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Health Conditions > Impotence
and Treatment of Male Sexual Dysfunction - American Association of
Clinical Endocrinologists and The American College of Endocrinology -
- "increased prolactin levels may also cause
erectile problems, even in the presence of a normal testosterone level"
- "Most problems revolve around dysfunction of the
hypothalamic-pituitary-gonadal axis and are associated with either excess
or decreased testosterone levels. Other
endocrine disorders that may cause libido or erectile difficulties include
hypothyroidism, hyperthyroidism, adrenal insufficiency, or excessive levels
of adrenal corticosteroids." - see
prolactin and cortisol
- "With any form of testosterone treatment, the
patient may have a slow and steady increase in libido and erectile capacity
during a course of months. If no improvement is noted after 3 months, the
hormone deficiency may not be the only cause of the sexual dysfunction"
can cause impotence. Angiotensin II receptor blockers (ARBs)
can treat hypertension without sexual side effects and of all the
hypertensives, have fewer side effects. See
Blood pressure drug reverses sexual dysfunction - Life Extension
Magazine, 7/01 - "the active ingredient in Cozaar
and Hyaar (losartan) can significantly improve sex lives of men who suffer
from sexual dysfunction" - also see
alternative ways to lower blood pressure
Dysfunction Guidelines - aace.com -
"Other endocrine disorders that may cause libido or
erectile difficulties include hypothyroidism,
hyperthyroidism, adrenal insufficiency,
or excessive levels of adrenal corticosteroids."
Dysfunction Guidelines - aace.com -
"With any form of testosterone treatment, the
patient may have a slow and steady increase in libido and erectile capacity
during a course of months. If no improvement is noted after 3 months, the
hormone deficiency may not be the only cause of the sexual dysfunction."
Patient's Fact Sheet: Prolactin Excess (.pdf format) - American Society
for Reproductive Medicine - "In men,
hyperprolactinemia may be associated with impotence and can affect
fertility." - see prolactin
Effect of Kaempferia
parviflora on sexual performance in streptozotocin-induced diabetic male rats
- Andrologia. 2017 Mar 10 - "A significant increase in
sperm density in diabetic rats was observed (p < .05) at highest dose of KP.
Furthermore, KP treatment demonstrated a significant recovery of sexual
behaviour and serum testosterone levels in diabetic rats. These results confirm
that KP exhibits aphrodisiac properties that improve the sperm density,
testosterone level and sexual performance of STZ-induced diabetic rats" -
See Kaempferia parviflora at Amazon.com.
Effect of rutin on
diabetic-induced erectile dysfunction: Possible involvement of testicular
biomarkers in male rats - Andrologia. 2016 Oct 26 -
"Diabetic-induced alterations in male sexual behaviour and sperm count, motility
and viability were markedly corrected following 5 weeks of rutin treatment to
the diabetic animals. Rutin also attenuated the inhibited serum testosterone and
penile cGMP content, while improved diabetic-associated inflammation and
testicular lipid peroxidation and oxidative stress. Histopathological evaluation
revealed damaged testicular tissues in diabetic rats, which was protected
following rutin treatment. In conclusion, treatment with rutin improved sexual
functionality and also protects against diabetic-induced testicular damage"
rutin at Amazon.com.
Pomegranate juice causes a
partial improvement through lowering oxidative stress for erectile dysfunction
in streptozotocin-diabetic rat - Int J Impot Res. 2016 Sep 1 -
"Erectile dysfunction (ED) is associated with diabetes
mellitus (DM). Pomegranate juice (PJ) is a potent antioxidant in diabetes
induced oxidative stress ... This is the first study to show that PJ treatment
ameliorates partially ED and completely oxidative stress and fibrosis in a
diabetic rat model. Our results highlight the success of antioxidant mechanism
of PJ in ED with diabetes and open the way for future understanding in
alternative treatment combinations with PDE5 inhibitors" - See
pomegranate extract at Amazon.com.
Waist circumference is
superior to weight and BMI in predicting sexual symptoms, voiding symptoms and
psychosomatic symptoms in men with hypogonadism and erectile dysfunction -
Andrologia. 2016 Jul 12 - "We investigated whether three
measurements of obesity, weight, body mass index and waist circumference,
correlate with the International Index of Erectile Function-5 (IIEF-5), the
Aging Males' Symptoms (AMS) and the International Prostate Symptom Score (IPSS)
questionnaires ... waist circumference was significantly inversely proportional
to IIEF-5 and directly proportional to AMS and IPSS. Weight was inversely
proportional to IIEF and directly proportional to IPSS but not associated with
AMS. BMI had no proportionality to measurements of sexual function and quality
of life. These results suggest that among weight, BMI and waist circumference,
the latter is the best predictor of health-related QoL in men with hypogonadism"
Testofen, a specialised
Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen
decrease, increases testosterone levels and improves sexual function in healthy
aging males in a double-blind randomised clinical study - Aging Male. 2016
Jan 20:1-9 - "Sexual function improved, including number of morning erections
and frequency of sexual activity. Both total serum testosterone and free
testosterone increased compared to placebo after 12 weeks of active treatment. Trigonella foenum-graecum seed extract is a safe and effective treatment for
reducing symptoms of possible androgen deficiency, improves sexual function and
increases serum testosterone in healthy middle-aged and older men" - [Nutra
USA] - See Trigonella foenum-graecum at Amazon.com.
flavonoid intake and incidence of erectile dysfunction - Am J Clin Nutr.
2016 Jan 13 - "In analyses stratified by age, a higher
intake of flavanones, anthocyanins, and flavones was significantly associated
with a reduction in risk of ED only in men <70 y old and not older men (11-16%
reduction in risk; P-interaction = 0.002, 0.03, and 0.007 for flavones,
flavanones, and anthocyanins, respectively). In food-based analysis, higher
total intake of fruit, a major source of anthocyanins and flavanones, was
associated with a 14% reduction in risk of ED"
Blueberries, citrus fruits, red wine associated with reduced erectile
dysfunction - Science Daily, 1/13/16 - "Of all the
different flavonoids, Anthocyanins (found in blueberries, cherries,
blackberries, radishes and blackcurrant), flavanones and flavones (found in
citrus fruits) were found to offer the greatest benefits in preventing the
condition ... It is already known that increased exercise can improve erectile
function, but this research shows that eating a flavonoid-rich diet is as good
for erectile function as briskly walking for up to five hours a week"
top-selling, over-the-counter sexual treatments unproven, some could be harmful,
review shows - Science Daily, 1/12/16 - "DHEA ...
Fenugreek ... Ginkgo Biloba ... Ginseng ... Horny Goat Weed ... L-arginine ...
Maca ... Tribulus ... Yohimbine ... Zinc"
Vitamin D Deficiency Might Be Tied to Impotence - WebMD, 11/13/15 -
"The researchers concluded that men with vitamin D
deficiency were 32 percent more likely to be impotent than those with sufficient
vitamin D levels. This association held even after the study authors accounted
for other factors associated with erectile dysfunction, such as drinking,
smoking, diabetes, higher blood pressure, inflammation and certain medications"
vitamin D at Amazon.com.
Dysfunction and cardiovascular risk factors in a Mediterranean diet cohort -
Intern Med J. 2015 Oct 20 - "ED presence and severity
were associated with age, obesity, waist circumference, hypertension,
antihypertensive treatment and ischemic disease. Patients with ED were more
frequently smokers, sedentary and consumed more alcohol. In multivariate
analysis, consumption of nuts (> twice a week) (OR 0.41 [95% CI 0.25 to 0.67]
and vegetables (≥ once a day) (OR 0.47 [95% CI 0.28 - 0,77]), were inversely
related to ED. Obesity (as BMI ≥ 30 kg/m2 ) (OR 2.49 [95% CI 1.48 -4.17]),
ischemic disease (OR 2.30 [95% CI 1.22 to 4.33], alcohol consumption
(alcohol-units a day) (OR 1.14 [95% CI 1.04 to 1.26], and age (year) (OR = 1.07
[95% CI 1.04-1.10] were directly related to ED"
between serum folic acid level and erectile dysfunction - Andrologia. 2015
Aug 25 - "The mean serum FA concentrations were 7.2 ±
3.7, 7.1 ± 3.2, 10.2 ± 4.6 and 10.7 ± 4.6 ng ml(-1) in the severe, moderate and
mild ED and control groups respectively. The mean serum FA concentration was
significantly higher in the control group than in the severe and moderate ED
groups (both P < 0.001), but not the mild ED group (P = 0.95). Considering the
significant differences in the serum FA levels between the control and ED
groups, serum FA deficiency might reflect the severity of ED" - See
folic acid products at Amazon.com.
With Metformin Improves Erectile Dysfunction in a Murine Model of Obesity
Associated With Insulin Resistance - Urology. 2015 Jul 18 -
"Treatment with metformin restored the erectile function
in obese mice, through improvement of in vitro endothelial and nitrergic
cavernosal relaxations. Therefore, use of metformin may be a good pharmacologic
approach to treat insulin resistance-associated erectile dysfunction" -
metformin at IAS.
intake associated with reduced levels of erectile dysfunction - Science
Daily, 5/20/15 - "Men who drink the equivalent caffeine
level of two to three cups of coffee a day are less likely to have erectile
dysfunction (ED) ... men who consumed between 85 and 170 milligrams of caffeine
a day were 42 percent less likely to report ED, while those who drank between
171 and 303 milligrams of caffeine a day were 39 percent less likely to report
ED compared to those who drank zero to seven milligrams a day ... Even though we
saw a reduction in the prevalence of ED with men who were obese, overweight and
hypertensive, that was not true of men with diabetes. Diabetes is one of the
strongest risk factors for ED"
linked to improved erectile, sexual function in men - Science Daily, 3/23/15
- "men who reported more frequent exercise, a total of
18 metabolic equivalents, or METS, per week, had higher sexual function scores,
regardless of race. MET hours reflect both the total time of exercise and the
intensity of exercise. A total of 18 METS can be achieved by combining exercises
with different intensities, but is the equivalent of two hours of strenuous
exercise, such as running or swimming, 3.5 hours of moderate exercise, or six
hours of light exercise ... In contrast, men of any ethnicity who exercised less
reported lower levels of sexual function. Additional contributors to low sexual
function included diabetes, older age, past or current smoking and coronary
Ginkgo biloba Extract (EGb-761) on Recovery of Erectile Dysfunction in Bilateral
Cavernous Nerve Injury Rat Model - Urology. 2015 Mar 12 -
"Forty-three male Sprague-Dawley rats underwent
cavernous nerve crush injury and were randomized into 4 groups, including:
vehicle only, high-dose GBE, medium-dose GBE, and low-dose GBE ...
