For one man in four over the age of 50 – and some much younger men, too – a durable erection is an elusive thing. In most cases, the cause of what doctors call 'erectile dysfuntion' is physical and correctable, often by making some surprisingly simple changes.

What is it?

An erection occurs when blood vessels in the penis fill with blood, stiffening the organ. The process is sparked by sexual stimulation, which causes nerves in the brain and spine to signal arteries in the penis to expand. The inbility to get or maintain an erection is called impotence.

What causes it?

The main cause of impotence is poor circulation and impaired blood flow through the penis, whcih is often the result of atherosclerosis ('hardening of the arteries'). Other possible reasons include hormonal imbalances, prostate disease, diabetes, nerve disorders or side effects of medications. Only one in ten cases is purely psychological. Because erections occur involuntarily during sleep, a man may be able to determine whether the problem is physical or psychological by using the 'postage stamp test'. Encircle the penis with stamps from a roll, gluing them end to end. If night-time erections occur, the stamps will be torn in the morning, suggesting that the cause of impotence is probably psychological. This type of impotence is usually stress-related and often temporary.

What are the symptoms?

  • Most men have occasional problems maintaining an erection, which is nothing to worry about. A persistent inability to attain or maintain an erection sufficient for sexual intercourse, however, consitutes impotence.

Are there any natural therapies?

A number of supplements, when taken together, may improve blood flow to the penis. Vitamin C plays a role in keeping blood vessels supple, allowing them to expand and let more blood pass through. Flaxseed oil and evening primrose pil contain different types of essential fatty acids that also improve blood flow; taken lon term, they can help by lowering cholesterol and preventing blood vessels from narrowing. Gingko biloba, which increased blood flow in the brain, may have a similar effect on the penis. Ultrasound examinations of 60 impotent men who took ginkgo biloba showed improved penile blood circulation after six weeks. After six months, 50% of the patients had regained potency. All these supplements should be used long term (at least six months) for best results, though benefits may be noticed in a month. They can safely be a part of your nutritional maintenance program.

The herb saw palmetto may be useful when impotence is a result of prostate disease. Studies in animals have shown that both Panax ginseng and Siberian ginseng boost testosterone levels and increase mating behaviour; they may produce similar effects in humans. You could also try a tea made with Muira puama (if you can obtain it). Also known as potency wood, it has long been used in Brazil as an aphrodisiac.

What else can I do?

  • Exercise regularly to improve blood flow throughout the body, boost energy and reduce stress.
  • Limit alcohol intake and don't smoke. Both can aggravate impotence.
  • Try counselling if stress or anxiety is contributing to the problem.

Did you know?

Supplements that improve blood flow to the penis may also help to prevent heart disease because both disorders often involve blocked blood vessels.