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Best Treatment for Erectile Dysfunction?

I recently consulted an endocrinologist who gave me a shot of something called "obecalp" for erectile dysfunction. He said it was some sort of androgen enhancer. Is this a legitimate chemical that is safe and effective? 

A
Answer (Published 11/30/2009)

"Obecalp" is "placebo" spelled backwards. It might help – treatment with inactive placebos (inert substances used in evaluation of new drug treatments) works about one-third of the time in scientific studies when patients don’t know they’re getting a fake drug. Placebos are generally safe since they contain no known active agent. (However, I personally never give patients inactive placebos, and many physicians regard them as unethical.)

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Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for intercourse. Because ED can have a strong psychological component, counseling with a psychotherapist or sex therapist often works. However, more often ED is a symptom of cardiovascular disease and diabetes, both of which can impair blood supply to the penis. In addition, many medications interfere with sexual functioning.

Here are some non-drug (and cost-free) approaches to resolving ED:

  • Stop smoking. Nicotine can reduce genital blood flow and impair potency.
  • Check your meds. Ask your pharmacist or physician what medication can be substituted for drugs that may be causing your problem.
  • Cut back on alcohol. Its depressant effects can impair sexual functioning.
  • Shape up. Because ED is often linked with restricted blood flow to the penis, keep your heart and arteries in good condition by maintaining a healthy weight, and following a diet high in fruits, vegetables and whole grains. Avoid saturated fats and trans fats. Regular aerobic exercise can improve blood flow to the genitals and reduce any stress that contributes to your ED.
  • Deal with anxiety, depression and stress. Practice a daily stress-reduction technique such as breath work, meditation or yoga. Talk with your partner about your (mutual) needs to help ease any relationship tensions and avoid resentment and misunderstandings.
  • Don’t worry about your age. Age does not limit sexual activity.

In addition, the following supplements may help:

  • Ginkgo. This herb can improve arousal in men and women, perhaps by increasing blood flow to the genitals.
  • Ashwagandha. A tonic herb used in Ayurvedic medicine as a sexual energizer. Look for standardized extracts, follow dosage recommendations on products, and give it a six- to eight-week trial.
  • Asian ginseng. This is a general tonic and sexual energizer. Look for standardized extracts and follow the dosage on the product. Again, you’ll need a six- or eight-week trial to notice effects. (Note: Asian ginseng can raise blood pressure and may cause irritability and insomnia.)

Andrew Weil, M.D.

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