Administration of GBE increases neuron survival and preserves the neural nitric
oxide synthase nerve fiber and contents of the corpus cavernosum after bilateral
cavernous nerve injury. These implications indicate the beneficial effects of
GBE use in the repair of the cavernous nerve and recovery of erectile function
after radical prostatectomy" - See
Ginkgo biloba at Amazon.com.
swimming activity on the copulatory behavior of sexually active male rats -
Int J Impot Res. 2014 Dec 18 - "Swimming significantly
improved the sexual performance of highly active rats, as indicated by increased
intromission frequency and intromission ratio, compared with the sedentary
controls. Swimming improved both sexual desire and performance, as indicated by
reduced mount latency and increased intromission ratio, respectively, in
swimming moderately active rats compared with the sedentary moderately active
controls. Therefore, swimming activity improves the copulatory behavior of both
highly active and moderately active male rats"
a novel water-soluble curcumin derivative versus sildenafil citrate in mediating
erectile function - Int J Impot Res. 2014 Aug 7 -
"The present study was conducted to assess the efficacy of a novel curcumin
derivative (NCD) versus sildenafil citrate in erectile signaling. The study was
conducted on 10 control male rats and 50 diabetic male rats divided into the
following groups: diabetic, curcumin, NCD, sildenafil and NCD combined with
sildenafil ... NCD or its combination with sildenafil showed significant
efficacy and more prolonged duration of action. In conclusion, NCD could enhance
erectile function with more efficacy and more prolonged duration of action"
curcumin products at Amazon.com.
signalling of a novel curcumin derivative versus Tadalafil in erectile
dysfunction - Andrologia. 2014 Jul 25 - "novel
curcumin derivative (NCD) ... curcumin (CURC) ... In conclusion, a tendency was
observed that CURC and NCD have high efficacy and more prolonged duration of
action in enhancing erectile function" - See
curcumin products at Amazon.com.
dysfunction may be the first clinical sign of insulin resistance and endothelial
dysfunction in young men - Clin Res Cardiol. 2013 Sep;102(9):645-51 -
"Patients with ED had significantly higher levels of
systolic blood pressure (SBP), high-sensitivity C-reactive protein (Hs-CRP),
high Insulin resistance index (HOMA-IR) and carotid intima-media thickness
(IMT), compared with controls ... ED may be the first clinical sign of
endothelial dysfunction and a clinical marker of cardiovascular and metabolic
diseases. Subclinical endothelial dysfunction and insulin resistance may be the
underlying pathogenesis of ED in young patients without well-known etiology"
metformin at IAS.
of ED with chronic periodontal disease - Int J Impot Res. 2013 Jul 4 -
"To examine the relationship between chronic periodontal
disease (CPD) and ED, the interview sheet including the CPD self-checklist (CPD
score) and the five-item version of the International Index of Erectile Function
(IIEF-5) was distributed to 300 adult men who received a comprehensive dental
examination ... There was a statistically significant correlation between the
CPD score and the presence of ED (P=0.0415). The results in the present study
suggest that ED is related to the damage caused by endothelial dysfunction and
the systematic inflammatory changes associated with CPD. The present study also
suggests that dental health is important as a preventive medicine for ED"
Korean Ginseng Berry
Extract Effect on Sexual Function in ED - Medscape, 5/6/13 -
"were administered 4 tablets of either standardized
Korean ginseng berry (SKGB, 350 mg ginseng berry extract per tablet), or
placebo, daily, for 8 weeks. Efficacy was assessed with the International Index
of Erectile Function (IIEF)-15 and premature ejaculation diagnostic tool (PEDT)
at the end of the 4th and 8th week. We observed that the total and each of the
individual domain scores of IIEF-15 increased from 40.95+/-7.05 to 46.19+/-12.69
significantly in the SKGB by the 8th week (P<0.05). The erectile function domain
of IIEF changed slightly from 17.17+/-2.57 to 18.59+/-5.99 in the SKGB group by
the 8th week (P<0.05). In addition, PEDT scores significantly improved from
9.14+/-4.57 to 7.97+/-4.4 and 7.53+/-4.26 in the SKGB group after 4 and 8 weeks
of treatment (P<0.05). Safety markers including hormone and lipid in the blood
were assessed at the end of the 4th and 8th week and they remained unchanged.
Oral administration of the SKGB extract improved all domains of sexual function"
- See ginseng at Amazon.com.
Extract Enhances Erectile Responses by Inhibition of Phosphodiesterase 5
Activity and Increase in Inducible Nitric Oxide Synthase Messenger Ribonucleic
Acid Expression in Rat and Rabbit Corpus Cavernosum - Urology. 2013 Apr 23 -
"The results suggest that SPE may have potential
application value for the prevention or treatment of erectile dysfunction
through an increase in iNOS mRNA expression and inhibition of PDE5 activity in
corpus cavernosum smooth muscles" - See
palmetto products at iHerb.
improves erectile dysfunction in patients initially irresponsive to Sildenafil
by the activation of endothelial nitric oxide synthase - Int J Impot Res.
2013 Jan 17 - "This study aimed at comparing the effects
of atorvastatin and vitamin E on erectile dysfunction in patients initially
irresponsive to sildenafil, with investigation into the underlying possible
mechanisms. Sixty patients were randomly divided into three groups: the
atorvastatin group received 80 mg daily, the vitamin E group received 400 IU
daily and the control group received placebo capsules ... glutathione peroxidase
(GPO) ... nitric oxide (NO) ... Both atorvastatin and vitamin E showed a
statistically significant GPO increase (P<0.05) and a statistically significant
IL-6 decrease (P<0.05). Only atorvastatin showed a statistically significant
increase in NO (15.19%, P<0.05), eNOS (20.58%, P<0.01), IIEF-5 score (53.1%,
P<0.001) and Rigiscan rigidity parameters (P<0.01), in addition to a
statistically significant decrease in CRP (57.9%, P<0.01). However, SOD showed a
statistically significant increase only after vitamin E intake (23.1%, P<0.05).
Both atorvatstain and vitamin E had antioxidant and anti-inflammatory
activities. Although activating eNOS by atorvastatin was the real difference,
and expected to be the main mechanism for NO increase and for improving erectile
dysfunction" - See
Jarrow FamilE (contains all eight members of the vitamin E family, includes
Tocomin) at Amazon.com.
Korean ginseng berry extract on sexual function in men with erectile
dysfunction: a multicenter, placebo-controlled, double-blind clinical study
- Int J Impot Res. 2012 Dec 20 - "Ginseng is beneficial
for many aspects of human physiology, including sexual function ... administered
4 tablets of either standardized Korean ginseng berry (SKGB, 350 mg ginseng
berry extract per tablet), or placebo, daily, for 8 weeks. Efficacy was assessed
with the International Index of Erectile Function (IIEF)-15 and premature
ejaculation diagnostic tool (PEDT) at the end of the 4th and 8th week. We
observed that the total and each of the individual domain scores of IIEF-15
increased from 40.95+/-7.05 to 46.19+/-12.69 significantly in the SKGB by the
8th week (P<0.05)" - See ginseng at Amazon.com.
erection problems are three times more likely to have inflamed gums, study finds
- Science Daily, 12/4/12 - "Turkish researchers compared
80 men aged 30 to 40 with erectile dysfunction with a control group of 82 men
without erection problems ... the men with severe periodontal disease were 3.29
times more likely to suffer from erection problems than men with healthy gums"
Treating gum disease may fix erection troubles, too, study finds -
nbcnews.com, 12/3/12 - "The study involved 120 patients
with severe or moderate erectile dysfunction and chronic periodontitis. Half
received treatment for their gum disease, while half did not. They filled out
questionnaires about their erectile function, and patients who received
treatment for their gum disease reported that levels of erectile function
improved after three months ... I feel that the causal element is probably
vascular disease, poor general health status, lack of medical attention (gum
disease), underlying diabetes/hypertension, or all of the above"
The use of
dehydroepiandrosterone in the treatment of hypoactive sexual desire disorder: A
report of gender differences - Eur Neuropsychopharmacol. 2012 Oct 17 -
"Data regarding the efficacy of dehydroepiandrosterone
(DHEA) in the treatment of hypoactive sexual desire disorder (HSDD) are scarce
and inconsistent. We aimed to determine possible gender differences in the
efficacy of DHEA as a treatment for HDSS. Postmenopausal women (n=27), and men
(n=21) with HSDD, were randomized to receive either DHEA 100mg daily or placebo
for 6 weeks in a controlled, double blind study ... In women only, significant
interaction effects were observed for sexual arousal (p<0.05), satisfaction
(p<0.05), and cognition (trend; p=0.06). For arousal, a significant improvement
was observed for the DHEA treated group at 6 weeks (p=0.001). Significant
correlations were observed between bioavailable T and sexual cognitions, arousal
and orgasm, while DHEAS was correlated with satisfaction. In the men,
significant correlations were observed between testosterone and arousal (r=.45),
sexual drive (r=.50) and orgasm (r=.55). In women with HSDD, DHEA treatment had
a significant beneficial effect on arousal, whereas no efficacy was demonstrated
in men, indicating a possible gender difference. This improvement seems to be
mediated via DHEA's metabolism to testosterone. Our positive results suggest
that the neurosteroid DHEA may be effective as a treatment for women with HSDD
if administered at a dose of at least 100mg per day" - See
DHEA at Amazon.com.
Propionyl-L-carnitine, L-arginine and niacin in sexual medicine: a nutraceutical
approach for erectile dysfunction - Andrologia. 2011 Oct 4 -
"In a group of 54 unselected men (35-75 years), consecutively presenting to our
ED clinic and naive to other ED treatments, we carried out a single-blind,
one-arm study to evaluate the effects of a 3-month supplementation with
propionyl-L-carnitine, L-arginine and niacin on their sexual performance ...
Analyses on GAQs revealed that treatment improved erections in 40% of cases,
with a partial response occurring in up to 77% of enrolled subjects. These
preliminary findings indicate that the favourable cardiovascular effects of
nutraceuticals might also reflect on male sexual function with possible
implication in the treatment and prevention of ED. This study documents a
considerable patients' interest toward nutritional supplementation - as
first-line or adjunctive treatment to PDE5 inhibitors - that goes beyond the
measurable increment in penile rigidity" - See
propionyl-l-carnitine products at Amazon.com,
niacin at Amazon.com
L-arginine products at Amazon.com.
α-lipoic acid on sperm quality, reproductive tract measures in thinner exposed
rats - Andrologia. 2011 Sep 15 - "The aim of this
study was to investigate the effect of alpha lipoic acid (ALA, an universal
antioxidant) on thinner-induced testicular toxicity regarding spermatological
features, body and reproductive tract measures in rats. Adult male
Sprague-Dawley rats were divided into five treatment groups, eight rats in each.
Control group was treated with placebo. Group O was given only olive oil. The
group L received only α-lipoic acid. Thinner + Lipoic Acid group received
thinner + α-lipoic acid and group T received only thinner. Thinner alone
administration caused significant decreases in body and some reproductive organ
weights, sperm count, motility and sperm membrane integrity, and significant
increases in seminal vesicle weight and abnormal sperm rates compared with the
values in the control group. However, concomitant administration of thinner with
α-lipoic acid provided significant improvements in sperm parameters compared
with values in alone group T. In conclusion, the results of this study suggest
that α-lipoic acid has a protective effect against thinner-induced reproductive
dysfunction in male rats"
alpha lipoic acid products at Amazon.com.
I assume that the thinner is something like this:
ScienceDirect - Toxicology Letters : Melatonin protects the central nervous
system of rats against toluene-containing thinner intoxication by reducing
reactive gliosis - Toxicology Letters, Volume 137, Issue 3, 3 February
2003, Pages 169-174 - "Thinner containing 60–70%
toluene is a neurotoxic mixture which is widely used as an aromatic
industrial solventThinner containing 60–70% toluene is a neurotoxic mixture
which is widely used as an aromatic industrial solvent"
Antioxidants of growing interest to address infertility, erectile dysfunction
- Science Daily, 7/28/11 - "A growing body of evidence
suggests that antioxidants may have significant value in addressing infertility
issues in both women and men, including erectile dysfunction, and researchers
say that large, specific clinical studies are merited to determine how much they
could help ... Some commonly used antioxidants, such as vitamins C and E, could
help, Hagen said. But others, such as lipoic acid, are a little more
cutting-edge and set up a biological chain reaction that has a more sustained
impact on vasomotor function and health ... Polyphenols, the phytochemicals that
often give vegetables their intense color and are also found in chocolate and
tea, are also of considerable interest"
Unhealthy lifestyle is associated with sexual dysfunction - Science Daily,
7/6/11 - "A new study published in The Journal of Sexual
Medicine reveals that several unhealthy lifestyle factors, such as weight
problems, physical inactivity, high alcohol consumption, tobacco smoking, and
hard drugs are associated with sexual dysfunctions in men. Additionally, an
unhealthy lifestyle is more common in persons who are sexually inactive ...
