Physiology of Erectile Dysfunctions

ED is characterized by the inability to attain or maintain an erection of the penis during sexual intercourse. ED can cause severe psychological consequence and affect one’s confidence and self-esteem.


  • Psychological impotence is where thoughts interfere during the act of intercourse, though this is a less frequent phenomenon; psychotherapy and placebo treatment is of great help
  • Medical conditions such as diabetes, cardiovascular diseases and neurological disease can lead to erectile dysfunctions
  • Postprostatectomy (removal of the prostate) can be a reason for impotence as the trauma caused during the surgery could hamper the normal anatomy of the male genital tract.
  • Hypogonadism is caused due to deficiency of growth hormone causing impotence due to lack of proper growth of the gonads
  • Medications such as antidepressants and analgesics overuse are a common cause
  • Substance abuse such as smoking, alcohol and drugs are the second commonest cause of impotence and smoking in particular causes narrowing of the arteries of the body as well as the genitals
  • Ageing is a natural process and thus affects potency as well.


  • Inability to attain or maintain an erection
  • Loss of libido
  • Depression, frustration and anger can be seen patients with ED
  • Loss of touch or tingling sensation below the torso

Treatment in Allopathy

There is no formal blood test to diagnose ED. Blood tests are generally carried out to rule out conditions such as diabetes mellitus, cardiovascular diseases, hypogonadism and prolactinoma.

Physical examinations are helpful in identifying groin hernia, varicose and abnormality of the gonad. Duplex ultrasound, penile biothesiometry, magnetic resonance angiography and dynamic infusion cavernosometry are few investigations to identify the cause of ED and plan a treatment accordingly.

  • Oral medications such as PDE5 inhibitors such as sildenafil and vardenafil
  • Vacuum devices with or without a ring to help draw blood into the penis and the ring to sustain the erection is prescribed to be used prior to sexual intercourse when oral medications fail to attain required results.
  • Surgery treatment using prosthetic implants inserted into the penis. This is usually the last resort when conservative methods fail.

Ayurveda and erectile dysfunction

ED is referred to as Klaibya in Ayurveda. The vitiation of vata dosha and unhealthy lifestyle are primarily responsible for ED. Ayurveda see it as an imbalance of shukra dhatu. Ayurveda divides erectile dysfunctions into following categories-

  1. Manasika klaibya is due to psychological causes
  2. Doshaj klaibya is due to physiological causes and systemic diseases
  3. Shukrakshayaji is caused due to a decrease in sperm count
  4. Aghataji is caused due to trauma to the perineal region.
  5. Shukranirodhaj is caused by suppression of sexual urge and
  6. Jaraja klaibya is caused due to advancing age
  7. Shaj refers to congenital disability hindering in healthy sexual activity.

Treatment of ED in Ayurveda

The patient’s medical history, lifestyle, diet and prakriti are taken into account to make a proper diagnosis and treatment. Some of the general guidelines are given below.

Panchakarma Therapies

Shirodhara is used to treat disorders affecting the nervous system. A thin stream of liquid, mostly oil is poured over the forehead continuously and this causes vibration in the forehead, which allows our mind and nervous system to experience a deep state of mental rest. This treatment energises the nerve endings and very effective in healing ED

Abhyangam involves the full body massage with medicated herbal oils. It stimulates vital pressure points, which leads to nervous stimulation and reduction in oxidative stress. Abhyangam balances the Doshas and treats Mental, Emotional, and Physical disorders. This therapy boosts Immunity and leads to well-being by preventing Stress and Depression which is very essential in dealing with ED

Pizhichil treatment involves the squeezing of warm medicated oils to help the system to balance itself thereby inducing both physical and mental relaxation. Pizhichil rejuvenates the body and boosts the functioning of the nervous system. It promotes blood circulation in the body and treats ED

Basti( medicated enema,  Virechana (purgation), and Vamana (emesis) can also be done to remove toxins from the body and balance the Vata dosha.

Diet Modifications

Since ED is primarily a vata dosha, hence a vata pacifying diet is beneficial.

