However, atherosclerosis (furring up) of the penile artery is now established as responsible for half of all cases in men over 50 (J Am Med Assoc, 1993; 270:83-90).

Atherosclerosis is caused by faulty diet and certain aspects of the Western lifestyle (and not simply high cholesterol alone). Nevertheless, there is solid scientific evidence of all sorts of dietary means of reversing it. Avoid all fried foods, sugar, meat, animal fats and proteins, hydrogenated vegetable oils (such as margarine), coffee, tobacco, recreational drugs and alcohol. Increase your consumption of cold water ocean fish (herring, mackerel, salmon, sardine), mucilaginous fibre (pectin, linseed, oat bran, for instance), beans, carrots, garlic, onion, shallot and chives (either raw or cooked). Use ginger freely both as a spice and as a drink. Get your body weight to normal and begin a regular programme of aerobic exercise for at least 40 minutes four times a week.

As for nutritional supplements, if blood platelet aggregation is high, increase your eicosapentanoic acid intake by taking EPA (fish oil capsules). Also have your essential fatty acid (EFA) profile checked. If your delta 6 desaturase (an EFA), is too low, take evening primrose oil. For alcoholics, diabetics and the elderly when there is high serum cholesterol, take the amino acid l-carnitine. If you are found to have ischaemic conditions (inadequate blood flow) take the mineral magnesium. Finally, find out if your zinc/copper ratio is abnormal, and if so, aim to balance it.

Avoid non organic animal and milk products, and tap water, both known to contain estrogen (The Lancet 1993; 341: 1392-95), and which has been implicated in some male reproductive problems.

A number of homeopathic remedies have good clinical evidence of success, including Caladium seguinum; Cicuta virosa (with prostatic inflammation); Cuprum metallicum or Moschus moschiferus (with diabetes); Lycopodium clavatum (with old age); Nuphar luteum (lack of sexual desire); Onosmodium (reduced pleasure); Staphysagria (excessive previous sexual activity); Titanium (ejaculates too soon).

A homoeopathic combination for male erectile dysfunction marketed under the name Amphosca H has a companion remedy, by the name Amphosca F, which can ensure adequate desire and arousal among both partners. These products work best used together and can help in the medium term (available from the Nutri Centre, 7 Park Crescent, London, W1N 3HE, tel. 0171 436 5122; and Enzymatic Therapy, Green Bay, Wisconsin 54311, tel. 414 469 1313.)

In my experience, the two Amphosca remedies work even better used with a herbal remedy for the male partner. Yohimbe bark has been approved for erectile dysfunction by the US Food and Drug Administration, and a number of scientific studies prove its success (Lancet 1987; ii: 421-3; J Urol 1989; 141(6): 1360-3). Occasionally Yohimbe may increase blood pressure and heart rates; and it can cause dizziness, panic attacks, headache, or skin flushing.

Of other herbs, the Brazilian Muira-puama (Potency Wood) has been shown to dramatically help 51 per cent of men after two weeks (J Waynberg, paper presented at The First Intl Congress on Ethnopharmacology, Strasbourg, 5-9 June, 1990).

Ginkgo biloba leaves can be effective when erectile dysfunction is due to arterial insufficiency (J Urol, 1989; 141:188A).

The bark of the Prunus africanum and Pygaeum africanum (Red Stinkwood) can enhance the ability to achieve an erection (Arch Ital Urol Nefrol Androl, 1991; 63: 341-45). This herb has also been shown to be able to treat benign prostatic hyperplasia (BPH) and prostatitis. If erectile dysfunction and BPH are present at the same time, as they so often are, this herb should be the remedy of choice.

!AHarald Gaier

Harald Gaier is a registered naturopath, homoeopath and osteopath.