Among those who had a sexual partner, risk of experiencing sexual dysfunction
was greater in men who lead unhealthy lives by 71% in those with substantially
increased waist circumference and more than 800% in men using hard drugs. Women
who used hashish had almost 3 times increased risk of anorgasmia (difficulties
or inability to reach climax during sexual activity with a partner) compared to
Assessment of a Supplement of Pycnogenol® and l-arginine in Japanese Patients
with Mild to Moderate Erectile Dysfunction - Phytother Res. 2011 May 27 -
"Subjects were instructed to take a supplement
(Pycnogenol® 60 mg/day, l-arginine 690 mg/day and aspartic acid 552 mg/day) or
an identical placebo for 8 weeks, and the results were assessed using the
five-item erectile domain (IIEF-5) of the International Index of Erectile
Function. Additionally, blood biochemistry, urinalysis and salivary testosterone
were measured. Eight weeks of supplement intake improved the total score of the
IIEF-5. In particular, a marked improvement was observed in 'hardness of
erection' and 'satisfaction with sexual intercourse'. A decrease in blood
pressure, aspartate transaminase and γ-glutamyl transpeptidase (γ-GTP), and a
slight increase in salivary testosterone were observed in the supplement group.
No adverse reactions were observed during the study period. In conclusion,
Pycnogenol® in combination with l-arginine as a dietary supplement is effective
and safe in Japanese patients with mild to moderate erectile dysfunction"
Pycnogenol at Amazon.com,
L-arginine products at Amazon.com
l-aspartic acid at Amazon.com.
dysfunction association with physical activity level and physical fitness in men
aged 40-75 years - Int J Impot Res. 2011 May 12 -
"This study showed that younger men with higher physical activity and better
physical fitness are less likely to suffer from erectile dysfunction.
Multivariable analysis through logistic regression showed that age (odds ratio
(OD)=1.15; 95% confidence interval (95% CI)=1.07-1.23), physical activity
(OD=10.38; 95% CI=3.94-27.39) and physical fitness (OD=4.62; 95% CI=1.75-12.25)
were independent variables associated with erectile dysfunction. This study
reinforces the concept that healthy habits have a direct effect on erectile
aphrodisiacs: 'Spicing' up your love life possible, finds study of ginseng and
saffron - Science Daily, 3/28/11 - "Ours is the most
thorough scientific review to date. Nothing has been done on this level of
detail before now ... They found that panax ginseng, saffron and yohimbine, a
natural chemical from yohimbe trees in West Africa, improved human sexual
function ... People report increased sexual desire after eating muira puama"
Fenugreek extract shows male libido boost: Human RCT - Nutra USA, 2/16/11 -
"A formulation containing a standardized extract of
Trigonella foenum-graecum and minerals was associated with an improvement in
libido for 81 percent of the men in the study, and a 63 percent improvement in
the ‘quality of sexual performance’, compared with no such improvements in the
placebo group" - See
Fenugeek products at iHerb.
Physiological Aspects of Male Libido Enhanced by Standardized Trigonella
foenum-graecum Extract and Mineral Formulation - Phytother Res. 2011 Feb 10
- "The aim of the clinical study was to evaluate the
effect of Testofen, a standardized Trigonella foenum-graecum (Fenugreek) extract
and mineral formulation, on male libido (sexual drive, urge or desire) in a
double blind randomized placebo controlled study. The study recruited 60 healthy
males aged between 25 and 52, without erectile dysfunction and randomized to an
oral dose (two tablets per day) of the active treatment (600 mg Testofen per
day) or placebo for 6 weeks. The primary outcome measure was the DISF-SR (male)
self-administered QOL total score and the four domain scores. The secondary
outcome was specific quality of life parameters. Testofen had an overall
positive effect on physiological aspects of libido. In particular, there was a
significant increase in the subdomains of sexual arousal and orgasm. Testofen
had a positive effect on QOL in self-reported satisfaction with muscle strength,
energy and well-being but did not have an effect on mood or sleep. Serum
prolactin and testosterone levels remained within the reference range. It was
concluded that Testofen demonstrated a significant positive effect on
physiological aspects of libido and may assist to maintain normal healthy
testosterone levels" - See
Fenugeek products at iHerb.
L-citrulline supplementation improves erection hardness in men with mild
erectile dysfunction - Urology. 2011 Jan;77(1):119-22 -
"L-arginine supplementation improves nitric
oxide-mediated vasodilation and endothelial function; however, oral
administration has been hampered by extensive presystemic metabolism. In
contrast, L-citrulline escapes presystemic metabolism and is converted to
L-arginine, thus setting the rationale for oral L-citrulline supplementation as
a donor for the L-arginine/nitric oxide pathway of penile erection ... A total
of 24 patients, mean age 56.5 +/- 9.8 years, were entered and concluded the
study without adverse events. The improvement in the erection hardness score
from 3 (mild ED) to 4 (normal erectile function) occurred in 2 (8.3%) of the 24
men when taking placebo and 12 (50%) of the 24 men when taking L-citrulline (P <
.01). The mean number of intercourses per month increased from 1.37 +/- 0.93 at
baseline to 1.53 +/- 1.00 at the end of the placebo phase (P = .57) and 2.3 +/-
1.37 at the end of the treatment phase (P < .01). All patients reporting an
erection hardness score improvement from 3 to 4 reported being very satisfied"
L-citrulline at Amazon.com.
Increasing BPA levels in urine associated with worsening male sexual
function, study finds - Science Daily, 5/26/10 -
"Increasing urine BPA level is associated with decreased sexual desire, more
difficulty having an erection, lower ejaculation strength and lower level of
overall satisfaction with sex life" - See
stainless steel water bottles at Amazon.com.
omega-3 fatty acid linked to male infertility, study suggests - Science
Daily, 4/12/10 - "In our experiment, we used 'knockout'
mice that lacked the gene responsible for an enzyme important in making
docosahexaenoic acid (DHA). In the absence of DHA, male mice are basically
infertile, producing few if any misshaped sperm that can't get where they need
to go ... But, when DHA was introduced into the diet, fertility was completely
restored. "It was very striking. When we fed the mice DHA, all these
abnormalities were prevented,"" - See
Jarrow Max DHA at Amazon.com.
herbal combination, Etana, for enhancing erectile function: an efficacy and
safety study in animals - Int J Impot Res. 2009 Jun 4 -
"a new herbal combination called Etana that is
composed of five herbal extracts including Panax quinquelotius (Ginseng),
Eurycoma longifolia (Tongkat Ali), Epimedium grandiflorum (Horny goat weed),
Centella asiatica (Gotu Kola) and flower pollen extracts. Most of the
above-mentioned extracts have a long historical and traditional use for
erectile dysfunction (ED) ... penile erection index (PEI) ... At a 7.5 mg
kg(-1) single dose, the percentage of responding rats was 53+/-7 with a PEI
of 337+/-72 compared with 17+/-6 with a PEI of 30+/-10 for control animals.
This PEI was significantly (P<0.001) higher than each single component and
than the sum of any two herbal components of Etana. When compared with
sildenafil citrate, Etana induced more pronounced PEI than 0.36 mg kg(-1),
but similar to 0.71 mg kg(-1) of sildenafil. Furthermore, full acute and
sub-acute toxicity studies showed no toxic effects of Etana. In conclusion,
this study describes a new and safe combination of herbal components that
enhance erectile function in male rats"
Talking And Treating Erectile Dysfunction - Science Daily, 2/4/09 -
"Stop smoking ... Control cholesterol ... Cut back
Ingredient in Chinese Herb Acts as a Natural Viagra - WebMD, 9/26/08 -
"the main compound in horny goat weed, called
icariin, acted the same way that Viagra does" - See
horny goat weed products at iHerb.
with alpha-tocopherol improves erectile function in hypertensive rats -
Hypertens Res. 2008 May;31(5):1007-13 - "Treatment
with 24 mg alpha-tocopherol decreased TBARS levels and increased SOD
activity in the serum and corpus cavernosum. Relaxation in response to
acetylcholine chloride in the corpus cavernosum was improved with
alpha-tocopherol treatment at each dose. These results suggest that
alpha-tocopherol treatment increases the diminished relaxation in the corpus
cavernosum of SHRs by improving neuronal or endothelial function related to
nitric oxide and carbon monoxide. This, in turn, indicates that antioxidant
therapy may play a role in treatment for ED in hypertensive patients"
Berries and pomegranate - the ultimate Valentine's combo? - Nutra USA,
2/14/08 - "The results of this study demonstrated,
for the first time, that daily consumption of PJ for seven weeks caused
increased spermatogenic cell density, epididymal sperm concentration, sperm
motility and decreased abnormal sperm rate related with decreased lipid
peroxidation in male rats ... Forty-seven per cent of subjects reported
erections improvements as a result of pomegranate juice, compared to only 32
per cent in the placebo group" - See
pomegranate at Amazon.com.
Exposure to the phytoestrogen daidzein attenuates apomorphine-induced penile
erection concomitant with plasma testosterone level reduction in dose and
time-related manner in adult rats - Urology. 2007 Sep;70(3):613-7 -
"The phytoestrogen daidzein has the potential to
adversely affect erectile function in a dose and time-related manner that is
at least partly attributable to androgen deficiency. These findings
implicate that phytoestrogens, especially isoflavones, if overconsumed for a
long period, might be a novel risk factor for erectile dysfunction"
Erectile Dysfunction In Diabetes Is Due To Selective Defect In The Brain
- Science Daily, 3/15/07
Erectile Function in Subjects With the Metabolic Syndrome - Medscape,
7/19/06 - "consumption of a Mediterranean-style diet
in men with the metabolic syndrome and ED at baseline produced significant
improvement of erectile and endothelial functions, together with a
significant reduction of systemic vascular inflammation, as indicated by the
reduced levels of CRP"
Restoring Sexual Potency? - Dr. Weil, 5/4/06 -
"Arginine ... Ginkgo biloba ... Ashwaganda"
Sexual Enhancement Supplements (L-Arginine, Yohimbe, Horny Goat Weed) -
erectile dysfunction? - Dr. Murray Natural Facts, 8/24/05 -
"by far the most common cause of impotence by far is
atherosclerosis of the penile artery. Atherosclerosis refers to a process of
hardening the artery walls due to a build up of plaque containing
cholesterol, fatty material, and cellular debris"
Preliminary observations on the use of propionyl-L-carnitine in combination
with sildenafil in patients with erectile dysfunction and diabetes -
Curr Med Res Opin. 2004 Sep;20(9):1377-84 - "Salvage
therapy with PLC plus sildenafil was more effective than sildenafil in the
treatment of ED in patients with diabetes refractory to sildenafil
Ester Carnitine Propionyl at iHerb.
Erection Supplements Under Fire - WebMD, 9/23/04
Diet and Exercise Programs Have Benefits for Obese Men With Erectile
Dysfunction - Doctor's Guide, 6/24/04
- Daily 2-Mile
Walk May Prevent Impotence - WebMD, 6/22/04
- Carnitine Improves
Symptoms of Male Aging - Medscape, 4/14/04 -
is more active than testosterone for improving symptoms of male aging such
as sexual dysfunction, depressed mood, and fatigue ... In this trial, 120
patients were randomized to receive testosterone undecanoate 160 mg/day,
propionyl-L-carnitine 2 g/day plus acetyl-L-carnitine 2 g/day, or placebo
for six months" [Abstract]
acetyl-l-carnitine products and
Nature's Cholesterol Balancer - Vitamin Research News, 2/04 -
"Statin drugs are also known to cause male
impotence" - See
policosanol at Amazon.com.
Exercise Can Help Prevent Impotence - WebMD, 8/22/03 -
"men over age 50 who kept physically active had a
30% lower risk of impotence than men who were inactive ... The fitter the
man, the better the erection. Frequent, vigorous exercise, the equivalent of
running at least three hours a week or playing singles tennis five hours per
week, produced the most benefit -- with a 30% lower risk of impotence"
- Korean Red Ginseng
Benefits Men with Impotence - New Hope Natural Media, 1/2/03 -
"Men experiencing sexual difficulties due to inability to achieve erection
may be helped by Korean red ginseng (Panax
ginseng), according to a study published in the Journal of Urology ... It is
a problem that affects nearly half of men over age forty worldwide ... Some
60% of participants reported improved erections while receiving ginseng.
