Erectile dysfunction (ED) is defined as the inability to get or keep an erection firm enough for sexual intercourse. It can happen at any age, but it becomes more common as men get older. According to the National Institutes of Health, about 5% of 40-year-old men and between 15% and 25% of 65-year-old men experience erectile dysfunction (ED). Erectile Dysfunction affects approximately 18 million men in the United States. According to International Journal of Impotence Research 2000, The worldwide prevalence of erectile dysfunction is expected to increase to 322 million men by 2025.


There are many potential causes of erectile dysfunction, both physical and psychological.

Physical causes

Heart disease: Heart disease can restrict the amount of blood that flows to the penis, which may then cause ED. In addition, having high blood pressure or high cholesterol levels can contribute to ED.


Diabetes may damage the nerves and blood vessels that control erections. This damage can lead to a reduced ability to get or maintain an erection.

Vascular Disease

Atherosclerosis (hardening of the arteries) is a common cause of erectile dysfunction. This occurs when plaque builds up in the arteries, narrowing them and preventing blood from flowing freely. This can lead to reduced blood flow to the penis, making it difficult to achieve or maintain an erection.


Being overweight can cause, or worsen, erectile dysfunction (ED). Losing weight and keeping it off can improve your chances of getting and keeping an erection.

Hormonal Imbalances

Low levels of testosterone can lead to erectile dysfunction. If you’re a man over the age of 45, it’s possible that your testosterone levels are declining. Herbal treatments like Tongkat Ali and Tribulus Terrestris can help to increase testosterone levels, which may in turn improve erectile function.

Neurological conditions

Some neurological conditions like Parkinson’s disease and multiple sclerosis can cause erectile dysfunction.

Psychological causes

Erectile dysfunction can also be caused by psychological factors such as stress, anxiety, depression, guilt and low self-esteem. Studies have shown that men who are suffering from these conditions are more likely to experience erectile dysfunction. If you are experiencing any of these psychological factors, it is important to seek professional help in order to treat the problem.

Lifestyle and diet

Certain lifestyles and diets also play a vital role in developing ED.

Smoking: Smoking cigarettes can damage the blood vessels and affect circulation, which can lead to ED. Quitting smoking may improve your erections.

Alcohol: Heavy drinking can lead to a drop in testosterone levels, which can in turn lead to ED. Cutting back on the number of drinks you have each week may improve your erections.

Drugs: Using illegal drugs can lead to low testosterone levels and ED. Stopping drug use may improve your erections.

Diet: Eating a healthy diet is good for your overall health and can help reduce the risk of ED. Focusing on eating fresh fruits, vegetables, whole grains, and lean protein can improve your sexual health.

Exercise: Getting regular exercise is good for your overall health and can help reduce the risk of ED. Exercise improves blood flow and helps maintain a healthy weight, both of which are important for maintaining erectile function.

Common ED Treatments

Oral medications: These are a first-line treatment for ED. They include sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil (Stendra).

Drugs injected into the penis: These can be used if oral medications don’t work or can’t be used because of potential side effects.

Vacuum devices: This is a mechanical way to create an erection using a vacuum pump and a constriction band.

Penile implants: This is a last resort for treating ED. It involves surgically placing devices in the penis that can result in an erection.

Counseling and lifestyle changes: This can include addressing psychological and relationship issues that can lead to ED. Making lifestyle changes such as quitting smoking, exercising regularly and eating a healthy diet can also help.

Herbal treatments

Herbal treatment for ED usually includes the use of natural herbs and supplements that have been shown to be effective in treating the condition. Some of the most common herbs used for treating ED include:

Red Ginseng

Red Ginseng or Panax ginseng is a popular choice for treating ED. This herb is known to improve blood circulation and energy levels, as well as increase libido. It is a natural antioxidant and has anti-inflammatory properties.

Red ginseng has been used in traditional Chinese medicine for centuries to treat a variety of conditions, including ED. In a study of 45 men with ED, those who took red ginseng saw a significant improvement in their condition after eight weeks of treatment. Another study of 75 men with ED found that those who took red ginseng saw a significant improvement in their erectile function and libido.

In addition to its potential use in treating ED, Panax ginseng has a number of other potential health benefits like improving mental clarity and memory, boosting energy levels, reducing stress and anxiety, lowering blood sugar levels and treating respiratory conditions such as bronchitis.

Gingko Biloba

This herb is often taken as a supplement to improve blood circulation. It is thought to help with ED by improving blood flow to the penis and helping to maintain an erection.

Gingko biloba has been used in traditional Chinese medicine for centuries to treat a variety of conditions, including ED. In a study of 100 men with ED, those who took gingko biloba saw a significant improvement in their erectile function after eight weeks of treatment.

In addition to being a possible treatment for erectile dysfunction, gingko biloba may offer other health benefits. These include:

  • Increased blood flow to the brain
  • Improved circulation
  • Antioxidant effect
  • Stress relief
  • Improved cognitive function
  • Enhanced sexual function
  • Relief from PMS symptoms
  • Reduced risk of cancer
  • Improved vision


Yohimbe is a natural herb that comes from the bark of an African tree. It has been used for centuries to treat a variety of sexual dysfunctions, including erectile dysfunction. The active ingredient in Yohimbe is a chemical called yohimbine, which has been shown to be effective in treating erectile dysfunction. Some studies have shown that yohimbe can be effective in treating ED, but more research is needed.

