By Jack Challem

Copyright 2001 by Jack Challem, The Nutrition Reporter™

All rights reserved. This article originally appeared in GreatLife magazine.

During the last seven years of his marriage, Richard and his wife had stopped sharing any kind of intimacy. No sex. No cuddling. Not even a kiss. After filing for divorce, Richard did what few men have the courage to do: he described his profound sense of sexual frustration to three buddies. To his surprise, all of them owned up to having the same experience as their marriages disintegrated.

For the typical man, the ups and downs of his sex life are often his most closely guarded secrets. Indeed, in many troubled relationships, a man and his significant other will often project an outward image that everything is hunky-dory. But only that couple really knows what's going on -- or not going on -- in the bedroom.

"Having a healthy sex life is a big part of staying physically healthy," says John Gray, Ph.D., a psychologist in Mill Valley, Calif., and the author of the popular Men Are from Mars, Women Are from Venus books and self-help tapes. "Healthy people tend to have healthy sex lives, and most people who have heart disease or other debilitating diseases aren't having sex."

Impotence or Infertility?

For men, the most common sexual problems are impotence - now often described in politically correct terms as erectile dysfunction - and infertility. These two sexual problems can lead to frustration and resentment powerful enough to derail a relationship.

Erectile dysfunction and infertility are often confused with each other. However, they are two very different conditions. Erectile dysfunction, the inability to develop or maintain an erection during sexual intercourse, may have either psychological or biological roots. In contrast, infertility is strictly a biological problem: the inability to produce sperm capable of making a woman pregnant. A sexual gymnast may be infertile and, conversely, a fully fertile man may lack any kind of sexual charge.

Either problem can have a disastrous effect on a man's self-esteem, regardless of his age or how enlightened he feels. After all, men are socialized to believe that potency equals strength, power, and masculinity. A sexually active, unmarried young man may want to demonstrate his sexual prowess to his dates. Later, he may want to prove his fertility by starting a family. And by middle or old age, he may worry about losing his sexual drive.

Common Causes of Erectile Dysfunction

Every man has an occasional erectile problem. As embarrassing as it might be in the heat of passion, it's nothing to fret about. Fatigue, work pressures, or even a heavy meal can dampen the ability to perform. It is chronic problems, however, that are serious. "Sexual issues are not problems that will kill you, but they are very significant in terms of enjoying life," says Michael Janson, M.D., a nutritionally oriented physician in Boston.

Erectile dysfunction is typically diagnosed if a man fails to maintain an erection more than half the times he attempts intercourse. About 50 percent of men between ages 40 to 70 have some degree of impotence, says Robert Ivker, D.O., a holistic physician who is assistant professor of family medicine at the University of Colorado, Denver. The cause depends on who you ask. A psychologist might venture that 90 percent of erectile problems originate in the mind, whereas medical doctors might say that 90 percent problems are "organic" - that is, related to physical causes, such as cardiovascular disease and medications. Translation: it all depends upon the individual.

There are, however, several common and specific causes of erectile dysfunction.

Stage fright. In some men, "performance anxiety" - the fear of failure - can create so much stress that it's impossible to relax and simply enjoy making love. "Impotence cuts to the core of men's self-esteem in our society," says Ivker. "Men see themselves as performers, very competitive, and how they perform in the bedroom has a lot to do with self-esteem." Ironically, the more a man thinks about how much he needs to get and maintain an erection, the more difficult it becomes.

Communication difficulties. In a long-term relationship, sexual problems may be a sign of unresolved marital issues. Often, the loss of intimacy and sexual activity follows a breakdown of communication. People often hold back their anger and resentment, and feelings of "not being heard" may be expressed through emotional withdrawal. Such problems rarely go away - and the longer a couple goes without having sexual intimacy, the more difficult it may become to resume.

Cardiovascular disease. Erectile dysfunction may be indicative of generalized cardiovascular disease. Flexible blood vessels are essential for normal sexual function. During an erection, some blood vessels expand while others contract, trapping sufficient blood to engorge the penis. When blood vessels in the penis harden or narrow, there may be insufficient blood for an erection. Regular erectile dysfunction justifies a heart checkup.

