Sunday, May 22, 2016

Erectile Dysfunction and Diabetes

The average man has several erections each day and night. The average male will have three to five sporadic erections throughout the night, and the last erection is the one that is noticed in the morning.

Not having a morning erection is an indicator of low testosterone levels, or a lowered libido, which is the psychological component in your sex drive. You can check your testosterone levels by undergoing a simple blood test from your doctor, which will determine the amount of hormones you have.

Most men will have a morning erection throughout their lifetime, and the frequency usually decreases with age. If you are consistently not having an erection when you wake, visit a urologist. They will be able to determine and rule out any physical problems, as sometimes morning impotence can be caused by emotional reasons as well.
Given the increase in diseases such as heart disease, diabetes, and obesity that cause damage to the cardiovascular system, it's not a surprise that there is an increase in health issues such as erectile dysfunction (ED) in men and sexual dysfunction in women.  These sexual health problems are primarily due to insufficient blood flow and poor arterial/venous circulation created by many years of poor eating habits, a sedentary lifestyle, fatigue, and stress. In fact, one in 10 men will suffer from ED at some point in their lives. Because of the connection to manhood, erectile dysfunction poses a serious problem to a man's self esteem.

The causes of erectile dysfunction in men with diabetes are complex and involve impairments in nerve, blood vessel and muscle function. Erectile Dysfunction (ED)

To get an erection, men need healthy blood vessels, nerves, male hormones, and a desire to be sexually stimulated. Diabetes can damage the blood vessels and nerves that control erection.

Therefore, even if you have normal amounts of male hormones and you have the desire to have sex, you still may not be able to achieve a firm erection.

Pathophysiology of Erectile Dysfunction
Penile erection is managed by two mechanisms: the reflex erection, which is achieved by directly touching the penile shaft, and the psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain.

In both conditions, an intact neural system is required for a successful and complete erection. Stimulation of the penile shaft by the nervous system leads to the secretion ofnitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection.

Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy erectile system. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system (i.e. diabetic neuropathy), lack of adequate penile blood supply or psychological problems. Restriction of blood flow can arise from impaired endothelial function due to the usual causes associated with coronary artery disease and diabetes. Long-term diabetic neuropathy that leads to autonomic neuropathy may affect erections.

The good news is that since the majority of ED cases is due to cardiovascular issues, then, ED can be best addressed with dietary changes that improve the cardiovascular system and endothelial function.

Key Point: The real key to successfully treating ED is to determine what is causing the ED; and, then, treat the cause instead of the symptoms. For example, depending on whether the cause is biochemical, hormonal, physical, or psychological will determine the best treatment strategy. Unfortunately, some men are reluctant or embarrassed to discuss sexual matters with their doctor. As a result, they miss an opportunity to get the help that could resolve their problem with ED, or even worse, miss the opportunity to discover and address a potentially serious health issue that may be causing ED. So, they tend to opt for something convenient like a pill.

What Treatments Are Available for Men With Diabetes and Erectile Dysfunction?

Men with diabetes having trouble with achieving and/or maintaining an erection can take oral medicine like Viagra, Cialis or Levitra.

However, because people with diabetes also tend to have problems with their heart, these medications may not be appropriate and cause dangerous interactions with your heart medicine.

Additional treatments men with diabetes might want to consider include intracavernous injection therapy, vacuum constriction devices, intraurethral therapy, and sex therapy.

So what treatment is best? It depends on many factors including whether a man is willing to change his diet or just take a pill. You can have your doctor refer you to a specialist (a urologist) to work with you and determine the best treatment for your situation, but, in most cases, the answer will either be a pill or surgery.

How High Blood Pressure Leads to Erectile Dysfunction

Since high blood pressure can lead to erectile dysfunction, actually, this may be good news! Why? Because you can get rid of high blood pressure by following a plant-based diet such as the Death to Diabetes program.

To understand how high blood pressure can lead to erectile dysfunction, you first have to understand how erections work. Getting an erection is really a complicated process.

Anatomy of an Erection
In the shaft of the penis there are two side-by-side chambers of spongy tissue called the corpora cavernosa. They're mainly responsible for erections. Just below them is another chamber called the corpus spongiosum. The urethra, which carries semen and urine, runs through the center of it.

The corpora cavernosa are made of small arteries and veins, smooth muscle fiber, and empty spaces. The chambers are wrapped in a sheath of thin tissue.

When you get an erection, nerve signals from your brain or from the nerve endings in your penis cause the smooth muscle of the chambers to relax and arteries to dilate, or open wider. This allows a rush of blood to fill the empty spaces.

The pressure of blood flow causes the sheath of tissue around the chambers to press on veins that normally drain blood out of the penis. That traps blood in the penis. As more blood flows in, the penis expands and stiffens, and you have an erection.

When the excitement ends, the smooth muscle contracts again, taking pressure off the veins and allowing blood to flow back out of the penis. Then the penis returns to a flaccid state.

High Blood Pressure and Other Causes of Erectile Dysfunction

High blood pressure is a major cause of erection problems. A study in the Journal of the American Geriatrics Society found that about 49% of men ages 40 to 79 with high blood pressure had erectile dysfunction. Cardiovascular System

A more recent study of men with high blood pressure, published in the Journal of Urology in 2000, found that 68% of them had some degree of erectile dysfunction. For 45% of the men, it was considered severe.

