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Managing Erectile Dysfunction: Simple herbal and lifestyle hacks for better erections
By Stephanie Hazel, Tradtional Western Herbalist

Erectile dysfunction is defined as the inability to attain or sustain an erection enough for satisfying sexual penetration. It affects 50% of men over the age of 50, and 10% of young men. Most men will experience some form of erectile dysfunction over their lives. In fact, some amount of impotence is perfectly normal, especially in times of stress or after illness.

What ED is not:

Despite popular myth, erections are not inextricably linked to sexual arousal and pleasure. Men can be extremely aroused, and experience intense pleasure and even orgasm without an erection.



From a western biomedical perspective, erectile dysfunction (ED) has three main types of causes:

  1. Psychological – especially likely with history of trauma, in younger men, and if men still have normal morning erections.
  2. Vascular – circulation and health of the veins and arteries.
  3. Neurological – damage to the penis nerves, or a reduced ability of nervous stimulus to result in relaxation of smooth muscular tissue and nitric oxide perfusion.

It is important to note that ED is often the byproduct of a different, more serious condition.

Diabetes, hypertension, vascular lesions, cardiovascular disease, and atherosclerosis are all conditions that when left untreated can cause damage throughout the body and cause ED as well. If you are experiencing ED, especially if you are a younger man, you really need to get checked by your doctor to ensure you do not have something serious and life-threatening lurking in the background.

Regardless of medical conditions, however, ED is a sign that something is not functioning optimally in the body and needs attention. Sexual function is not necessary for survival of the body, so when the body is run-down, stressed or functioning poorly, libido and arousal are often the first thing to go.



The Role of Blood Circulation

During an erection, the flow of blood changes in two ways: the smooth muscles of the arteries dilate, increasing the amount of blood flowing into the penis, and the veins constrict, reducing the amount of blood flowing out of the penis.

Increased blood pressure, thickening of the blood and build-up of plaque or lesions in the pelvic arteries all interfere with proper circulation and erection.

Signs of poor circulation as a cause of ED:

  • Cold hands and feet.
  • Blotchy red-white skin on hands, feet, face.
  • Tingling of limbs
  • smoking
  • easy bruising
  • heart palpitations or irregular heartbeat

Herbs to support healthy circulation:

Ginkgo has strong clinical evidence to support its use in ED. By thinning the blood and increasing peripheral circulation it is excellent at reversing the effects of poor circulation on erectile function. As a bonus, it supports healthy brain function.

Cinnamon is a circulatory stimulant par excellence! It is best indicated when impaired circulation is accompanied by sensations of cold. It is also useful for obesity and diabetes, helping to regulate blood sugar and metabolism.

Hawthorn is one of the best herbs for supporting healthy cardiovascular function. It is best indicated when ED is occurring as a result of poor heart health.

Lifestyle Hacks:

Quit smoking! Easier said than done, I know. But it will change your erections and may just save your life.

Exercise – half an hour per day is crucial for the circulation to function properly.

Drink water – dehydration makes the blood thicker and circulation worse.



One of the main causes of ED in Chinese Medicine is called ‘yang deficiency’. This loosely translates to exhaustion and debility of the nervous-adrenal axis. When the nervous system becomes worn out, it becomes less responsive, meaning that sexual or erotic stimulation does not trigger the changes in circulation that are necessary for erection.

This ‘Yang deficiency’ can happen through overwork, adrenal exhaustion, overuse of stimulants (coffee, tobacco, amphetamines), or recovery from debilitating illness. However, there is another important causative factor here: excessive sexual activity (especially masturbating to intense pornography, or addiction to intense sexual experiences) can start to change the brain’s response to stimulus. This ultimately means that a person needs stronger and stronger stimulus to feel a normal level of arousal.

Regardless of the cause of this nervous exhaustion, using herbs that slowly rebuild and rebalance nervous function will have positive impacts throughout your life.

 Signs of nervous exhaustion as a cause of ED:

  • history of stimulant overuse, overwork, or poor sleep
  • ongoing fatigue
  • sex or pornography addiction (past or current)
  • significant energy slump in the middle of the afternoon
  • inability to concentrate without caffeine
  • feeling easily cold, or colder than others around you

Herbs to strengthen the nervous system:

Saw Palmetto is the primary herb for ED used by the Eclectic physicians of the early 1900s. Ellingwood states: “[Saw Palmetto] is demanded in the treatment of impotence in young men who have been excessive in their habits, or have masturbated, it can be relied upon with positiveness. It will overcome the excitability from exhaustion and increase sexual power in those newly married, who, having been anxious concerning their sexual strength or ability, have become suddenly almost entirely impotent after marriage.” It is useful in cases of low sexual desire, prostatic enlargement, exhaustion and emaciation.

