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It is #MensHealthAwarenessWeek, and time to highlight a topic that men are often reluctant to talk about - Erectile dysfunction (ED)

It is #MensHealthAwarenessWeek, and time to highlight a topic that men are often reluctant to talk about - Erectile dysfunction (ED)

By Merete Linden Dahle

Many men struggle with lack of sex drive, ability to have sexual intercourse and premature ejaculation. Erectile dysfunction is defined as the "inability to achieve or maintain an erection adequate for sexual satisfaction,” and can be classified as psychogenic, vasculogenic, neurologic, and endocrinologic. More than 40% of men over the age of 40 experience various forms of potency problems, and the causes can be anything from illness, lifestyle, stress, obesity, emotional or relationship problems. Erectile dysfunction is associated with age but also with chronic diseases such as diabetes, multiple sclerosis, hypertension, high cholesterol levels, cardiovascular disease and depression. Many are not aware that medication can cause erection failure as a side-effect. Both prescription and non-prescription medications can increase the risk of potency problems and affect both desire and ability to have sexual intercourse. The most common medications that may cause erectile dysfunction are: blood pressure medication, antidepressants, antihistamines, Parkinson's medicine, chemotherapy, opiates, but also one of our most commonly used drugs NSAIDS.

Studies have demonstrated that a higher number of men under 40 years, than previously appreciated, suffers from erectile dysfunction caused by a physical, not psychological problem. ED may be the first sign of more serious disease, which make it important for men to understand and recognise that they need to seek help.

A good sex life is important for living a good life.

Erectile dysfunction is a prevalent sexual dysfunction affecting men´s health both physically and psychologically and may have a substantial impact on health-related quality of life. Regardless of whether the cause is psychological or physical, ED often leads to the same emotional stress with depression, loss of self-esteem and self-confidence, and reduced quality of life for both the person concerned and the partner. These psychological effects can themselves effect the ability to achieve an erection, perpetuating a vicious cycle.

Being strong and virile are characteristics often associated with being manly and masculine. Therefore, suffering from ED has a deeper more severe effect on men´s self-perceived masculinity than previously appreciated. Many of my patients say that potency problems affect their relationship. They avoid situations where they have to be intimate, many avoid close relationships, and many report that their relationship ended as a direct consequence.

Potency problems are often a source of jokes, limiting further the extent to which men with erectile dysfunction feel they can confide in others or approach health professionals for treatment. Studies show that men are hesitant to speak to other men, their partner or GP about their erectile dysfunction, despite this being a common problem. The complexity of the physical and psychological impact related to erectile dysfunction and a need for someone to advocate for male health in the acupuncture community are some of the reasons I became interested in the subject.

Therefore, it is important not only to think about sexual function, but also the psychological aspects when considering effective treatment for erectile dysfunction. The treatment protocol for erectile dysfunction recommends PDE5 inhibitors, such as Viagra, Cialis, Levitra, as first choice. These are effective in about 60 to 70% of cases. Unfortunately, the drugs have some adverse side effects, and for many men, these drugs are not an alternative either because of other underlying diseases or side effects. A group of 30-40% will also find that the PDE5 inhibitors have no effect. Many of my patients want an effective treatment without using medication, either because of their own principles or because of the side effects or no effect of the medication. Acupuncture does not produce such side effects and can therefore be a good option for those who do not want or cannot use potency pills. Recent studies have shown that acupuncture has an effect on stress, depression and anxiety and can therefore be an effective treatment for the psychological impact of sexual dysfunction.

The research literature on acupuncture and erectile dysfunction is limited and of poor methodology but studies indicates that acupuncture may have an effect on ED. High-quality clinical trials on acupuncture as a treatment for ED is recommended. There may be different explanations for why acupuncture works for erection failure. Nitric oxide is one of the most important signal molecules in the erection process. Studies have shown that acupuncture increases the secretion of nitric oxide, and other signaling substances and hormones in the body that are important in the erection process, such as promoting blood flow and affecting the inflammatory process. To date, a comprehensive explanation of the mechanism behind the effect of acupuncture remains to be found.

My experience from the last 15 years however is that acupuncture treatment increases sexual desire and confidence in the ability to perform sexual intercourse, provide surplus energy, prolonged erections and better control over ejaculations.

Because of the taboo nature and social stigma of erectile dysfunction it is difficult to find patients willing to come forward and present their experience of acupuncture. The commonly used word-of-mouth advertising also does not apply when working with male health issues in the same way as when working with women’s health issues. However, it is important to share information to show that acupuncture can be a relevant treatment modality for these issues.

The following case study is both complex and interesting:

43-year old man, in a good relationship and married for 10 years with 2 children. He works long hours with a lot of travelling and stress. Erectile dysfunction the last 18 months. Insufficient erections that don’t last long, not sufficient for having sexual intercourse. No morning erection the last two years.

Other symptoms: Insomnia, Stressed, angry, and frustrated. Does not like weather changes, draft and wind. Pain/soreness back and knees. Memory and concentration problems, and heavy headaches after a serious bicycle accident. Improved by heat, movement and massage.

Appetite too big. Like hot food. Craves chocolate, licorice, soda and potato chips. Feeling of heaviness after eating. Heartburn. Pensiveness. Smelly sweat. Urine dark and smells strong. No thirst.

After the third treatment, he had sexual intercourse for 20 minutes which was the first time in a long time. Morning erections twice between 4th and 5th treatment, but eventually almost every morning. After the 6th treatment, the erection lasts up to one hour. The wife was very happy. He took on some lifestyle changes after the 8th treatment, such as reducing the work load and hours. The headache was less painful and the patient states that he has a normal sex life.

