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The real problem of erectile dysfunction is that this is a difficult subject for a lot of guys to talk about, especially older guys, who come from a generation were talking about anything as personal and intimate as ED was just embarrassing.
But the thing is, ED isn’t something that just randomly strikes a few guys. It’s something that a lot of guys suffer from. And the older you are, the more likely it is that you’re one of those guys. If you’re over 50, then you’ve got about a 50/50 chance of getting it. If you’re over 70, then the odds are stacked against you with about 70% of guys who are over 70 suffering from ED.
But it doesn’t have to be that way. ED, especially age-related, has been the subject of intense study for a number of decades now, and there are a lot of different paths to recovery available, and we’re going to go over most of them.
Mechanics of an erection
Let’s briefly explain the mechanics of an erection. First off, you’ve got arteries and veins. There are six primary arteries. The two biggest arteries are located right in the center of the two primary erectile tissue areas, called the corpus cavernosum. There’s another body of erectile tissue called the corpus spongiosum, and it has two smaller arteries located inside of it.
There’s also a couple of arteries located along the top of the penis, but these are less involved in an erection. These arteries are where the blood enters the penis, inflates the erectile tissue, and causes an erection. There’s also a couple of veins located along the top of the penis, alongside the dorsal arteries where the blood leaves the penis, deflating your erection. The other structure that really important is the urethra. This is where the seminal fluid flows when you ejaculate.
All erections start with some type of stimulus. This can be either type of direct stimulation, like fondling, or it can be something that’s more emotional or intellectual, like a fantasy or thoughts of a loved one. Either way, once the stimulation occurs, the first thing that happens is that the stimulus causes the endothelial tissue in your arteries to secrete nitric oxide, which in turn causes an increase in a chemical compound called cyclic guanosine monophosphate.
This causes the smooth muscles in the arteries of the erectile tissue to relax, allowing the blood to rush in. This is what causes an erection. The erectile tissue is filling up with blood and increasing the volume of your penis by as much as six times. This sudden swelling also causes the dorsal veins to collapse, trapping the blood inside of the erectile tissue and sustaining your erection.
But the cyclic GMP that’s allowing the blood to rush in is countered by an enzyme called phosphodiesterase type 5, or PDE5. PDE5 breaks down the cyclic GMP. As long as the stimulation is ongoing, new cyclic GMP is being created as fast as the PDE5 is breaking it down, and you can continue to sustain an erection.
But when arousal ends, as with ejaculation, the endothelial cells stop producing nitric oxide, cyclic GMP production drops off, and the PDE5 takes over. When that happens, all the cyclic GMP is broken down by the PDE5, the arteries collapse, and the dorsal veins re-inflate, allowing the blood to drain from the penis. And that’s the end of your erection.
Now, that’s what happens when you’re young and healthy, and your penis is working like it’s supposed to. But as you age, problems develop.
Causes of erectile dysfunction
Like there are two different types of stimulation, there are a couple of different categories of problems. If your problem is emotional, if it’s connected to an emotional trauma that you’ve suffered, if it’s in any way connected to your mental health, then it’s probably a libido problem.
Your libido is the amount of sexual desire that you’re able to generate. If you can’t generate much desire, you’re unlikely to achieve an erection. On the other hand, if you’re problem is functional, then it could be related to the fact that as we get older, most of us suffer a pretty serious decline in our production of nitric oxide. But it could also be the result of an overall decline in the health of your cardiovascular system. Erectile dysfunction can be an early warning system for your heart health.
Another cause of ED can be low testosterone. Testosterone is the male hormone, and it controls a huge number of factors that determine everything from our masculinity, energy levels, health, muscle mass, and reproductive system. If you’ve got low testosterone, then you’re going to experience erectile problems. And unfortunately, for a lot of guys, as we age, our production of testosterone can go into the toilet.
