debuted in 2003; orally soluble Staxyn (vardenafil), approved in 2010; and Stendra (avanafil), approved in 2012.

There is no way that a “complete list” of ED statistics could be presented here or in any other forum with limited space. And “complete list” would seem to imply data from every conceivable health and medical authority across the globe. What we can give you is the data developed from one of the most exhaustive ED studies ever undertaken in the United States.

This study was published in a 2006 issue of “Archives of Internal Medicine” and based its findings on ED-related questions that were posed to 3,566 men who were 20 years or older. It found that ED affects roughly one in every five men over the age of 20 but had a somewhat higher overall rate among Hispanic men. The incidence of ED increased sharply among elderly men, affecting 77.5 percent of those who were 75 or older.

Based on the data collection in this study, the risk of ED increased significantly among men who had one of the following pre-existing conditions: diabetes, obesity, current smoking, and high blood pressure.

Among the medications prescribed for the treatment of erectile dysfunction, the first line of drugs are the so-called PDE5 inhibitors, which include Viagra, Cialis, Levitra, Staxyn, and Stendra. All of these are oral medications designed to be taken 30 minutes to an hour before sexual activity. They work by temporarily blocking the effects of an enzyme known as phosphodiesterase-5, which tends to impede blood flow to the penis and make it difficult to achieve an erection.

The other main category of prescription ED medications covers the drugs that are directly injected into the penis. Like the PDE5 inhibitors, these drugs are designed to maximize blood flow to the penis. They do so by dilating or widening the blood vessels that supply your penis and generally take effect within 5 to 10 minutes after the injection. Medications in this category include the generic injectables alprostadil, papaverine, and phentolamine and brand name drugs that contain one or more of these generics. Brand name medications include Caverject (alprostadil), Pavabid (papaverine), Bimix (alprostadil and papaverine), and Trimix (alprostadil, papaverine, and phentolamine).

If other forms of therapy have been unsuccessful in resolving your erection difficulties, your doctor might refer you to a urological surgeon for a surgical procedure. According to eMedicineHealth.com, such procedures usually are undertaken to accomplish one of three goals:

Implantation of a prosthetic device in the penis. Such a device is usually either malleable or inflatable. With a malleable prosthesis, the man can physically manipulate his penis into an erect or semi-rigid position suitable for intercourse. For an inflatable prosthetic, two cylinders are implanted within the penis along with a reservoir placed beneath the tissue of the lower abdomen and a pump device in the scrotum. When the pump is activated, it draws fluid from the reservoir to fill up the penile cylinders, thus creating an erection.

Reconstruction of the arteries within the penis to increase blood flow, thus making it easier to achieve erection.

Blocking off veins within the penis that carry blood away, thus allowing an erection to be maintained.