Dr. Espinosa shares that 40-50% of men suffer from sexual issues. He suggests that younger men are having issues as well where even about 30% of men in their 30’s have erectile dysfunction. Dr. Holly asks why ED is being seen more often in younger men and what it can possibly mean. Dr. Espinosa shares that most men define their manhood based on their last sexual performance, this plays a major role in confidence and personal lives. When it comes to erections, Dr. Espinosa states that there may be a major problem if a man has not had a spontaneous or sexual erection in 3 months or more. This can lead way to serious vascular or cardiovascular issues.

Prevalence of ED in younger people can be attributed to an increase in pornography use (it is much easier to have access to now than in the past) according to Dr. Espinosa. This leads to teenagers getting an ideal of sex that is unrealistic and further hinder their ability for emotional intimacy with future partners. Another reason is stress causing too much adrenaline production, which is a chemical that is really an “erection killer”.

Dr. Espinosa suggests that there are 3 reasons why men can get erections. The first is neural pathways from the brain to penis, vascular for blood flow and lastly muscular structure that allows those muscles to work. If any of these pathways are hindered, that can change a man’s ability to have erections. Getting enough nitric oxide, having healthy penile muscles and having balanced neurotransmitters are important to have a successful erection.

It is important for women to understand a few things about being with a partner with ED. Primarily, knowing that it is “not you” is paramount, especially for couples. This can inadvertently add an extra layer of stress to a man already dealing with ED. Second, it helps for women to know that “he’s not cheating on you”. This is a common paradigm Dr. Espinosa sees in couples. Seeking natural support for these issues is important too because many common pharmaceuticals like beta blockers can cause ED. Also, if a prostate is enlarged enough, it can cause neurogenic ED.

ED can also come from men who have overused erectile drugs. Abuse of PD5 inhibitors causes several issues like priapism which can break down the muscles in the penis. Over use is a problem as well because the organ can literally be exhausted and once an erection happens again, they can experience performance anxiety. This leads to the question, what can people naturally do about erectile dysfunction?

Dr. Espinosa cautions people to use PD5 inhibitors very carefully because it’s a short-term fix. Using a smaller dose is recommended with perhaps some other natural supplements can be more successful. Another issue with PD5 inhibitors can be delayed ejaculation because these drugs can numb those nerves which can be very frustrating for both partners. Dr. Espinosa recommends seeing a naturopathic doctor to address underlying issues like hormone imbalance and metabolic syndrome issues. Staying “lean and mean” goes hand in hand with this, focusing on interval weight resistance.

For supplement support, the amino acid arginine is effective for vascular flow, but Dr. Espinosa suggests using l-citrulline because it is a powerful precursor to arginine. The problem with arginine is compliance because you need to take higher doses 3-4 times a day for it to be effective, hence making l-citrulline a great option. Horney Goat Weed, also known as epimedium is a Chinese herb that has a chemical in it called icariin which is a PD5 inhibitor possessing the same effect as popular prescription drugs. Rhodiola and Ashwagandha are adaptogenic botanicals that have historically been used for ED as well. With ED, identifying and treating the cause is key. Taking a holistic approach can potentially treat this disorder and is encouraged for men hoping to really obtain their health and vitality without pharmaceutical intervention.

Dr. Geo Espinosa is a naturopathic doctor, licensed acupuncturist and certified functional medicine practitioner recognized as an authority in holistic urology and men’s health. He is a professor and holistic clinician in Urology at New York University Langone Medical Center and faculty for the Institute for Functional Medicine. As an avid researcher and writer, Dr. Geo has authored numerous scientific papers and books including co-editing the Integrative Sexual Health book, and author of the best selling prostate cancer book: Thrive, Don’t Only Survive. Dr. Geo is the Chief Medical Officer (CMO) and formulator at XY Wellness, LLC and lectures internationally on the application of science-based holistic treatments in urological clinics. On his free time, he enjoys writing on his popular blog, DrGeo.com, spending time with his wife and three kids and practicing the Israeli martial art, Krav Maga.

Dr. Holly Lucille, ND, RN serves as the President of California Association of Naturopathic Physicians. Dr. Lucille works at the Los Angeles Free Clinic providing health education, promotion and prevention. Dr. Lucille serves as a Naturopathic physician, an expert on women’s health issues. In her private practice, Healing from Within Healthcare in Los Angeles, California, she specializes in Women’s Wellness. She has extensive education in various modalities, including homeopathy, clinical nutrition, botanical medicine, body and energy work and mind body and lifestyle counseling. She serves as a Member of the Scientific Advisory Board of PhytoPharmica Inc. She serves as a Member of Scientific Advisory Board at EuroPharma, Inc. She serves as a Member of Medical Advisory Board at Integrative Therapeutics, Inc. She served as Member of the Scientific Advisory Board of Enzymatic Therapy, Inc. She serves as Member of Naturopathic Scientific Advisory Committee at Kamedis Bio Herbal Skincare. She is the recipient of the 2004 Southwest College of Naturopathic Medicine Legacy Award recognizing her incredible service and contributions to the naturopathic medical community. She is a Registered Nurse. Dr. Lucille has Doctorate from the Southwest College of Naturopathic Medicine where she received the ‘Daphne Blayden’ award for her ‘Commitment to Naturopathic Medicine.

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