Damiana is a famous Aztec herb used for increasing desire and fertility in men and women alike. It is best indicated when low mood, anxiousness and exhaustion co-exist. It is also useful for slow digestion and constipation.

Ashwangandha is an Indian Ayurvedic herb whose name means ‘the strength of horses’. As well as increasing desire and sexual potency, it also relaxes nervous tension and tonifies the nerves. Ashwagandha is best indicated when someone feels ‘tired and wired’.

Milky Oat Seed should be included in all impotence formulas as a secondary herb. It is fantastic at nourishing an exhausted nervous system, and will strengthen the effect of more sexual-specific herbs like Damiana, Tribulus or Saw Palmetto.

Lifestyle Hacks:

  • Get more sleep.
  • Reduce coffee and other stimulants from your life.
  • Abstain from sex and masturbation for one month to allow a neurological ‘reset’.
  • Go on holidays for a few weeks and aim for deep rest and relaxation



Healthy hormonal balance changes for men as they go through their forties and fifties, just as it does for women during menopause. Reduced testosterone causes a number of changes in the male body, including reduction in libido, arousal and erection.

Testosterone insufficiency is most likely to be a cause of ED for men 50 or over.

 Signs that testosterone insufficiency is causing your ED:

  • Over 50
  • low libido and arousal
  • feel like you’ve ‘lost your mojo’
  • weight gain, especially a paunch

Key Herbs:

Tribulus is best known for its ability to increase testosterone levels, making it useful for increasing libido and sexual performance, as well as for increasing muscle mass and exercise endurance. It is also one of the only herbs listed here that is cooling, making it useful for inflammation, heat and irritation of the urogenital organs.

Lifestyle Hacks:

  • losing weight can support healthy hormonal balance
  • reduce consumption of high-oestrogen foods such as non-organic eggs, dairy and chicken; soy products
  • reduce the use of plastic food wrappers or water bottles. Soft plastics leach a chemical that acts like the female hormone oestrogen in the body.

Emotional and psychological considerations

Our sexual response is strongly connected to our psyche. Some people go so far as to say that our mind is our primary erogenous zone, not our genitals. Sexual and emotional trauma can have long-lasting effects on our sexual performance and enjoyment. Unresolved issues relating to self-worth, desirability and shame can easily impact erections.

Regardless of whether psycho-emotional factors cause ED, most men who experience ED (especially younger men) also experience sexual shame, anxiety or depression.

What can we do to address this?

First of all, we must remove the immense pressure men feel to perform sexually, wielding their rock-hard erections as symbols of their sexual power. It is entirely possible for men, and their partners, to have pleasurable, satisfying sexual experiences, and even orgasms, without an erection.

Let’s talk openly about erections, impotence and the many forms of pleasure we can experience as humans coming together erotically. This will go a long way towards alleviating the anxiety men feel when their erections are anything less than raging.

Secondly, we need to recognise the need for counselling and support for the psycho-emotional aspects of ED. Relationship counselling can be very helpful.



Cigarette smoking is a significant risk factor for ED. Men who smoke daily have double the chance of developing erectile problems. The good news is that quitting tobacco usually reverses the ED after a matter of months.

Why does smoking have such an effect on the penis? It’s to do with the combination of changes in the vascular system and over-irritation of the nervous system. Smoking changes the way that our vascular system responds, by thickening the blood, and often causing plaques in the arteries that restrict the free flow of blood. Aside from impotence, this obviously also has dangerous effects in the heart and the brain.

If you are a heavy smoker who is experiencing erectile dysfunction, and you are under the age of 40, you need to consider quitting asap, as this is a sign that the smoking is dangerously affecting your arteries.



Erectile dysfunction is a difficult problem to live with, as it affects us in our most intimate moments. It can affect our relationships, our mental health and our sense of self in profound ways. By identifying the cause of your ED and choosing the right herbs and lifestyle hacks, you can vastly improve your sexual satisfaction.


Holmes, P. (1989). The Energetics of Western Herbs: Integrating Western and Oriental herbal medicine traditions. Boulder, Colorado: Artemis Press.

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