Medications. A large number of commonly prescribed medications may cause erectile dysfunction. Among them are drugs used to treat hypertension, anxiety, depression, and benign prostate enlargement. Alcohol often increases desire by reducing inhibitions, but it leads to erectile dysfunction. Even some herbs, such as St. John's wort and saw palmetto, can cause erectile dysfunction in a small number of men (though the effects of prescription drugs are far worse).

Nerve damage and disease. Diseases that involve nerve damage can also lead to erectile dysfunction. In diabetics, peripheral neuropathy can lead to erectile dysfunction. Similar problems may occur in multiple sclerosis and after a stroke. Surgery or radiation to treat prostate cancer can also damage nerves involved in erections.

Low hormone levels. Levels of testosterone, the "male" hormone, decrease slowly with age and may affect sexual function, although some men may experience an unusual decline of testosterone levels early in life. Levels of dehydroepiandrosterone (DHEA), the precursor to testosterone, decline much more sharply with age. In addition, high levels of cortisol, a stress hormone, may depress DHEA levels. The stress may be work or family related.

Taking Charge of Your Health

Being overweight is often overlooked as a cause of sexual difficulties. "Obesity is a big problem in sexual dysfunction," Janson says. "Fat cells produce estrogen, so obesity can affect hormone balance. Obesity also reduces energy levels and agility - and facility. With 61 percent of Americans overweight, and 27 percent clinically obese, this is serious and affects a huge segment of the population."

Obesity is also a major risk factor for adult-onset diabetes, which increases the risk of nerve damage and erectile dysfunction. To trim down and reduce your risk of diabetes, avoid refined carbohydrates - sugary foods, breads, cereals, and pastas - and instead emphasize lean meats, chicken, fish, and a lot of vegetables. Such a protein-rich diet can stabilize blood sugar levels.

Ivker recommends cutting back on saturated fats and increasing the healthy omega-3 fats found in cold-water fish (e.g., salmon, tuna, and sardines) and flaxseed, a lot of vegetables, and pumpkin seeds.

"Anything that improves circulation would be worthwhile," Jensen says. That is because better circulation lets more blood enter the penis - and more blood leads to a stronger erection.

• Vitamin E. If a man's erectile dysfunction is related to cardiovascular disease, vitamin E may improve blood vessels of the penis as well as the heart. Several major studies have found that vitamin E supplements - 400 to 800 IU daily - lower the risk of heart attack and ischemic stroke (the most common type). It also helps maintain "endothelial function" - that is, normal blood vessel flexibility, which is essential for normal erectile function. Opt for natural vitamin E - d alpha tocopherol or d-alpha tocopheryl - in fine print on the label. It's absorbed twice as well as the synthetic form.

[Editor's note: Backed by scientific evidence, PHP believes the the best source of vitamin E is Rice Bran Solubles.]

• Arginine. This amino acid (protein building block) plays a central role in the function of the penis, according to Robert Fried, Ph.D., and Woodson C. Merrell, M.D., authors of The Arginine Solution (Warner Books, 1999). Arginine increases production of nitric oxide, a chemical that helps dilate, or expand, blood vessels. That ability to vasodilate enables blood vessels in the penis to trap blood and maintain an erection. Arginine supplements may be helpful, and Janson suggests that men take 1,000 mg twice a day and 2,000-3,000 a half hour before lovemaking.

• Ginkgo. The herb Ginkgo biloba also has vasodilating properties. In one study, researchers asked 60 patients with erectile dysfunction to take 60 mg of ginkgo daily. All of the men had been treated unsuccessfully with injections of papaverine, a vasodilating drug. After receiving ginkgo supplements (60 mg daily) for six months, half of them regained normal sexual function. Twenty percent more achieved erections with a combination of ginkgo and papaverine, and 25 percent had improved penile blood flow but without erections.

