How to Remedy Erectile Dysfunction Naturally

Erectile Dysfunction (ED) affects up to 70% of aging men and 10% of younger men under forty. The definition of erectile dysfunction (ED) is the inability to obtain or maintain an erection firm enough for sexual intercourse. Historically, admitting to having ED was considered taboo and downright embarrassing until the advent of sildenafil citrate (Viagra) in 1998. Sildenafil liberated men from the stigma of having ED and opened a conversation about a problem that has existed for centuries. 

How Erections Work

A penile erection is a neurovascular (nerve and blood vessel involvement) event influenced by psychological and hormonal factors. During sexual stimulation, sexual thoughts, or nocturnal erections, the neurotransmitter Nitric Oxide (NO) is released from the blood vessels and the part of the central nervous system causing the relaxation of two cylinder-like penile muscles. In addition, NO influences an increase in concentrations of cyclic guanosine monophosphate (cGMP), which after numerous pathways, triggers penile muscle relaxation and simultaneous closing of small veins to trap blood in the muscles resulting in an erection. 

A flaccid penis after ejaculation occurs from two events: a breakdown of cGMP by the enzyme phosphodiesterase - 5 (PDE-5) and an opening of the veins, which let's blood out of the penile muscles, restoring flaccidity. 

The bottom line is that for penile erections to occur, there needs to be a smooth and unobstructed transmission of nerve impulses and blood to the penis, resulting in NO production, which opens up blood vessels that lead to an erect gland.

What are the major causes of Erectile Dysfunction?

ED is caused by psychogenic, vascular, hormonal, neurogenic, or pharmacological reasons. Performance anxiety, where the person fears failing in a sexual scenario, is a common psychogenic cause of ED. Neurogenic causes are related to diseases like Alzheimer's, Parkinson's, stroke, or spinal cord injuries. Finally, surgical prostate removal (also called prostatectomy) is the cause of nerve-related ED, as nerve injury from the procedure is possible despite advances in surgical methods. 

Testosterone (T) has an indirect influence on penile function. While the connection between T and erectile dysfunction is not linear, the master androgen is still significantly involved in penile function in adults. T supports the integrity of the penile muscles and the vasculature that feeds it.  

NO is the key result for optimal erections. NO is produced by the enzyme NO synthase (NOS), found in the inner lining of the blood vessels – the reason why keeping healthy and supple blood vessels is so essential for erectile function.

Metabolic Causes of ED – A Lifestyle Problem

Men with metabolic problems tend to have ED. Metabolic disorders can be identified by abdominal obesity (waist size >40 inches in men), abnormal cholesterol readings on lab tests, hypertension, and blood sugar abnormalities. A common metabolic cause of ED, called metabolic syndrome and insulin resistance from poor blood sugar control, are linked to ED by up to 73%. The good news is that metabolic disorders and insulin resistance can be successfully treated with lifestyle medicine and numerous nutritional methods, leading to better penile function.

Lifestyle Approaches to Better Erections

A sedentary lifestyle, smoking, alcohol or drug misuse, sleep disorders, obesity, and metabolic syndromes have all been associated with erectile dysfunction. Conversely, intensive lifestyle changes that include an XY Wellness approach to diet, and circuit-type resistance training, with 15 to 60-second rest between sessions, has shown to decrease blood glucose, improve insulin sensitivity, cholesterol, triglycerides, and blood pressure, and improve erectile function.

L-citrulline (L-Cit) is known to increase nitric oxide (NO) production via the increase of L-arginine (L-Arg) concentration in the blood and improve endothelial dysfunction in cardiovascular diseases. A few foods, like watermelon and squash, contain a moderate amount of L-Cit. However, supplementation with L-Cit is a better option as getting enough of it from food alone is difficult for better erections.

Resveratrol is a natural antioxidant found in grapes and red wine with benefits for a variety of age-related challenges, including circulatory and sexual health concerns. Studies indicate that resveratrol supplementation may help to ward off the hardening of the arteries while enhancing nitric oxide circulation, erection quality, blood testosterone levels, and sperm count and motility. 

Pomegranate is abundant in the antioxidant anthocyanin—a flavonoid that enhances erection-stimulating nitric oxide bioavailability while promoting arterial health and optimal penile blood flow. As a result, controlled trials have revealed that supplementation with pomegranate may be able to facilitate firm erections and enhanced sexual performance in men with both cardiovascular and erectile function concerns—two challenges that often present simultaneously. 

The botanical Ashwagandha root also has a long history of use and would be considered an adaptogen. Ashwagandha has a history of use as a sexual tonic, particularly for men. Numerous studies have demonstrated that this botanical from India can reduce the stress hormone cortisol and improve testosterone production, leading to better erections.

Closing Thoughts

Lifestyle approaches are medicine and can improve erectile function. While medical treatment for ED with phosphodiesterase Inhibitors – 5 (PDE-5) like Viagra and Tadanafil (Cialis) are good options, they do not treat the cause of the problem. In other words, pharmaceuticals are a "Band-aid" at best. Nutrition, exercise, and other lifestyle methods better address the crux of the problem while improving sexual performance. Lifestyle medicine combined with targeted use of nutritional supplements is what I've seen to improve male sexual function in men of all ages clinically, and often even obtain erections after prostate cancer treatment. As always, let us know how you do and how we can help.

Be Healthy,

Dr. Geo, Co-founder & Medical Director