Eric Bakker N.D.May 24, 2022

Erectile dysfunction can occur when  a man is unable to obtain or maintain an adequate erection in order to achieve sexual intercourse. Erectile dysfunction can indicate either a medical or psychological problem. It can lead to anxiety, relational conflict, and low self-esteem. The main symptom is a man's inability to get or maintain a hard adequate erection for sexual activity.


What Is Erectile Dysfunction?

ED – Erectile dysfunction is also known as ED, and is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. The inability to maintain a satisfactory erection is more common than you may think, this condition is experienced by up to one in five men and is increasingly common with age. This condition can affect men of all ages, but tends to be more common with older men. ED is a condition I have seen many men over the years who come into our clinic or who call me up wanting to know what they can do about ED, and I would expect that there are many more men out there who are just too embarrassed to ask for help. Are you one of them reading this article?

Erectile Dysfunction Symptoms

  • The ability to get and maintain an erection, but every time you want to have sex.
  • Not being able to maintain an erection long enough to have sexual intercourse.
  • Not being able to get or maintain an erection on demand, at any time.

Younger men generally have no problems with their sexual performance, but many find that as they age they may not be able to perform as confidently as they could. A reasonable percentage of men in their mid to late forties may experience inconsistent erections, or wake up without a morning erection and yet others only experience brief erections.

This causes a lack of confidence and self-esteem issues which only further serves to undermine the ability to maintain a good erection. Over half of men aged between fifty to seventy years of age experience ED to varying degrees, although this varies greatly from individual to individual.

In my clinical experience, quite a few men by the age of 40 will have experienced inconsistent erections at different times, and in some instances will experience only brief erections. Over half of men aged between 50 and 70 years of age experience varying degrees of erectile dysfunction, although it is not an inevitable consequence of normal ageing. For men who experience frequent erectile dysfunction, there can be a great deal of guilt and embarrassment which may cause emotional and relationship problems.

Some men have ED problems to the point of ending their relationship making any future sexual relationships difficult, which can lead to a diminished self-esteem and even depression.

How to Improve Erectile Dysfunction

What is good to know is that a few simple lifestyle changes may be all there is to solving this problem which prevents you from having a satisfactory sex life. Do you have diabetes or heart disease? There is recent research that has revealed that ED is more common in men with diabetes and heart disease, and particularly in those who are physically less active. The three most important things you can do to improve your ED without any medication is to get regular exercise, eat a healthy diet and learn how to de-stress.

Erectile Dysfunction Causes

ED has several causes, there is no single cause. Different men will experience different causes, and some men will have one single cause, where as others may have several causes. The main causes are:

  • Diabetes. About 20 to 50% of men with diabetes may experience erectile dysfunction.
  • Kidney disease
  • Alcoholism. Even moderate to heavy drinking may lead to erectile dysfunction.
  • Atherosclerosis (plaque build up of the arteries). Smokers are more likely to suffer from erectile dysfunction due to poor circulation.
  • Heart disease (angina and myocardial infarction)
  • Neurological
  • Psychological factors. Experts believe that as many as 20% of erectile dysfunction may be cause by stress, anxiety, depression, guilt or shame or even a fear of sexual failure.
  • Surgery. Radical prostate or bladder surgery which is more common in prostate cancer, may lead to ED.
  • Prescription drugs. The side effects from various pharmaceutical drugs can very much affect a male’s libido and consequently his ability to maintain a good erection. The main prescribed drugs which affect a man’s erections are the blood pressure drugs, antihistamines, antidepressants, cimetidine (anti stomach ulcer drug) and tranquilisers.

What Is The Main Cause Of Erectile Dysfunction?

Erectile dysfunction can have several causes and there are many reasons why ED can occur, but a more common reason as men age is primarily due to a physical cause involving the arteries and/or veins in and around the penis itself. When the problem is arteries, it is usually caused by arteriosclerosis, (hardening of the arteries), although trauma or damage (accident) to the arteries may be the cause.

Erectile Dysfunction Is Recognised Today

man1Why put up with ED? Sexual activity is healthy and is an important part of an intimate relationship,. so why just give up if you have ED and think “this is it”. Maintaining an active sex life has many health benefits researchers say, it has shown to help reduce blood pressure, improve sleep and can even boost your immune system helping you resist many different acute and chronic illness. Some experts have discovered that men are interested in sex every five days, whereas women every ten days. In the 50’s and 60’s, men weer less likely to speak about their ED to their family and friends.

There was more embarrassment over a guys lack of performance in the bed room and this was an area which was best left alone due to shame or guilt. With the discovery and promotion of pharmaceutical ED drugs like Viagra and Cialis, everything changed. ED became a much more recognised male complaint and viewed as a common problem many men face, and men today are much more willing to discuss this sensitive topic and seek help.

