Trying times: CBD for Erectile Dysfunction
Erectile dysfunction (ED) is the inability to get and maintain an erection, making it impossible to carry out sexual intercourse. When a man that doesn’t have ED is sexually aroused, the muscles in the penis relax and blood flow to the penis increases. Blood fills two chambers of spongy tissue that run along the length of the penis, called the corpora cavernosa. ED occurs when there’s a problem with this process. Simply, men who experience ED have decreased blood flow to the penis.
ED: the facts and figures
Before we get started on what causes ED and how it can be treated, it is important to emphasise that this disorder is pretty common and thus not something to feel isolated about. In fact, the Cleveland Clinic states that it is normal to have trouble attaining or keeping an erection for up to 20 per cent of sexual encounters; so if you think it is just you or your sexual partner that cannot get or keep an erection sometimes - it isn’t. It only becomes a cause for concern if you or your partner has trouble getting an erection more than 50 per cent of the time when attempting intercourse; at which point you should perhaps consider talking to your doctor.
The same source also states that 1 in 10 men is estimated to be affected by ED at some point in his lifetime. Furthermore, if you thought that there were no men suffering from ED under 40, you’d be mistaken. Indeed, despite the fact it is predominantly older men that grapple with it, just over a quarter of men below 40 also experience ED.
According to the International Journal of Impotence Research, the worldwide prevalence of erectile dysfunction is on the rise, forecasted to increase to 322 million men by 2025.
What causes ED?
There are many factors that may be involved in causing ED, some of which include:
- Drug side effects
- High blood pressure
- Testosterone deficiency
- Alcohol use
- Illicit drug use
- High cholesterol
- Heart disease
- Blocked blood vessel
- Metabolic syndrome
- Some medications, e.g blood pressure medications
- Sleep disorders
- Scar tissue inside the penis
- Parkinson’s disease
- Multiple sclerosis
- Relationship issues
Common symptoms of ED
- Difficulty becoming erect
- Difficulty maintaining an erection
- Reduced sex drive
- Low self-esteem
Treatments and solutions
There are numerous approaches for managing erectile dysfunction, but they vary depending on the root cause of the issue. We will be outlining some of the common solutions that could help tackle this confidence-shattering disorder:
Usually, the first port of call for men suffering from ED, there are scores of pharmaceuticals out there, each of them aiming to increase blood flow to the penis.
Some of the names you have undoubtedly heard of include Viagra, Stendra, Cialis and Levitra. Pfizer’s Viagra has become one of the most widely-known and talked-about pharmaceutical products on the market over the last few decades, even entering mainstream popular culture. In 2019, Viagra sales revenues were at 500 million U.S dollars, which is indicative of its widespread use. The success rate of these drugs speaks for itself: 70 per cent of men who use them end up with an erection that is fit for successful intercourse.
If the root of the problem is low testosterone, your doctor may recommend testosterone replacement therapy.
Exercise more, drink and smoke less!
Doing regular exercise can improve your circulatory health, and since ED is a problem of circulation and blood flow, it may help improve the situation.
Those with a BMI of over 25 are more likely to struggle with ED, so exercising more can tackle this. A 2018 review investigated the effect of exercise on ED caused by inactivity, obesity, high blood pressure, metabolic syndrome and cardiovascular disease. The researchers concluded that 160 minutes of weekly aerobic activity over a period of 6 months can help relieve ED symptoms.
Changing unhealthy aspects of your lifestyle is always a good place to start, so if you are a heavy smoker or drinker and you have symptoms of ED, it is strongly advised to kick these habits. Not only this, but maintaining a healthy diet can also help ameliorate symptoms of ED. Indeed, in the words of one study, “greater adherence to a Mediterranean-style diet [...] has been associated with a lower prevalence of ED in both diabetic and nondiabetic men”. The correlation between a Mediterranean diet and lower likelihood of ED may go some way towards explaining the low occurrence of this disorder amongst Spanish men, of which it is thought that only 10% are affected.
A penis pump may be used by men with mild to moderate cases of ED. Also known as a vacuum erection pump, or a vacuum constriction device (VCD), one fits over the penis and alters the air pressure to draw blood into the penis and trigger an erection.
A penis pump consists of a plastic tube or cylinder that fits over the penis, a hand or battery-powered pump attached to the tube, and a band that fits around the base of the penis once it is erect (constriction ring). The cylinder and pump are used to create a vacuum to help the penis become erect; the band or constriction ring is used to help maintain the erection. You then place a rubber ring around the base of the penis to maintain the erection.
