Erectile dysfunction (ED) and men's sexual health conditions were taboo for the majority of human history. Worse, it wasn't until 1998 that the first well-studied and vetted pharmaceutical treatment emerged in Viagra® (sildenafil), so what was the point of talking about it anyway?
That doesn’t mean that erectile dysfunction went completely untreated before this time, however. Cultures around the world have experimented and relied on all kinds of remedies aimed at improving sexual function, libido, and pleasure. Natural or herbal ED treatments – or purported treatments – have been used consistently across geographies––with mixed results.
From grinding up rhinoceros horn to eating piranha soup, and grilling ants to using toad venom, there have been plenty of audacious “natural” remedies for sexual disorders over the years. Some of the more reasonable and potentially more effective remedies included herbs.
While herbal ED treatments may have been the best (and only) choice for a long time, research suggests that not only are most natural herbs and remedies less effective than newer pharmaceutical medications, but it may be best to avoid them.
What Is Erectile Dysfunction?
Erectile dysfunction is the medical term for when men experience difficulty achieving or maintaining an erection firm enough for sex. Nearly 30 million men are estimated to routinely experience ED in the United States alone, making it a common condition.
While causes can range from physical (heart conditions, diabetes, and high blood pressure are common causes) to psychological (depression, anxiety, and stress all commonly contribute), the right treatments can make a firm erection attainable once again.
The chemical and physical processes that lead to an erection are:
1. Physical, visual, or psychological sexual stimulation or arousal lead to your brain sending chemical messages to various parts of your body.
2. These neurotransmitters, primarily nitric oxide, are sent to the muscles and veins of your penis, which causes a physiological cascade and relaxation.
3. As these muscles relax and blood vessels dilate, more blood is able to flow into the penis. As blood enters the penis in greater volume, soft tissues in the penis full with blood, much like a sponge, and become firm, like a balloon filling with air. During an erection, your penis can contain seven times its normal blood volume.
4. The same muscle response also works to reduce blood flow out of the penis, further contributing to the erection.
5. After orgasm, or when stimulation has stopped, other messengers tell your penile tissues to return to normal, blood flows back into circulation, and the erection begins to soften.
Any disruptions to this delicate process can result in erectile dysfunction. Most often, physical conditions that involve the cardiovascular system or effect blood flow are the major culprits of erectile dysfunction. Diabetes, heart disease, and high blood pressure are all risk factors.
Getting around these disruptions is the primary goal of erectile dysfunction treatments.
How Can You Treat Erectile Dysfunction?
As is the case with most medical conditions, the cause of erectile dysfunction will determine the treatment. But there are a few treatments that can help just about regardless of the cause. While they might not flat out cure the problem, when all three of the following treatment approaches are combined, there's a high likelihood of decreasing the frequency and severity of erectile dysfunction symptoms.
These are the best treatments for erectile dysfunction:
Perhaps the most popular treatment for erectile dysfunction, it’s also the easiest. Originally discovered by accident, phosphodiesterase 5 (PDE5) inhibitors have been around since the late 1990’s, but they've quickly become the “go to” treatment for erectile dysfunction.
While these medications won’t cure the problems leading to erectile dysfunction, they can help most users achieve an erection.
Sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) are all prescription medications that work by improving blood flow into the penis. They work by stopping the enzyme (PDE5) that typically reduces an erection after orgasm. They all require sexual arousal or stimulation to work, but they're effective for the majority of men who try them: the best treatments for erectile dysfunction available today.
Eating a healthier diet and getting more exercise are both helpful in improving your cardiovascular health, which is key to strong erections. Blood flow is crucial to the formation of a firm erection, and a healthier heart with lower blood pressure can both contribute to easier, firmer, and longer-lasting erections.
This strategy is more about dealing with the root causes of erectile dysfunction, and while lifestyle changes can be a powerful positive influence on erectile dysfunction, the effects are not guaranteed.
Being overweight, cardiovascular issues like heart disease and atherosclerosis, and metabolic issues like diabetes are all known risk factors for developing ED.
Work to get about 30 minutes of cardio exercise daily while reducing your sodium and sugar intake and increasing the amount of whole foods, fruits, and vegetables you eat. Cutting back on drinking alcohol and quitting smoking can also dramatically improve overall health and sexual wellness.