Premature Ejaculation

Premature ejaculation (formerly known as impotence) is common to many men. Some men may notice that the duration of intercourse may become shorter as they age. After many years of maintaining a normal sexual relationship, including normal ejaculations, having intercourse regularly and being satisfied with the duration of intercourse, things may change. I have spoken with many men over the years in my clinic who experience premature ejaculation, they have a tendency to ejaculate during foreplay or well before intercourse. This can have a devastating effect on sexual performance and cause much embarrassment, leading to further sexual dysfunction with future intimate encounters.

Erectile Dysfunction Can Be An Early Warning Sign of Heart Disease

Erectile dysfunction can be very stressful, but relax, it isn’t a life-threatening health problem, but heart disease can be. Erectile dysfunction — difficulty maintaining an erection sufficient for sex — can be an early warning sign of heart problems. Understanding the connections between erectile dysfunction and heart health may help you recognise signs and symptoms of heart disease early on and get treatment before heart problems become a more serious problem. Similarly, if you have heart disease, getting the right treatment may help with erectile dysfunction. The following factors all increase the likelihood that your erectile dysfunction could be a sign of underlying atherosclerosis and heart disease:

  • Diabetes. Men who have diabetes are at especially high risk of erectile dysfunction, heart disease and other problems caused by restricted blood flow. Do you have metabolic syndrome?
  • Your age. The younger you are, the more likely your erectile dysfunction is a sign that you are at risk of heart disease. Men under age 50 are at especially high risk. In men over age 70, erectile dysfunction is much less likely to be a sign of heart disease.
  • Being overweight. Being overweight or obese increases your risk of both heart disease and erectile dysfunction due to atherosclerosis (plaque build-up in the arteries) and other reasons.
  • Having high cholesterol. A high level of low-density lipoprotein (LDL, or “bad”) cholesterol can lead to atherosclerosis. You can read a lot more about cholesterol and the best blood tests here.
  • Smoking. Smoking raises your risk of developing atherosclerosis. It also directly affects your ability to get an erection. Smokers are much more likely to suffer with circulatory problems leading to ED.
  • High blood pressure. Over time, high blood pressure damages the lining of your arteries and accelerates the process of atherosclerosis. You can read more about high blood pressure here.
  • Having a family member with heart disease. It’s more likely your erectile dysfunction could be linked to heart disease if you have a blood relative such as a sibling or parent who had heart disease at a young age.
  • Depression. There’s some evidence that depression is associated with an increased chance of having heart problems — and erectile dysfunction. You can read more about mood disorders here.
  • Sedentary lifestyle and a lack of exercise. Two of the biggest lifestyle factors for circulatory disease and sitting down too much, not being active and failing to exercise regularly. You can read more about the connection between exercise and circulatory disease on our healthy lifestyle page.

The tiny arteries and veins surrounding the penis will become compromised before the heart’s coronary blood vessels are affected, and this effect will often produce erectile failure before progressing to affect the heart. The blood vessels of the penis are only 0.6 – 0.7mm in diameter, and those of the heart are approximately 1.5 – 2.0mm in diameter, so you can see how ED will form prior to the coronary arteries becoming affected, and unless there is a change in lifestyle, coronary artery disease may follow impotence within a few years.

What Can You Do About Erectile Dysfunction?

Is is important that you understand there are several factors within your control which may well contribute to erectile dysfunction, including being overweight, smoking and drinking excess alcohol. These lifestyle factors can and often do lead to high blood pressure and high cholesterol and consequently the development of arterial disease. In addition, are you exercising enough and ensuring you are stay reasonably active? It is a fact that many men over the age of forty slow down, spend more time watching TV or on a computer. There are also various ways you can enhance your libido and erectile dysfunction naturally, without having to resort to pharmaceutical drugs like Viagra or Cialis. Here are some of the main points to consider when wanting to overcome erectile dysfunction:

  •     Learn to deal with stress
  •     Learn more about stress, anxiety or depression
  •     Exercise regularly
  •     Improve your nutrition and learn about your best protein, carbohydrate, fat and beverage choices
  •     Reduce alcohol intake. Do you think when you drink?
  •     Get adequate sleep. Beat insomnia
  •     Taking steps to deal with personal conflict. Beat negative thinking
  •     Stop smoking

doctor_1Medical Male Enhancement Products

Your medical doctor will have several solutions, including drugs, injections, vacuum devices and even penile implants. While these solutions may suit some men, I have found that the majority of men seek a more natural, less expensive and invasive and side-effect free solution to their ED problems. Pharmaceutical drug options like Viagra can be very costly, with these little blue tablets costing as much as twenty-five dollars each! Other solutions include injecting a fine needle into the penis, implants into the sides of the penis, inflatable devices and even invasive vascular surgery.

