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Before reaching for that infamous little blue pill when things aren't looking up in the bedroom, researchers and sex therapists want men who experience erectile dysfunction to consider trying out some natural solutions first.
Of course, many cases of ED stem from medical conditions, including diabetes, coronary artery disease, or hypertension, and would need to be treated medically. But there are also a slew of psychological and emotional reasons for erectile dysfunction that can lead to the inability to achieve an erection and/or sustain an erection, as well as ejaculate prematurely.
So, before filling that prescription, buying a penis pump, or undergoing the more invasive treatments such as stem cell injections, try these holistic options first. If they don't work, then head to your urologist for a full medical checkout and to discuss other treatment options.
Get Better Sleep
A new study presented at the 113th Annual Scientific Meeting of the American Urological Association (AUA) in San Francisco, California on May 20 showed that poor sleep quality is associated with clinically signification erectile dysfunction.
The study group included 377 men, with an average age of 46-years-old, who were given questionnaires to assess their quality of sleep and erectile function. Patients were asked about comorbidities, which is the simultaneous presence of two chronic diseases or conditions in a patient, as well as smoking and shift work habits, their body mass index (BMI), and their daily caffeine and medication use.
"Researchers assessed the relationship between sleep and erectile function while controlling for age, BMI, burden of comorbidity, testosterone and PDE5 inhibitor [phosphodiesterase type 5 inhibitor, which cause vasodilation in the penis] use. Caffeine, melatonin, and other sleep medication use, CPAP [Continuous Positive Airway Pressure] use, shift work, smoking, depression status and antidepressant use were also assessed," states the research report.
The results, as measured by the Pittsburgh Sleep Quality Index, showed that men had worse erectile function as sleep quality decreased. It also showed that age, depression, and increased comorbidities were associated with worse erectile function. One surprising result is that sleep apnea was not associated with worse erectile function, but the use of the supplement melatonin was associated with significantly worse erectile function.
"These studies point to some very alarming consequences for men with impaired sleep habits," says Dr. Tobias S. Köhler, MD, MPH, FACS, men's health specialist and urologist with the Mayo Clinic in Rochester, Minnesota. "Men should be aware that a commitment to improving one's sleep habits could lead to improved erectile function along with a host of many other established health benefits that accompany a good night's sleep."
Getting a good night's sleep is easier said than done. Dr. Alon Avidan, a professor of neurology and director of the UCLA Sleep Disorders Center, offers these tips for getting better sleep:
• Avoid alcohol and caffeine close to bedtime, as they disrupt sleep architecture and lead to fragmented sleep.
• Keep your bedroom dark. Use light exposure to your advantage. Light is the most important circadian cue, so it's critical to limit exposure to bright light during the evening.
• No computers, TVs, or tablets at least two hours before bedtime.
• Get plenty of sun exposure in the morning, so you'll feel alert during the day and be sleepy by nightfall.
• Avoid excessive naps, except for a brief 15- to 20-minute snooze between 1 p.m. and 3 p.m., if you need it. Excessive napping may take away the drive for sleep at night.
• Keep your bedroom quiet, well ventilated, and at a comfortable, slightly cooler temperature throughout the night.
• Create a consistent and relaxing bedtime routine, such as reading a pleasant book or listening to soothing music.
Connect To Your Body
Often times erectile dysfunction that comes in the form of premature ejaculation and/or performance anxiety, which prohibits an erection or sustaining of the erection, is psychologically rooted.
"It can cause psychological hang-ups," explains Los Angeles-based sex therapist Moushumi Ghose, a licensed marriage and family therapist, author, and coach. "You're thinking about it all the time and it becomes psychological damaging. When you're worrying that you're not going to be able to perform and your self-esteem is suffering because of it, it can turn into a self-fulfilling prophecy that turns into a vicious cycle that keeps going and going."
Ghose says the key is to "get out of your head, and into your body." "There is a disconnect between your mind and body," she explains. "The mind is working overtime and the body doesn't have a chance to catch up, or respond, and your body is telling you something. It's saying, 'Hey I don't feel like working the way you want me to.' The key is to connect your mind and body."
