Few words are guaranteed to strike dread and terror, guilt and even shame into the hearts of men as easily as ‘impotence’. Maybe that explains the recent name change to erectile dysfunction (ED), which sounds more like a treatable medical condition than a vitriolic insult. Erectile dysfunction affects 1 in 10 men, and between 20–46 per cent of men over 40 years of age, so it’s a relatively common condition. Maybe it’s a man thing, but very few men feel comfortable talking about it.

Erectile dysfunction means the inability to develop or sustain an erection. It is not the same as infertility and is not to be confused with lack of desire or libido. The ‘gurus’ of sexual studies, Masters and Johnson (whose work was first published in the 50s and 60s) believed that both physical and psychological reasons exist for erectile dysfunction – and this is still the current understanding.

Erectile dysfunction is generally viewed as a male complaint, probably because the effect is visual. However, women may also experience impotence, where there is no feeling of stimulation to the clitoris or vagina. Many of the recommendations, particularly the dietary recommendations and herbs, will also help female impotence.


  • Inability or difficulty in getting an erection.
  • Difficulty sustaining an erection adequate for sexual activity.
  • For women inability to experience a climax

What causes it?

  • Smoking. Nicotine decreases blood flow to the peripheral blood vessels, including the penis.
  • Being overweight. Obesity can lead to diabetes, heart disease and lowering of testosterone, all causes of ED.
  • Diabetes is a common cause of erectile dysfunction as it affects both nerves and blood vessels.
  • Alcohol acts as a depressant on the nervous system: ‘[Drink] provokes the desire, but it takes away the performance’(Shakespeare).
  • Atherosclerosis (AQ: or the thickening of artery walls) OKreduces blood flow to the penis.
  • Nerve damage or disorders affect nerve pathways.
  • Hormone imbalance. Testosterone is the hormone of libido in both men and women. If testosterone levels are low, then arousal and performance will be too.
  • Testicular disease, injury or infection.
  • Medical illness including cirrhosis of the liver, kidney failure and lung disease.
  • Drugs including some kinds of heart medication, antidepressants, amphetamines, heroin and tranquillisers.
  • Masters and Johnson also suggested that erectile dysfunction may also be due to a fear of failure, particularly in terms of sexual performance. Society fosters the stereotype of the ‘perfect’ male: healthy, good-looking, successful, rich, young and, of course, extremely virile. Trying to live up to this unrealistic ideal is impossible, and fear of not succeeding may cause more than heartache.
  • Mental and physical fatigue and stress.
  • Depression.
  • Sexual monotony or boredom. This does not mean that a new partner is needed, but that care, imagination, effort and communication are required.

What to do

There are many modern treatments, ranging from tablets to hormonal injections, implants, microsurgery and rubber water-pumps. Natural remedies can help in certain circumstances. Everyone is different and each situation requires its own unique solution.


  • Go raw. It is easier to feel virile on a diet full of vitality and life force than on reconstituted, processed and preserved fodder. Eat as much raw food as possible: raw fruit, sprouts, vegetables, seeds and nuts.
  • Try a vegetable juice a day filled with raw carrot, beetroot, celery, ginger, parsley and kale.
  • Oysters have achieved notoriety as slimy aphrodisiacs, perhaps because they are so high in zinc (an important constituent of semen), which is necessary for the hormonal health of men and women. Half a dozen oysters contain as much as 85 mg of zinc.
  • Avoid alcohol, coffee, sugar, white flour products and highly processed food.


Before Viagra, the natural world was scoured for aphrodisiacs – from tiger’s penis to jackal’s bile, from ginseng to horny goat weed. Unfortunately, the area of sexuality is a prime target for scam artists and there are many ‘natural’ products sold which are as likely to give you ‘the horn’ as a soggy sock in a hailstorm. Nevertheless, there is never smoke without fire and many herbal aphrodisiacs have retained their reputation for hundreds of years. There must be a good reason.

Natural aphrodisiacs work in three ways. Some restore the balance of the sex hormones, particularly testosterone (which is as important for women’s libido as it is for men’s). Some assist the adrenal glands, which can be helpful when the problem lies in stress and fatigue, while others improve circulation to the areas concerned. Interestingly, many herbs fulfil all three roles.

  • Aphrodisiac herbs include panax ginseng, the evocatively named horny goat weed, tribulus, withania, damiana, muira puama, maca and saw palmetto.
  • ED is one of the side effects of certain antidepressants. The herb ginkgo biloba can work very well to combat this problem, for both men and women, and is safe to be taken with antidepressant medication. Ginkgo biloba is also good for microcirculation. That is not about the size of the organ, but the size of the blood vessels therein.
  • Vitamin E can also improve circulation. Take 500 iu daily.
  • Zinc deficiency is common. Men are more likely to be deficient as approximately 2.5 mg of zinc is lost per ejaculate. Take a supplement daily.
  • Take a Vitamin B complex daily, particularly if you are under stress.
  • The Bach flower Larch is a good one if you are lacking in confidence in this arena, and Crab Apple may help if there is an element of shame.


  • Lose weight if necessary.
  • Stop smoking.
  • Exercise is important. It increases energy, improves circulation and, depending on the type of exercise, can increase testosterone levels. Exercise that builds muscle tissue increases testosterone levels. This does not mean for women that they will end up looking like an Arlene Schwarzenegger. Try weights at the gym, boxing classes – anything that improves muscle tone.
  • Stress and worry are big killers of desire and performance. Learn how to relax.
  • Acknowledge there is a problem and discuss it openly with your partner. You might be surprised at how liberating just shining some light on this subject can be. If not your partner, talk to a friend, doctor or counsellor.
  • Sex therapists have a technique to take the fear out of performance anxiety. It encourages a couple to spend more time sensually. They suggest no sex initially. Every few days, spend half an hour every evening massaging each other. Sex is forbidden. The massage is to encourage closeness and intimacy in the relationship and touching without the need for sexual expression. Try this for a month.
  • Hypnotherapy can also help.
  • Aromatherapy offers several fragrances to enhance sexuality: the exotic oil of patchouli, jasmine, the intense floral smell of ylang ylang and the (expensive) pure oil of rose is said to free the true expression of the heart. A few drops of these essential oils may be combined with almond oil for a massage oil, or added to the bath or an oil burner to create a sensual atmosphere.
  • The sexual organs are located at the sacral chakra (an energy centre located along the spinal column). This chakra represents the ability to enjoy pleasure and give to yourself on all levels. The colour of the sacral chakra is orange. Perhaps try orange Y fronts? Or sheets?
    • Erectile dysfunction may reflect feelings impotence in other areas of life – work, relationships, money?

At a glance


  • To feel vital and virulent, avoid over-cooked, over-processed food. Eat as much raw food as possible.


  • Aphrodisiac herbs include panax ginseng, horny goat weed, tribulus, withania, damiana, muira puama, maca and saw palmetto. They are as useful for men as women.
  • Take circulation-boosting supplements including ginkgo biloba and vitamin E.
  • Zinc is needed for testosterone. Testosterone is needed for erections. Get some zinc into you.


  • If you are on the cuddlier side, lose weight. This will increase energy and testosterone levels and reduce your risk of atherosclerosis and diabetes, both causes of ED.
  • ED is often as much psychological as it is physical. Seek counselling and start talking about your condition. You will be surprised at how common it is.