Yohimbe side effects can include stomach upset, increased blood pressure, and fast or irregular heartbeat. It can also interact with other medications, so it’s important to talk to your doctor before taking it. Other benefits of Yohimbe include improved circulation and increased libido.

Rhodiola Rosea

This is an herb that grows in colder climates and has been used to treat sexual dysfunction for centuries. It is thought to work by increasing levels of serotonin and dopamine, which are neurotransmitters that play a role in sexual desire. Rhodiola Rosea has been shown to improve erectile function in men with mild-to-moderate ED by improving blood flow to the penis. The herb also helps increase sperm count and motility, and it has been traditionally used to treat infertility.

Tribulus terrestris

Tribulus terrestris is a small flowering plant that’s native to warm temperate and tropical regions of the world. Tribulus terrestris is sometimes called puncture vine because its fruits contain sharp, pointy spines. The plant has been used for centuries in traditional Chinese and Indian medicine to treat various health conditions like urinary problems and low libido.


Maca is a root vegetable that’s native to South America. It’s been shown to improve circulation and increase libido. Maca is rich in minerals like iron, magnesium, and zinc which are essential for sexual health.

Fruits and veggies for ED

There certain fruits and vegetables to improve blood circulation and libido.

Watermelon – This juicy fruit is rich in an amino acid called citrulline, which relaxes and dilates blood vessels, improving blood flow.

Pomegranate – Pomegranates are rich in antioxidants that can help improve blood flow by relaxing and dilating blood vessels.

Citrus fruits – Citrus fruits like oranges, lemons, and grapefruit are rich in a nutrient called citric acid, which helps improve blood circulation by breaking down plaque and cholesterol in the arteries.

Leafy greens – Leafy greens like spinach and kale are rich in nitrates, which help improve blood flow by dilating blood vessels.

Beets – Beets are rich in nitrates, which help improve blood flow by dilating blood vessels.

Garlic – Garlic is rich in a compound called allicin, which has been shown to improve blood circulation.

Ginger – Ginger is another herb that’s traditionally been used to improve circulation. It’s thought to work by relaxing and dilating blood vessels.

Niacin, also known as vitamin B3, is another nutrient that’s essential for blood circulation. Niacin is found in foods like meat, fish, eggs, and green vegetables. Some people take niacin supplements to help improve their circulation.

Bottom Line

If you suffer from erectile dysfunction (ED), don’t be ashamed to talk to your doctor about it. It’s a common problem, and there are treatments available that can help. There are many possible causes of ED, including physical problems like diabetes or heart disease and psychological issues like anxiety or depression. Sometimes, a combination of factors is involved. Whatever the cause, ED can be a frustrating and embarrassing problem. But it’s important to remember that you’re not alone. ED is quite common, and there are treatments available that can help. Your doctor can discuss all of your treatment options with you, and together you can decide which approach is best for you. Common treatments include oral medications, injections into the penis, vacuum devices, and surgery.

Frequently Asked Questions

Is ED normal?

Erectile dysfunction (ED) is not a normal part of aging. While the frequency of ED increases with age, it is not an inevitable part of growing older. Even though erections may become less firm and more infrequent as men age, most men will still experience erections during their lifetimes.

Can ED cause infertility?

There is no evidence to suggest that erectile dysfunction causes infertility. However, ED can be a sign of an underlying medical condition, such as low testosterone levels, that can cause infertility. If you are concerned about your fertility, it is best to consult with a healthcare provider.

Are ED exercises helpful?

There is no scientific evidence to support the claim that specific exercises can improve erectile function. However, pelvic floor muscle exercises may help some men with ED by improving blood flow to the penis and reducing urinary incontinence.

How do I know if I have erectile dysfunction?

If you are experiencing difficulty achieving or maintaining an erection, you may have ED. However, it is important to keep in mind that occasional erectile difficulties are not necessarily indicative of ED. If you are experiencing persistent or recurrent problems with your erections, it is best to consult with a healthcare provider to rule out any underlying medical causes.

Is ED permanent?

No, erectile dysfunction is not always permanent. In many cases, it can be reversed with lifestyle changes, psychotherapy, or medication. However, even when ED cannot be cured, treatments are available that can help relieve the symptoms.


Red ginseng for treating erectile dysfunction: a systematic review

Is the hype around the reproductive health claims of maca (Lepidium meyenii Walp.) justified?

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Alternative medicine and herbal remedies in the treatment of erectile dysfunction: A systematic review

A placebo-controlled, double-blind trial of Ginkgo biloba for antidepressant-induced sexual dysfunction


  • Noor Ain, BSc, Master Herbalist

    Noor Ain has Bachelor of Science (BSc) from Clarkson University New York and Florida Atlantic University Florida. In addition he has completed Advanced Master Herbalist Diploma Course, Center of Excel...

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