Merete Linden Dahle is a Norway based acupuncturist and specialist in the field of men's health.

Merete has recently completed a master's degree in conjunction with the Northern College of Acupuncture which is validated by Middlesex University, and accredited by the British Acupuncture Accreditation Board.


Many men struggle with lack of sex drive, ability to have sexual intercourse and premature ejaculation. Erectile dysfunction is defined as the "inability to achieve or maintain an erection adequate for sexual satisfaction,” and can be classified as psychogenic, vasculogenic, neurologic, and endocrinologic. More than 40% of men over the age of 40 experience various forms of potency problems, and the causes can be anything from illness, lifestyle, stress, obesity, emotional or relationship problems. Erectile dysfunction is associated with age but also with chronic diseases such as diabetes, multiple sclerosis, hypertension, high cholesterol levels, cardiovascular disease and depression. Many are not aware that medication can cause erection failure as a side-effect. Both prescription and non-prescription medications can increase the risk of potency problems and affect both desire and ability to have sexual intercourse. The most common medications that may cause erectile dysfunction are: blood pressure medication, antidepressants, antihistamines, Parkinson's medicine, chemotherapy, opiates, but also one of our most commonly used drugs NSAIDS.

Studies have demonstrated that a higher number of men under 40 years, than previously appreciated, suffers from erectile dysfunction caused by a physical, not psychological problem. ED may be the first sign of more serious disease, which make it important for men to understand and recognise that they need to seek help.

A good sex life is important for living a good life.
Erectile dysfunction is a prevalent sexual dysfunction affecting men´s health both physically and psychologically and may have a substantial impact on health-related quality of life. Regardless of whether the cause is psychological or physical, ED often leads to the same emotional stress with depression, loss of self-esteem and self-confidence, and reduced quality of life for both the person concerned and the partner. These psychological effects can themselves effect the ability to achieve an erection, perpetuating a vicious cycle.

Being strong and virile are characteristics often associated with being manly and masculine. Therefore, suffering from ED has a deeper more severe effect on men´s self-perceived masculinity than previously appreciated. Many of my patients say that potency problems affect their relationship. They avoid situations where they have to be intimate, many avoid close relationships, and many report that their relationship ended as a direct consequence.

Potency problems are often a source of jokes, limiting further the extent to which men with erectile dysfunction feel they can confide in others or approach health professionals for treatment. Studies show that men are hesitant to speak to other men, their partner or GP about their erectile dysfunction, despite this being a common problem. The complexity of the physical and psychological impact related to erectile dysfunction and a need for someone to advocate for male health in the acupuncture community are some of the reasons I became interested in the subject.

Therefore, it is important not only to think about sexual function, but also the psychological aspects when considering effective treatment for erectile dysfunction. The treatment protocol for erectile dysfunction recommends PDE5 inhibitors, such as Viagra, Cialis, Levitra, as first choice. These are effective in about 60 to 70% of cases. Unfortunately, the drugs have some adverse side effects, and for many men, these drugs are not an alternative either because of other underlying diseases or side effects. A group of 30-40% will also find that the PDE5 inhibitors have no effect. Many of my patients want an effective treatment without using medication, either because of their own principles or because of the side effects or no effect of the medication. Acupuncture does not produce such side effects and can therefore be a good option for those who do not want or cannot use potency pills. Recent studies have shown that acupuncture has an effect on stress, depression and anxiety and can therefore be an effective treatment for the psychological impact of sexual dysfunction.

The research literature on acupuncture and erectile dysfunction is limited and of poor methodology but studies indicates that acupuncture may have an effect on ED. High-quality clinical trials on acupuncture as a treatment for ED is recommended. There may be different explanations for why acupuncture works for erection failure. Nitric oxide is one of the most important signal molecules in the erection process. Studies have shown that acupuncture increases the secretion of nitric oxide, and other signaling substances and hormones in the body that are important in the erection process, such as promoting blood flow and affecting the inflammatory process. To date, a comprehensive explanation of the mechanism behind the effect of acupuncture remains to be found.

My experience from the last 15 years however is that acupuncture treatment increases sexual desire and confidence in the ability to perform sexual intercourse, provide surplus energy, prolonged erections and better control over ejaculations.

Because of the taboo nature and social stigma of erectile dysfunction it is difficult to find patients willing to come forward and present their experience of acupuncture. The commonly used word-of-mouth advertising also does not apply when working with male health issues in the same way as when working with women’s health issues. However, it is important to share information to show that acupuncture can be a relevant treatment modality for these issues.

The following case study is both complex and interesting:
43-year old man, in a good relationship and married for 10 years with 2 children. He works long hours with a lot of travelling and stress. Erectile dysfunction the last 18 months. Insufficient erections that don’t last long, not sufficient for having sexual intercourse. No morning erection the last two years.
Other symptoms: Insomnia, Stressed, angry, and frustrated. Does not like weather changes, draft and wind. Pain/soreness back and knees. Memory and concentration problems, and heavy headaches after a serious bicycle accident. Improved by heat, movement and massage.
Appetite too big. Like hot food. Craves chocolate, licorice, soda and potato chips. Feeling of heaviness after eating. Heartburn. Pensiveness. Smelly sweat. Urine dark and smells strong. No thirst.

After the third treatment, he had sexual intercourse for 20 minutes which was the first time in a long time. Morning erections twice between 4th and 5th treatment, but eventually almost every morning. After the 6th treatment, the erection lasts up to one hour. The wife was very happy. He took on some lifestyle changes after the 8th treatment, such as reducing the work load and hours. The headache was less painful and the patient states that he has a normal sex life.

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