Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain an erection for satisfactory sexual activity. Erectile dysfunction is different from other conditions that interfere with male sexual intercourse, such as lack of sexual desire (decreased libido) and problems with ejaculation and orgasm (ejaculatory dysfunction). ED affects about 50% of men aged 40 and over.

What are erectile dysfunction symptoms and signs?
-- Penile erection occurs but it is not maintained for the length of sexual activity
-- Penile erection that is not firm enough to penetrate the vagina
-- Inability to obtain a penile erection

Ginkgo biloba
The extract from the leaves of ginkgo biloba, also known as the Chinese maidenhair tree, is recommended for circulation problems, low energy levels and general fatigue. Ginkgo's role in regulating circulatory disorders can also help improve impotence. Research has shown the complex chemicals in the leaves, known as flavonoids, relax blood vessels while simultaneously improving sluggish circulation caused by paralysed or flaccid blood vessels. Another study showed that Ginkgo helped sexual function in three-quarters of men tested. A clinical trial two years ago found Ginkgo biloba to be 84 per cent effective in treating impotence caused by depression, raising desire, excitement and orgasm results. Recommended dose: 40-80 mg of standardised extract of Ginkgo biloba, three times a day.

Gingseng
Known as the 'male remedy' in China, there is evidence to suggest that gingseng can do much to enhance vitality and protect from the effects of stress. The chief organs in the body responsible for dealing with stress are the adrenal glands, which secrete a variety of hormones, such as adrenaline and cortisol, which have important roles to play in the body's response to stress. Gingseng is believed to improve the body's capacity for mental and physical exertion by mopping up cortisol and adrenaline - which can stir up stress in the body. A clinical trial from Korea shows that 60 per cent of patients taking ginseng benefitted from its therapeutic properties during intercourse. Recommended dose: 150mg, three times a day.

Reflexology
Reflexologists claim they can work on impotence in two ways. Using the thumbs, a reflexologist applies pressure to certain reflex points - or energy channels - found on the inside and outside of the ankle. According to the principles behind reflexology, these points correspond to the reproductive areas in the body. This thumb action stimulates blood supply to the penis, encouraging an erection. Reflexology also works by stimulating the nerve pathways leading to the brain. This lowers the breathing rate in the heart and lung area, thus helping to reduce stress.