High blood pressure keeps the arteries that carry blood into the penis from dilating the way they're supposed to. It also makes the smooth muscle in the penis lose its ability to relax. As a result, not enough blood flows into the penis to make it erect.

Men with high blood pressure may also have a low testosterone level. Testosterone is the male hormone that plays a big role in sexual arousal.

High blood pressure by itself can lead to erectile dysfunction especially if you are clogging your arteries with processed foods, fast foods, fried foods, other high fat foods, and excess animal meat.

In addition, some drugs that are prescribed for treating high blood pressure can actually cause erectile dysfunction as well.

Diuretics -- or water pills -- and beta-blockers are the high blood pressure drugs most commonly linked to erectile dysfunction.

Diuretics may cause erectile dysfunction by decreasing the force of blood flow into the penis. They may also decrease the amount of zinc in the body. Your body needs zinc to make testosterone.

Beta-blockers dampen the response to nerve impulses that lead to an erection. They also make it more difficult for the arteries in the penis to widen and let in blood. What's more, they can make you feel sedated and depressed -- and the mind always plays some part in sexual arousal.

Sometimes, the choices that some men with high blood pressure make can add to the problem. Smoking, especially, is one of those. Smoking increases blood pressure, and damages blood vessels and reduces blood flow all around the body.

The power to take control of your blood pressure and your sexual health is in your hands. By changing your diet (to plant-based) and by living a healthy lifestyle (with consistent exercise, less stress, and quality sleep), there's a chance you'll once again be able to have normal sexual function.

Low Testosterone

In general, large spikes in blood sugar can reduce a man's level of circulating testosterone by about a 25% whether he is diabetic or not. However, we don't recommend testosterone shots to counteract this. Instead, just follow a healthy dietary program and exercise regularly, including weight resistance training.Doctors need accurate testosterone testing to see whether men are hypogonadal and require testosterone supplementation. Because testosterone may be tied to blood-sugar levels, some  men with low testosterone levels may need to be reevaluated in the fasting state.
Both men and women need optimal testosterone levels. While the average male has ten times more testosterone than a female, females are much more sensitive to the hormone. Whether you’re a man or woman, testosterone is responsible for many of the body’s functions. A very short list of these include:
  • sexual desire
  • bone strength
  • mental and physical energy
  • protein synthesis
  • hair growth
  • muscle growth
  • fat loss
With testosterone being such an important hormone, you should be doing everything you can to keep this powerful androgen at optimal levels. How do you do that? The following are 7 ways you can naturally boost testosterone levels.
Lift heavy weights. Lifting those pink 5 pound dumbbells isn’t going to cut it. You need to be using heavy weights with compound movements that recruit maximum muscle fibers. Exercises like bench press, squats, and dead-lifts should be staples in your exercise routine. Push yourself hard in the gym and try to keep your rest intervals around 90 seconds or so. Studies have shown that resistance training coupled with short rest intervals boost testosterone and growth hormone production.
Do sprints. Sprints are one of the best full body fat burning exercises. No other exercise puts your entire body at 100% intensity for an extended period of time. All the lactic acid that is produced from sprinting is correlated with testosterone production. That burning sensation you get in your muscles when you are lifting weights – lactic acid.
When your demand for energy is high (such as when sprinting), your levels of lactate rise faster than your body can remove it. This causes lactic acid levels to rise. This lactate production is a sure sign that you are working out with enough intensity to boost testosterone production.
Eat (healthy) fat. Fats, especially saturated and monounsaturated fats have been shown to be correlated with testosterone levels. Healthy fats like those in nuts and seeds aid in the production of testosterone. Essential fatty acids also need to be ingested through your diet. If you aren’t getting enough, consider supplementing with an omega-3 oil. And yes, even saturated fat plays a vital role in our bodies. It’s the trans fat that you need to avoid. A diet consisting of 20-30 percent fat seems to be the sweet spot to boost testosterone levels. Make sure you are eating fat. Eating fat does not make you fat! Eating too many calories and processed foods will.

Tip: Avoid high fat meals before sex. Excess fat intake lowers testosterone levels in your body, decreases libido and makes erection and ejaculation more difficult.

