Erectile Dysfunction (ED)

Overview of Erectile Dysfunction (ED)

• The term impotence has been replaced by the term erectile dysfunction.
• Moreover, the prevalence of partial or complete ED is about 50% in men 40 to 70 and increases with aging. However, many men can be successfully treated.[1]
• The incidence of moderate or severe ED more than doubled between the ages of 40 and 70.
• Incidence was highest among men in the age group 50–59 (21%) and men who were poor (14%), divorced (14%), and less educated (13%). [3]

Indian epidemiology then other

Causes of Erectile Dysfunction (ED)

• Primary ED (the man has never been able to either attain or sustain erections) is rare also is almost always due to psychologic factors or clinically obvious anatomic abnormalities.
• Guilt, fear of intimacy
• Depression
• Severe anxiety
• Psychologic factors
• Most often, ED is secondary
• A man who previously could attain also  sustain erections no longer can.
• ED may be situational, involving a particular place, time, or partner
• Atherosclerosis of penile arteries
• Diabetes
• Prostate surgery
• Hormonal disorders also drug [1]
• Hypogonadism. [2]

Classification of Erectile Dysfunction (ED)

• Primary
• Secondary

Risk factor of Erectile Dysfunction (ED)

• Smoking
• Medications used in treating either diabetes or cardiovascular disease
• There is a higher incidence of ED among men who have undergone radiation or surgery for prostate cancer also in those with a lower spinal cord injury
• Stress
• Anger. [3]

Pathogenesis refers to the development of a disease. It’s the story of how a disease gets started and progresses.

This is the entire journey of a disease, encompassing the cause but going beyond it.

Pathophysiology of Erectile Dysfunction (ED)

ED may result from three basic mechanisms:

1. Firstly, Failure to initiate
2. Secondly, Failure to fill (in other words, arteriogenic)
3. Thirdly, Failure to store adequate blood volume within the lacunar network

These categories are not mutually exclusive, also  multiple factors contribute to ED in many patients. [3]

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Sign & Symptoms of Erectile Dysfunction (ED)

• Infertility
• Trouble getting erection
• Trouble keeping an erection
• Reduced sexual desire
• Feeling of either embarrassment or guilt
• Low self-esteem [4]

Clinical / Physical Examination For Erectile Dysfunction (ED)

• Generally, Medical, surgical, psychological and sexual history should be taken.
• Inspection: In detail, In light of the increasing recognition of the relationship between lower urinary tract symptoms and ED.
• A history of either nocturnal or early morning erections is useful for distinguishing physiologic ED from psychogenic ED.
• All in all, Questions should be asked about whether ejaculation is normal, premature, delayed, or absent. [3]

Diagnosis of Erectile Dysfunction (ED)

 Clinical evaluation i.e.:

• Include history of drug also  alcohol use, smoking, diabetes, hypertension, and atherosclerosis and symptoms of vascular, hormonal, neurologic, also psychologic disorders
• Satisfaction with sexual relationships should also be explored. Additionally, Partner sexual dysfunction ( e.g. atrophic vaginitis, depression) must be considered and evaluated

Screening for depression i.e.:

• Screen for depression, which may not always be apparent. The Beck Depression Scale or, in older men, the Yesavage Geriatric Depression Scale is easy to administer and may be useful.

Testosterone level i.e.:

Complications are what happen after you have a disease. They are the negative consequences of the disease process.

Investigation of Erectile Dysfunction (ED)

Blood test i.e.:

• Glucose
• Prolactin
• Testosterone
• Luteinising hormone (in other words, LH)
• Follicle-stimulating hormone (in other words, FSH).

Plethysmograph: In brief, To establish whether blood supply and nerve function are sufficient to allow erections.

Internal pudendal artery angiography [2]

Treatment of Erectile Dysfunction (ED)

• Treatment of cause
• Usually, an oral phosphodiesterase inhibitor
• Sometimes a mechanical device or an either intracavernosal or intraurethral prostaglandin
• Apomorphine
• Alprostadil
• Surgery: In detail, For patients who do not respond to drug therapy.[1]
• Drugs: e.g. Antidepressants, Antihypertensive, Tranquilizers
• Hormones: e.g. Progesterone, Estrogens, Corticosteroids, GnRH agonists [3]

Prevention of Erectile Dysfunction (ED)

• Stop smoking
• Maintain healthy diet
• Prevent diabetes and hypertension
• Be physically active
• Avoid taking stress [4]

Homeopathic Treatment of Erectile Dysfunction (ED)

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?.

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improved with homeopathic medicines.

Homeopathic Medicines for Erectile Dysfunction:

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor.

So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).

Medicines:

Anacardium Orientalis:

• Generally, Dual personality, Lack of self-confidence with severe depression associated with impaired memory

Argentum Nitricum:

• Very Apprehensive from the first night of marriage, fearful and nervous, leading to premature ejaculations. Moreover, “Erection fails when coition attempted”.

