ERECTILE DYSFUNCTION

Erectile dysfunction (ED), or impotence, is the inability to obtain or maintain an erection for sexual activity.

Depression, anxiety, and stress can all play a role in ED, but for most men, ED is from physical causes, such as high blood pressure, diabetes, atherosclerosis, spinal cord injuries, neurological diseases like multiple sclerosis and Parkinson's disease, kidney disease, and overweight or obesity. Alcohol, some drugs, and treatment for prostate or bladder problems may also lead to ED.

Be sure to speak with your doctor about ED. Your doctor may discover an underlying condition that needs to be treated. In many cases, treatment can return you to normal sexual activity.

Lifestyle recommendations for ED

• Lose some weight. Excess weight means less testosterone is available for getting and keeping an erection. Penile blood flow is also impeded in overweight men. ED can often be corrected by shedding some extra pounds.
• Quit smoking. Blood vessels, including those that supply the penis, are especially susceptible to damage from cigarette smoke. Quitting smoking may completely restore normal sexual function in men with ED.
• Drink less. Even though having a drink might help you relax, alcohol can interfere with maintaining an erection that allows sex. Alcohol abuse can decrease testosterone production and damage the nerves involved with getting an erection.
• Move more. As little as 30 minutes of walking three times per week can reduce the risk of ED by improving blood flow throughout the body.

Top-rated supplements for ED

• Asian ginseng. This traditional herb may be used to improve libido and the ability to maintain an erection. Suggested dose: 900 mg of concentrated extract 2 to 3 times per day.
• Yohimbe. Yohimbe and a derivative drug, yohimbine, appear to improve blood flow to the penis and help with ED related to any cause. Suggested dose: A tincture of yohimbe bark is often used in the amount of 5 to 10 drops three times per day. It is best to use yohimbe and yohimbine under a doctor's supervision.
• Arginine. This amino acid may help dilate blood vessels and improve blood flow especially in men whose ED is related to abnormal nitric oxide metabolism in the body. Suggested dose: 1,670 to 2,800 mg per day.

"Arginine has earned the nickname, herbal Viagra, as it has the ability to "pump up" the vascular system, including blood vessels in the penis," says Dr. James Mullane of Natural Family Medicine in Danbury, CT. It is not an "on-demand" treatment like true Viagra, but rather takes ongoing use for effects to be seen. According to Mullane, time-release arginine seems to have the dual effect of lowering blood pressure and improving ED symptoms.

MALE FERTILITY

A couple is considered infertile if they've had unprotected sex for more than one year without achieving pregnancy. Male and female causes are equally likely to contribute to infertility.

Sperm factors-including abnormal sperm movement (motility), quality, and quantity-account for most cases of male infertility. Environmental toxins, drug or alcohol abuse, chemotherapy or radiation to treat cancer, cigarette smoking, and overheating of the testicles can all affect male fertility.

Struggling with infertility?

Before trying different options to treat infertility, it's important to visit your doctor to get to the root of the issue.

Lifestyle recommendations for male infertility

• Keep cool. Wearing tight-fitting underwear or soaking in a hot tub for extended periods can decrease sperm function.
• Get clean. Limit alcohol consumption and avoid recreational drugs, smoking, and environmental toxins when you're trying to get pregnant. If your house has lead paint, you might want to consider having a lead abatement company do work for you so that you, your partner, and your future baby stay lead-free.

Top-rated products for male infertility

• Zinc. Taking a zinc supplement may improve sperm count, motility, and quality in infertile men. Suggested dose: 30 mg of zinc two times per day, plus 2 mg of copper per day to prevent zinc-induced copper deficiency.
• Ginseng. Preliminary studies suggest that Asian ginseng may improve sperm count and motility. American ginseng may help protect against the toxic effects of some chemotherapy drugs on sperm quality. Suggested dose: 900 mg of concentrated extract 2 to 3 times per day.

FAMILY PLANNING

Preventing and planning pregnancy often fall in women's hands, but there are lots of reasons and ways for men to be equally involved.

Vasectomy

A vasectomy is a surgical procedure that involves cutting and sealing off the vas deferens so that sperm can't enter the ejaculate. The surgery is usually performed on an outpatient basis under local anesthesia. The average healing time after vasectomy is about one week.

Pros of vasectomy:

• It's permanent; there's no need for other contraception with that partner.
• The chance of pregnancy is close to zero.
• It provides freedom from condoms.
• It's less dangerous and costly than female sterilization.

