It sucks. Most men (basically all men) have been there at least once, or even a couple of times. You’re all revved up, but your hardware won’t comply with your desires. The worst part is that once it’s happened, it’s hard to get it out of your mind. And when the next opportunity presents itself, you’re worried that it’ll happen again, which in and of itself creates a vicious stress cycle that only heightens the problem.
While ED often carries an embarrassing social component, the good news is that it’s typically caused by only minor health issues that stem from the side effects of modern living.
As Mark Sisson puts it, “Modern life isn’t friendly to the human libido. Contemporary challenges to a healthy sex drive are many: obesity, diabetes, high blood pressure, thyroid dysfunction, adrenal exhaustion, poor nutrition, prescription medications, too much stress and too little sleep.” Well said. Let’s now dig into the details of this problem’s root causes, as well as a few little-known tricks that could be a game-changer for you.
What Exactly is Erectile Dysfunction?
While you don’t need a high-resolution image to see what erectile dysfunction is, there are varying degrees of the problem.
Whether you know it or not, ED isn’t a term used simply to describe a total inability to get it up. More specifically, it’s characterized by a lack of sex drive and the inability to get and maintain an erection firm enough for sex. And while sufferers might be feeling embarrassed, they’re certainly not alone. ED affects an estimated 15-30 million men in the United States.
How Does Erectile Dysfunction Occur?
ED is usually the result of:
Improper psychological impulses: Initiation of an erection requires the brain to send the appropriate signals to the nerve pathways in the penis, which relaxes the smooth muscle tissue to increase blood flow. Issues with sexual impulses usually stem from anxiety and stress.
Inadequate hormone levels: Male sex hormones, known as androgens, are responsible for sex drive and play an important role in sexual stimulation. Having low levels of testosterone or high levels of estrogen can negatively impact sex drive and prevent erections from occurring.
Unhealthy vascular tissue in the penis: Blood flow to the penis has to be uninhibited for an erection to occur. Hypertension (high-blood pressure), arteriosclerosis (clogged arteries), and other issues related to heart disease can prevent adequate blood flow to the penis.
Acute vs Chronic Erectile Dysfunction
Erectile Dysfunction can manifest as an acute, short term problem or a more prolonged condition.
Acute: Symptoms occur occasionally/briefly, and are typically the result of psychological stress. This can be in the form of performance anxiety, work-related stress or relationship issues. The best way to deal with acute psychological issues is to examine ways to reduce anxiety.
Chronic: Symptoms appear consistently over time and usually stem from underlying health issues such as metabolic syndrome, heart disease or hormone imbalances. Reversing chronic ED usually requires lifestyle changes such as improving diet, exercise and quality of sleep.
Root Causes of Erectile Dysfunction
Erectile dysfunction has many underlying causes that can be related to acute events or long term health conditions. Here are the most common variables that can trigger acute bouts of erectile dysfunction:
Acute Stress: Stress of all varieties can affect performance. Some of the most common causes of stress that lead to ED are work, finances and low self esteem.
Alcohol Intoxication: Four average-sized alcoholic beverages are more than enough to negatively impact erectile function, as they can disrupt nerve pathways between the brain and the penis.
Prescription medications: Antidepressants, antihistamines and high blood pressure medications have been shown to cause ED.
Illicit-drug use: Marijuana and cocaine can damage blood vessels and restrict blood flow to the penis.
Lack of Sleep: Inadequate amounts of sleep increase stress hormones and reduce levels of male sex hormone in the blood, decreasing the chance of achieving an erection.
The underlying causes of more chronic cases of erectile dysfunction often come down to altered or reduced physiology. This can include:
Hormone Imbalances: The most common hormone-related causes associated with ED are low sex hormone levels, high cortisol levels and unbalanced prolactin levels.
Poor Circulatory/Cardio-Metabolic Health: Lifestyle factors such as poor diet, lack of exercise, lack of sleep, smoking and alcohol consumption can result in diabetes and cardiovascular disease, which can impair androgen levels, decrease critical nutrients and promote inflammation. The resulting effect is often times ED.
