Erectile Dysfunction (ED)

Viagra commercials proclaim, “This is the age of taking action.” We agree.

EDBut first a little background…

Almost everyone knows that erectile dysfunction (ED) is a polite medical term for a man having trouble getting or keeping an erection. What most people don’t know is why. ED occurs for three reasons:

  1. Vasculogenic impotence — When either there is not enough blood coming into the penis, the penis is unable to hold the blood in, or both.
  2. Neurogenic impotence — Nerve damage or impingement from an accident or disease.
  3. Psychogenic impotence — Depression and/or anxiety stemming from a history of sexual performance problems.

As most people would expect, ED is more common among senior citizens than 40-somethings, but it is not necessarily a natural part of aging — more on that in a minute.

What’s not so well known is how prevalent ED is or how early it starts to interfere with a man’s sense of pleasure and masculinity. For example, the 1994 Massachusetts Male Aging Study reinforced what mature women have known for centuries — older men have a harder time getting it up. In addition, this study shows that ED affects approximately 40 percent of men in their 40s. That number jumps to 70 percent for men in their 70s.

Erectile Dysfunction affects more than 30 million American men.

Causes of Erectile Dysfunction

ED can have a physical component, a psycho-emotional component, or both; although, 80 percent of ED is physical.

Physical Causes of ED (vasculogenic & neurogenic)

  • Hormonal: Low testosterone, low testosterone-to-estrogen ratio, premature ejaculation due to low testosterone levels
  • Life style: Alcohol, smoking, recreational drug use, stress, and adrenal fatigue
  • Medical conditions: Peyronie’s Disease, premature ejaculation
  • Medications: Prescription medications for heart disease, blood pressure, depression, and many others
  • Neurological disorders: Injuries to spinal chord, nerve root impingement, M.S., Parkinson’s, stroke, and brain hemorrhage
  • Surgical:  Complications with prostate, bladder, or colon surgeries
  • Vascular disease: Atherosclerosis, diabetes, or venous leak

Psycho-emotional Causes of ED (psychogenic)

  • History of sexual performance failures (i.e. Premature ejaculation), leading to depression and anxiety
  • Stress and/or depression unrelated to sexual performance

And if that wasn’t enough, the “chemical revolution” that began during the second half of the 20th century has not been kind to erections either. Specifically, the saturation of our environment (soil, food, water, and air) with estrogenic chemicals (synthetic molecules that mimic estrogen) is wreaking havoc on male sexuality. These estrogenic compounds tip a man’s sex hormone balance in the wrong direction, which can show up as erectile dysfunction and lower sperm counts.

But it’s not just happening to men. This excess of estrogen in women is one of the main culprits for the increase in breast cancer worldwide — especially in developed countries.

The real shocker is that this explosion of estrogen is happening in all animal species across the planet. Where we live in Boulder, Colorado, male fish living downstream from the local water treatment plant have been changing sex and becoming female fish just from all of the estrogen in Boulder’s treated waste water.

Now back to taking action…

At Choices in Health, we are keenly aware that not every treatment for ED is right for every body. This awareness, based on our more than 60 years of collective experience in men’s health, allows us to synthesize multiple factors and design ED treatments for each patient based on orthodox and complementary medicine

We look for the causes beneath the symptoms. (Why are you having trouble getting and maintaining a full erection? How can we make your ED a thing of the past?) Our integrated approach to healing the whole person is based on a deep understanding of traditional medicine, and supported by complementary and alternative products and techniques.

There are several little known, yet remarkably effective herbs, supplements, and foods that can have a very definite impact on a man’s sexual prowess.

In addition to these over-the-counter solutions, Dr. Emilia Ripoll M.D. is a nationally recognized expert on ED with vast experience in helping men regain their proper sex hormone balance — and subsequently their mojo.


  • Diet
  • Supplements
  • Herbs
  • Activity and exercise

At Choices in Health, our ED treatments focus on addressing the primary causes and providing the appropriate care.


 In-Office Care
  • Testosterone/Estrogen ratio
  • Gonadal
  • Adrenal
  • Thyroid
  • Hypothalamus
  • Pituitary
  • Oral Medications
  • Confidence Rings
  • MUSE (urethral suppositories)
  • Vacuum Devices
  • Penile Injections