How many men experience erectile dysfunction?
If you think it's just you, consider yourself far from alone as erectile dysfunction impacts over 3 million fellow Canadians over the age of 40. Of those millions, almost half struggle with a severe case relating back to the frequency of the problem.
To understand the problem, we need to understand the cause.
There is a distinct difference between primary and secondary forms of erectile dysfunction.
- Primary. Supplying the tissue of the penis are nerves, arteries, veins and muscles such as the corpus cavernosum. During an erection, these tissues flood with blood and cause the tissue to move from soft to rigid. This is related to nerve signals sent from the brain indicating a state of arousal. Primary dysfunctions occur when the individual has never been able to achieve an erection. This could be due to issues with any of the biological tissues mentioned earlier.
- Secondary. This form of erectile dysfunction means the individual was able to have an erection before, but something has changed and they can no longer maintain one. The causes for this a far more multi-faceted and range from psychological distress including performance anxiety to the use of certain medications including anti-hypertensives or antidepressants. Many companies also market alcohol as nearly synonymous with a 'good time', but it is a depressant which may damage libido and reduce nerve ending sensitivity in the penis. It also dehydrates the body which may reduce blood flow to reproductive tissues.
Could there be any relation to the urinary symptoms I'm having?
If you find yourself struggling with urinary symptoms including an urge to visit the bathroom more frequently, getting up in the night to pee, or trouble starting or stopping your stream, it may be worth considering a diagnosis of benign prostatic hyperplasia (BPH). The condition is so common that some argue the problem is ubiquitous in aging men, though we now know there are some controllable risk factors.
The most common intervention is via the use of a 5α-R inhibitor. The enzyme converts testosterone into its more active and potent form known as dihydrotestosterone (DHT). DHT tends to act on the prostate tissue, causing it to enlarge, but by reducing the activity of this enzyme, you reduce the active DHT levels and mitigate further enlargement. The urethra travels through the walnut shaped prostate gland and when the tissue swells, it can block the urethra and reduce blood flow to the muscles of the penis. This makes it difficult to initiate or maintain an erection, worsening symptoms of erectile dysfunction.
An open, multicentre clinical pilot trial was conducted to determine whether a preparation of an herb known as Prostate 1, synthesized from the berries of saw palmetto (Serenoa repens), could influence symptoms of BPH or sexual dysfunction. This is because saw palmetto acts as a 5α-R inhibitor like the commonly prescribed medications, finasteride or dutasteride.
Over the course of the 8-week trial, the participants took one 320mg capsule of Prostate 1 daily and saw their symptoms improve dramatically.
Their International Prostate Symptom Scores improved by 51% while their ability to '[get] and [keep] an erection' improved by 64% measured with the brief Sexual Function Inventory.
What are some of my options?
- Consider counseling. As a patient or client, your options are far more diverse than they were decades ago. While a discussion with your primary care provider may have been done in private without so much as your partner aware of the visit, things have evolved. Sex therapists are trained to help you work through potential causes of erectile dysfunction through exercises focused on self-exploration and intimacy building. They can also involve the partner, and while this may be frightening, 40% of men in a study felt supported after an initial discussion.
- Physical exam. Visiting your primary care provider for an examination is the first step in determining the cause of your current condition. They can help identify contributing factors by ordering relevant lab tests and helping to determine the next best steps.
- L-arginine + pycnogenol. In a clinical trial, 40 men battling organic erectile dysfunction were followed for three months. Daily supplementation of 1.7g (1,700mg) of L-arginine improved their condition by only 5% following one month of treatment using strictly L-arginine. However, when L-arginine was combined with pine bark extract (Pycnogenol), the success rate dramatically jumped to 80% after the second month of treatment, and 92.5% after the third. It is thought to work by increasing nitric oxide which acts to open up blood vessels, encouraging circulation.
Hopefully this had made you feel more informed about erectile dysfunction and ways to manage your symptoms. Don't forget to check out other helpful articles including 'Difference Between Prostatitis and Enlarged Prostate' and '4 Ways Alcohol Can Affect Your Enlarged Prostate'.
References:
http://www.cssam.com/files/content/VIAG_5205_BetterSexBroch+EHS%20TO_E34.pdf
https://europepmc.org/article/MED/22522969
https://pubmed.ncbi.nlm.nih.gov/12851125/
https://pubmed.ncbi.nlm.nih.gov/17703218/
https://pubmed.ncbi.nlm.nih.gov/19143912/
https://pubmed.ncbi.nlm.nih.gov/30232467/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5914267/