Agnus Castus:

• Especially indicated in old men with history of sexual excesses and in premature old age, arising in young persons from abuse of sexual powers.
• Apathy, melancholy and self-contempt from sexual abuse. Impotence with gleet (with those who have frequently had Gonorrhoea.)
• Lastly, Penis is small, cold, also flaccid; no desire or power; complete impotence. [6] [7]

Caladium:

• Penis remains relaxed, even when excited.
• In point of fact there is sexual desire and excitement; no emission and no orgasm during an embrace.
• Impotence in vigorous persons from suppressed gonorrhoeal discharge.
• Worse – motion. On the other hand, Better – after sweat after sleeping in daytime [6] [7]

Lycopodium:

• Reputed to be one of the best remedies for impotence.
• Furthermore, Erections imperfect or absent.
• In “old men who marry again but find themselves impotent.”
• Besides this, Young men who become impotent from masturbation or sexual excesses.
• Old men with strong desire but imperfect erections.
• Worse – Right side, from right to left, from above downward, especially, 4 to 8pm, from heat or warm room, hot air, bed. Whereas, Better – Motion, particularly after midnight, warm food and drink, on getting cold, being uncovered.[6] [7]

Natrum Mur:

• Male – Impotence with retarded emission. Emission even after coitus.
• Worse – noise, music, warm room, lying down, about 10 am, specifically; at seashore, mental exertion, heat. On the other hand; Better – open air, cold bathing, going without regular meals, lying on right side, pressure against back, especially by tight clothing. [6] [7]

Cantharis:

• Painful swelling of genitals.
• Pulls at penis.
• Sexual desire increased not better by sex.
• Bloody semen. Additionally, Pollutions.
• Burning in urethra after sex.
• Strong desire, painful erection.
• Worse – During or after urination, drinking cold water or coffee, sound of water, bright objects.
• Better – Better from rubbing, warm applications, warmth. [5]

Selenium:

• Irritability after sex.
• Loss of sexual power with lascivious fancies. In addition, Lascivious but impotent.
• On attempting sex, penis relaxes. Moreover, Easy loss of semen during sex with feeble erection, but long continued voluptuous thrill during stools.
• Semen watery, odorless. Dribbling of semen during sleep.
• Prostatitis, prostatic adenoma.
• Bedwetting, chronic urethritis. Papilloma on the penis
• Worse – By touch, pressure, motion, after seminal losses, specifically after stools, loss of sleep, night watching, after sleep, rest, in open air, draft, even if warm.
• Better – Better after sunset, inhaling cool air, taking either cold air or cold water into mouth. [5]

Conium:

• Suppressed sexual desires.
• Desire increased; but power decreased.
• Sexual desire without Sexual nervousness with feeble erection.
• Erections imperfect and of too short duration. Impotence. Seminal discharge, provoked by mere presence of a woman or contact. Additionally, Cutting in urethra while semen passes.
• Sexual nervousness, dejection after sex. Prostatitis. Dribbling of prostatic fluid, worse stools, emotions, etc. Prostate cancer. Testicles hard also  enlarged. Itching in prepuce.
• Besides this, Worse- sexual abuse or excess, from celibacy, alcohol, pressure of tight clothing, raising arms, standing, lying down with head low.
• Better- while fasting, from letting limbs hang down, walking bent, sitting down, stooping, walking, motion, pressure sun, dark.[5]

Dioscoria:

• Suited very well to tea drinkers.

Phosphoric Acid:  

• Generally, Gives excellent results in Oligo-asthenospermia. It increases the motility of sperm.

Titanium:

• In brief, Too early ejaculation

Tribulus Terrestris:

• A very good medicine for patients in their mid- 40’s having partial impotence caused either by overindulgence or advancing age.

Diet & Regimen of Erectile Dysfunction (ED)

• Avoid Smoking
• Be physically active
• Reduce stress level

These foods could be beneficial for men’s health. In addition to decreasing ED:

• Blackberries
• Watermelon
• Spinach
• Oatmeal
• Avocado
• Pomegranate juice
• Fish
• Bananas

These should be Avoid for ED diet i.e.:

• Alcohol
• Sugary drinks
• Soy based products [8]

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References use for Article Erectile Dysfunction (ED)

[1] The Merck Manual

[2] Davidsons Principles and Practice of Medicine (PDFDrive.com)

[3] Herrison-s_Principles_of_Internal medicine_19th_Eddition-2…

[4] https://www.everydayhealth.com/erectile-dysfunction/

[5] Nature’s Materia Medica by Robin Murphy, Md

[6] Homoeopathic Body-System Prescribing – A Practical Workbook of Sector Remedies

[7] The Homoeopathic Prescriber By K. C. Bhanja

[8] https://www.singlecare.com/blog/erectile-dysfunction-diet/

Frequently Asked Questions

What is Erectile Dysfunction?

Erectile dysfunction (ED) is the inability to attain or sustain an erection satisfactory for sexual intercourse.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Erectile Dysfunction?

• Anacardium
• Argentum Nitricum
• Agnus Castus
• Caladium
• Lycopodium
• Natrum Mur
• Cantharis

What causes Erectile Dysfunction?

• Psychologic factors or anatomic abnormalities.
• Guilt, fear of intimacy
• Depression
• Severe anxiety
• Psychologic factors
• Most often, ED is secondary

Give the symptoms of Erectile Dysfunction?

• Infertility
• Trouble getting erection
• Trouble keeping an erection
• Reduced sexual desire
• Feeling of embarrassment or guilt
• Low self-esteem

What are the types of Erectile Dysfunction?

• Primary
• Secondary