Treatment of erectile dysfunction
Fortunately, there are a lot of different ways to treat ED. And the first that we want to talk about is a lifestyle. Many lifestyle choices can have a negative impact on your ability to get erections – things like alcohol consumption, smoking, too much stress, not getting enough sleep, not getting enough exercise, and eating junk food.
So if you’re got ED, we’d recommend taking a good look at your lifestyle: getting more exercise, eating clean, whole foods, and supplementing is the foundation for just about everything. Lifestyle choices can also have a big impact on testosterone levels. Naturally, optimizing your hormone levels is all about lifestyle. You can certainly do testosterone replacement therapy, but you can have great results in boosting testosterone production just by improving your lifestyle choices.
The chances are that your ED isn’t caused by just one thing. It’s more likely the result of a combination of things. And for a lot of guys, it’s the decline in nitric oxide production. It’s been documented that nitric oxide production goes into decline with age, but it doesn’t have to. There’s an exercise that you can do that will stimulate nitric oxide production. In fact, it was designed specifically to do just that. It’s called the nitric oxide dump, or NOD. The exercise only takes about 2 or 3 minutes to do, but you need to do it three times a day.
Nitric oxide has a huge impact on whether or not most ED meds like Viagra or Cialis work. The Big 3: Viagra, Cialis, and Levitra are all PDE5 blockers. Viagra and Levitra are for the more spontaneous situations. They are absorbed and cleared more quickly by the body. Both take effect within about an hour, but the effects only last for 6 to 8 hours.
Cialis is for situations where a little more planning is called for. It takes a little longer to be absorbed by the body, about 2 hours, but it can last for up to 36 hours. So if you’re planning a romantic weekend, you’d want to go with Cialis. The problem is that these drugs can be expensive. It’s not unusual to see pharmacies charging $45 to $65 a pill. And you may have to fill prescriptions 2 or 3 pills at a time. But there is a solution, except buying much cheaper generics – GoodRx.
If your problem isn’t that you can’t get an erection, but you have a hard time sustaining one, then another solution is a constriction device, better known as a cock ring. These devices can restrict the flow of blood out of the dorsal vein, which is the cause of detumescence, which is when your erection deflates. But they can also restrict everything else: they can restrict the arteries that carry blood into the erectile tissue, and they can restrict the urethra, making for a painful ejaculation. Now there are some restriction devices that have been designed to only restrict the dorsal vein and not the arteries or the urethra.
Some therapies have gotten great results for some guys, but they’re expensive: ShockWave therapy and the P-Shot. Without getting too technical, ShockWave therapy involves breaking up damaged tissues with sound waves, and the P-Shot is an injection of Platelet-Rich Plasma into the penis, which promotes healing.
There are also some other treatments for ED like surgery, implants, and injections of ED drugs directly into the penis. They are also some herbal remedies like Panax Ginseng, Rhodiola Rosea, DHEA, Ashwagandha, and acupuncture, while it’s not an herb. The thing is, we’ve tried all of those but didn’t really get good results. But you might have a completely different experience, and we’ve heard from a lot of men who did.
If your problem isn’t your “equipment,” but your desire for sexual activity, your libido? Well, we’ve got a solution for that too – PT-141, also known as bremelanotide. PT-141 is an analog of an alpha-melanocyte-stimulating hormone or MSH. One of the things that MSH does is that it can have a very beneficial impact on your sexual drive.
PT-141 is a peptide, which is simply a short-chain amino acid, but it has to be injected – NOT an injection directly into your penis, but a subcutaneous injection, like an insulin injection. Now, it’s been approved by the FDA for treating the lack of sex drive in women. It’s sold under the brand name Vyleesi, and it’s very expensive. It comes in a pack of 6 auto-injectors, but even with GoodRX, it comes to a little over $4,000, so some of you might consider this a little sketchy.
However, PT-141 is available from a number of sources as a freeze-dried powder that has to be reconstituted with bacteriostatic water and is then available for injection, so it’s much, much cheaper – from about $40 to $60 for a 10 mg. vial.
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