Yohimbine: The main component of an African tree bark, yohimbine is probably one of the most problematic of all natural remedies for ED. Some research suggests that yohimbine can improve a type of sexual dysfunction that is linked with a drug used to treat depression. However, studies have linked yohimbine to a number of side effects, which can include anxiety, increased blood pressure, and a fast, irregular heartbeat. Like all natural remedies, yohimbine should only be used after advice and under supervision from a doctor.
The patient should be given every opportunity to choose among options, and to determine which fits best to his special needs and expectations. The clinician should also provide a supportive environment for shared decision-making. This management strategy must be supplemented by a careful follow-up in order to identify changes in patients’ expectations, possible side effects that may need treatment optimization.
The normal aging process and age related risk factor accumulation contribute to the increased prevalence of erectile dysfunction in the elderly. Systemic changes and alterations in the structure and function of the penis in elderly men include hormonal changes (mainly testosterone decrease and increase in sex hormone binding globulin that resulting decreased bioavailability of testosterone) (Margolese 2000), decrease in elastic fibers and increase in collagen fibers in the tunica albuginea (Akkus et al 1997) and molecular changes (decrease in nitric oxide synthase) (Andrew and Mayer 1999).

Can’t or don’t want to take ED drugs? The vacuum pump method is the next most common choice among men with erectile dysfunction who pass on pills, says Dr. Bennett. To create an erection, you place a plastic cylinder over the penis and pump the air out of the cylinder to force blood to flow into the penis. An elastic ring that you slide onto the base of your penis holds the erection. This ED treatment device is effective for about 75 percent of men. Side effects include numbness, bruising, and weak ejaculation — and the ring must be removed after 30 minutes.
Psychosexual Relationship Specialist at End the Problem, Jacqui Olliver is a published author who renews relationships by solving people's emotional and sexual issues. In the past 7 years, she has helped over 1,000 men, women, and couples restore a relaxed, happy, and fulfilling sex life and enhance their overall connection. Click here to check out her programs or to book a complimentary strategy session and start getting real answers to solve the real problems.
Aside from pelvic floor exercises, it has been found out that aerobic exercises also work in treating erectile dysfunction. This condition is often caused by problems related to blood flow to the penis. Diabetes, obesity, vascular disease as well as high cholesterol may affect blood flow. This results to erectile dysfunction. By adding some aerobic exercises to your routine, you can significantly enhance your overall male sexual health and may even remove the problem totally in the long run.
According to a recent study published in the Journal of Sexual Medicine research at the University of Adelaide Australia showed that men can reverse erectile dysfunction by focusing on lifestyle factors and not solely relying on medication. The major risk factors are typically physical conditions rather than psychological ones such as being overweight overconsumption of alcohol stress age insomnia or obstructive sleep apnea.
Aside from pelvic floor exercises, it has been found out that aerobic exercises also work in treating erectile dysfunction. This condition is often caused by problems related to blood flow to the penis. Diabetes, obesity, vascular disease as well as high cholesterol may affect blood flow. This results to erectile dysfunction. By adding some aerobic exercises to your routine, you can significantly enhance your overall male sexual health and may even remove the problem totally in the long run.

On the other hand, high zinc levels have negative effects on sperm quality. Excessive zinc intake in mice have indicated a negative effect of increasing doses of zinc on sperm count and motility.[5] Although there have been studies focusing on various aspects of zinc related reproductive functions, studies on zinc related sexual behavioral aspects have received scant attention. In one study, intranasal irrigation with zinc sulphate has been reported to completely abolish the sexual behavior of male rats.[6]
The sunshine vitamin will brighten things up in the bedroom. In a recent study published in the Journal of Sexual Medicine, Italian researchers found that of 143 men with erectile dysfunction, 80% had less-than-optimal levels of D, and the men with severe ED had, on average, a 24% lower level of D than with a milder condition. They theorize that low levels of D damage blood vessels and lead to a shortage of nitric oxide.
Consider the case of Mr. Jones, a new patient I was helping in an ambulatory cardiac clinic. Most of my patients are on multiple medications for their heart conditions and other complicated issues, so I often review their medications to make sure everything is all right. This includes screening labs, checking vitals, reviewing past reports, and conducting drug interaction checks related to therapy. If there are any concerns, I’ll meet with the patient and make recommendations to the healthcare team.

Your doctor may also choose to lower your dose of certain medications. Or your provider may switch the type of drug you’re taking if it’s interfering with your sex life. Some medicines used for managing blood pressure, insomnia, anxiety, depression, seizures and prostate problems increase the risk for erectile dysfunction. Beta-blockers (for high blood pressure), SSRIs (often used to treat depression) and the class of drugs called benzodiazepines (like Ativan, Xanax, Librium and Valium) are commonly tied to ED. You may want to speak to your doctor about this.
do not take sildenafil if you are taking or have recently taken riociguat (Adempas) or nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure whether any of your medications contain nitrates.