Improved sexual desire was also reported during ginseng treatment.
Testosterone levels did not change with treatment, leading the
researchers to conclude that improvements observed with ginseng are not due
to hormonal effects"
Korean (Panax) ginseng.
Ginkgo Supplements Useful for SSRI-Related Sexual Dysfunction - Clinical
Psychiatry News, 9/02 - "Ginkgo
has multiple systemic effects. It acts as a free-radical scavenger, inhibits
platelet aggregation, causes vasodilation, and allows more efficient
cellular uptake of oxygen and glucose. The effects of ginkgo on sexual
arousal are thought to result from increased blood circulation to the
genital area ... The proprietary multi-ingredient ginkgo preparation
ArginMax (Daily Wellness Co.) is “one of the best things I've ever seen
for SSRI sexual dysfunction,”" - See ArginMax at Amazon.com
- Natural Remedy for
Erectile Dysfunction - New Hope Natural Media, 9/5/02 -
"received three separate treatments for two weeks each, in random order: (1)
3.25 grams of
arginine plus 6 mg of
yohimbine alone and (3) placebo ... Combination treatment was considered
successful by 40% of the participants, compared with 28.9% with yohimbine
alone and 17.8% with placebo ... Arginine is available in health food stores
without a prescription, but yohimbine can be obtained only with a doctor's
prescription. Although the herb yohimbe is sold in health food stores, it
contains much less yohimbine than the amount used in the new study" -
Yohimbine Plus L-Arginine Potential Therapy For Mild To Moderate Erectile
Dysfunction - Doctor's Guide, 7/31/02 -
"randomly assigned 45 men with erectile dysfunction
to treatment with 6 mg of L-arginine
glutamate combined with 6 mg of
hydrochloride, to 6 mg of yohimbine hydrochloride alone, or to placebo ...
They took the drugs orally one to two hours before intended sexual
intercourse ... Changes in this score [Index of Erectile Function (IIEF)]
were significantly greater among patients taking yohimbine plus L-arginine
compared to those taking placebo" - Note: That "6 mg of L-arginine
glutamate" has to be a misprint. It probably should have been 6 grams as in
U. of Texas study on
Low testosterone levels can mean high health risks - Life Extension
Study: Supplement Can Help Take the 'Dys' Out of Female Sexual Dysfunction,
Researchers Promote Idea of 'Sexual Wellness' - WebMD, 6/5/01 -
"ArginMax -- a dietary
cocktail consisting of ginseng, ginkgo, B vitamins, calcium, folic acid, and
other vitamins and minerals -- is being heralded as one component of a
lifestyle that improves sexual performance and helps prevent problems
associated with intimacy"
Want a love potion? What to know before you try - CNN, 6/15/00 -
"a study of 21 men with "mild to moderate" impotence
taking a supplement called
ArginMax (3,000 milligrams per day) found big
improvements in erection and sexual satisfaction."
When It Comes to Love, the Nose Knows - WebMD, 2/14/01-
"Another spirit in the heady cocktail making us
intoxicated with romantic love is phenylethylamine (PEA) ... I believe that
PEA may be the hormone of libido ...
high PEA levels help explain increased sex drive and activity in the manic
phase of manic-depressive illness, while low PEA levels reflect loss of
libido in depression. PEA is effective when given by mouth, but like Viagra,
could be dangerous in patients with heart disease" -
Amino Acids anyone? at DrBob.org says
can also be converted (through a separate pathway) to phenylethylamine,
a substance that occurs naturally in the brain and appears to elevate
Study: Oversexed Monkeys Immune - Intelihealth, 11/11/00 -
"Promiscuous species of monkeys appear to have
immune systems than less-active ones, researchers say."
- Herbal Viagra
Alternative Works -- at Least on Rats
- WebMD, 10/23/00 - "All the rats fed the
high-cholesterol diet indeed ended up with high cholesterol levels -- and
all became impotent. But those who drank the herbal mixture [BetterMAN] were
later able to achieve erections, while the other eight rats remained
Study finds exercise reduces the risk of impotence - CNN, 10/2/00
Exercise May Reduce Impotence Risk - Intelihealth, 10/2/00
With Regular Exercise, You May Never Need Viagra - WebMD, 8/30/00
Laboratory Investigations of Erectile Dysfunction - WebMD -
"men with erectile dysfunction frequently have low
levels of high-density lipoproteins, the good form of cholesterol." -
Saving Yourself from AGE - Life Enhancement Magazine, 8/00 - with
American Ginseng, "The researchers found a reduction
in plasma prolactin, a hormone connected with passive "nesting" behavior,
suggesting that this may play a role in the ability of American ginseng to
stimulate sexual activity in the male rat."
Want a love potion? What to know before you try - CNN, 6/15/00 -
"a study of 21 men with "mild to moderate" impotence
taking a supplement called
ArginMax (3,000 milligrams per day) found big
improvements in erection and sexual satisfaction."
Natural Alternatives to Viagra with Ellen Kamhi - WebMD, 5/26/00
Replenish Testosterone Naturally - Life Extension Magazine, 1/00
Study finds new therapy for impotence [l-arginine] - CNN, 10/27/99
Be All That You Can Be - Life Enhancement Magazine, 7/99
Dehydroepiandrosterone in the treatment of erectile dysfunction: a
prospective, double-blind, randomized, placebo-controlled study -
Urology. 1999 Mar;53(3):590-4; discussion 594-5
- Long Term Safety and
Efficacy of Ginkgo Biloba in the Treatment of Anti-Depressant-Induced Sexual
Dysfunction - Alan Jay Cohen, M.D., UCSF Faculty
Ginkgo biloba for antidepressant-induced sexual dysfunction - J Sex
Marital Ther. 1998 Apr-Jun;24(2):139-43
effect of chronic antipsychotic drug administration on nitric oxide synthase
activity and gene expression in rat penile tissues - Eur
Neuropsychopharmacol. 2009 Nov 13 - "Antipsychotic
drug treatment may be associated with common and problematic sexual
dysfunction, especially impotence, which can diminish quality of life and
lead to treatment noncompliance. Nitric oxide synthase (NOS) is an important
cellular modulator of erectile function. We have therefore investigated the
effect of antipsychotic drug on activity and gene expression of NOS in rat
penile tissues. The activity of constitutive NOS was significantly
suppressed below control by a 21days administration of 1mg/kg haloperidol,
which also significantly decreased expression of endothelial NOS (eNOS) and
neural NOS mRNA. Risperidone at 0.5mg/kg also reduced eNOS mRNA expression.
Haloperidol or risperidone did not change gene expression and activity of
inducible NOS (iNOS). Quetiapine significantly increased activity and mRNA
expression of iNOS with 20 and 40mg/kg doses"
Study: High Bisphenol A ( BPA) Linked to Sex Problems in Men - Science
Daily, 11/11/09 - "Compared to the unexposed factory
workers in the study, BPA-exposed workers were four times more likely to
report erectile dysfunction, low sexual desire, and less than optimal
satisfaction with their sex lives. They were seven times more likely to
report problems with ejaculation ... BPA has been used for more than three
decades to make plastic bottles and other products shatter resistant and
clear. It is also used in the lining of many canned foods and a wide range
of other commercial goods"
function in men with diabetes type 2: correlation with glycemic control
- Int J Impot Res. 2009 Sep 17 - "the level of
HbA(1c) is significantly higher with declining degrees of potency
(P-value=0.003). Also, there is an association between potency degree and
glycemic control (P=0.002). We conclude that glycemic control is
independently and inversely associated with ED in men with diabetes type 2"
Between Erectile Dysfunction And Obesity Explored In Obesity And Weight
Management - Science Daily, 8/25/09 - "Obese men
are at increased risk for erectile dysfunction (ED), likely caused by
atherosclerosis-related hypertension and cardiovascular disease, as well as
hormonal changes associated with obesity"
alpha-Blocker Use Is Associated With Decreased Risk of Sexual Dysfunction
- Urology. 2009 May 8 - "Lower urinary tract
symptoms (LUTS) ... alpha-Blocker use was associated with a decreased risk
of sexual dysfunction across all domains for men >/=50 years old
(age-adjusted hazard ratio 0.53-0.69). A decreased risk of erectile
dysfunction and low libido remained significant only among those using
alpha-blockers who also experienced an improvement in LUTS (P = .01)"
relationship of serum and salivary cortisol levels to male sexual
dysfunction as measured by the International Index of Erectile Function
- Int J Impot Res. 2009 May 7 - "testosterone (T)
and cortisol (F) ... (Total-T, Free-T, Bioavailable-T, Total-F and
Bioavailable-F) and salivary hormones (Saliva-T and Saliva-F) ...
International Index of Erectile Function (IIEF) ... Free-T and
Bioavailable-T showed significant inverse correlations with age (P<0.01). In
the group not taking antidepressants, the levels of Bioavailable-F and
Saliva-F showed significant inverse correlations with a portion of the IIEF
score (P<0.05). However, reductions in Bioavailable-T and Saliva-T showed no
association with the IIEF score. In the group taking antidepressants, these
hormone levels showed no correlation with IIEF"
Major Statin Study Reveals Several Important Findings For Reducing Prostate
Cancer And Disease - Science Daily, 4/26/09 -
"non-statin users were three times more likely to develop prostate cancer,
suggesting statin use may prevent development of prostate cancer ...
Overall, statin use was not significantly associated with a decreased risk
of developing ED. However, statins were associated with a decreased risk of
ED among older men (>60 years). Men in this age category who used statins
were less likely to develop ED, compared to older men who did not use
statins. Additionally, men who took statins for a longer time were more
protected against developing ED. For example, men who took statins for
nearly nine years or more were 64 percent less likely to develop ED, while
men who took statins for less than three years had about the same risk of
developing ED. compared to men who did not take statins" - See
Tadalafil Response in Patients With Erectile Dysfunction Is Androgen
Dependent - Doctor's Guide, 3/23/09 -
"Testosterone gel therapy significantly improves the response to tadalafil
in nonresponding patients with erectile dysfunction (ED) -- but only if they
have total testosterone levels of less than 3 ng/mL or bioavailable
testosterone levels of less than 0.6 ng/mL"
Statin study: Lower cholesterol, diminished joy of sex linked - USA
Today, 3/5/09 - "In the study, sexual pleasure sank
along with LDL levels ... Some studies have found that statins improve
sexual function, probably because the pills can improve blood flow to the
genital area, Golomb says. But she says the drugs also may reduce Coenzyme
Q10, a nutrient that helps cells convert oxygen, blood and glucose into
energy. "Orgasm is a high-energy activity," so losing the nutrient could
weaken sexual pleasure, she says" - See
ubiquinol products at Amazon.com.
Obesity Linked To Hormone Imbalance That Impacts Sexual Quality Of Life
- Science Daily, 3/3/09 - "In our study population,
we found that lower testosterone levels and diminished ratings for sexual
quality of life were correlated with increased BMI ... Subjects who lost
weight through bariatric surgery experienced a reduction in estradiol
levels, an increase in testosterone levels and an increase in ratings of
sexual quality of life" - See my
aromatization page. Another way to increase testosterone and decrease
estradiol is with
letrozole. I take a
quarter tablet every other day.
Improvement in erectile
function in a rat model of high cholesterol diet-induced atherosclerosis by
atorvastatin in a manner that is independent of its lipid-lowering property
- Andrologia. 2017 Mar 10 - "This effect on erectile
function preservation of atorvastatin was attributed to its preservation of
endothelial function, possibly through amelioration of oxidative stress and
improvement in eNOS expression"
Hair Loss Drug Propecia Carries Risk of Losing Something Else - NBC News,
3/10/17 - "It's a low risk— overall, just 1.4 percent of
men who took the drugs suffered long-term erectile dysfunction. But it lasted a
very long time: more than 3 ½ years after they stopped taking the drugs ... The
younger the men, the bigger the risk ... The drugs are sold under the brand
names Propecia, Proscar and Avodart and are known generically as finasteride and
dutasteride ... It was a hard problem to fix. Taking Viagra or other drugs did
not seem to help ... "I have hundreds of these patients," he told NBC News.