One of the best ways to do this is through some form of meditation, which can include traditional meditation, yoga, breathing techniques, or even sound therapy. "Even just sitting at your desk quietly and closing your eyes for 20 seconds to breath and connect that breath to your body will help make you more aware of the sensations in your body," she continues. "Notice what is going on with yourself physically — are your hands sweaty? Is your heart beating fast? Are you constipated? Noticing all these sensations in the body can really be the key to understanding what is happening in your genitals."
Patience is needed here. It takes practice to quiet the mind and body. "If you're constantly anxious, worried, or stressed because you have a lot going on in your life, taking the time out to connect to your body is something you might feel that you don't have the luxury of doing. But, it's important and it takes daily practice, even if just for a few minutes every day to start."
Or, if your life is the opposite and you are feeling depressed, isolated, lonely, or having too much time on your hands, that can affect your sexual function as well. "What's happening in either situation is that you're not allowing yourself to connect to your body," she adds.
Build Your Self-Confidence
Sometimes insecurity about one's body, sexual prowess, success level, or even penis size can cause a feeling of insecurity that can lead to problems in the bedroom. Boosting one's confidence outside of the bedroom that isn't tied to their sexual performance is key here.
"Get your head straight and do whatever you can to feel confident with yourself no matter what," says Ghose. "You can try positive affirmations, or if you need to work out more, go work out more. Do what you can to make yourself feel good and it will help you get more in touch with yourself."
Another aspect of this is to not idolize your partner. "I've seen in relationships where one partner is super attractive and it gives the other performance anxiety. They feel they're not good enough for her or him and often put them on a pedestal, which leads to a misbelief that you won't be able to please them. Recognize the greatness in you and that the partner is there with you for a reason. Get that person off the pedestal because it really can perpetuate the cycle of performance anxiety," says Ghose.
Talk About It
Most people were raised with little, if any, tools for talking about sex openly and honestly with their friends or partners. So when issues come up, such as erectile dysfunction, it's not surprising that it's something men don't freely share with their partners.
"Everyone needs to start having more conversations about sex — whether it's with a therapist, their buddies, or their partner. And to be honest with themselves when there is a problem, instead of just ignoring it and hoping it will go away. If it's plaguing you, it's a big deal. It's you're avoiding the topic or brushing it under the rug, it's time to bring it up," says Ghose.
Finding a solution together can be a fun outcome of this. "Let your partner know that you want to work on this. And make your partner be part of the solution. Together you can come up with great fun things to do to work on this," she continues.
One solution is to not focus entirely on penetrative intercourse with the goal of orgasm each time you get together. Instead, play around with other ways to please one another. "There's so much more to sex than intercourse and there's a lot more to sex than orgasm. I say this over and over to my clients... do other things! Use your hand, mouth, sex toys, and have fun. Sex is about having fun. Taking the pressure off can really be the key," she says.
While it might feel uncomfortable at first, it gets easier. "The more conversations you have openly and honestly, the more comfortable you'll feel. And sometimes just getting it out there can help reduce the anxiety and shame," adds Ghose.
Just Do It!
To quote the famous 1988 Nike campaign: Just Do It! "The more you do it, the better you become at it and the less anxiety you will have over it," advises Ghose. And, she's not just talking about sex. Ghose advises men to kick up their masturbation game a few notches in order to help them have more control and less hang-ups during sex.
"When something doesn't work or you're ashamed or scared, the natural tendency is to avoid it and not deal wit it at all. Men with erectile issues often just avoid having sex. Don't do that. It's not going to get better," she advises.
For clients whose main erectile dysfunction symptom is premature ejaculation, Ghose teaches them the "start and stop technique." "It's a good practice for men to masturbate just to feel good, but not always to orgasm. They can play around with the start and stop technique, which is to get close to orgasm, but then just stop, take a break, let the erection go down a little, and then pick it back up again," says Ghose.
This helps with control, and it takes practice. "Practicing not to orgasm takes time, but it can help you train your body to slow it down and last longer. In time, you'll get more control of your erections and orgasms, and more of a sense of well-being around it," she adds.
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