Therapy and counselling
Often, ED can stem from an underlying psychological issue. If you think your ED may be related to low self-esteem, depression, anxiety, PTSD or any other psychological disorder for that matter, it may be wise to seek a professional counsellor to help you get to the bottom of the issue.
Equally, it could be that ED has kickstarted one of the above issues described, even if you didn’t previously suffer from mental health issues. Research even alleges that having ED can increase a person’s risk of depression by 192%, creating a vicious cycle in terms of ED and mental health. Whether you suffered previously with mental health issues or ED has set one in motion, talking to a counsellor or therapist will be useful either way.
Talking about an issue has proved time and again in research to produce huge differences in one’s mental health, so perhaps seeking a safe space in which to articulate the issues behind the ED will help you to overcome it.
In severe cases, surgery
Surgery is generally the last resort if all other options have failed you and there is a physiological issue at play that is stopping you from attaining an erection.
Known as a penile prosthesis, this procedure involves surgically inserting an inflatable or flexible rod into the penis. Inflatable rods require another device (a pump) which is typically hidden in the scrotum. These are filled with saline solution and have a pump which is ready to be activated whenever you choose. When you press on the pump, the saline solution travels to the device and inflates it, resulting in an erection. Later, the device can be deflated again.
Surgery will not be considered if the patient has what seems like reversible ED. It will also not be offered if the cause of ED comes down to emotional issues. Other factors like urinary tract infections, inflammation or skin problems on your penis or scrotum will also render you ineligible for this surgery. These procedures have a 90 to 95 per cent success rate; in that, they bring back the ability to obtain an erection.
CBD for ED
Another solution that shows great potential for alleviating some of the symptoms associated with ED is cannabidiol (CBD), the cannabis-derived compound. Before we get into how it might help with erectile dysfunction, a brief refresher on this cannabinoid.
What is CBD?
CBD is the second most abundant cannabinoid in cannabis, after THC. These two are the most commonly-occurring cannabinoids in the Cannabis sativa plant and are the most well-known and widely-researched. If THC is ringing a bell, it is because it is the notorious cannabinoid due to its intoxicating effects on the user. Tetrahydrocannabinol (THC) is associated with recreational cannabis usage and thus the predominantly illegal status of marijuana. While CBD and THC share common characteristics, one thing they do not share is their ability to elicit the euphoric “high” when used.
To date, very few adverse effects have been reported amongst CBD users; such that the World Health Organisation (WHO) has given it their seal of approval. Minor reactions that have been recorded include nausea, diarrhoea, loss of appetite, weight changes, lightheadedness or hunger pangs. WHO commented in their report that adverse reactions “may be as a result of drug-drug interactions between CBD and patients’ existing medications”.
For those who have doubts, CBD is legal. Hemp-derived CBD products are legal in the UK and across the EU, as well as at a federal level in the US. CBD-based products have their THC concentration capped at 0.2% in the UK and most EU countries. Recreational marijuana, which usually contains on average 15% THC, is largely illegal, with the exception of some countries. With this in mind, it may be worth consulting your country or state’s unique laws surrounding CBD, before importing it, as some country’s laws can be quite particular and sometimes confusing.
CBD and the body
Each of our bodies has a biological system known as the endocannabinoid system (ECS). This system is made up of receptors, enzymes and the body’s own cannabinoids - known as endocannabinoids. Some of the ECS’s functions include regulating memory, mood, appetite, metabolism, stress response, immunity, pain control and sleep. In terms of receptors, there are two types of cannabinoid receptors in the body: CB1 and CB2. CB1 receptors are mostly concentrated in the central nervous system (the brain and spinal cord) while CB2 receptors can be found in the peripheral nervous system.
When we take CBD, the desired outcome is that as much of it as possible reaches the bloodstream in its greatest potency. It is believed that when CBD reaches our bloodstream, it modifies the way our endocannabinoids bind to receptors, subsequently influencing the functions that are carried out by the ECS. It is also thought to enhance our natural supply of endocannabinoids, which are otherwise broken down by the ECS’s enzymes.
CBD: previous success stories
While the cannabis plant species is by no means new, this cannabinoid in particular has become a global buzzword over the last decade or so, capturing the attention of wellness fanatics and scientists alike. There is still some way to go in CBD research, but here are some of the therapeutic properties we know of so far:
- It is a proficient anticonvulsant - CBD can reduce seizures in patients with epilepsy.
- It is an anti-inflammatory, believed to be able to tackle inflammation by working with CB2 receptors in the immune system.
- It is an antioxidant: it has been seen to fight oxidative stress and its associated illnesses.