"They have low libido. They have flat emotions. They see a woman, they say
intellectually, 'I know I am supposed to be interested in you. But I am actually
not interested in you'. They have muted orgasms, reduced volume of ejaculate,
reduced penile sensation.""
Impotence Meds Might Give Men's Hearts a Boost - WebMD, 3/9/17 -
"Men taking this type of ED drug had a 33 percent
reduced risk of death within three years of their first heart attack, compared
to men not taking the PDE5 inhibitor ... The men also experienced a 40 percent
reduced risk of subsequent hospitalization for heart failure"
Dysfunction with Finasteride 1 mg Taken for Hair Loss - Pharmacotherapy.
2016 Sep 19 - "persistent sexual dysfunction (PSD) ...
The rate of PSD for finasteride 1 mg users and omeprazole users was 37.9 and
15.0 per 1000 person-years, respectively ... The risk of PSD in men who stopped
finasteride 1 mg therapy was higher than that for omeprazole users. Patients who
stopped finasteride therapy sought physician visits for sexual dysfunction up to
1 year after stopping finasteride" - Both are good to know but I don't
get why they're comparing a proton pump inhibitor to a 5α-reductase inhibitor.
Risk of Erectile
Dysfunction Associated With Use of 5-α Reductase Inhibitors for Benign Prostatic
Hyperplasia or Alopecia - Medscape, 10/20/16 - "5-α
reductase inhibitor (finasteride or dutasteride) ... 5-α reductase inhibitors do
not seem to significantly increase the risk of incident erectile dysfunction,
regardless of indication for use. Risk of erectile dysfunction increased with
longer duration of benign prostatic hyperplasia"
Testosterone Treatment and
Sexual Function in Older Men with Low Testosterone Levels - J Clin
Endocrinol Metab. 2016 Jun 29 - "Compared with placebo,
T administration significantly improved 10 of 12 measures of sexual activity.
Incremental increases in total and free T and estradiol levels were associated
with improvements in sexual activity and desire, but not erectile function. No
threshold T level was observed for any outcome, and none of the 27 baseline
characteristics predicted responsiveness to T"
More Side Effects in First
Year With BPH Drugs - Medscape, 12/31/15 - "At year
1, the incidence of impotence was significantly higher with finasteride
(1.9-fold higher; p=0.006) and combination therapy (2.4-fold higher; p <0.001).
Beyond year 1, the rates between the drug treatment groups and placebo were
similar ... Incidence rates for decreased libido were also significantly higher
at year 1 with finasteride (1.7-fold higher; p=0.021) and combination therapy
(2-fold higher; p=0.001). After year 1, the rates between the treatment groups
and placebo were similar ... at year 1, the incidence of abnormal ejaculation
was significantly higher with finasteride (2.5-fold higher; p=0.002) and
combination therapy (5.5-fold higher; p<0.001). And after year 1, only the
combination therapy group had a significantly higher incidence rate compared
Simvastatin Improves Sexual
Health QoL in Older Men With ED - Medscape, 5/26/14 -
"Our secondary analysis has shown a significant
improvement in sexual health related quality of life, specifically in relation
to perception of control and emotional health in men with untreated ED given 40
mg simvastatin [Zocor] for six months"
As Statins Boost Erectile
Function, Adherence May Rise Too - Medscape, 3/29/14 -
"In men who took statins, erectile-function scores
increased by 3.4 points, from 14.0 to 17.4 points—a 24.3% increase. The increase
in erectile-function score was about one-third to one-half of that reported with
phosphodiesterase inhibitors, such as sildenafil (Viagra, Pfizer), tadalafil (Cialis,
Lilly), or vardenafil (Levitra, Bayer/GlaxoSmithKline), and larger than the
effect of lifestyle modification or testosterone" - [Science
Selective Alpha-blocker Tamsulosin on Erectile Function in Patients With Lower
Urinary Tract Symptoms due to Benign Prostatic Hyperplasia - Urology. 2013
May 25 - "randomized single blinded study in one-to-one
fashion conducted upon 60 patients, all of them married, between May 2010 and
May 2011 ... Tamsulosin HCl capsules showed a significant statistical
improvement in the erectile function, sexual desire, and intercourse
satisfaction score with significant improvement in total IIEF in patients with
lower urinary tract symptoms because of benign prostatic hyperplasia" -
Note: Tamsulosin is Flomax.
Erectile dysfunction may
be the first clinical sign of insulin resistance and endothelial dysfunction in
young men - Clin Res Cardiol. 2013 May 17 - "192
patients and 33 normal controls were enrolled. ED was evaluated by using the
International Index of Erectile Function-5 (IIEF-5) questionnaire ... Patients
with ED had significantly higher levels of systolic blood pressure (SBP),
high-sensitivity C-reactive protein (Hs-CRP), high Insulin resistance index
(HOMA-IR) and carotid intima-media thickness (IMT), compared with controls"
effect of testosterone treatment for erectile dysfunction caused by
high-estrogen levels in rats - Int J Impot Res. 2013 May 2 -
"testosterone treatment did not improve the ED caused by
high-estrogen levels" - Note: One of the problems with testosterone
replacement is that it increases estrogen (percentage wise) as much as
Erectile Dysfunction in Diabetic Patients - Medscape, 12/3/12 -
"In this study, we found that diabetic patients
suffering from ED were responsive to the losartan treatment. The IIEF-5 scores,
the percentage of positive answers to the SEP-2, SEP-3 and GAQ after treatment
are all significantly increased as compared with baseline and the end point of
control groups. The analysis of our study also indicated that losartan worked
better in mild and moderate ED than severe cases. It is consistent with our
previous studies, which shows that losartan can downregulate the local
expression of AT1 and Ang II, but it cannot elevate the reduced smooth
muscle/collagen ratio in diabetic rats [7,8] We believe that the losartan may
not completely reverse the severe damaged penile tissues due to diabetes"
- Note: It says that's the first study in diabetics but I've read several
studies over the years supporting losartan and ED. See my ARB page. It would
seem that it would extend to the entire ARB class of antihypertensives but I
haven't seen studies on that. See losartan (Cozaar)
Syndrome: A Potential and Independent Risk Factor for Erectile Dysfunction in
the Chinese Male Population - Urology. 2012 Oct 4 -
"our results showed that subjects with MetS had a significantly greater risk of
ED (OR 1.34, 95% CI 1.04-1.72; P = .02), especially in middle-age (40-59 years)
men (OR 2.43, 95% CI 1.71-3.47; P <.001). Of the MetS components, abnormal
fasting blood glucose was the most significantly independent factor of MetS for
ED (OR 1.31, 95% CI 1.11-1.55; P = .002)"
improves erectile dysfunction in diabetic patients: a clinical trial - Int J
Impot Res. 2012 Aug 30 - "A total of 124 diabetic
patients with ED were included in this study and treated with losartan or
tadalafil or losartan plus tadalafil or watch for waiting as control for 12
weeks ... Losartan or tadalafil or losartan plus tadalafil significantly
improved the mean IIEF-5 scores ... The combination of losartan and tadalafil is
more effective than the single-use of losartan or tadalafil" - See
losartan and tadalafil at
Disorders Linked to Waist Size - Medscape, 8/2/12 -
"The researchers divided the men into 3 groups based on WCs of less than 90 cm
(<36 inches; 153 men), 90 to 99 cm (36 - 39 inches; 137 men), and more than 100
cm (39+ inches; 119 men), to determine whether WC could be a simple metric to
predict LUTS prevalence. Median age for all men was 57.6 years ... The overall
prevalence of lower urinary tract symptoms as measured by the IPSS did not
differ significantly among the three WC groups ... "Sexual dysfunction
significantly differed with WC. The prevalence of erectile dysfunction increased
from 32.1% to 74.5% as WC increased (P = 0.001). The prevalence of ejaculatory
dysfunction also increased from 21.4% to 64.7% as WC increased (P = 0.002),"
they continue. In addition, the prevalence of ejaculatory dysfunction went up
from 21.4% to 64.7% for the same groupings"
of metabolic syndrome, atherosclerosis risk factors, sex hormones in ED in
aboriginal Taiwanese - Int J Impot Res. 2012 Apr 12 -
"International Index of Erectile Function (IIEF)
questionnaire ... Using age-adjusted multivariate logistic regressive analysis,
this study showed that aboriginal males with ED had a significantly higher
prevalence of MS (OR=12.02, 95% confidence intervals (CI): 6.33-22.83, P<0.001).
Among the MS components, abnormal fasting blood sugar was the most significantly
independent factor for ED in aboriginal males (OR=8.94, 95% CI: 4.71-16.97,
P<0.001). The presence of MS had a significant correlation with lower IIEF-5
scores, lower sexual desire scores, lower testosterone serum level (P<0.01) and
abnormal interleukin-6 (IL-6) and high sensitivity C-reactive protein (HsCRP).
The results of this study support the idea that MS, low serum testosterone and
HsCRP may predict ED in aboriginal Taiwanese males" - See
metformin at IAS.
testosterone levels in diabetic men with and without erectile dysfunction -
Andrologia. 2012 Apr 4 - "TT was lower in diabetic men
with ED as compared to those with normal erectile function (EF), 392.4 +/- 314.9
versus 524.3 +/- 140.2 ng dl(-1) , respectively ... Receiver operating
characteristic (ROC) curve of TT in men without associated co-morbidities showed
that EF was compromised at TT = 403.5 ng dl(-1) or less. Sensitivity of 63.3%
and a specificity of 94.0% were detected. At this level, ED was found in 33/38
(86.8%) men with TT 403.5 ng dl(-1) , whereas ED was observed in 57/147 (38.8%)
men with TT ≥ 403.5 ng dl(-1) (P < 0.0001). We propose a cut-off value of 403.5
ng dl(-1) of TT blood levels as an indicator for initiation of testosterone
replacement therapy in diabetic men with ED. Further prospective controlled
trials are recommended"
Do Glaucoma, Erectile
Dysfunction Have a Common Cause? - Medscape, 2/7/12 -
"Men with erectile dysfunction (ED) have a nearly 3-fold
greater risk for also having open-angle glaucoma (OAG) than men with normal
erectile function ... The study suggests that OAG and ED appear to have a common
mechanism of endothelial dysfunction related to nitric oxide"
A jolt to
the penis may cure impotence - MSNBC, 10/28/11
Relationships between Sex Hormones and Sexual Function in Middle-Aged and Older
European Men - J Clin Endocrinol Metab. 2011 Aug 17 -
"The aim of the study was to investigate the
relationships between serum testosterone (T), estradiol (E2), and
dihydrotestosterone (DHT) and sexual function in a multicenter population-based
study of aging in men ... Total and free T, but not E2 or DHT, was associated
with overall sexual function in middle-aged and older men. E2 was the only
hormone associated with sexual function-related distress such that higher levels
were related to greater distress. Free T levels were associated with
masturbation frequency and erectile dysfunction in the fully adjusted models,
such that higher T was associated with less dysfunction and greater frequency.