Tip: Ingest zinc every day by eating foods such as liver, seafood, peas, and beans; or, take a zinc supplement. Zinc is vital for production of testosterone, seminal fluid and sperm.
Eat enough food. When you don’t eat enough food, your body’s starvation mechanisms start to show themselves. When your body senses famine ahead, it has no need to reproduce, and as a result, it shuts down testosterone production. Make sure you are eating enough calories. This is one of the top reasons diets fail. Once you start cutting calories too low, it causes a cascade of negative reactions in the body, none of which are beneficial to your fat loss goals. Eat at least 10 calories per pound of body weight. There really is no reason to go below this number unless you are either morbidly obese, or you’re not exercising.
Make sure you rest and recover. Rest and recovery are probably the most overlooked aspects of a fitness program. In order to be successful, you need to place equal importance on your diet, exercise, and recovery. Make sure you are getting at least 7-8 hours of sleep every night, and that you are going to sleep at similar times every night. Studies have shown that circulating testosterone levels can drop by more than 40% as a result of under-recovering. If you are lifting heavy, give your muscles enough time to recover. Soreness is usually a good sign that you need more rest. At the beginning of a fitness program, you might be sore for a longer period of time until your body adapts to the new stresses placed on it. Don’t get ahead of yourself at the beginning. Give yourself ample time to recover.
Eat low-glycemic foods. Research has shown that blood sugar levels are tied to testosterone production. High levels of blood sugar can cut circulating testosterone by as much as 25%. So how do you keep your blood sugar levels low? One way is to not eat any carbohydrates. Unfortunately, this isn’t the ideal scenario for most people. Carbohydrates are needed to fuel high intensity exercise and resistance training. And as you already read, heavy weight lifting and sprints, both of which use carbohydrates as fuel, are two ways to effectively increase testosterone production.
The other way to keep your blood sugar “low” is to eat low glycemic carbohydrates such as vegetables, legumes, and whole grains. These foods are digested slowly, and they produce a nice steady drip of glucose into the bloodstream. Eat whole foods with plenty of fiber, and you should be on the right track.
Lower your body fat. Your body fat levels are inversely correlated with testosterone levels. What this means is that as your body fat rises, your testosterone levels decrease. Fat cells produce estrogen. The more fat you have, the more estrogen is produced, and the more testosterone is suppressed. You need to make sure you are working towards a goal of having a lower body fat percentage. The more fat you put on, the more of an uphill battle it becomes to lose fat.
Use the ways (listed above) to naturally boost testosterone levels. You’ll notice that they all seem to have something in common – they all have to do with your diet and exercise. Nearly every hormone in your body can be manipulated through diet and exercise. No need for supplements or prescription drugs. If you have low testosterone levels, more than likely your problem stems from a lack of optimizing one of the 7 natural ways to boost testosterone listed above. Use as many as you can, you have no reason not to.

Ways to Treat Erectile Dysfunction

There are many new products on the market that claim to help men improve and maintain stronger and longer erections. These products include drugs (i.e. Viagra, Cialis, Levitra), vacuum pumps, surgical penile implants, injection therapy (i.e. injectable drug alprostadil), constriction rings (aka cock rings), suppository (inserted into the urethra), vascular surgery (very risk!), and hormone therapy (with testosterone injections, bio-identical hormones, patches, or gels applied to the skin to improve mood and sex drive) -- but, they all come with some risk and some can be quite expensive.
Before opting for one of these products, consider one or more of the following natural alternatives first.

Eat well. 
Simple changes in your diet can increase your libido and give you a harder erection. Foods like bananas, eggs, nuts, figs, chillies, onions, and (a little) wine can increase your sexual prowess. Word of caution: Steer clear of junk food and fast food.

Ingest zinc. Eat foods such as oysters, liver, seafood, peas, and beans; or, take a zinc supplement. Zinc is vital for production of testosterone, seminal fluid and sperm.

Supplements. In addition to zinc, supplements such as l-arginine and magnesium will help to improve circulation. L-arginine is known to relax the muscles in the penis, allowing enhanced blood flow and leading to an erection. L-arginine is found naturally in meat, dairy, poultry, and fish. Herbs such as maca and horny goat weed may help. Horny goat weed contains chemicals which might help increase blood flow and improve sexual function. Other herbs that may help include ginkgo biloba, saw palmetto, and yohimbe. But, most of the herbal supplements have not been shown by any reliable studies to prevent, treat, or improve erectile dysfunction. Moreover, supplements are unregulated and can have many side effects or interfere with prescribed medications you’re already taking. Don’t jeopardize your health by taking a supplement to treat erectile dysfunction without first talking with your doctor.

Exercise! This is one of the best ways to increase your sex drive and sexual potency. It reduces stress which is an erection-killer, and helps enhance testosterone production in the body.

Do abdominal exercises. This will help your abdominal muscles support and hold your erection, as opposed to holding your belly. Furthermore, if you have a large gut, it tends to make your unit small by comparison. Being in shape and having a good physique will make you feel good about yourself and up your confidence. This will, in turn, make you comfortable with your body, enticing you to have sex and increasing your sex drive. You can also give your penis a workout with some Kegel exercises to help you stay hard longer.

Know the right sex positions. Always warm up with oral sex. Sexual positions like missionary and doggy style allow more blood flow, leading to a stronger and harder erection. And don't ever let her ride you first!Throw away those tight undergarments. Avoid wearing tight, or any, undergarments, for that matter, while sleeping. It restricts blood flow to the penile tissues which in turn can affect erection strength. Always go for loose, airy underwear.
Avoid alcohol & tobacco. Smoking cigarettes gives you bad circulation. Drinking too much alcohol/beer numbs your penis and can inflate your prostate.

Ensure prostate is healthy. The prostate is an exocrine gland of the male reproductive system that acts as a valve directing the flow of urine and sperm. The prostate makes the fluid called semen that carries the sperm from the testicles through the penis when a man ejaculates.

