Understanding Erectile Dysfunction: Ayurvedic Solutions from Aksa Ayurveda
Definition:
Erectile dysfunction is a condition of recurrent and persistent inability, partial or complete, to maintain an erection firm enough for satisfactory sexual intercourse in the presence of proper erotic stimuli.
According to WHO ( World Health Organisation ) the prevalence of Erectile dysfunction approximately is 15% of men each year. Over 150 million men worldwide were estimated to have been affected by erectile dysfunction in 1995, and this is projected to rise to 320 million by 2025.
According to the Indian Journal of psychiatry the prevalence of erectile dysfunction in India is around 15.77%.
There are about 6% incidence of ED in the group of 20-29 years, 17% men in 40-49 years of age, 35.5% in 50-59 years of age, 68.8% in 60-69 years of age, 82.9% in ≥70 years of age.
Causes of Erectile Dysfunction:
There are two types of Erectile Dysfunction Causes-
- Psychogenic ED
- Organic ED
1. Psychogenic ED
Psychogenic erectile dysfunction is the inability to achieve or maintain an erection during sex due to psychological factors. These factors can include stress and anxiety,depression, guilt, low self-esteem, or relationship concerns, performance anxiety. About 40% of erectile dysfunction (ED) cases are considered psychogenic. It mainly develop in younger men
2. Organic ED
Organic erectile dysfunction (ED) is a type of ED that's caused by physical or medical issues that affect the vascular, neurological, or hormonal systems involved in erections.
Vascular changes:
Disease like Hypertension, Dyslipidemia, or coronary Heart disease Develops atherosclerosis that usually starts in small size arteries like cavernosal arteries and coronary arteries that cause blockage and reduce blood flow to the particular organ which are related to those artery like the heart and penis. Low blood circulation to the penis develops the Inability of proper hardness to the penis causing erectile dysfunction. Almost 50% of coronary heart disease patients develop significant ED.
Neurogenic causes:
Neurogenic ED results from a lack of neural signals to the corpora cavernosa making the penile unable to sustain proper erections . This is caused by injury to the central nervous system (CNS) or peripheral nervous system (PNS). CNS disease like CNS tumor, spinal cord injury, stroke and PNS disease like type 1, type 2 diabetes, pyeloneuropathy, liver failure, renal failure, etc. causes Erectile Dysfunction.
Hormonal causes:
Hypothalamus-pituitary axis is a link between brain and peripheral glands including gonads. Dysregulation in the axis can cause ED.
Low testosterone, high prolactin level, thyroid disorder, excessive release of growth hormone, imbalance in estrogen-testosterone levels, all these causes develop ED in men.
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Risk factors of Erectile Dysfunction
- Hypertension
- Diabetes mellitus
- hyperlipidemia
- hypogonadism
- chronic kidney disease
Medications: Antidepressants, anti-anxiety medications, blood pressure medications, diuretics, antihistamines, chemotherapy drugs, and prostate cancer drugs
Injuries: Damage to the nerves or arteries that control erections, such as from pelvic surgery or radiation therapy
Psychological conditions: Stress, anxiety, depression, relationship conflicts, and worry about sex performance
Substance abuse: Alcoholism and long-term drug use
Tobacco use: Restricts blood flow to arteries and veins
Obesity: Being overweight or obese
Sedentary lifestyle: Lack of exercise
Aging: Men are at higher risk as they get older
Diagnosis of ED:
The evaluation of the male with ED comprises three categories:
(1) History and physical exam
(2) Lab testing
(3) Adjunctive testing with imaging and related modalities.
Treatment (modern medicine):
Initial treatment involves improving general health status through lifestyle modifications. This treatment not only improves erectile function but reduces cardiovascular risk. Recommended lifestyle modifications would include the following:
- Increased physical activity
- Switching to a Mediterranean diet or nutritional counseling
- Stopping smoking, drugs, and alcohol
- Gaining reasonable control of diabetes, lipids, and cholesterol.
- Supplemental L-arginine increases nitric oxide synthase levels, theoretically improving erection function.
- Oral phosphodiesterase-5 inhibitors (PDE-5 inhibitors)
- External vacuum devices are an excellent, non-surgical option for many patients with ED
- Intraurethral prostaglandin E1 (alprostadil) pellets (also called medicated urethral system for erection or MUSE) are available for use as urethral suppositories.
- Intracavernosal Injections with prostaglandin E1 are frequently the next choice of therapy if oral PDE-5 inhibitors are unsuccessful
Treatment in Ayurveda:
According to ayurveda vajikarana or vrishya chikitsa one of the 8 pillar of ashtanga ayurveda is concerned with vigor , vitality, sexual health, to improve desire for sexual health , treating sexual dysfunction like premature ejaculation, low sperm quantity or quality , erectile dysfunction, low testosterone, loss of libido, etc.
The basic concept of treatment in vajikarana chikitsa is same as other types of chikitsa mentioned in ayurveda .
Tridosha ( vata, pitta, kapha ) are the main driving force of body metabolism and functioning. In equilibrium of tridoshas the body becomes healthy and disease free, like this saptadhatu viz rasa, rakta, mamsa, meda, asthi, majja, shukra are the structural and molecular forms that body contains, any depletion or increasing of these dhatu cause problems in the body .
Shukra dhatu is the basis of sexual performance that maintains the sexual hormone balance, and maintains sexual related issues. Shukra dhatu is the last dhatu that get nourishment only when al, other six dhatus are well nourished. So the principle of sexual problems treatment in ayurveda is based on maintaining balance of trisdosha and nourishment of saptdhatu.
Then only, a person is well performed and good in reproductive properties. There are 100s of formulations described in different samhitas of ayurveda under vajikarana chikitsa. According to the prakruti and vikruti of an individual, the ayurvedic physician decides what formulation will suits the patient.
There may be some primary causes that can develop sexual dysfunction, for that ruling out the cause and treating the cause is also mandatory in ayurvedic way of treatment. Modern researches also confirmed the activities of some herbs that are described in ayurveda for increasing sexual performance like gokshura, ashwagandha, safed musli, shilajit, shatavari, etc.
In Aksa Ayurveda we follow the principles of ayurveda to manage Erectile Dysfunction by providing the proper consultation, ruling out the main cause and treating the cause effectively.
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