Moreover, there was a T threshold for the relationship between total T, sexual
function, and erectile dysfunction. At T concentrations of 8 nmol/liter or less,
T was associated with worse sexual functioning, whereas at T levels over 8
nmol/liter, the relationship came to a plateau. Conclusions: These findings
suggest that different hormonal mechanisms may regulate sexual functioning (T)
vs. the psychological aspects (E2) of male sexual behavior. Moreover, there was
a T threshold for overall sexual function such that at levels greater than 8
nmol/liter the relationship between T and sexual function did not become
Loss Improves Erections in Obese Men With Diabetes - Medscape, 8/10/11 -
"For the study, researchers recruited obese men who had
body mass indexes (BMIs), a number calculated from weight and height, of greater
than 30 and waist sizes over 40 inches ... The average age of men in the study
was 60 ... men were randomly assigned to either a low-calorie diet, where two
daily meals were replaced by weight loss shakes, or to a higher-protein,
lower-carbohydrate eating plan ... In the healthy eating plan, which focused on
three meals of lean protein, five daily servings of vegetables, and two daily
servings of whole grain carbohydrates and fruit, was designed to shave about 600
daily calories off what the men would normally eat ... After eight weeks, the
men on the low-calorie meal replacement diets were switched to the healthy
eating plan, and all continued to be followed for a year ... After eight weeks
on the diets, the men on the low-calorie plan had lost about twice as much
weight as the men on the healthy eating plan, 20 pounds vs. 11 pounds ... But
they had similar improvements in erectile function, sexual desire, and urinary
symptoms ... Of the 17 men with severe erectile dysfunction, Wittert says that
after eight weeks, seven had improvements in their symptoms, with some achieving
normal function. After a year, 25% had normal erectile function"
health of men with chronic heart failure significantly improves with CRT, study
finds - Science Daily, 6/3/11
Non-Steroidal Anti-Inflammatory Drugs Linked to Increased Risk of Erectile
Dysfunction - Science Daily, 3/2/11 - "After
controlling for age, race, ethnicity, smoking status, diabetes, hypertension,
heart disease, high cholesterol and body mass index, the researchers found that
ED was 1.4 times more likely -- a modest risk -- among regular NSAID users
compared to men who did not take the drugs regularly. This association was
consistent across all age groups"
replacement or revision of an inflatable penile prosthesis lead to decreased
patient satisfaction? - Int J Impot Res. 2011 Feb 10 -
"Approximately 58.3% were satisfied with their
prosthesis, 75% would have the surgery performed again and 91.7% would still
recommend prosthesis surgery. Device malfunction was the primary reason for
replacement/removal at our institution. Despite the complications of prosthesis
reoperation, the majority of patients were still satisfied with their
prosthesis, would have the surgery performed again and would recommend
prosthesis surgery to a friend"
for hair loss and benign prostatic hyperplasia may result in loss of libido,
erectile dysfunction in men - Science Daily, 1/11/11 -
"5a-reductase inhibitors (5a-RIs), while improving
urinary symptoms in patients with benign prostatic hyperplasia (BPH) and
possible hair loss prevention, produces significant adverse effects in some
individuals including loss of libido, erectile dysfunction (ED), ejaculatory
dysfunction and potential depression" - Note: That goes back and forth.
One study claimed that finasteride improved sex after after six months of taking
it. Regarding gynaecomastia, if you're taking low dose letrozole to increase
testosterone and to prevent aromatization it many also help prevent
Prostate Drug May Not Dim Sex - WebMD, 6/26/07 -
"Six months after the men started taking their assigned drugs, the survey
scores were about three points higher for the men taking Proscar. By the end
of the study, that gap narrowed to about two points"
Prostate Drug Doesn't Limit Sexual Function In Most Men - Science Daily,
7/19/07 - "The study suggests that finasteride will
cause little or no sexual dysfunction for most men who decide to take it"
Ask a Medical Question - Can letrozole cure gynecomastia - JustAnswer -
"Letrozole may be effective in preventing and
reversing the gynaecomastia provided it is used early enough in steroid
induced gynaecomastia" - See letrozole at
believe the recommended dose is something like a quarter tablet every three
days but don't quote me on it. That's what I take.
Patients' preference in
the treatment of erectile dysfunction: a critical review of the literature -
Int J Impot Res. 2010 Dec 30 - "the majority of the
patients preferred tadalafil versus either vardenafil or sildenafil" -
See tadalafil at
of sildenafil and vardenafil treatments on sleep quality and depression in
hemodialysis patients with erectile dysfunction - Int J Impot Res. 2011
Jan 6 - "Sleep quality and depression were evaluated
via post-sleep inventory (PSI) and Beck's depression inventory (BDI),
respectively, at baseline and at the end of the treatment. Sildenafil and
vardenafil both improved PSI and BDI scores significantly compared with
pretreatment values. However, there was no difference between sildenafil and
vardenafil with respect to these parameters"
Obesity may harm your sexual health, study suggests - Science Daily,
6/15/10 - "obese women were 30% less likely to have
had a sexual partner in the last 12 months. Obese men were 70% less likely
to have had more than one sexual partner in the same period and were two and
half times more likely to experience erectile dysfunction"
established between erectile dysfunction and calcified coronary arteries
- Science Daily, 6/1/10 - "men with ED had a 54
percent greater likelihood of having a high-risk CACS than men without ED.
The increased risk was similar to that of patients with a history of
hypertension and smoking"
Erectile dysfunction and increased dangers of cardiovascular disease -
Science Daily, 4/25/10 - "men with erectile
dysfunction and low testosterone have a higher than normal risk of dying
from cardiovascular disease. Further work from the same research group shows
that obesity is also associated with an impairment of blood flow to the
penis, which in turn is also associated with cardiovascular disease in men
with erectile dysfunction ... Low testosterone itself was not associated
with major cardiac events, but those patients with the lowest testosterone
who had a major cardiac event were significantly more likely to die than
those with higher levels of testosterone (P<0.001; the risk is increased by
a factor of seven ... In a second study (but using the same group of
patients as above), the group showed that the degree of obesity, along with
erectile dysfunction, were significantly and independently associated with
testosterone gel in the treatment of erectile dysfunction in hypogonadal
hemodialysis patients: a pilot study - Int J Impot Res. 2009 Nov 19 -
"T administration significantly increased serum T levels
to the normal range, and was associated with statistically significant
improvements of the scores of the IIEF domains (erectile function from 7.6+/-8.0
to 12.8+/-7.8; intercourse satisfaction from 3.4+/-4.5 to 4.8+/-3.1; orgasmic
function from 4.8+/-3.1 to 3.4+/-2.9; sexual desire from 3.4+/-2.9 to 4.4+/-0.6;
overall sexual satisfaction from 2.6+/-1.3 to 3.8+/-1.0). But scores of the IIEF
did not normalize. Frequency of weekly sexual intercourse increased from
0.4+/-0.4 to 1.1+/-0.8 (P<0.05) after 6 months. There were no adverse effects"
- Note: One problem with testosterone administration is that it increased
estradiol by about the same percentage. I'm 60 years old and my testosterone
was above the limits just by taking a half tablet of
letrozole per day. I've
cut it to a quarter tablet but haven't had it rechecked. Letrozole has been
shown to double or triple testosterone and lower estrogen at the same time.
Some studies indicate that you might want to keep estrogen around 25 for men.
See letrozole at
Androgel prescribing information - androgel.com -
"Serum estradiol (E2) concentrations
increased significantly within 30 days of starting treatment with
AndroGel 5 or 10 g/day and remained elevated throughout the
treatment period but remained within the normal range for eugonadal
- High, Low
Estradiol Levels and Mortality in Men With Systolic HF -
Medscape, 5/19/09 - "Both low and high serum
levels of estradiol, compared with mid-range levels, are
significantly and independently associated with increased all-cause
mortality in men with chronic systolic heart failure"
Short-term aromatase inhibition: effects on glucose metabolism and
serum leptin levels in young and elderly men - Eur J Endocrinol.
2008 Dec 2 -
"Ten elderly and nine young healthy men were
randomized to receive letrozole 2.5 mg daily or placebo for 28 days
in a crossover design. Results: Both in young and elderly men,
active treatment significantly increased serum testosterone (+128
and +99%, resp.) and decreased estradiol levels (-41 and -62%,
resp.). Fasting glucose and insulin levels decreased in young men
after active intervention (-7 and -37%, resp.) compared to placebo.
Leptin levels fell markedly in both age groups (-24 and -25%,
resp.), while adiponectin levels were not affected by the
intervention. Lipid profile was slightly impaired in both groups,
with increasing LDL-cholesterol levels (+14%) in the younger age
group and 10% lower levels of ApoA1 in the elderly. A decline in
IGF-1 levels (-15%) was observed in the younger age group. No
changes in weight or BMI were observed in either young or old men"
a week normalizes serum testosterone in obesity-related male
hypogonadism - Eur J Endocrinol. 2008 May;158(5):741-7 -
"Isolated hypogonadotropic hypogonadism
(IHH) is frequently observed in severely obese men, probably as a
result of increased estradiol (E(2)) production and E(2)-mediated
negative feedback on pituitary LH secretion. Aromatase inhibitors
can reverse this process ... treated with 2.5 mg letrozole once a
week for 6 months ... Six weeks of treatment reduced total E(2) from
123+/-11 to 58+/-7 pmol/l (P<0.001, mean+/-s.e.m.), and increased
serum LH from 4.4+/-0.6 to 11.1+/-1.5 U/l (P<0.001). Total
testosterone rose from 5.9+/-0.5 to 19.6+/-1.4 nmol/l (P<0.001), and
free testosterone from 163+/-13 to 604+/-50 pmol/l (P<0.001). Total
testosterone rose to within the normal range in all subjects,
whereas free testosterone rose to supraphysiological levels in 7 out
of 12 men ... Letrozole 2.5 mg once a week produced a sustained
normalization of serum total testosterone in obese men with IHH.
However, free testosterone frequently rose to supraphysiological
levels. Therefore, a starting dose <2.5 mg once a week is
Comparative assessment in young and elderly men of the gonadotropin
response to aromatase inhibition - J Clin Endocrinol Metab. 2005
Oct;90(10):5717-22 - "As assessed after 28 d
of treatment, letrozole lowered E2 by 46% in the young men (P =
0.002) and 62% in the elderly men (P < 0.001). In both age groups,
letrozole, but not placebo, significantly increased LH levels (339
and 323% in the young and the elderly, respectively) and T (146 and
99%, respectively) (P value of young vs. elderly was not
significant). Under letrozole, peak LH response to GnRH was 152 and
52% increase from baseline in young and older men, respectively"
Letrozole normalizes serum testosterone in severely obese men with
hypogonadotropic hypogonadism - Diabetes Obes Metab. 2005
May;7(3):211-5 - "Six weeks of treatment
decreased serum estradiol from 120 +/- 20 to 70 +/- 9 pmol/l (p =
0.006). None of the subjects developed an estradiol level of less
than 40 pmol/l. LH increased from 4.5 +/- 0.8 to 14.8 +/- 2.3 U/l (p
< 0.001). Total testosterone rose from 7.5 +/- 1.0 to 23.8 +/- 3.0
nmol/l (p < 0.001) without a concomitant change in sex
hormone-binding globulin level. Those treated with Letrozole 17.5 mg
per week had an excessive LH response"
Is In The Brain, Whether It Be Lack Of Sexual Interest Or Hypoactive Sexual
Desire Disorder - Science Daily, 3/2/09
Younger Men With Erectile Dysfunction At Double Risk Of Heart Disease -
Science Daily, 2/2/09
Association of Sexual Dysfunction With Lower Urinary Tract Symptoms of BPH
and BPH Medical Therapies: Results From the BPH Registry - Urology. 2009
Jan 21 - "The severity of lower urinary tract
symptoms (LUTS) has correlated with erectile dysfunction (ED) and
ejaculatory dysfunction (EjD) ... The alpha(1A)-subtype nonsuperselective
quinazoline alpha(1)-blockers alfuzosin, doxazosin, and terazosin appeared
to be associated with better ejaculatory function than were the
alpha(1A)-subtype superselective sulfonamide alpha(1)-blocker tamsulosin,
5alpha-reductase inhibitors, and alpha(1)-blocker plus 5alpha-reductase
inhibitor combination therapy"
Testosterone Gel Monotherapy Improves Sexual Function of Hypogonadal Men
Mainly Through Restoring Erection: Evaluation by IIEF Score - Urology.
