Herbal Health

Getting expectations clear and discussing them in detail with the therapist and your partner is an essential part of sex therapy. If you can get erections in some situations but not others, it’s realistic to explore what is happening in the situations when you don’t become erect. For example, a man who feels he “should” have sex whenever his partner is willing may discover that just removing that requirement solves the problem. If you have a physical illness which plays a role in your potency, your expectations of what constitutes success must, of course, be defined with those facts in mind. A sex therapist will probe and help you define what constitutes success for you. It’s important to get this clear before you embark on a program of therapy, so everyone knows the goals and objectives of the program.

Sometimes a couple comes in for one problem, and in the process of defining the man and woman’s expectations, different concerns emerge. Harry’s announced reason for wanting sex therapy was his inability to consistently maintain an erection. This 57-year-old man suffered from high blood pressure and had to take medication for this condition. He also had been diagnosed recently as diabetic, a fact he found very difficult to accept.

Harry’s first marriage had ended in divorce. In discussions with the therapist it became clear that Harry blamed his erection problem for the breakup of this relationship. He was convinced that the same thing might happen again with his second wife, Shirley, a vivacious 54-year-old who also had been married before. For the most part, Harry and Shirley considered themselves a happy couple. But increasingly, Harry was fixated on his “sexual failures.” He was convinced that Shirley would reject him just as his first wife had—and that his erectile problems were to blame.

Harry felt an erect penis was necessary to satisfy a woman, and he was quite surprised when the therapist explained in detail that this was not true. He was even more surprised when Shirley, encouraged by the therapist, explained that she was not overly concerned with Harry’s erection problem.

When Harry lost potency, Shirley’s usual comment was, “Don’t worry about it.” Harry interpreted this remark as a well-intended solace for his failure. But Shirley meant her words, and more. Her first husband had been, she explained, a “slam-bam thank you ma’am” kind of guy, and Shirley was quite happy to be cuddled, kissed and caressed. She wanted to be physically close to Harry, but she did not feel especially deprived by Harry’s loss of potency. What she did want was physical affection. Harry’s preoccupation with intercourse as the only “real” sex was troubling her.

What Harry and Shirley learned in sex therapy helped their fundamentally sound relationship. They learned to communicate more clearly and directly. Each learned to say what was wanted without confusing the other. Relieved of the self-induced pressure to always produce an erection, Harry relaxed and found his erections improved. He also began taking better care of himself, because he could accept more easily the changes his diabetes required in his life.

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If you thought that stress couldn’t tamper with your life any more than it already has, consider this. Stress can dampen sexual arousal. An action that includes the surging of blood, increased heart rate, and erection, arousal depends, to a great extent, on a number of various hormones to spark specific reactions in the body.

But there are other hormones discharged from the adrenergic system—epinephrine and norepinephrine, especially—that can effectively shut down sexual response. Whenever you are under stress, no matter what the source is, these hormones begin to course through your veins, directing blood flow to the heart and major muscles and, therefore, away from the genitals, in both men and women. This results in increased heart rate and blood pressure, two physical factors that can contribute to lowered libido and performance.

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Based on extensive research by scientists, as well as my own experience, I have put together a list of seven supplements which can improve penile health. These substances have other wide-ranging effects. Not only can they decrease the risk of ED, they also offer increased protection against cardiovascular diseases such as atherosclerosis.

The seven are vitamin E, vitamin C, Pycnogenol, ginkgo biloba, coenzyme Q (also called Co-Q-10), ginseng, and saw palmetto. You may already be taking one or two of them. If so, see my recommendations to ensure that you are taking a high enough dosage to make an impact on your health. Keep in mind that you can try any or all of these supplements. But as is always the case with new remedies, consult with your doctor before you decide which to take, and in what dosage. Five out of the seven substances listed have powerful antioxidant effects (ginseng and saw palmetto have other properties). Utilizing them to your best advantage can help to ward off—or significantly diminish —the effect of one of the body’s great enemies: free radicals.

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But what about those anxiety-related situations that most men can relate to? Job performance, concern over finances, problems with teenagers at home, relationship issues with a partner—the list goes on and on, changing each day. Problems stemming from daily life are universal.

Consider the example of a thirty-four-year-old patient of mine whose job as a Wall Street trader gives him more than his share of high anxiety. It so happened that Eric’s third wedding anniversary coincided with the day of a stock market freefall. That night he went home, trying to put the awful day behind him, anticipating a sexual celebration. Only, it didn’t happen. There was no way that he could circumvent his worry over the events of that afternoon and the result was a disappointing evening.

When he called me the next morning, I understood why his erectile failure had occurred; so did he. Then he wanted to know if he could have a prescription for the pills for those times when he might need them. He is healthy and doesn’t smoke. His drinking is limited to an occasional glass or two of wine and he exercises regularly. His ED is solely anxiety-related. Why shouldn’t a man with his profile, in a loving relationship, have the fallback support he may need? Isn’t his quality of life being compromised otherwise?

For Eric, and the millions of men like him who will—if they haven’t already—experience anxiety-related ED, the pills can relieve worry and offer substantial piece of mind. Isn’t that a valid function of medicine?

I do feel, however, that the decision to provide the medication to males who are already performing at the highest sexual levels, and who have never experienced any kind of ED, must be made on a case-by-case basis. Presently, there is a lack of scientific data to support any preventive use of the oral drug. Although controlled medical studies are being planned to measure the benefits of prophylactic use—some experts are predicting that, in the near future, the drug will be taken two or three times a week, even when a man is not engaging in sex, to ensure erectile health—we may not have definitive answers for several years.

Based on my own experiences and on the extensive reports of my fellow medical colleagues, I’m extremely pleased with the profile of the medication. With the information on hand, I can weigh the merits of the drug on a risk-to-benefit ratio on a patient-by-patient basis.

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Before I provide a man with the ED medications, I have a serious discussion with him about the importance of understanding how the pills work. I make it very clear that the erection pill will allow him to I unction sexually within a relatively large window of opportunity. It does not, however, mean that the medications can cure the condition i hat caused ED in the first place. I also reiterate that more is not better. I doubling a dose will not make a belter lover. In fact, it might bring on some undesirable side effects, such as plummeting blood pressure, light-headedness, and a racing heart.

When a Patient Doesn’t Want Medication

For some people, the idea of having to take medication is less than thrilling. It signifies getting older, losing control of their bodies, and facing their mortality. Even though the ED drugs have proven to be so successful, some of my patients are still reluctant to use them. Or they use them for a while and suddenly stop. I think this is linked to the unspoken desire to feel “normal” and in control. But if a patient stops taking the drugs, thinking that he is cured permanently, he is going to subject himself to another, potentially more devastating round of failure, deflated self-confidence, and embarrassment.

Using ED medication is hardly a sign of weakness or inadequacy. On the contrary, taking it means that a man is dealing with his problem and, in fact, overcoming it in the most painless, practical way possible. It basically comes down to this: Without the drugs, junction is going to remain impaired. With them, it will be corrected.

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