The first step in overcoming impotence is to find out which type you have. Physical impotence is caused by nerve damage (often as a result of injury or chronic conditions such as diabetes) or poor circulation in the penis (often caused by fatty deposits in penile blood vessels). In addition, certain drugs can cause physical impotence. Nine out of 10 cases of impotence are of physical origin.
Psychological impotence stems from emotional stress, depression or strife within your personal relationship. If you have this form of impotence, your best bet is psychotherapy or couples counseling. About 10% of all cases of impotence have a psychological basis.
How can you tell physical from psychological impotence? Find out whether you have erections during sleep. There are fancy machines for measuring “nocturnal penile tumescence.” But you don’t need them. Here’s a simple, inexpensive test you can do at home.
Just before going to bed, use tape to fasten a perforated strip of stamps around the base of your penis. Don’t wrap your penis too tightly. You should be able to slip a coin between the stamps and your skin. In the morning, check to see if the strip of stamps has broken. Do this every night for a week.
If you’re consistently breaking the stamps, odds are you have a psychological problem. Consider asking your doctor for referral to a therapist. If you’re not breaking the stamps, your problem is probably physical. If so, your next step is to determine whether any medication you’re taking is the culprit.
A variety of over-the-counter (OTC) and prescription drugs and many herbal remedies can cause impotence. These include decongestants containing pseudoephedrine, blood pressure medications, especially beta-blockers such as propranolol (Inderal) and atenolol (Tenormin) and selective serotonin reuptake inhibitor (SSRI) antidepressants such as fluoxetine (Prozac) and sertraline (Zoloft).
If you suspect that your impotence is a side effect of a drug, ask your doctor about switching to another drug. If drugs don’t seem to be causing your impotence, consider trying one of the natural remedies that are effective against impotence. These include…
• Ginkgo biloba
Good circulation to the penis is essential for good erections, and this potent blood thinner helps boost circulation throughout the body. In a study conducted by Alan Cohen, MD, of the University of California at San Francisco, 32 of 37 patients with sexual problems (including impotence and inability to achieve orgasm) got better when they took 120 mg of ginkgo extract twice a day.
Although it’s best known as a mild stimulant, ginseng is also effective against impotence. Two varieties of ginseng are readily available Panax ginseng and Panax quinquifolius. These can be taken as a tea, in capsule form (take one or two daily) or liquid extract (one or two dropperfuls a day). Be sure to take it in the morning. Taken in the evening, its stimulant properties can cause insomnia. Never combine ginseng with coffee or any other stimulant food or drug.
Made from the bark of a West African tree, yohimbe is often touted as a cure for impotence. Unfortunately, it can raise blood pressure and heart rate and cause anxiety, dizziness, headache and tremor. A pharmaceutical form of the herb, yohimbine, is available by prescription. However, I don’t recommend either version of the herb because of these disturbing side effects.