Psychosomatic/Psychological: Anxiety, depression and low self esteem prevent the brain from sending the appropriate messages to the body that allow an erection to occur.
Root Cause of Erectile Dysfunction: Hormone Imbalance
Low Testosterone levels typically occur due to:
Metabolic syndrome, obesity and diabetes produce irregular, mostly elevated, insulin levels. In a healthy individual insulin is used to clear glucose from the blood after we eat. Consistent consumption of high levels of sugars and carbohydrates results in elevated insulin levels, which can prevent testosterone production.4
Excessive amounts of body fat can produce aromatization of androgens in the male body. Aromatization occurs when an enzyme in fat cells turns testosterone into estrogen, further inhibiting libido.1-4
Consuming processed soy can decrease testosterone, as it’s a phytoestrogen, which mimics the hormone estrogen in the body and lowers testosterone levels.5
When soy is processed, the phytoestrogens are condensed and absorbed at a higher rate, which increases the amount of estrogen in your body.
Dr. Lawrence Palevsky has strongly recommended for years that parents refrain from feeding their children soy, citing a study from the publication Nutrition that links hypogonadism, which is a condition where the male body doesn’t produce enough testosterone, as well as erectile dysfunction with soy consumption.6
Eating foods that are packaged in plastic decreases testosterone production through estrogenic effects. As Dr. Frank Lipman points out, “common chemicals in our food linings and plastics can cause erectile dysfunction.” Plastic contains chemicals including BPA, BPS, and phthalates that act as xenoestrogens, or estrogen mimics, which have been shown to dramatically decrease testosterone levels.7 Similar xenoestrogens can also be found in personal care and cleaning products, as well as fragrances.
Zinc deficiency usually stems from an unbalanced diet and the insufficient consumption of zinc containing foods. The best natural sources of zinc are seafood (oysters, crab, lobster in particular), red meat, spinach and pumpkin seeds.
Vitamin D is produced when the body is exposed to sunlight. If optimal exposure to the sun isn’t a luxury you can enjoy, vitamin D supplements are the next best option. Cod liver oil is also a good supplemental source of vitamin D.
Lack of sleep can prevent the production of testosterone, which is made only during specific phases of sleep.10
Alcohol abuse can prevent deep REM sleep and reduce nutrient levels in the blood, which both negatively impact testosterone. High alcohol consumption can prevent nerve cells from firing properly, which can lead to short-term ED, as well damage the Leydig cells in your testicles responsible for testosterone production.11
Elevated cortisol is a byproduct of high stress levels. It’s a “fight or flight” hormone produced to help your body deal with imminent threats. In modern times our stressors are very different than when our ancestors worried about how to avoid becoming a lion’s dinner. High cortisol levels now typically occur due to:
- Lack of sleep
- Emotional/Relationship issues
- Financial trouble
- Poor diet
- Lack of exercise
- Chronic illness or infection
According to Dr. Daniel Kalish, DC, high cortisol levels can be a cyclical self-fulfilling prophecy. Lack of sleep, coupled with sexual performance anxiety can increase cortisol levels, which can in turn prevent quality sleep and increase sexual anxiety.
Prolactin is a hormone most commonly found in women who are breast feeding. Scientists still don’t fully understand its function in the male body, but prolactin levels that are too high or low directly correlate with erectile dysfunction and poor sexual health.12 Unhealthy prolactin levels are usually caused by:
- Obesity and high blood glucose levels, typically stemming from poor diet and/or sedentary lifestyle.
- Taking antidepressant and/or antipsychotic medication.
- A prolactinoma is a non-cancerous tumor of the pituitary gland (a gland that secretes hormones to manage growth, blood pressure, and sex organ function), which causes your brain to overproduce prolactin.
Root Cause of Erectile Dysfunction: Poor Circulatory and Cardiometabolic Function
Dr. Steven Masley believes that “the number one cause of erectile dysfunction is cardiovascular disease,” which can hinder blood flow to the penis or lead to degeneration of penile blood vessels.