The pharmaceutical drug solution

There are several oral ED medications available from your doctor for male enhancement, and these have changed the whole arena of men’s sexual health by making it much more acceptable for a man to admit to erectile dysfunction and to seek actual treatment. The main pharmaceutical erectile drugs are Viagra, Levitra and Cialis. These three drugs work by enhancing the effects of nitric oxide as a chemical messenger that relaxes smooth muscles in the penis, increasing the amount of blood and allowing an erection to sexual stimulation. Nitric oxide is a chemical produced by the tiny cells lining your arteries, it helps to relax the smooth muscle allowing blood to flow more easily. Your doctor may have prescribed you a nitrate spray or pills if you have suffered from angina (chest pains) in the past, this is a synthetic form of nitric oxide. If you take a nitrate drug you will most certainly want to avoid the pharmaceutical ED drugs Viagra, Cialis or Levitra.

The injection solution

There is another solution your doctor may offer called prostaglandin E needle injection therapy. A very fine needle is injected into the side of the penis which produces an erection in five to 20 minutes that lasts for about an hour. The downside to this treatment (apart from sticking a needle into your penis, ouch!) is that there is a risk which can include scarring, and the cost per injection can be very high, seriously, who in their right mind would settle for this option?

The vacuum pump solution

A vacuum constriction device (VCD) is an external pump with a band on it that a man with erectile dysfunction can use to get and maintain an erection. The VCD consists of an acrylic cylinder with a pump that may be attached directly to the end of the penis. A constriction ring  is placed on the cylinder at the other end, which is applied to the body. The cylinder and pump are then used to create a vacuum to help the penis become erect; and the band or constriction ring is used to help maintain the erection. Some studies I have read suggest that up 80% of men are initially satisfied with the results of VCDs, but that satisfaction rates decrease with time. Is it any wonder, it sounds like a weird device if you ask me.

Penile implants

A penile implant is another treatment option for men with erectile dysfunction and there are two main types, the device is either bendable or inflatable. The simplest type of implant consists of a pair of rods surgically implanted within the erection chambers of the penis. There are problems here as you can imagine, because with this type of implant the penis is always semi-rigid and merely needs to be lifted or adjusted into the erect position to initiate sex. The other type a hydraulic, inflatable implant which allows the man to have an erection whenever he chooses and is much easier to conceal, it is also a lot more natural. The implant option is usually used when there is a clear and underlying medical cause for ED and when the problem is unlikely to be resolved or improve naturally or with other medical treatments.

Vascular surgery

Vascular reconstructive surgery is performed to improve the blood supply of the penis in attempts to improve a man’s ability to get and maintain an erection. This procedure is difficult, expensive, and not always effective, it is very rarely performed. Vascular reconstructive surgery involves by-passing the blocked arteries by transferring an artery from an abdominal muscle to a penile artery so that it creates a path to the penis that bypasses the area of blockage that is inhibiting blood flow to the penis. The long-term results from vascular surgery have been disappointing with even the best of results showing only about a 5% improvement.

Erectile Dysfunction Pills

Do you really still need to take – Viagra? According to folklore, natural herbal aphrodisiacs help to raise libido and increase sexual desire. They are being used by an increasing number of men and women to give their sex lives a boost. What you may not be aware of is that here are natural medicine options for erectile dysfunction. For many thousands of years, man has utilised herbal medicines since he noticed how animals had ample sexual vigour, animals which were feeding on various herbs which maintained their sex drive.

Science has since validated these specific compounds found in certain plants, and specific herbal medicines have now been recognised as some of the best plant based medicines which enhance libido and significantly help erectile dysfunction.

Herbal medicines contain active ingredients which can be measured, analysed and made into tablets or capsules by companies with strict good manufacturing processes. The key active ingredients in most all herbal medicines have now been identified and isolated, so why should you rely on pharmaceutical drug based medicines to enhance your libido and erectile issues when you can opt for effective natural compounds?These products are of the highest possible quality and tested and guaranteed for their clinical efficacy, so why should you settle for a chemical based drug for libido and ED when an effective and powerful natural medicine option is available?


Maca for ED, libido and male infertility. Try Maca, it is one of my favourite herbal medicines I use to recommend in my clinic for ED as well as for male infertility. There are many (expensive) and useless herbal sex pills on the internet which promote anything from “increasing male size” to an almost “unlimited sexual performance”. These false claims are nonsense of course! Buyer beware, if the advertisement sounds fake – it is fake.

How Does Maca work?

Science tells us that Maca contains a particular chemical called p-methoxybenzyl isothiocyanate, and this chemical is the primary reason for its sexual enhancement properties and its ability to boost libido in both men and women. Maca root contains almost 60 naturally occurring beneficial phytochemicals. Modern scientific research has shown that Maca supports normal testosterone levels, and testosterone is the male hormone which is primarily implicated in male sexual performance and is vital for libido, muscular growth and strength as well as having the ability to generate overall male energy, confidence and stamina.


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