  • As much as possible consume fresh cooked, preservatives and dyes free products
  • Avoid heavy carbohydrate meals as it can slow down digestion and lead to constipation and vitiation of apana vayu. Imbalance in apana vayu is responsible for penile erection and can hamper sexual performance
  • Avoid excess sour, salty and acidic food.
  • Dry fruits, fresh fruits and milk produce enhance sexual performance and prevent ED

Lifestyle Modifications

  • Say no to substance abuse and intoxicants.
  • Regular exercise, yoga and meditation is beneficial in treating ED and managing stress
  • Sleep is essential to maintain sexual health and manage stress
  • According to Ayurveda masturbation decreases potency and worsens ED
  • A positive outlook towards life is beneficial

Ayurvedic herb

  • Ashwagandha/ Indian ginseng (Withania somnifera) is best known to improve male fertility by promoting a healthy sperm count and regularising hormone levels. It also helps in  improving mental clarity and reducing stress.
  • Asparagus racemosus (shatavari) known as the ‘’curer of one hundred diseases” is also known to improve sexual health. It  improves blood circulation and relaxes the nerves. Asparagus racemosus is also considered as an aphrodisiac
  • Cassia cinnamon or Chinese cinnamon powder is made from the bark of an evergreen tree that grows in India when taken in prescribed quantity  can treat ED.
  • Jaiphal (nutmeg), Kaunch beej (mucuna pruriens), Safed musli (Chlorophytum borivilianum) is a powerful aphrodisiac, improves fertility and treats ED
  • Kokilaksha (Hygrophila auriculata) helps release nitric oxide in the body. Nitric oxide is vital for dilating the arteries. Dilation of arteries is essential in maintaining the  erection
  • Shilajeet (mineral pitch) rejuvenates the body improves sexual vigour and increase the tone and blood flow to the perineal region.

Yoga and Pranayama

Non-empirical literature focuses on the benefits of yoga and pranayama in improving  ED and overall sexual health.

  • Naukasana (boat pose)
  • Kumbhakasana (plank pose)
  • Uttanpadasana (raised leg pose)
  • Paschimottanasana (seated forward bend)
  • Dhanurasana (bow pose)
  • Ardha ushtrasana (half camel pose) and Ardha chandrasana (half moon pose)

These asanas help improve the sexual health by activating the male sexual hormones, strengthening the muscles of hip; thigh, buttocks and perineal region,and  improving the blood flow to the lower torso. They also help to improve stamina and endurance which is crucial for sexual health.

Kapalbhati pranayama which is one among the seven pranayamas said to be most beneficial in improving sexual health and acts as a beneficiary for infertility.

Nadi shodhana pranayama, Udgeeth pranayama and sheetkari pranayama have also been found to be beneficial.

Naturopathy and erectile dysfunction

Poor diet may lead to vascular disease which interferes with the erection process of the penis resulting in erectile dysfunction. Diet and exercise play a vital role in the treatment of ED.

Treatment of ED in Naturopathy

Detox by taking 2 cloves of garlic on empty stomach, early in the morning followed by a glass of warm milk. This helps in improving the blood circulation and also act as an aphrodisiac. Following this after an hour drink about one litre of warm water as this cleanses the colon and balances the hormone levels in the body.

Diet changes

  • Eat fresh, unrefined and unprocessed food.
  • Fresh fruits rich in pigments help maintain vascular integrity
  • Consuming whole grains, beans, seeds, nuts and cold water fish are beneficial in treating ED
  • Food sensitivity should be eliminated and diet should be changed accordingly
  • Increase in fluid intake as it eliminates toxins an aids digestion
  • Dietary supplements containing bioflavonoids, selenium, vitamin C and vitamin E are beneficial in treating ED

Lifestyle modifications

  • Regular exercise improves overall health and benefits in treating ED as well by maintaining a healthy blood pressure, androgen level and sugar level.
  • Stress management is very important to maintain a healthy sexual life
  • Sexual activities that lead to even partial erection may have a positive impact on ED
  • Smoking increases the risk of ED, total abstinence is advised
  • Acupuncture improves the quality of erection

Botanical herbs

Asian ginseng, Rhodiola rosea, Muira puama, Ginkgo, horny goat weed increases blood flow to the penis, increases libido, reduces fatigue and improve ED.

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