Dr. Joel Fuhrman states that ED is also “an accurate predictor of ischemic vascular events down the road, meaning heart attacks and strokes in the future.” Therefore, it is particularly important to focus on the underlying cause of Erectile Dysfunction and not just the symptoms.
The most common culprits behind poor circulatory function are:
Cardiovascular Disease: Leads to atherosclerosis (hardening and narrowing of the arteries)13 commonly caused by a sedentary lifestyle and a diet high in processed foods, sugar, and bad fats.
Low Nitric Oxide (NO) Levels: This chemical is the primary mediator of erectile function, and low levels are thought to be one of the leading causes of ED15. NO is a potent vasodilator and levels can be depleted by inflammation and free radicals from poor diet, alcohol, smoking and insufficient exercise or sleep.
Smoking: Produces high blood pressure, causing the arterial walls to lose elasticity, as well as a reduction of blood flow. There’s also a strong correlation between smoking and the intensity of ED symptoms.14
Diabetes: Poor blood sugar management results in obesity, inflammation and nerve damage, which all contribute to ED. According to Deepak Chopra, “ Diabetics should be especially vigilant, as nerve damage from their disease commonly interferes with their ability to get an erection.”
Root Cause of Erectile Dysfunction: Psychosomatic or Psychological Factors
The psychological aspects of ED are not limited to merely the mental aspect, but can also stem from medication use. Many drugs interfere with physiological processes that control the erection, while others cause mood altering symptoms.
According to Dr. Kelly Brogan, statins that are used to treat high cholesterol and heart disease are often reported to induce sexual dysfunction through depression, anxiety and antisocial behavior.
There are several intangible causes of Erectile Dysfunction that come in the form of sexual performance anxiety. Many different kinds of worries can lead to sexual performance anxiety, including:
- Fear that you won’t perform well or satisfy your partner sexually.
- Poor body image, including concerns over physical appearance.
- Difficulties in your relationship.
- A man’s worry that his penis won’t ‘measure up’.
- A man’s concerns about ejaculating prematurely or taking too long to reach orgasm.
Natural Relief from Erectile Dysfunction
While addressing the root causes of erectile dysfunction should be your long-term goal, there are some quick interventions that can help remedy symptoms.
- Supplementing with maca root helps, as this herb acts as a natural aphrodisiac and stimulant. It has been shown to improve sexual desire, sperm production, sperm motility and semen volume.2 Maca comes in capsules or as a powder that can be mixed into smoothies. Adding antioxidant-rich fruits and vegetables will pack more ED-reversing power as well.
- Consuming cholesterol-rich foods before bed can increase androgen hormones. A common cause of ED is low testosterone levels, and since testosterone is produced in the testicles through the conversion of cholesterol,3 consuming at least 800 milligrams (4 eggs) of cholesterol before bed can increase the amount of testosterone your body produces.
Increasing sleep duration can increase hormone levels. Testosterone is produced during sleep, so adequate sleep is imperative for healthy testosterone levels. It also reduces cortisol levels, a stress hormone that prevents testosterone production.
- Reducing stress will go a long way toward getting it up. Chronic stress can result in Adrenal Fatigue, which prevents your body from producing enough cortisol to function properly. Over time this disrupts the production and balance of sex hormones.
- Yohimbe, recommended by Dr. Andrew Weil, comes from the bark of an African tree and is the basis of many drugs used to treat impotence. It contains a chemical called yohimbine, which can increase blood flow and nerve impulses to the penis. It also helps to counteract the sexual side effects associated with certain anti-depressants known as selective serotonin reuptake inhibitors (SSRI’s). Yohimbe typically comes in capsule form.
While many of the natural relief options mentioned in this article can help to get you “up” and running again, the solution rests in addressing the root causes.
ED is merely a manifestation of something bigger going on inside your body, and it’s important to lift up the hood to see what’s going on underneath.
Be sure to read up on hormonal imbalance, gut issues and other related symptoms to help piece your health puzzle together. Nobody’s going to care as much about your health as you will, so become the go-to expert on your own body.