Cons of vasectomy:

• Complications from surgery, including chronic pain, may occur. Other birth control is needed until sterility is guaranteed. Most doctors recommend two post-vasectomy semen samples (usually done two and three months post-surgery) to make sure that the procedure was successful.
• Reversals don't always work. Post-reversal pregnancy rates are about 50%.
• Vasectomy doesn't prevent sexually transmitted diseases (STDs). Barrier contraception in the form of male condoms is the most effective way to reduce the risk of STD transmission.

Condoms

A male condom is a thin sheath made of rubber (latex), polyurethane, polyisoprene, or lambskin that is placed over the erect penis prior to penetration to prevent pregnancy.

Pros of condoms:

• The chance of pregnancy is between 3% and 14%, depending on usage.
• Besides abstinence, condoms are the best way to prevent the transmission of STDs.
• They're easy to obtain.

Cons of condoms:

• Condoms may cause allergic reactions in either partner, especially latex condoms or those with spermicides or other additives.
• Some users claim decreased sensation.
• Condoms can slip off or break during intercourse.

Things to keep in mind:

• Lambskin condoms DO NOT prevent the transmission of STDs.
• Oil-based personal lubricants can break down condom material, rendering them less successful in preventing pregnancy and disease transmission.
• Male condoms cannot be used in conjunction with female condoms.
• Condoms with spermicide are no more effective for preventing pregnancy and may be more likely to cause irritation or allergy.
• Though some users claim that they can decrease sensation, it is not uncommon for a couple to be unaware when a condom breaks during intercourse, so it's important to check them.

PROSTATE HEALTH

The prostate gland surrounds the urethra and the lower portion of the bladder in men. The prostate's main function it to make and secrete seminal fluid.

BPH

Benign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate.

When the prostate enlarges, it puts pressure on the surrounding structures, causing symptoms like frequent urination (especially at night), dribbling stream, and inability to completely empty the bladder. Urinary obstruction may lead to bladder and kidney infections.

About one half of all 50-year-old men have BPH, and the number rises with the passing years.

Think you have BPH?

Other conditions may cause similar symptoms to BPH. See your doctor for an accurate diagnosis.

Lifestyle recommendations for BPH

• Take up exercise. Studies have shown that men who are physically active are less likely to develop BPH. Just two-to-three hours of walking each week may lower BPH risk by 25%.

Top rated products for BPH

• Beta-sitosterol: Taking this plant-derived compound may improve urinary flow and other symptoms in men with BPH. Suggested dose: 60-130 mg per day.
• Nettles: Men with early-stage BPH may increase their urinary volume and flow rate by taking nettles. Suggested dose: 120 mg of root extract (capsules or tablets) twice per day
• Saw palmetto: This herb may limit the amount of testosterone that can bind in the prostate, thereby lessening BPH symptoms. Saw palmetto seems to be especially helpful for reducing nighttime urination and improving urinary flow rates. In some studies, but not all, saw palmetto was as effective in relieving BPH symptoms as the prescription drug, finasteride, without the negative side effects. Suggested dose: 160 mg of saw palmetto extract standardized to contain 80 to 95% fatty acids, twice daily.

Prostate cancer

Prostate cancer is the most common cancer in men, but most men who are diagnosed with it will not die from the disease.

Prostate cancer risk increases with advancing age and is greater in African American men, obese men, and those with a strong family history of the disease.

Early-stage prostate cancer is rarely accompanied by noticeable symptoms. In later stages of the disease, symptoms can be similar to those of BPH, including increased urinary frequency, dribbling, and inability to empty the bladder.

Concerned about prostate cancer?

To screen for prostate cancer, your doctor will perform a physical examination of your prostate and may order lab work.

Prostate-specific antigen (PSA) is a protein produced by cells in the prostate. Higher PSA levels may be associated with the presence of prostate cancer, but they can also be caused by other factors. The PSA test has fallen out of favor in recent years due to lack of sufficient evidence to support its widespread use.

Lifestyle recommendations for prostate cancer

• Be trim. Help lower your risk of developing prostate cancer by maintaining an ideal weight.
• Go red. Tomatoes are high in the antioxidant nutrient, lycopene, which may reduce prostate cancer risk. Cooking tomatoes with some oil increases lycopene's absorption.
• Get crunchy. Cruciferous vegetables like broccoli, cauliflower, kale, and Brussels sprouts may help prevent prostate cancer.
• Be sunny. Men with low vitamin D levels may be at higher risk of developing prostate cancer. Expose your face, arms, hands, and legs to the sun for about 15 minutes several times each week to help ensure adequate vitamin D levels.
• Go green. Drinking green tea may help prevent prostate cancer, especially in those at risk for the disease.