Natural supplements for prostate health include the following: Saw palmetto (which works to reduce the size of enlarged prostates and relieves urinary problems); Nettle root, Pygeum (which reduce the obstruction of urinary flow); Red clover (which contains an antioxidant that inhibits DHT (Dihydrotestosterone) formation and fights cancerous growth; Selenium (which is found in Brazil nuts, slows the progression of tumor growth); Lycopene (which is found in red tomatoes);

Other natural supplements include: Garlic, turmeric, ginger, zinc (with copper), and rosemary, which act as supplements for an enlarged prostate. Other enlarged prostate health supplements include green tea (EGCG), skullcap, holy basil, and oregano.

Psychological counseling, Sex therapy. If erectile dysfunction is caused by fear or anxiety of the fight-or-flight response, performance anxiety, depression, a poor relationship, or stress, then,  individual or couples counseling or sex therapy with a licensed sexual health professional may be the answer.

Watch X-rated movies. Use this to get in the mood, but, don't masturbate! Save it for your partner!

Acupuncture therapy. Acupuncture involves several strategically places needles placed into the skin. This an ancient Chinese practice believed to assist the body in natural healing from illness and psychological stress. But, there are no studies to validate that this will work to successfully treat ED.

If all fails, try the penis ring. Most penis enlargement devices are painful, scary and terribly ineffective. There are, however, always those faithful who claim these extreme techniques give them big results. The safest and best bet amongst these is the ever-dependable penis ring. This is a little rubber or plastic ring you place at the base of your penis to trap blood inside, kind of like tying off a balloon -- this will make your penis firmer. But, side effects include numbness and weak ejaculation.

Treatment for ED
The best way to improve ED is to make some simple lifestyle changes. For some men, adopting a healthier lifestyle, such as eating healthierquitting smokingexercising regularlyreducing stress, and weaning off prescription drugs may be all that is needed to find relief. For those who require more intensive treatment, adopting these lifestyle changes in addition to other treatments can further help.

Eating Healthier

Eating healthier is not that difficult -- it is more of a mindset change to stop eating the processed foods and junk foods that clog up your arteries and cause circulatory issues that lead to ED.
In general, avoid the processed foods, fast foods, alcohol, tobacco, and drugs. Drink raw vegetable juices, and eat more green and bright-colored vegetables such as spinach, kale,  broccoli, red peppers, and Brussels sprouts for the Vitamin C, chlorophyll, folate, and  other nutrients.

Also, eat wild salmon and sardines for the Omega-3 EFAs. Foods and nutrients such asfiltered water, celery, CoQ10, onions, and garlic help the ciculatory system, which helps to prevent erectile dysfunction (ED).
Add raw juicing to your nutritional program if you want to dramatically improve your circulation and overall cardiovascular health. Since most people juice improperly, we recommend that you get Mr. McCulley's Power of Juicing & Smoothies book. Even if you don't like to juice, the juicing book contains scrumptious recipes for healthy milkshakes (i.e. smoothies) that will help to alkalize your body in your fight against the diabetes and ED.
Also, refer to Chapters 6, 7, 8, 14, and 15 of the Death to Diabetes book for more details about a sound nutritional program and specific wellness protocols for improving one's cardiovascular health.

Quit Smoking

Quitting smoking can be very difficult and there is no single best way to quit that works for all people. Some approaches to try that might help you kick the habit include:
  • Pick a quitting date one to three weeks in the future. Prepare for the date by cutting down on smoking, staying away from your favorite places to smoke, and making a plan for how you will deal with stressful events without smoking.
  • On your quitting date, get rid of all cigarettes, keep busy, and stay in smoke-free places.
  • Talk to your doctor to see if you should try nicotine replacement therapy. The nicotine patch, nicotine gum, or other medication can be helpful but they will not take away your cravings to smoke.
  • Make a clean break. Do not allow yourself to smoke "now and then." An addiction to nicotine can be reactivated anytime, even years after quitting.
  • Take it one moment, one hour, one day at time. Cravings to smoke are usually short-lived and will go away whether or not you have a cigarette.
  • Get help with quitting if you need it. Choose a comprehensive smoking cessation program that does not rely on a single technique (such as hypnosis). Your doctor can point you in the right direction.

Exercise Regularly

Regular exercise can improve your health in many ways. Along with improving erectile function, exercise can:
  • Strengthen the heart.
  • Improve the flow of oxygen in the blood.
  • Build energy levels.
  • Lower blood pressure.
  • Improve muscle tone and strength.
  • Strengthen and build bones.
  • Help reduce body fat.
  • Help reduce stress, tension, anxiety and depression.
  • Boost self-image and self-esteem.
  • Improve sleep.
  • Make you feel more relaxed and rested.
  • Make you look fit and healthy.
To get the most benefit, you should exercise at least 20 to 30 minutes, preferably on most days of the week. Current studies suggest that at least five times a week is best. If you are a beginner, exercise for a few minutes each day and build up to 30 minutes.
When starting out, you should plan a routine that is easy to follow and stick with. As the program becomes more routine, you can vary your exercise times and activities. Here are some tips to get you started.
  • Choose an activity you enjoy. Exercising should be fun not a chore.
  • Schedule regular exercise into your daily routine. Add a variety of exercises so that you do not get bored. Look into scheduled exercise classes at your local community center.
  • Exercise does not have to put a strain on your wallet. Avoid buying expensive equipment or health club memberships unless you are certain you will use them regularly.
  • Stick with it. If you exercise regularly, it will soon become part of your lifestyle.
  • If you feel you need supervision or medical advice to begin an exercise program, ask your doctor to refer you to physical therapy. A physical therapist can evaluate your needs and start you on a safe and effective exercise program.