2008 Dec 30 - "After 3 months of testosterone gel
therapy for the hypogonadal men, the most beneficial effect on sexual
function was erectile function, with sexual desire and orgasmic satisfaction
insignificantly affected. CONCLUSIONS: The results of our study have shown
that transdermal testosterone gel treatment for hypogonadal patients can
improve their sexual dysfunction mainly through restoring erectile function"
Sexuality and the management of BPH with alfuzosin (SAMBA) trial - Int J
Impot Res. 2008 Dec 11 - "Alfuzosin for the
treatment of patients with BPH is effective in improving sexual function, as
well as lower urinary tract symptoms (LUTSs) and quality of life, and is
Testosterone Gel Addition Benefits Men With Erectile Dysfunction Who Do Not
Respond to PDE5s Alone if Testosterone Levels Are Low - Doctor's Guide,
12/10/08 - "Addition of testosterone gel to improve
efficacy of the phosphodiesterase-5 (PDE5) inhibitor tadalafil in men with
erectile dysfunction (ED) shows significant improvements for those with a
serum testosterone level <=3 ng/mL at baseline"
Dysfunction in Men With Congenital Heart Disease - Am J Cardiol. 2008
Dec 15;102(12):1728-1730 - "beta blockers ... Men on
BB were 3.13 times more likely to report ED"
endothelial dysfunction as a marker of vasculogenic erectile dysfunction in
young habitual cannabis users - Int J Impot Res. 2008
Nov-Dec;20(6):566-73 - "We conclude that early
endothelial damage may be induced by chronic cannabis use (and
endocannabinoid system activation); insulin resistance may be the hallmark
of early endothelial dysfunction and may concur to determine vascular ED in
the absence of obesity"
Obesity Linked to Erectile Dysfunction - WebMD, 10/31/08 -
"conditions related to obesity, particularly
hypertension (or high blood pressure), are the most significant causes of
obesity-related erectile dysfunction. Abnormal penile blood flow was found
to be linked to high blood pressure"
Erectile Dysfunction Lower In Men Who Have Intercourse More Often -
Science Daily, 7/2/08
Effect of irbesartan on erectile function in patients with hypertension and
metabolic syndrome - Int J Impot Res. 2008 Jul 3 -
"Erectile function increased significantly (P<0.0001) after 6 months of
treatment with irbesartan, irrespective of dosage and independent of additional
treatment with hydrochlorothiazide. Prevalence of ED declined to 63.7% from
78.5% at baseline, along with a significant increase in orgasmic function
(P<0.001) and intercourse satisfaction (P<0.001). Treatment with irbesartan
alone, as well as in combination with hydrochlorothiazide is associated with an
improvement of sexual desire, frequency of sexual contacts and erectile function
in hypertensive patients with the metabolic syndrome. These results suggest a
beneficial role of angiotensin receptor antagonists in the treatment of
metabolic syndrome, and ED"
- Note: I've been suggesting telmisartan (an ARB) for some time as the
first line treatment for
hypertension. See telmisartan at
Testosterone Gel Improves Insulin Sensitivity, Sexual Function in
Hypogonadal Men With Diabetes and Metabolic Syndrome - Doctor's Guide,
6/20/08 - "Among patients with type 2 diabetes with
or without metabolic syndrome, insulin resistance as measured by HOMA-IR
improved from baseline in the testosterone-treated group compared with
placebo at 6 months (testosterone: -0.62, placebo: +0.16; P = .049) and at
12 months (testosterone: -.58 ... Patients receiving testosterone also
achieved more than a 5-point improvement over placebo-treated patients on
the International Index of Erectile Function (IIEF) at 6 months (P < .05)
and more than 6 points over placebo-treated patients at 12 months"
Testosterone May Cause Health Problems That Lead To Erectile Dysfunction
- Science Daily, 6/16/08 - "It is becoming clear
that obesity, diabetes, high blood pressure, cholesterol problems and
erectile difficulties are intertwined, and a common denominator is
Erectile Dysfunction May Signal A Broken Heart - Science Daily, 5/20/08
Hyperhomocysteinemia is a risk factor for erectile dysfunction in men with
adult-onset diabetes mellitus - Urology. 2008 May;71(5):897-900 -
"Hyperhomocysteinemia (HHcy) ... those with HHcy had
5.2 times the odds of vasculogenic ED compared with men without HHcy"
Dysfunction in Patients with Hyper- and Hypothyroidism: how Common and
Should We Treat? - J Clin Endocrinol Metab. 2008 Feb 12 -
"ED was more prevalent in patients with
hyperthyroidism and hypothyroidism compared to controls ... ED is extremely
common in males with dysthyroidism. Treatment of the latter restores
Erectile Dysfunction Epidemic - Dr. Weil, 1/18/08
Erectile dysfunction is associated with low bioactive testosterone levels
and visceral adiposity in men with type 2 diabetes - Int J Androl. 2007
Nov;30(6):500-7 - "ED is associated with low
bioavailable and free testosterone levels, age, visceral adiposity and
hypertension in type 2 diabetic men"
Epilepsy Drugs May Cause Sexual Disorders - Science Daily, 10/29/07
Erectile Dysfunction Linked To Smoking - Science Daily, 7/27/07 -
"An estimated 22.7 percent of erectile dysfunction
cases among Chinese men might be attributable to cigarette smoking"
Inflammation, Metabolic Syndrome, Erectile Dysfunction, and Coronary Artery
Disease: Common Links - Eur Urol. 2007 Aug 13 -
"Increased circulating levels of inflammatory and endothelial-prothrombotic
compounds are related to the presence and severity of ED"
The prevalence of newly diagnosed hyperlipidaemia in men with erectile
dysfunction - BJU Int. 2007 Jun 6 -
"This study shows the high prevalence of undiagnosed
hypercholesterolaemia and hypertriglyceridaemia in men presenting with ED"
Erectile Dysfunction and Hypertension - Medscape, 5/24/07
ED Drugs May Treat Urinary Problems - WebMD, 5/23/07 -
"Sexual performance in men seems to decline as their
prostate enlargement becomes more severe, experts have begun to notice ... A
once-a-day dose of Cialis helped men with erectile dysfunction and moderate
to severe urinary tract symptoms due to an enlarged prostate improve sexual
functioning" - See tadalafil at
The role of nitric oxide in erectile dysfunction: implications for medical
therapy - J Clin Hypertens (Greenwich). 2006 Dec;8(12 Suppl 4):53-62 -
"Impaired NO bioactivity is a major pathogenic
mechanism of erectile dysfunction" - See my
nitric oxide page for ways to increase it.
Testosterone use in men with sexual dysfunction: a systematic review and
meta-analysis of randomized placebo-controlled trials - Mayo Clin Proc. 2007
Jan;82(1):20-8 - "Testosterone
use in men is associated with small improvements in satisfaction with erectile
function and moderate improvements in libido"
The effects of quinapril and atorvastatin on the responsiveness to sildenafil in
men with erectile dysfunction - Vasc Med. 2006 Nov;11(4):251-7 -
"International Index of Erectile Function (IIEF)
questionnaire ... Compared to placebo,
quinapril (p < 0.01)
significantly improved symptoms of ED as measured
by the IIEF-5 questionnaire. There was a trend toward a significant improvement
in IIEF-5 with atorvastatin"
- See atorvastatin at
Getting to The Heart Of ED - washingtonpost.com. 3/13/07
Prevalence of Metabolic Syndrome and Its Association with Erectile Dysfunction
Among Urologic Patients: Metabolic Backgrounds of Erectile Dysfunction -
Urology. 2007 Jan 30 - "waist circumference (WC) and
triglyceride (TG) ... MS was strongly associated with ED. Fasting blood glucose
levels, hypertension, and WC are the most significant risk factors predicting
the risk of ED. A more pronounced increase in ED risk in the presence of
abdominal obesity, together with altered TG and HDL cholesterol levels, may
indicate a special metabolic background of ED regarding lipid metabolism"
Erectile Dysfunction Hits 18 Million - WebMD, 2/1/07
Doppler Evaluation of Erectile Dysfunction – Part 2 - Medscape, 1/11/07
Doppler Evaluation of Erectile Dysfunction – Part 1 - Medscape, 1/9/07
Metabolic syndrome and erectile dysfunction : Epidemiologic associations and
pathogenetic links - Urologe A. 2006 Dec 12 -
"There is abundant evidence for the association between
erectile dysfunction (ED) and the traditional atherosclerotic risk factors, such
as dyslipidemia, hypertension, glucose intolerance, and obesity, that make up
the metabolic syndrome. Recent findings have demonstrated a linear relationship
between the number of these risk factors and the prevalence of ED"
Hyperhomocysteinemia: a novel risk factor for erectile dysfunction -
Metabolism. 2006 Dec;55(12):1564-1568 -
"Hyperhomocysteinemia, known to be an important risk
factor in endothelial dysfunction, seems to be an important determinant in ED.
These data suggest that slightly elevated Hcys levels are significantly related
with arterial and probably endothelial dysfunction in patients with ED"
The Evolving Role Of
Testosterone In The Treatment Of Erectile Dysfunction - Medscape, 10/30/06 -
"testosterone replacement therapy has evolved from a monotherapy for ED in cases
of low testosterone, to a combination therapy with PDE5 inhibitors. There is
increasing evidence that combination therapy is effective in treating the
symptoms of ED in patients for whom treatment failed with testosterone or PDE5
inhibitors alone. Screening for hypogonadism and combination therapy of ED may
be particularly useful in men with type 2 diabetes or the metabolic syndrome"
Comparison of phosphodiesterase type 5 (PDE5) inhibitors - Int J Clin Pract.
2006 Jun 16 - "With regard to the onset of action,
achievement of an erection that leads to successful intercourse has been
reported for 35% of patients treated with sildenafil within 14 min, 21% of
patients treated with vardenafil within 10 min and 16% of patients treated with
tadalafil within 16 min. Sildenafil and vardenafil both have half-lives of
approximately 4 h but the half-life of tadalafil is 17.5 h. Another difference
between the PDE5 inhibitors is that food, especially fatty food, affects the
pharmacokinetic profiles of sildenafil and vardenafil, but not that of
Clomiphene Citrate Restores Fertility in Men With Prolactinoma and Decreased
Sexual Function - Doctor's Guide, 6/30/06
Erectile Dysfunction Drugs Affect Other Systems, Mostly for the Better -
Doctor's Guide, 6/16/06 - "PDE-5 inhibitors actually
improve blood flow even in areas where there is a blockage of an artery, thereby
having a protective effect on the heart muscle"
Erectile Dysfunction Goes Into Remission On its Own - Doctor's Guide,
New ED Drugs on
Horizon - WebMD, 5/24/06
Switching to Tiagabine Alleviates Antidepressant-Induced Sexual Dysfunction in
Patients With Generalized Anxiety Disorder
- Doctor's Guide, 3/29/06 - "After 14 weeks of tiagabine
treatment, patients had maintained improvement of GAD symptoms, as indicated by
HAM-A and HADS scores, while having significant improvement in sexual function
scores" - See
Smokers: More Erectile Dysfunction? - WebMD, 3/22/06
Erectile Dysfunction and Statin Treatment - Medscape, 3/21/06 -
"Simvastatin was found to cause impotency in five
men with coronary artery disease, and within 1 week of discontinuing
simvastatin, sexual function was restored. The Australian Adverse Drug
Reactions Committee reported 42 cases of ED associated with simvastatin.
