Impotence

Impotence, or erectile dysfunction, is the inability to achieve an erection.Impotence may occur for any of at least 15 possible causes, including diabetes, drug side effects, pituitary tumors, hardening of the arteries, hormonal imbalances, and psychological factors. A few of these conditions respond to specific treatment. For example, if a blood pressure drug is causing impotence, the best approach is to change drugs. If a pituitary tumor is secreting the hormone prolactin, treating that tumor may result in immediate improvement. However, in most cases, conventional treatment of impotence is nonspecific.
Generic treatment options include the drug Viagra, mechanical devices that utilize a vacuum to produce an erection, drugs for self-injection, and implantation of penile prostheses. Psychotherapy can also be helpful for treating all varieties of impotence, even when an organic cause can be identified.

Treatment

Proposed Treatments for Impotence:

DHEA

A double-blind placebo-controlled study enrolled 40 men with difficulty achieving or maintaining an erection, who also had low measured levels of DHEA. The results showed that DHEA at a dose of 50 mg daily improved sexual performance; however, the authors failed to provide a statistical analysis of the results, making the meaningfulness of this study impossible to determine.

L-Arginine

In a double-blind trial, 50 men with problems developing an erection received either 5 g of L-arginine per day or placebo for 6 weeks. More men in the treated group experienced improvement in sexual performance than in the placebo group.

A double-blind crossover study of 32 men found no benefit with 1500mg of arginine given daily for 17 days; the much smaller dose and shorter course of treatment may explain the discrepancy between these two trials.

Ginkgo

A slight amount of research suggests that ginkgo may be useful in impotence. One study of 60 men whose impotence was due to poor blood circulation demonstrated a 50% success rate after 6 months.However, because this was not a double-blind study, the improvement noted may have been due to the power of suggestion.

A slight amount of research suggests that ginkgo extract may be useful in impotence. One study of 60 men whose impotence was due to poor blood circulation demonstrated a 50% success rate after 6 months. However, because this was not a double-blind study, the improvement noted may have been due to the power of suggestion.

Very preliminary evidence suggests that ginkgo extract may also be useful in reversing the impotence caused by drugs in the Prozac family as well as other types of antidepressant medications. One open trial failed to find benefit, but it appears to have used a non-standard form of ginkgo.

For more information, including dosage and safety issues, see the full ginkgo article.

Other Treatments

A double-blind placebo-controlled study performed in China reported evidence that ginseng (Panax ginseng) can improve symptoms of impotence.

Zinc deficiency is known to negatively affect sexual function. Because zinc is one of the most commonly deficient minerals in the diet, it is logical to assume that supplementation with zinc may be helpful for some men. For more information, including dosage and safety issues, see the full zinc article.

One animal study suggests that melatonin might have some potential value in the treatment of impotence.

Many other herbs are also reputed to improve sexual function, including ashwagandha, damiana, muira puama, pygeum, saw palmetto, and suma. However, there is as yet no real evidence that they work.

Not Recommended Treatments

The herb yohimbe is the source of the drug yohimbine, which has been shown to be modestly better than placebo for impotence. However, this is a fairly dangerous treatment, and we do not recommend it.

The herb licorice may reduce testosterone levels in men. For this reason, men with impotence, infertility, or decreased libido may want to avoid this herb.