Reduce Stress

Stress is common to everyone. Our bodies are designed to feel stress and react to it. It keeps us alert and ready to avoid danger. But it is not always possible to avoid or change events that may cause stress and it is easy to feel trapped and unable to cope. When stress persists, the body begins to break down and illnesses can occur. The key to coping with stress is to identify stressors in your life and learn ways to direct and reduce stress.
Learning an effective means of relaxation and using it regularly is a good first step. Allow yourself some "quiet time," even if it's just a few minutes. Examine and modify your thinking, particularly unrealistic expectations. Talking problems out with a friend or family member can help put things in proper perspective. Seeking professional assistance can help you gain a new perspective on how to manage some of the more difficult forms of stress. Other approaches to reducing stress include:
  • Keep a positive attitude. Believe in yourself.
  • Accept that there are events you cannot control.
  • Be assertive instead of aggressive. "Assert" your feelings, opinions or beliefs instead of becoming angry, combative or passive.
  • Learn to relax.
  • Exercise regularly. Your body can fight stress better when it is fit.
  • Eat well-balanced meals.
  • Stop smoking.
  • Limit or avoid use of alcohol and caffeine.
  • Set realistic goals and expectations.
  • Get enough rest and sleep. Your body needs time to recover from stressful events.
  • Don't rely on alcohol or drugs to reduce stress.
  • Learn to use stress management techniques and coping mechanisms, such as deep breathing or guided imagery.
Refer to Chapter 10 of the Death to Diabetes book for more details about exercise, or get the Exercise PDF. Also, refer to Chapter 13 to learn simple ways to reduce the stress in your life, or get the How to Reduce Stress PDF.

Natural & Herb-based Products

There are quite a few natural products and supplements that are being marketed as the solution to erectile dysfunction. But, most of these natural products, herbs, and supplements don't work. In fact, the side effects from some of these products may cause more harm than good!

However, some of the supplements listed in Chapter 15 of the Death to Diabetes book may help, as long as they are wholefood-based, organic, and used in conjunction with a sound nutritional (plant-based) program that improves your cardiovascular health and overall circulation.

FYI: Some of the nutritional and herbal supplements that may help include: arginine, bioflavonoids, zinc, vitamin C, vitamin E,  flaxseed meal, Asian ginseng, ginkgo biloba, and DHEA -- if you have low levels of the hormone dehydroepiandrosterone. However, because the long-term safety of DHEA is not known, most experts do not recommend its use.

Wean Off the Drugs

There are quite a few OTC and prescription drugs that can slow down the blood flow to the penis, and lead to erectile dysfunction (see detailed list of drugs below).

If you're taking multiple prescription drugs, you may want to get our Drug Weaning PDFto learn how to safely wean off the drugs; and, get the Cleanse/Detox PDF to help detox your body and remove the excess toxins and chemicals that could be affecting your circulation and blood flow.

Drugs Linked to Erectile Dysfunction

If you are having problems achieving or maintaining an erection you may want to take a look at your medicine cabinet. There are a number of prescription and over-the-counter drugs that may cause erectile dysfunction. While these medications may treat a disease or condition, in doing so they can affect a man's hormones, nerves, or blood circulation, resulting in ED or increase the risk of ED.

There are many types of drugs that cause ED, including: Diuretics and Antihypertensives, Antidepressants, anti-anxiety drugs and antiepileptic drugs, Antihistamines, Non-steroidal anti-inflammatory drugs, Parkinson's disease medications, Antiarrythmics, Histamine H2-receptor antagonists, Muscle relaxants, Prostate cancer medications, and Chemotherapy medications.

Specific examples of medicines that may cause ED are listed below. The list of possible offenders is long, however, so check with your doctor about all medications you are taking to rule out any as a cause of, or contributor to, your ED.

Diuretics and Antihypertensives
Hydrochlorothiazide (Esidrix, HydroDIURIL, Hydropres, Inderide, Moduretic, Oretic, Lotensin)
Chlorthalidone (Hygroton)
Triamterene (Maxide, Dyazide)
Furosemide (Lasix)
Bumetanide (Bumex)
Guanfacine (Tenex)
Methyldopa (Aldomet)
Clonidine (Catapres)
Verapamil (Calan, Isoptin, Verelan)
Nifedipine (Adalat, Procardia)
Hydralazine (Apresoline)
Captopril (Capoten)
Enalapril (Vasotec)
Metoprolol (Lopressor)
Propranolol (Inderal)
Labetalol (Normodyne)
Atenolol (Tenormin)
Phenoxybenzamine (Dibenzyline)
Spironolactone (Aldactone)

