Herbs for Male Impotence

I can't make love, I have a terrible headache." This phrase has become well-recognized, and even a subject of humor to epitomize a popular belief that women may often need an excuse to avoid love-making with a man whose sexual appetite is much more insistent that hers. In recent years, however, we have been hearing increasingly about men who are intimidated by women, or for one reason or another, cannot perform--"performance anxiety." Do women or men have a higher incidence of inhibited sexual desire to the point where it becomes a problem in their life? Perhaps it is much more equal than is popularly thought, but men are more reticent to talk about it. It's no joke to many men when it comes to what is called in the Merck Manual (14th ed.) abnormal fear of the vagina. Other intrapsychic (it's all in the mind) causes in men for "inhibited sexual excitement" (impotence) are listed as sexual guilt, fear of intimacy, depression, and some recreational drugs (see sidebar).

In no other area of human health does the mind enter in more thoroughly than in human sexuality--an ironic statement, because most of us realize that this is precisely one area of human activity where the mind can often do more harm than good. But in fact, statistics show that for both men and women, up to 80% of sexual dysfunction and inhibited sexual desire are of mental or emotional origin.

According to the Merck Manual, impotence in men is of two types: primary, which is rare, and "generally indicates severe psychopathology;" and secondary, "in which erectile dysfunction prohibits completion of successful sexual intercourse in about 25% (or more) of opportunities." As mentioned, a full 80% of the secondary impotence is directly attributable to mental and emotional factors and only 20% to disease and functional abnormalities such as diabetes, cardiovascular diseases, surgery, and disorders of the hypothalamic-pituitary-gonadal hormone processes, which might lead to lowered levels of testosterone. Although low levels of testosterone might even be found in a majority of men with impotence, it is difficult to know whether psychological factors inhibiting sexual contact leads to lowered testosterone levels, or visa versa.
 Drugs and their effect on Sexual Performance
Drugs, such as alcohol, can also be a factor. I recently read a study that was carried out in the 60s in San Francisco with a group of volunteers, which clearly showed that while cocaine (which is considered the 'cadillac' of sexual stimulants) and marijuana led to increased sexual interest and improved performance, drugs such as heroin, alcohol, and a variety of downers (such as reds and quaaludes) and amphetamines actually led to a mild to strong decrease in these areas. Common prescription drugs can also lead to impotence as a side-effect. This is especially notable with hypertensives, sedatives, and tranquilizers.
A common myth in this culture is that older people loose their sexual desire and ability to have satisfactory intercourse. Statistics and studies do not support this, however. According to the Merck Manual again, "Aging is not an inevitable cause of impotence, even into the 70s and 80s." Of course, the desire to have sex will cool off somewhat as we get older. I've often felt how fortunate I am to not have the same desire in my 40s as I did when I was 19!

The most common prescription for functional impotence is yohimbine hydrochloride. The drug originated from a West African tree, Pausinystalia johimbe, which has been sold for years on the herb markets of countries world-wide, including the U.S. The alkaloid is an -adrenergic blocker, increases parasympathetic tone and decreases sympathetic tone, as well as a central nervous system (CNS) stimulant. There are a few modern studies showing that it is effective for some types of impotence, especially ones of vascular, diabetic, or psychogenic origins, and it can improve the quality and staying power of erections, usually without increasing sexual excitement. However, the drug should be used cautiously, because it is a CNS stimulant and can lead to side-effects such as dizziness nervousness and anxiety (Physicians Desk Reference, 43rd edition). Yohimbe is also available in some products sold in health food stores, but again, it should be used with caution.

Because many cases of impotence are associated with our mind and emotions, it is appropriate to seek the services of a qualified psychologist, marriage and family counselor or social worker. I prefer to work with practitioners who do not view such problems as pathological, but as a process of self-discovery and personal growth. It is important to clearly understand the root causes of impotence, and often doing so, the problem will disappear on its own.