Until recently, the very mention of erectile dysfunction or impotence could bring about a blush to even the most manly of men. Embarrassing as it may be, erectile dysfunction affects more than 18 million men in America. It can vary in severity from an inability to achieve, maintain and sustain an erection, to an inability to achieve an orgasm, even though a healthy sexual desire exists. Because of the sensitive nature of this disorder, it often goes unreported.

Achieving a normal erection is a complex process. It involves psychological impulses from the brain, adequate levels of testosterone (male sex hormone), a functioning nervous system, and healthy vascular tissue of the penis. Electrical impulses from the brain, when stimulated, cause the nerves in the penis to release nitric oxide. This, in turn, increases the production of guanylate MonoPhosphate (cGMP) in the muscle cells of the corpora cavernosa (the tissue of the penis, consisting of smooth muscles, fibrous tissues, spaces, veins and arteries). The cGMP triggers the muscles of the corpora cavernosa to relax and fill with blood, which causes the penis to expand.

Because of the intricate nature of the physiological processes involved, a number of different factors can interfere with a man's ability to achieve a normal and healthy erection. The most common of these is aging. As a man gets older, his ability to produce nitric oxide decreases, thus affecting the proper functioning of the corpora cavernosa.

A number of health issues can also underscore this disorder. The most frequently seen are diabetes mellitus and hypertension. Diabetes, for example, can damage the sensory nerves in the body. In turn, individuals who suffer from hypertension exhibit low nitric oxide production. Other factors that can contribute to erectile dysfunction include cardiovascular disease, nerve or spinal cord damage, cigarette smoking, low testosterone levels, prescription medications, depression, stress and anxiety.

Until recently, it was believed that little could be done to help a man who is suffering from erectile dysfunction, but there are a number of natural alternative health remedies that can be tried before having to rely on the "little blue pill".

Recommendations For Wellness

If you think your stress, anxiety or depression is affecting you physically, perhaps psychological counseling, meditation, bio-feedback or hypnotherapy can help.

If you are taking prescription medications such as MAO inhibitors or anti-hypertensives, talk to your doctor about their possible side effects.

Have your hormone levels checked. You might be suffering from low testosterone levels. In some men, low levels of the hormone dehydroepiandrosterone (DHEA) have also been reported. DHEA is essential for the production of testosterone.

Quit smoking.

Try supplementing with the amino acid L-arginine. Nitric oxide formation depends on sufficient levels of L-arginine in the body and has been found particularly effective for men with abnormal nitric oxide metabolism.

Yohimbe bark has a history of helping men with erectile dysfunction. Yohimbe dilates blood vessels and may help regardless of the underlying cause. If you are on prescription medications, talk to your doctor before taking yohimbe.

Muria puama can be used to increase the libido and erectile strength. It works best when combined with yohimbe bark. This combination can be found in Nature's Sunshine's X-Action for Men.

In Mexico, the herb damiana is used as a male aphrodisiac and is an herb traditionally recommended for men with erectile dysfunction.

In Peru, maca is known as a potent aphrodisiac. Maca is often called the herbal "Viagra" and does not alter circulation. Instead it works to regulate hormones and bring the body back into balance.

Asian (panax) ginseng is an herb that has long been used to support male potency.

Sarsaparilla has a history of being used as a tonic for male sexual potency and is thought to assist in the production of testosterone.

Some men find relief when taking ginkgo biloba. Ginkgo biloba supports blood circulation and may help by increasing blood flow to the penis. This supplement is not recommended if you are taking any kind of prescription blood thinner.

Traditionally used to lessen the symptoms of an enlarged prostate, saw palmetto stimulates a low libido and increases sexual energy.