Antidepressants, anti-anxiety drugs and antiepileptic drugs
Fluoxetine (Prozac)
Tranylcypromine (Parnate)
Sertraline (Zoloft)
Isocarboxazid (Marplan)
Amitriptyline (Elavil)
Amoxipine (Asendin)
Clomipramine (Anafranil)
Desipramine (Norpramin)
Nortriptyline (Pamelor)
Phenelzine (Nardil)
Buspirone (Buspar)
Chlordiazepoxide (Librium)
Clorazepate (Tranxene)
Diazepam (Valium)
Doxepin (Sinequan)
Imipramine (Tofranil)
Lorazepam (Ativan)
Oxazepam (Serax)
Phenytoin (Dilantin)

Dimehydrinate (Dramamine)
Diphenhydramine (Benadryl)
Hydroxyzine (Vistaril)
Meclizine (Antivert)
Promethazine (Phenergan)

Non-steroidal anti-inflammatory drugs
Naproxen (Anaprox, Naprelan, Naprosyn)
Indomethacin (Indocin)

Parkinson's disease medications
Biperiden (Akineton)
Benztropine (Cogentin)
Trihexyphenidyl (Artane)
Procyclidine (Kemadrin)
Bromocriptine (Parlodel)
Levodopa (Sinemet)

Disopyramide (Norpace)

Histamine H2-receptor antagonists
Cimetidine (Tagamet)
Nizatidine (Axid)
Ranitidine (Zantac)

Muscle relaxants
Cyclobenzaprine (Flexeril)
Orphenadrine (Norflex)
Prostate cancer medications
Flutamide (Eulexin)
Leuprolide (Lupron)

Chemotherapy medications
Busulfan (Myleran)
Cyclophosphamide (Cytoxan)

If you experience ED and think that it may be a result of medication you are taking, do not stop taking the medication without first consulting your doctor. If the problem persists, your doctor may be able to prescribe a different medication.

Other substances or drugs that can cause or lead to ED include recreational and frequently abused drugs, such as:

    * Alcohol
    * Amphetamines
    * Barbiturates
    * Cocaine
    * Marijuana
    * Methadone
    * Nicotine
    * Opiates

Aside from the well-known complications that the use and abuse of these drugs can cause, ED is not often mentioned. However, use of these drugs can cause ED. These drugs not only affect and often times suppress the central nervous system, but can also cause serious damage to the blood vessels, resulting in permanent ED.

Note: If you're taking multiple prescription drugs, you may want to get our Drug Weaning PDF to learn how to safely wean off the drugs.