Tuning Up Your Mental Health
It’s entirely possible that there is no physical cause for your erectile dysfunction. It may be related to your mental health. If you're feeling depressed, anxious, or chronically stressed, lifestyle changes may not be enough to affect your erectile dysfunction.
Consider seeing a therapist or psychiatrist to help evaluate your mental health.
Herbal Treatments That You Should Probably Avoid
It’s common to see “natural remedies” and herbal supplements being sold as treatments for erectile dysfunction, but a large majority of these are either outright scams or simply promising more than they'll likely delivery.
While there are reasons to believe in the effectiveness of some of these herbs, they're generally little more than folk medicine with scant research supporting their effectiveness.
At least, they certainly don't compare to the demonstrable capabilities of prescription PDE5 inhibitors.
This a list of common herbs associated with treating erectile dysfunction:
- Ginseng has been linked to an increase in alertness and energy, can help with symptoms related to heart disease, and may help to promote the release of nitric oxide, a chemical that’s crucial during the erection process. However, ginseng can interfere with medications for blood pressure and insulin for diabetes. It can also severely boost the effects of caffeine and result in insomnia, headaches, and vertigo.
- Maca root has been linked to reduced stress, which can contribute erectile dysfunction, and extracts improved the overall sexual performance of rats in various studies. However, similar evidence that it affects hormone levels in men has not been forthcoming. Also, maca root contains substances called goitrogens that can interfere with the normal function of the thyroid gland, making it potentially dangerous for anyone with already impaired hormone or thyroid function.
- Yohimbe is thought to help improve blood flow to the penis, in addition to being a possible treatment for depression, but neither of these assertions are backed by thorough research. What has been noted are the side effects associated with yohimbe, which can include increased blood pressure, an elevated or irregular heartbeat, and increased anxiety.
- Ginkgo biloba might be an effective way to increase the flow of blood to the penis, but research has been mixed. Ginkgo biloba does work as a natural blood thinner, which can help to increase blood flow overall, but will also increase the potential for unintended bleeding as well.
- Rhodiola rosea is commonly associated with an increase in energy and reduction in fatigue, which may help with some sexual dysfunctions. It is also commonly associated with dizziness, dry mouth, and excessive saliva production.
- Horny goat weed has been found to improve the erectile function of rats, but this effect has yet to be replicated in humans. Horny goat weed contains icariin, a substance known to have mild PDE5 inhibiting capabilities, like prescription Viagra and Cialis. It’s possible for horny goat weed to work in a similar fashion, and while horny goat weed is one of the more likely "useful" herbs for ED, its impact on erectile dysfunction is still unclear.
Counterfeits and Dangers Of Herbs For ED
Part of the reason that you see so many “natural remedies” and “herbal supplements” to help with erectile dysfunction is that the Food and Drug Administration does not regulate most of these herbal ED remedies to the same extent that they regulate pharmaceutical ingredients.
Prescription medications must be thoroughly tested in large, controlled studies, often over the course of ten years or more. For example, Viagra was discovered in 1989 but wasn’t approved for medical use in the United States or the European Union until nearly a decade later, in 1998. In contrast, an herbal supplement that's considered "Generally Recognized As Safe" or GRAS by the FDA, doesn’t need approval by the FDA and only needs to list its ingredients.
Worse, many brands of natural or Chinese herbs for ED have been the subject of FDA warnings and investigations because they contain regulated substances, including sildenafil. The FDA makes regular warnings on this topic, published throughout the year here.
Plenty of herbs have been used over the centuries to treat erectile dysfunction, but these natural remedies have largely not demonstrated meaningful effectiveness in larger research efforts. That's particularly true when compared to modern medicines like sildenafil (Viagra) and tadalafil (Cialis). While they have the potential to improve the symptoms of erectile dysfunction, the potential for unintended side effects and their poor track record should give you pause.
Prescription ED medications have been used by millions of men since their approval in the late '90s and early '00s, and they've been through rigorous clinical testing. Not only are they more effective at treating erectile dysfunction than traditional herbs, they may be safer, too, when prescribed by a licensed clinician.
They're more affordable and convenient than ever thanks for online pharmacies like Rex MD.
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