[Editor's note: Ginkgo biloba is a key ingredient in PHP's Super Male Formula, for more information see product description below]

• Horny goat weed. Don't laugh - that's the name of an actual Chinese herb (Epimedium graniflorum) reputed to be an aphrodisiac. In a recent unpublished study, Steven Lamm, M.D., of New York City, gave a combination of horny goat weed and other herbs to 25 healthy men and 13 who had been using Viagra. Daily use of the herb combination enhanced sexual satisfaction in 60 percent of the healthy men and 45 percent of those who had been using Viagra.

• Antler velvet. Chinese medicine has cherished the soft, fuzzy velvet of antlers from male deer as a health tonic for more than 2,000 years. Limited human research indicates that velvet antler extracts may boost athletic performance, and animal studies have found that it might promote development of sexual organs. Such evidence suggests a role in sexuality, but direct research has not yet been conducted.

[Editor's note: Velvet Antler is a key ingredient in PHP's Super Male Formula, for more information see product description below]

• DHEA/testosterone. The hormones testosterone and DHEA may increase sexual libido and activity. Testosterone is available only by prescription, but DHEA (its precursor) is available at many health food stores. DHEA is a form of hormone-replacement therapy, so it would be wise to have your physician monitor blood levels of DHEA. Ray Sahelian, M.D., of Marina de Rey, Calif., recommends starting at a low dosage, in the range of 5-10 mg daily.

[Editor's note: PHP's Super Male Formula contains Green-lipped Mussel; studies have shown this to increase the level of Human Growth Hormone (HGH), which affects the production of testosterone in men.]

Related Article: The Problem with Sperm

A guy can have great sex, but still be infertile. Male infertility is the inability to make a woman pregnant. The most common problems are low sperm numbers, deformed sperm (known as morphology defects), and poor swimming ability (motility).

Heat can be a big problem for sperm. One sperm-destroying condition is varicocle, which is comparable to having a varicose vein in the scrotum. The blood vessel dissipates enough heat to damage sperm. Smoking tobacco - loaded with hazardous molecules called free radicals, is also strongly associated with male infertility.

Sperm do much better in an environment a couple degrees cooler than the rest of the body, which is probably why nature designed the testes to hang away from the groin. In addition, boxer shorts (instead of jockeys) and showers (instead of hot baths) may give sperm a better chance.

Several studies have found that infertile men have relatively high levels of free radicals.

[Editor's note: Montmorency tart cherries are perhaps nature’s most nutritionally dense food containing a wide variety of powerful antioxidants and phyto-chemicals unmatched by any other fruit as measured by the scientifically validated ORAC method. In fact each serving (2 tbs.) of PHP's Apothe-Cherry contains 7,000 ORAC units! ORAC is an acronym for Oxygen Radical Absorbance Capacity or the ability to scavenge free radicals.]

REFERENCES

Stephens NG, Parsons A, Schofield PM, et al. Randomized controlled trial of vitamin E in patients with coronary disease: Cambridge heart antioxidant study (CHAOS). Lancet, 1996;347:781-786.

Leppala JM, Virtamo J, Fogelholm R, et al., " Vitamin E and beta carotene supplementation in high risk for stroke," Archives of Neurology, 2000;57:1503-1509.

Burton GW, Traber MG, Acuff RV, et al. Human plasma and tissue a-tocopherol concentrations in response to supplementation with deuterated natural and synthetic vitamin E. American Journal of Clinical Nutrition, 1998;67:669-684.

Sikora R, et al. Ginkgo biloba extract in the therapy of erectile dysfunction. Journal of Urology, 1989;141:188A.

Lamm S, Couzens GS. Effect of HGW herbal complex supplement on sexual satisfaction in healthy men and men treated with Viagra. Unpublished preprint, 2001.

Kodama H, Yamaguchi R, Fukuda J, et al. Increased oxidative deoxyribonucleic acid damage in the spermatozoa of infertile male patients. Fertility and Sterility, 1997;68:519-24.

The information provided by Jack Challem is strictly educational and not intended as medical advice. For diagnosis and treatment, consult your physician.