  1. ^ Risk of erectile dysfunction induced by arsenic exposure through well water consumption in Taiwan.Hsieh FI, Hwang TS, Hsieh YC, Lo HC, Su CT, Hsu HS, Chiou HY, Chen CJ.School of Public Health, Topnotch Stroke Research Center, Taipei Medical University, Taipei 110, Taiwan
  2. ^ Montague DK, Jarow JP, Broderick GA et al. (July 2005). "Chapter 1: The management of erectile dysfunction: an AUA update". J. Urol. 174 (1): 230–9.doi:10.1097/01.ju.0000164463.19239.19PMID 15947645.
  3. ^ "Erectile Dysfunction causes"Erection Problems (Erectile Dysfunction). Healthwise. 2006. Retrieved 2007-10-07.
  4. ^ "Male Sexual Dysfunction Epidemiology"Erectile dysfunction. Armenian Health Network, 2006. Retrieved 2007-10-07.
  5. ^ Tom F. Lue, MD (2006). "Causes of Erectile Dysfunction"Erectile dysfunction. Armenian Health Network, Retrieved 2007-10-07.
  6. ^ "Erectile dysfunction"Erectile dysfunction. Mayo Clinic. 2006. Retrieved 2007-10-07.
  7. ^ "Erectile Dysfunction Causes"Erectile Dysfunction. 1998. Retrieved 2007-10-07.
  8. ^ "Erectile Dysfunction". Retrieved 2010-07-01.
  9. ^ Peate I (2005). "The effects of smoking on the reproductive health of men". Br J Nurs 14 (7): 362–6. PMID 15924009.
  10. ^ Korenman SG (2004). "Epidemiology of erectile dysfunction". Endocrine 23 (2–3): 87–91. doi:10.1385/ENDO:23:2-3:087PMID 15146084.
  11. ^ Kendirci M, Nowfar S, Hellstrom WJ. (2005). "The impact of vascular risk factors on erectile function". Drugs Today (Barc) 41 (1): 65–74.doi:10.1358/dot.2005.41.1.875779PMID 15753970.
  12. ^ Sommer, F; Goldstein, I; Korda, JB (2010 Jul). "Bicycle riding and erectile dysfunction: a review.". The journal of sexual medicine 7 (7): 2346-58.PMID 20102446.
  13. ^ Huang, V; Munarriz, R; Goldstein, I (2005 Sep). "Bicycle riding and erectile dysfunction: an increase in interest (and concern).". The journal of sexual medicine 2(5): 596-604. PMID 16422816.
  14. ^ Zadik Y, Bechor R, Galor S, Justo D, Heruti RJ (April 2009). "Erectile dysfunction might be associated with chronic periodontal disease: two ends of the cardiovascular spectrum". J Sex Med 6 (4): 1111–6. doi:10.1111/j.1743-6109.2008.01141.x.PMID 19170861.
  15. ^ Friedewald VE, Kornman KS, Beck JD et al. (July 2009). "The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: periodontitis and atherosclerotic cardiovascular disease"Am J Cardiol 104 (1): 59–68.doi:10.1016/j.amjcard.2009.05.002PMID 19576322.
  16. ^ Khader YS, Albashaireh ZS, Alomari MA (August 2004). "Periodontal diseases and the risk of coronary heart and cerebrovascular diseases: a meta-analysis". J Periodontol 75 (8): 1046–53. doi:10.1902/jop.2004.75.8.1046PMID 15455730.
  17. ^ "Most Popular E-mail Newsletter"USA Today.
  18. ^ Dawson C, Whitfield H (April 1996). "ABC of urology. Subfertility and male sexual dysfunction"BMJ 312 (7035): 902–5. PMC 2350600PMID 8611887.
  19. ^ Sexual Function in Men Older Than 50 Years of Age,, August 5, 2003
  20. ^ John P. Mulhall, M.D., Saving Your Sex Life: A Guide for Men with Prostate Cancer, Chicago, Hilton Publishing Company, 2008
  21. ^ Bujdos, Brian. "New Topical Erectile Dysfunction Drug Vitaros Approved in Canada; Approved Topical Drug Testim Proves Helpful for Erectile Dysfunction". Retrieved 15 April 2011.
  22. ^ American vein and aesthetic institute, "Intra-Corporeal Injections For Erectile Dysfunction"
  23. ^ Penile prostheses (implants) Chris Steidle, MD,
  24. ^ "Dangers of Sexual Enhancement Supplements".
  25. ^ Gryniewicz, CM; Reepmeyer, JC; Kauffman, JF; Buhse, LF (2009). "Detection of undeclared erectile dysfunction drugs and analogues in dietary supplements by ion mobility spectrometry". Journal of pharmaceutical and biomedical analysis 49 (3): 601–6. doi:10.1016/j.jpba.2008.12.002PMID 19150190.
  26. ^ Cox RM, John-Alder HB (December 2005). "Testosterone has opposite effects on male growth in lizards (Sceloporus spp.) with opposite patterns of sexual size dimorphism". J. Exp. Biol. 208 (Pt 24): 4679–87. doi:10.1242/jeb.01948.PMID 16326949.
  27. ^ Reed WL, Clark ME, Parker PG, Raouf SA, Arguedas N, Monk DS, Snajdr E, Nolan V, Ketterson ED (May 2006). "Physiological effects on demography: a long-term experimental study of testosterone's effects on fitness". Am. Nat. 167 (5): 667–83.doi:10.1086/503054PMID 16671011Lay summary – ScienceDaily.
  28. a b c d Mooradian AD, Morley JE, Korenman SG (February 1987). "Biological actions of androgens". Endocr. Rev. 8 (1): 1–28. doi:10.1210/edrv-8-1-1PMID 3549275.
  29. ^ Bassil N, Alkaade S, Morley JE (June 2009). "The benefits and risks of testosterone replacement therapy: a review"Ther Clin Risk Manag 5 (3): 427–48. PMC 2701485.PMID 19707253.
  30. ^ Tuck SP, Francis RM (2009). "Testosterone, bone and osteoporosis". Front Horm Res. Frontiers of Hormone Research 37: 123–32. doi:10.1159/000176049ISBN 978-3-8055-8622-1PMID 19011293.
  31. ^ Torjesen PA, Sandnes L (March 2004). "Serum testosterone in women as measured by an automated immunoassay and a RIA". Clin. Chem. 50 (3): 678; author reply 678–9. doi:10.1373/clinchem.2003.027565PMID 14981046.