In contrast, in one study in men aged 49.7 years and isolated
hypercholesterolaemia [low-density lipoprotein (LDL)-C 4.3 mmol/l] as a risk
factor which used penile Doppler ultrasound in a per protocol analysis of
50% of the cohort of 18 patients (n = 9), atorvastatin therapy was
associated with improvement in erectile function"
Erectile Dysfunction Common, Linked with Severity of Heart Disease -
Doctor's Guide, 1/24/06 - "Erectile dysfunction (ED)
affects approximately one in five American men, appears to be associated
with cardiovascular and other chronic diseases and may predict severity and
a poor prognosis among those with heart disease"
Erectile Dysfunction-Heart Risk Link - WebMD, 12/20/05 -
"Our data suggest that older men in this group have
about a twofold greater risk of cardiovascular disease than men without
erectile dysfunction ... any sign of erectile dysfunction should prompt them
to make an appointment for a complete cardiovascular examination"
Erectile Dysfunction, Artery Problems Linked? - WebMD, 10/11/05 -
"Erectile dysfunction often stems from blood vessel
problems tied to atherosclerosis, the hardening of the arteries"
Serious Riders, Your Bicycle Seat May Affect Your Love Life - New York
Studies Link Bike Seats, Erectile Dysfunction - WebMD, 8/25/05 -
"three new studies in The Journal of Sexual Medicine
... when erectile dysfunction is related to bicycling, it's linked to
pressure on the perineum (the area between the anus and scrotum where nerves
and arteries pass). The pressure, which comes from sitting on a bicycle seat
with a nose extension, restricts blood flow to the penis"
Cause Of Diabetes-related Erectile Dysfunction Is Clarified By Johns Hopkins
Researchers - Science Daily, 8/11/05 -
"one particular simple sugar, present in increased
levels in diabetics, interferes with the chain of events needed to achieve
and maintain erection and can lead to permanent penile impairment over time"
Vascular Disease Most Common Cause of Male Erectile Dysfunction -
Doctor's Guide, 6/28/05
AUA Releases Guidelines for Erectile Dysfunction - Doctor's Guide,
Pills Best for Erectile Dysfunction - WebMD, 5/24/05
Erectile Dysfunction Seen in Men With Prehypertension - Doctor's Guide,
Linked to Erectile Dysfunction - WebMD, 5/16/05 -
"if a man's blood pressure is anything but normal,
he may have a higher risk of erectile dysfunction ... Thirty-five percent
had some degree of erectile dysfunction, compared with 14% of men without
high blood pressure ... In men with high blood pressure, 20% of those
taking no medication had erectile dysfunction, while 36% on one medication
and 47% on more than one reported erectile dysfunction ... Men on older high
blood pressure medications (diuretics, beta-blockers) had higher rates and
more severe erectile dysfunction than men on newer medications (calcium
antagonists, ACE inhibitors, angiotensin II receptor blockers)"
Glycosylated haemoglobin levels and the severity of erectile function in
diabetic men - BJU Int. 2005 Mar;95(4):615-7 -
"This study suggests that the severity of ED is associated with increasing
HbA(1c) levels in diabetic men"
Problems In The Bedroom Can Indicate Heart Problems
- Science Daily, 2/2/05 -
"ED is now being considered an important barometer
of a man's overall cardiovascular health and an early symptom of a more
generalized vascular problem"
Treating Sexual Dysfunction - Clinical Psychiatry News. 12/04
Problems Common Among Obese People - WebMD, 11/15/04
Guidelines, CCBs, ACEs, and ARBs, and Novel Predictors
- Medscape, 9/14/04 - "spontaneously hypertensive
rats (SHR) demonstrate detectable erectile dysfunction (ED) before the onset
of hypertension This may be due to earlier manifestation of the effects of
endothelial dysfunction and tissue remodeling in erectile tissue compared
with vascular tissue"
Erectile Dysfunction in Diabetic Men May Predict Silent Heart Disease
- Doctor's Guide, 6/22/04
Dysfunction May Be Warning Sign - WebMD, 1/20/04 -
"erectile dysfunction affects about 52% of men
between ages 40 and 70 years, and the majority of cases are caused by
conditions that affect blood flow to the penis, such as atherosclerosis and
Love Potions - Time Magazine, 1/19/04
in 3 Older Men Have Erection Difficulty - Physician's Weekly, 9/1/03
Dysfunction Common With Age - WebMD, 8/4/03
Relationship between obesity-related metabolic abnormalities and sexual
function - J Endocrinol Invest. 2003;26(3 Suppl):62-4 -
"it will be reported about the 3 possible mechanisms
through which obese people may suffer from sexual dysfunction: a) insulin
resistance and associated hormonal changes, b) dyslipidemia and related
drugs, and c) psychological problems"
Pathophysiology of diabetic sexual dysfunction - J Endocrinol Invest.
Men with Borderline Low and Low Baseline Testosterone Benefit Equally from
Testosterone Gel (Androgel) - Doctor's Guide, 6/23/03 -
testosterone replacement gel (Androgel)
improves sexual function, body composition and bone mineral density in men
with borderline low testosterone levels almost equal as in men with
pretreatment testosterone levels below the normal"
Sexual Dysfunction Common But Conservatively Treated In Depressed Patients
- Doctor's Guide, 5/26/03 - "Sexual
dysfunction was observed in 35% of those spontaneously reporting
problems and in 69% of those with problems identified by physician
questioning. Of patients treated with antidepressants, 71% reported sexual
dysfunction compared to 65% in untreated patients. The researchers also
found that treatment with
tianeptine was associated with a lower
incidence of sexual dysfunction than was treatment with
tricyclic antidepressant or serotonin reuptake inhibitors" -
Interesting because depression is associated with high
cortisol and tianeptine has been shown
to counter the effects of cortisol. That supports the theory of cortisol
being the cause. - Ben
Improving Erectile Function: Detection, Prevention, and Treatment of ED
- PowerPak.com, exp. 4/1/05 - "ED was 82% more
likely in men with depression ... Low serum
testosterone levels are noted in up to 36% of patients with ED. However,
the correction of sexual dysfunction with testosterone replacement therapy
alone is poor, with treatment response at approximately 35%" - That
may be because testosterone does two things that hinder sexual function. It
decreases HDL cholesterol and it
increases estrogen. - Ben
Valsartan Appears to Improve Sexual Function in Men and Women with
Hypertension - Doctor's Guide, 5/18/03 -
"Men and women being treated with the
angiotensin II receptor blocker valsartan for mild-to-moderate
hypertension appear to show improvements in sexual function and desire"
Lead to Erectile Dysfunction - WebMD, 3/6/03
Focus on Risk Factors in Erectile Dysfunction - Clinical Psychiatry
News, 1/03 - "I generally tell patients that what's
good for your heart is generally good for your sex life—and so maintaining
cholesterol levels, exercising, losing
excess weight—all these things could make a difference to the severity
of a patient's ED [erectile dysfunction]—partly by improving vascular flow"
Check Erectile Dysfunction Patients For Vascular and Cardiac Disease -
Clinical Psychiatry News, 1/03
Sex and the Serious Cyclist - Time Magazine, 10/28/02 -
"Goldstein has been warning cyclists that hours of
sitting on a bike saddle can create enough pressure on the perineum, the
area between the anus and the pubic bone, to permanently damage the artery
that supplies blood to the penis"
Intrathecal Opioids Linked to Sexual Dysfunction - Doctor's Guide,
Impotent Patients on Valsartan Find Increased Interest in Sex; Use
Sildenafil More Often - Doctor's Guide, 5/19/02 -
"Because the use of
increased with the use of valsartan, it suggests that angiotensin II
antagonism induces an increase in sexual desire in
impotent hypertensive men ... It could be related to the reactive
stimulation of angiotensin cascade due to AT1 receptors blockade"
Why is this man smiling? It's not Viagra - USA Today, 4/18/02
Pressure Kills Sex - WebMD, 3/21/02 -
"the problem may not be with blood flow alone. New
research suggests plummeting levels of the male hormone
testosterone could partly be to blame"
1/3 of Diabetic
Men Have Impotence - WebMD, 2/1/02
Physical and Psychological Effects of Stress - MedicineNet.com, 2/02 -
"Under excessive stress, we tend to produce
cortisol, the classic anti-stress hormone produced by our body, perhaps to
conserve energy. However the side-effect here is sexual dysfunction and
infertility as cortisol also inhibits production of the hormones essential
Likelihood Of Impotency - Doctor's Guide, 12/4/01
Blood pressure drug reverses sexual dysfunction - Life Extension
Magazine, 7/01 - "the active ingredient in Cozaar
and Hyaar (losartan) can
significantly improve sex lives of men who suffer from sexual dysfunction"
Antidepressants and Sex: What to Watch For, Common Problem Manageable With
Doctor's Help - WebMD, 5/11/01 -
"The antidepressants that caused the least sexual
dysfunction were Serzone (28%) the slow-release Wellbutrin SR (24%), and the
immediate-release Wellbutrin (22%) -- all of which are non-SSRIs"
Newest Hypertension Drug,
Losartan, May Improve Sexual Function
- Doctor's Guide, 5/1/01
Carvedilol Reduces But Valsartan May Increase Sexual Activity In
Hypertensive Men - Doctor's Guide, 2/1/01 -
"carvedilol induces a chronic reduction of sexual
activity whereas valsartan, an angiotensin II antagonist, not only does not
significantly reduce sexual activity but may even increase it."
Newest Hypertension Drugs
May Improve Sexual Function - Doctor's Guide, 11/13/01
Submissive Men More Likely to Suffer Erectile Dysfunction - WebMD,
Is a Male 'Change
of Life' Fact or Fiction? - WebMD, 10/20/00 -
"A very small drop in testosterone -- 10% or so --
might cause symptoms like depression, mood swings, decreased muscle strength
and energy, reduced sex drive, problems with erections."
Impotence Risk High for Both Prostate Cancer Treatments - WebMD, 9/22/00
Antidepressant [Wellbutrin SR] Can Boost Sex Drive - Intelihealth,
Lifestyle may play role in potential for impotence - CNN, 5/3/00
in the Spotlight -- for Different Reasons
- WebMD, 5/3/00
Viagra sometimes fails, but there are alternatives - CNN, 4/5/00
FDA Approves Prescription
AndroGel For Low Testosterone - Doctor's Guide, 2/29/00
Impotence May Be Early
Warning Of Heart Disease - Doctor's Guide, 11/10/99
Tanning drug may find new life as Viagra alternative - CNN, 6/14/99
Muse Offers Second Chance
For Patients Unsuccessful With Viagra - Doctor's Guide, 5/6/99
Uprima Shows Promise In
Patients With Erectile Dysfunction - Doctor's Guide, 5/5/99
Approved In The U.K. For Impotence - Doctor's Guide, 3/29/99
Viagra anniversary sees herbal competitors by the dozens - CNN, 3/26/99
Antidepressant-Induced Sexual Dysfunction Associated with Low Serum Free
Testosterone - Psychiatry Online
Associated With Depression - Doctor's Guide, 7/23/98
Doctor says bike-riding can hurt a man's sex life - CNN, 6/1/98
Letrozole once a week normalizes serum testosterone in obesity-related male
hypogonadism - Eur J Endocrinol. 2008 May;158(5):741-7 -
"Isolated hypogonadotropic hypogonadism (IHH) is
frequently observed in severely obese men, probably as a result of increased
estradiol (E(2)) production and E(2)-mediated negative feedback on pituitary
LH secretion. Aromatase inhibitors can reverse this process ... treated with
2.5 mg letrozole once a week for 6 months ... Six weeks of treatment reduced
total E(2) from 123+/-11 to 58+/-7 pmol/l (P<0.001, mean+/-s.e.m.), and
increased serum LH from 4.4+/-0.6 to 11.1+/-1.5 U/l (P<0.001). Total
testosterone rose from 5.9+/-0.5 to 19.6+/-1.4 nmol/l (P<0.001), and free
testosterone from 163+/-13 to 604+/-50 pmol/l (P<0.001). Total testosterone
rose to within the normal range in all subjects, whereas free testosterone
rose to supraphysiological levels in 7 out of 12 men ... Letrozole 2.5 mg
once a week produced a sustained normalization of serum total testosterone
in obese men with IHH. However, free testosterone frequently rose to
supraphysiological levels. Therefore, a starting dose <2.5 mg once a week is
recommended" - See
Femara (letrozole) at OffshoreRX.
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