- It is believed to be a neuroprotector, helping to protect your neurological health against neurodegenerative diseases like Parkinson’s, Alzheimer’s and Huntington’s.
How can it help with ED, then?
CB1 receptors have been sighted in and around both female and male reproductive organs, meaning CBD can target these receptors and potentially have an impact on issues relating to overall sexual health, such as libido and importantly, ED.
CBD and its reported assistance with sex drive is a source of division among researchers, with some claiming that chronic cannabis use in males lowered sex drive and that sex drive decreased the more cannabis a man took. Other research counters this, offering that CBD products improve libido by reducing anxiety. Many suffer from performance anxiety which can vastly reduce libido. Numerous studies have attested to the benefits of CBD on general cases of anxiety, which could be useful for sufferers of ED, if the root cause is performance anxiety or general anxiety.
Ayurveda practitioners have long used Cannabis sativa to improve ejaculatory function and enrich sexual performance.
For ED, the precise mechanism by which CBD may help remains unclear. One theory is that CBD could help relax the blood vessels and stimulate blood flow, which could alleviate ED if this increased blood flow travelled to the penis. Better blood flow means longer-lasting erections and in turn, better endurance during sex. Equally, CBD is purported to lower blood pressure. According to a small study, a single dose of CBD was sufficient in reducing blood pressure, which is another contributing factor toward ED. So, regular CBD consumption may help those suffering from ED whose high blood pressure is to blame.
As we mentioned earlier, another potential factor that could lead to ED is illicit drug use. Chronic marijuana use has been cited as a possible cause of ED and lowered sex drive. Fortunately, CBD has been found to counteract the negative effects of THC, meaning CBD could help with ED if the root cause of it is excessive marijuana intake.
Since obesity is another physical cause of erectile dysfunction, managing weight may be crucial for improving symptoms of ED. Again, enter CBD. There have been mounds of studies that speak to the success of this cannabinoid in managing obesity and BMI. Particularly when combined with tetrahydrocannabivarin (THCV), cannabidiol has shown promising results on suppressing appetite in obese individuals and lowering blood glucose levels. Therefore, the CBD/THCV combination could indirectly help men with ED by decreasing appetite and, potentially, contributing to weight loss.
Similarly, cannabis use has been linked to lower body mass index (BMI), rates of diabetes, and other metabolic diseases. Because CBD is either the primary or secondary ingredient in most varieties of whole-plant cannabis, it could play a very important role in managing BMI, which would support healthy sexual function for men. The specific role of CBD in these conditions is still being investigated.
Another way that CBD may indirectly assist with ED is by managing sleep disorders. As well as having a detrimental effect on numerous other aspects of your health, lack of sleep can negatively impact your sexual health. Sleep deficiency can cause or exacerbate symptoms of ED and lower sex drive due to lack of energy. CBD has proved itself in multiple studies to promote rich, restful night’s sleep, which could in turn produce better outcomes for patients with ED, perhaps increasing sex drive and therefore helping to gain and keep an erection.
Things to think about
There are some things to consider before starting a daily regime of CBD (particularly when taking cannabidiol for the purpose of alleviating symptoms of ED).
- CBD may help manage symptoms of ED but will not necessarily get rid of the problem altogether. If symptoms persist, it may be worth discussing alternative therapies with your doctor. You may be prescribed one of the treatments we explored earlier.
- If you’re looking to start a family with your partner, it may be best to avoid CBD. There are conflicting opinions on its impact on fertilisation; some, for example, claim that it may negatively influence sperm function.
- Adverse reactions from CBD are rare. Nevertheless, if they do occur, you should stop taking CBD immediately and speak to a doctor if you are concerned.
- If you are on medications, it is worth speaking to your doctor before adding CBD to your daily routine, just to be sure it won’t interact with your medication.
- Always check for a certificate of analysis (COA) for any CBD product you’re looking to purchase. This should outline the cannabinoids and terpenes in your CBD product and confirm that it has undergone testing in a verified laboratory completely detached from the CBD outlet from which you’re buying.
- Always check the legality of CBD where you are before trying to have it shipped to you.
It can be a long road to overcoming ED, but luckily, there is no shortage of solutions to be tried for combatting this frustrating disorder.
When it comes to CBD for ED, then, there is really not much to be lost from giving it a try. So long as you bear in mind that there is a limited body of research concerning the effects of cannabidiol on erectile dysfunction and that there is thus some way to go before its success can be confirmed, there can only be positive outcomes.
As research continues, there will no doubt be more light shed on CBD’s place in matters of sexual health - hopefully in the very near future. Until then, why not do your own research by testing it out yourself and seeing where it gets you?