  32. ^ Southren AL, Gordon GG, Tochimoto S, Pinzon G, Lane DR, Stypulkowski W (May 1967). "Mean plasma concentration, metabolic clearance and basal plasma production rates of testosterone in normal young men and women using a constant infusion procedure: effect of time of day and plasma concentration on the metabolic clearance rate of testosterone". J. Clin. Endocrinol. Metab. 27 (5): 686–94.doi:10.1210/jcem-27-5-686PMID 6025472.
  33. ^ Southren AL, Tochimoto S, Carmody NC, Isurugi K (November 1965). "Plasma production rates of testosterone in normal adult men and women and in patients with the syndrome of feminizing testes". J. Clin. Endocrinol. Metab. 25 (11): 1441–50.doi:10.1210/jcem-25-11-1441PMID 5843701.
  34. ^ Dabbs M, Dabbs JM (2000). Heroes, rogues, and lovers: testosterone and behavior. New York: McGraw-Hill. ISBN 0-07-135739-4.
  35. ^ Nelson, Randy F. (2005). An introduction to behavioral endocrinology. Sunderland, Mass: Sinauer Associates. p. 143. ISBN 0-87893-617-3.
  36. ^ De Loof A (October 2006). "Ecdysteroids: the overlooked sex steroids of insects? Males: the black box". Insect Science 13 (5): 325–338. doi:10.1111/j.1744-7917.2006.00101.x.
  37. ^ Mechoulam R, Brueggemeier RW, Denlinger DL (September 1984). "Estrogens in insects". Journal Cellular and Molecular Life Sciences 40 (9): 942–944.doi:10.1007/BF01946450.
  38. a b Swaab DF, Garcia-Falgueras A (2009). "Sexual differentiation of the human brain in relation to gender identity and sexual orientation". Funct. Neurol. 24 (1): 17–28. PMID 19403051.
  39. ^ Browne KR (2002). Biology at work: rethinking sexual equality. New Brunswick, N.J: Rutgers University Press. p. 112. ISBN 0-8135-3053-9.
  40. ^ Forest MG, Cathiard AM, Bertrand JA (July 1973). "Evidence of testicular activity in early infancy". J. Clin. Endocrinol. Metab. 37 (1): 148–51. doi:10.1210/jcem-37-1-148PMID 4715291.
  41. ^ Corbier P, Edwards DA, Roffi J (1992). "The neonatal testosterone surge: a comparative study". Arch Int Physiol Biochim Biophys 100 (2): 127–31.doi:10.3109/13813459209035274PMID 1379488.
  42. ^ Dakin CL, Wilson CA, Kall√≥ I, Coen CW, Davies DC (May 2008). "Neonatal stimulation of 5-HT(2) receptors reduces androgen receptor expression in the rat anteroventral periventricular nucleus and sexually dimorphic preoptic area". Eur. J. Neurosci. 27 (9): 2473–80. doi:10.1111/j.1460-9568.2008.06216.xPMID 18445234.
  43. ^
  44. a b Bhasin S, Storer TW, Berman N, Callegari C, Clevenger B, Phillips J, Bunnell TJ, Tricker R, Shirazi A, Casaburi R (July 1996). "The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men". N. Engl. J. Med. 335(1): 1–7. doi:10.1056/NEJM199607043350101PMID 8637535.
  45. ^ Mehta PH, Jones AC, Josephs RA (June 2008). "The social endocrinology of dominance: basal testosterone predicts cortisol changes and behavior following victory and defeat"J Pers Soc Psychol 94 (6): 1078–93. doi:10.1037/0022-3514.94.6.1078PMID 18505319.
  46. a b MedlinePlus Encyclopedia Hypogonadotropic hypogonadism.
  47. a b MedlinePlus Encyclopedia Hypogonadism
  48. ^ "Low Testosterone Symptoms". Low Testosterone Supplements. Retrieved 7 January 2012.
  49. ^ Brooke JC et al. "Severity of Erectile Dysfunction and Testosterone Deficiency Are Associated with Reduced Quality of Life (HRQoL) in Men with Type 2 Diabetes Mellitus".
  50. ^ NIH Osteoporosis and Related Bone Diseases - National Research Center
  51. ^ Crawford, E. David; Barqawi, Al Baha; O'Donnell, Colin; Morgentaler, Abraham (2007). "The association of time of day and serum testosterone concentration in a large screening population". BJU International 100 (3): 509–13. doi:10.1111/j.1464-410X.2007.07022.xPMID 17555474Lay summary – UroToday (12 July 2007).
  52. ^ MedlinePlus Encyclopedia Testosterone
  53. ^ Nieschlag E, Swerdloff R, Behre HM, et al. (2006). "Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA, ISSAM, and EAU recommendations". Journal of Andrology 27 (2): 135–7. doi:10.2164/jandrol.05047.PMID 16474020.
  54. a b
  55. a b Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H (February 2007). "Position statement: Utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement". The Journal of Clinical Endocrinology and Metabolism 92(2): 405–13. doi:10.1210/jc.2006-1864PMID 17090633.
  56. ^ Morris PD, Malkin CJ, Channer KS, Jones TH (August 2004). "A mathematical comparison of techniques to predict biologically available testosterone in a cohort of 1072 men". European Journal of Endocrinology 151 (2): 241–9.doi:10.1530/eje.0.1510241PMID 15296480.
  57. ^ Morgentaler (2006). "Testosterone and prostate cancer: an historical perspective on a modern myth". European Urology 50 (5): 935–9.doi:10.1016/j.eururo.2006.06.034PMID 16875775.
  58. ^ Chudnovsky, A.; Niederberger, C. S. (2007). "Gonadotropin Therapy for Infertile Men with Hypogonadotropic Hypogonadism". Journal of Andrology 28 (5): 644–6.doi:10.2164/jandrol.107.003400PMID 17522414.
  59. ^ Whitten, S; Nangia, A; Kolettis, P (2006). "Select patients with hypogonadotropic hypogonadism may respond to treatment with clomiphene citrate". Fertility and Sterility 86 (6): 1664–8. doi:10.1016/j.fertnstert.2006.05.042PMID 17007848.
  60. ^ Laughlin, G. A.; Barrett-Connor, E.; Bergstrom, J. (2007). "Low Serum Testosterone and Mortality in Older Men"Journal of Clinical Endocrinology & Metabolism 93 (1): 68–75. doi:10.1210/jc.2007-1792PMC 2190742.PMID 17911176Lay summary – The Endocrine Society (5 June 2008).

No comments: