Caution: There is a higher rate of heart disease in men with erectile dysfunction. All men with ED -- particularly older men who are more likely to have physical causes as opposed to psychological erectile dysfunction -- need a medical evaluation, detailed cardiac assessment, blood pressure measurement, lipid profile and blood sugar tests, as well as lifestyle advice regarding weight management, diet improvement, smoking cessation, sleep quality improvement, and exercise. If you have erectile dysfunction, make sure to have a full medical evaluation before starting therapy, whether with an herbal product or a drug. Some herbs are very potent and have a tendency to accelerate heart rate or increase blood pressure which may not be well tolerated by those who have cardiac or cardiovascular problems. Even though herbs are safer than prescription medications, they do have side effects in high doses.

Passion Rx -- Medical Doctor formulated herbal remedy for Erectile Dysfunction

Passion Rx, formulated by Ray Sahelian, M.D., provides results that are often noticed the second or third day. Results continue to improve over several days. Our feedback thus far indicates more than 80% user satisfaction by the end of the first week. Dr. Sahelian and his research staff have tested various doses and extracts of dozens of herbs from a number or raw material suppliers to determine the ideal dosage and combination for optimal aphrodisiac properties with the fewest side effects. After years of trial and error, a special proprietary blend with 15 herbal extracts from the best raw material suppliers has been created which works within hours. The exact dosages and potencies of this herbal blend is a close kept secret only known to the doctor and his research staff.

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Understanding the causes
Erectile dysfunction can be classified simply under two headings. Psychological erectile dysfunction: that is, mental; or Organic erectile dysfunction: that is, due to some form of physical or medical problem. Organic erectile dysfunction becomes more common as men get older.

Psychological causes
The causes of psychological erectile dysfunction are numerous, and it is difficult to list them all, but most often erectile dysfunction is related to depression, performance anxiety, marital stress or relationship problems, marital boredom, life crisis, financial difficulties, religious repression, or some type of mental illness. Improving erectile dysfunction in these cases may require addressing the underlying causes.

Organic causes
There are four major causes of organic erectile dysfunction: Vascular, Neural, Hormonal, and Drug-induced. The type of erectile dysfunction determines the treatment approach.

Vascular causes
Alterations in the flow of blood to and from the penis are thought to be a common cause of male erectile dysfunction. For instance, medical conditions such as atherosclerosis (hardening of the arteries), high cholesterol, hypertension, or diabetes reduce blood flow to the penis and genital organs thus leading to difficulty with erection or genital swelling.  Erectile dysfunction could be an early indication of oxidative stress and vascular dysfunction. A vascular problem in the penis may precede a wider, systemic problem in other blood vessels in the body. Patients with cardiovascular disease and patients with diabetes represent the largest group of patients with erectile dysfunction. Lowering cholesterol through diet, supplements, or medicines improves erectile dysfunction.
   Metabolic syndrome can increase inflammatory markers in blood and negatively influence endothelial function resulting in poor vasodilation and a higher incidence of erectile dysfunction.
   Additional factors that can impede blood flow include penile injury and surgery in the pelvic and abdominal area. Smoking can reduce genital blood flow. Some men with erectile dysfunction may have an underlying vascular disease such as atherosclerosis.

Neural causes
Nerve damage from disorders such as multiple sclerosis, Parkinson’s disease, diabetes, and stroke affect the brain’s ability to respond to sexual stimulation and cause erectile dysfunction. In women, abdominal or pelvic operations can occasionally lead to nerve damage. Erectile dysfunction is common in men undergoing surgical treatment for prostate enlargement or cancer.

Hormonal causes of Erectile Dysfunction
Low levels of androgens, such as testosterone, are sometimes a component of erectile dysfunction. Testosterone levels decline about 1 percent each year in men, which may contribute to erectile dysfunction with aging. Testosterone also declines with age in women leading to a decrease in female libido. Replacement of androgens can sometimes be helpful in those with age related erectile dysfunction. Testosterone is available by prescription only. An over the counter hormones, such as DHEA, converts into testosterone and thus has a positive influence on erectile dysfunction. Pregnenolone is another over the counter hormone that may increase testosterone levels and thus improve erectile dysfunction. Many herbal aphrodisiacs also have a positive influence on erectile dysfunction. Routine hormone blood studies for erectile dysfunction evaluation are not needed during the initial evaluation but perhaps later if treatment modalities are not successful. Prominent diseases of the endocrine system, such as diabetes mellitus, hypogonadism, and hyperprolactinemia, may cause erectile dysfunction. Sometimes erectile dysfunction treatment with hormones such as DHEA or testosterone can be effective.

Drug or Medication-induced Erectile Dysfunction
Drugs that interfere with erectile function include some anti-hypertensives, SSRIs (like Prozac), sedatives, and beta-blockers. SSRIs - treatment for depression - cause erectile dysfunction mostly due to their effect on serotonin metabolism. Serotonin has an inhibitory effect on erectile function and sexuality. Beta blockers such as propranolol, atenolol, and others, are some of the most common medications that cause erectile dysfunction.
     Surprisingly, NSAIDs such as ibuprofen and naproxen also cause erectile dysfunction. Regardless of the reason for taking them, painkillers classified as non-steroidal anti-inflammatory drugs (NSAIDs) apparently increase the likelihood that middle-aged and elderly men will develop erection difficulties. A study involved 1126 men, between 50 and 70 years of age, without erectile dysfunction in 1994 when they completed a questionnaire that included, among other things, questions about erectile function and medication usage. The questionnaire was then re-administered five years later. The investigators found that the erectile dysfunction rate was 93 cases per 1000 persons per year among NSAID users compared with just 35 cases among nonusers.

Herbal remedy for erectile dysfunction emails
Is there an herbal remedy for erectile dysfunction? I'm looking for something with few side effects.
   Depending on the cause, there can be a natural treatment. We are quite impressed by a number of natural herbs and hormones that can make a significant difference in improving erection.