Geraerts, I., van Poppel, H., Devoogdt, N., de Groef, A., Fieuws, S., & van Kampen, M. (2016, January–February). Pelvic floor muscle training for erectile dysfunction and climacturia 1 year after nerve sparing radical prostatectomy: A randomized controlled trial [Abstract]. International Journal of Impotence Research, 28(1), 9–13. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26538105
Lifestyle changes like getting more exercise and adjusting your diet can help. In a study of obese men with E.D. who restricted calories for two years and were advised to be more active, participants not only lost weight but also experienced decreased severity of their E.D. Research also shows aerobic exercise can significantly lower your risk of erectile dysfunction thanks to its ability to boost blood flow and circulation. Eating certain foods can also reduce incidence of E.D.
Ancient Incans consumed this energizing Peruvian plant before battle or a bout of sex, Chris Kilham, an ethnobotanist at the University of Massachusetts at Amherst, told Outside Online. Maca increases sexual appetite, stamina, endurance, and fertility. One 2008 study conducted at the Depression Clinical and Research Program at Massachusetts General Hospital in Boston found that maca helped people with antidepressant-induced sexual dysfunction to regain their libidos.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
After supplementation of 500 milligrams of zinc daily for 30 days, zinc levels improved slightly and sexual dysfunction resolved in 5 of the 22 patients in the group completely.[10] Based on this study, there is enough evidence to highlight a link between zinc levels and sexual function, but it is still too ambiguous to proclaim this to be a "wonder drug" to include as a natural supplement for erectile dysfunction just yet. 

Several new studies have proven not only the cardiovascular safety of sildenafil, but have also suggested that sildenafil may have a cardioprotective role. PDE5A inhibition by sildenafil blunts systolic responses to beta-adrenergic stimulation suggesting a possible role in modifying stimulated cardiac function (Borlaug et al 2005). Chronic inhibition of cGMP phosphodiesterase 5A by sildenafil prevents and reverses cardiac hypertrophy (Takimoto et al 2005). Finally, sildenafil is the only PDE5i that improved arterial oxygenation in patients with pulmonary hypertension (Ghofrani et al 2004) and it has been recently approved in doses of 20 mg and 40 mg, taking every 8 h life-long by patients with pulmonary hypertension (Galie et al 2005).
The availability of phosphodiesterase type 5 inhibitors (PDE5i) has resulted in increasing numbers of patients seeking medical help for erectile function problems, but has also altered dramatically the medical management of ED (Hatzichristou and Pescatori 2001; Lewis et al 2001; Steers et al 2001). More physicians are treating ED, especially in the primary care setting, including minimal patient work-up and prescription of PDE5i due to their proven efficacy and safety profile. The management of ED by non-specialists includes minimal patient work-up and prescription of exclusively first-line treatment options in most cases, mainly due to the lack of time and background knowledge (Hatzichristou 2002). Sildenafil was the first available PDE5i that revolutionized ED treatment (Goldstein et al 1998). More than 30 million of men are treated worldwide with sildenafil accompanied by vast experience and research with more than 2600 papers published in Medline as of July 2006. Furthermore, new data suggest that sildenafil has beneficial effects in several chronic conditions. It has been recently approved for the treatment of idiopathic pulmonary hypertension (Galie et al 2005), and numerous articles have suggested that PDE5i may improve endothelial function (Katz et al 2000; Desouza et al 2002; Halcox et al 2002; Vlachopoulos et al 2003; Vlachopoulos et al 2004; Gori et al 2005; Hirata et al 2005). PDE5i have been also suggested to be beneficial for patients with premature ejaculation (Abdel-Hamid 2004). However, clinical studies have shown controversial results so far (Salonia et al 2002; Chen et al 2003; Atan et al 2006) and it remains uncertain, whether PDE5i act on the physiologic process of ejaculation, or indirectly, improving erectile function and therefore, reducing performance anxiety in men with ED.
Take note that you may not be able to complete a series of about 10 kegel exercises on your first try. This is just fine. Just do what you can, and gradually work on more kegel exercises until you reach 10 to 20 kegels, up to three times in a day. When performing these exercises, avoid holding your breath, or pushing your stomach, thigh muscles, or buttocks in. It would be helpful if you relax after every count of five. You may also challenge yourself by alternating between long and short squeezes.
Counselling or sex therapy (58% of people find this works for them) –mind-related causes of erectile dysfunction can affect anyone. They are more likely if you experience erectile dysfunction at a younger age. Talking to a counsellor or therapist can help some people overcome erectile dysfunction related to these problems, possibly for good. They can also help you if your erectile dysfunction is causing you stress, as this can make matters worse.

As we mentioned before, there are a lot of treatment options that you could use to treat a condition as erectile dysfunction. A lot of the men diagnosed with erectile dysfunction decide to try some of the natural remedies before they refer to some of the top men enhancement pills. Exercise is one of the most commonly recommended ways as a natural remedy for erectile dysfunction. We all know that exercising has a lot of different beneficial effects on our bodies so why not use it as a part of the treatment for this condition? 


The normal aging process and age related risk factor accumulation contribute to the increased prevalence of erectile dysfunction in the elderly. Systemic changes and alterations in the structure and function of the penis in elderly men include hormonal changes (mainly testosterone decrease and increase in sex hormone binding globulin that resulting decreased bioavailability of testosterone) (Margolese 2000), decrease in elastic fibers and increase in collagen fibers in the tunica albuginea (Akkus et al 1997) and molecular changes (decrease in nitric oxide synthase) (Andrew and Mayer 1999).
Nitric Oxide (NO) is released with sexual stimulation from nerve endings and endothelial cells in the corpus cavernosum of the penis. An enzyme then converts guanosine triphosphate (GTP) into cyclic guanosine monophosphate (cGMP). cGMP causes the smooth muscle of the penis to relax, which causes an inflow of blood which then leads to an erection. cGMP is then hydrolysed back to the inactive GMP by phosphodiesteras type 5 (PDE5).
A 2011 study of 160 men with moderate or severe erectile dysfunction divided the group in two—80 men were given niacin supplements, and 80 a placebo. The group given niacin reported improved ability to “maintain an erection versus the control group.” It’s not exhaustive research, but still promising. The best part about niacin is that it’s naturally found in foods like turkey, avocado, and peanuts (yum). If you’re not a turkey sandwich fan, you can supplement with a vitamin B complex.

The mind and body are intricately connected, and exploring this connection can help you combat stress and fatigue, both of which can contribute to erectile dysfunction. Adding mind-body exercise to your life helps lower stress, improve breathing, and reduce general tension. Yoga can also be terrific for improving your sense of well-being, and it’s great for helping keep you limber so you reduce the risk of sports-related injuries. Partnered yoga classes and routines let men engage in relaxing and beneficial exercise with their partners, and there are even specific yoga postures designed to improve blood circulation to the pelvic region.
A study published in The American Journal of Cardiology confirmed that aerobic exercises will help you to cure your erectile dysfunction. Erectile dysfunction is most commonly caused by obesity, hypertension, and diabetes, which decrease the blood flow in the penis. Aerobic exercises can and will help you to improve your health in general, improve your blood flow, and ultimately treat your condition.
Zinc therapy (5 mg/day) improves sexual competence by increasing penile thrusting and prolonging ejaculatory latency without disturbing arousability and motivation of male rats. Increase in the T levels observed with zinc supplementation is beneficial in this regard. However, increase in PRL is responsible for the reduced libido index. Further studies on pigs and monkeys are needed to evaluate the possible therapeutic use of zinc in sexual dysfunction.
I would think the 25% is just an average. Some men never have a problem with erections. Some healthy men in their 60's never have a problem with their erections -- no Viagra needed at all, thank you. And, no, it is NOT completely associated with age. In fact, many men in their 40's and even younger, are already dealing with ED, especially if they smoke, are obese, don't exercise, or are addicted to porn, among other things. In fact, even men in their 20's and 30's can have these problems.
The human body only contains 2 or 3 grams of zinc at any given time. Zinc is distributed throughout the body in organs, blood, and bones. It can be difficult to diagnose zinc deficiency. While a low blood zinc level does indicate a deficiency, a normal blood level does not necessarily indicate the absence of a deficiency. And examination of the hair for zinc or a zinc taste test (ZTT) may also be used for supportive evidence in the diagnosis of zinc deficiency.
Once I meet someone and we share that we have a common experience; their diabetes and my life long experience as a care taker, we tend to have an instant bond. Think about it. How many people do you meet who you feel really get you right after your introduction? The conversations that follow tend to be very personal. Not a common experience with all strangers.
In patients who either fail to respond to first or second-line therapy, or are not interested in the conservative therapies, penile prosthesis implantation is available. Malleable and rigid implants were available for many years, but in 1973 the world of penile prosthetics took a giant leap forward with the advent of the inflatable penile implant. Most implants done nowadays are of the inflatable variety. Adverse events including malfunction and infection are rare, and patient satisfaction is very high.45
Ginkgo Biloba increased nitric oxide in one study by nearly 13% and decreased endothelin-1 a potent vasoconstricting peptide produced by endothelial cells by almost 6% increasing the NO/ET-1 ratio by approximately 20%. These three factors: increasing nitric oxide decreasing ET-1 and increasing in the NO/ET-1 ratio had a synergistic effect with increased vasodilation. 
Before a man concludes that oral drugs don’t work for him, he should have his testosterone levels checked to rule out hormone deficiency as the cause of (or as a contributor to) his sexual dysfunction. Other symptoms of low testosterone include a low sex drive and infertility. Checking testosterone levels requires a blood test. If a man’s levels of testosterone are decreased or at the lower end of normal, his doctor may prescribe supplemental testosterone therapy, either as testosterone injections or testosterone gel, which is applied daily to the skin. In some cases, testosterone therapy alone can resolve sexual dysfunction, or it can be combined with the use of oral erectile dysfunction drugs.
In addition, when research has shown a nutrient such as zinc or niacin to improve sexual function, it's usually in people who are deficient in it. So, before you stock up on over-the-counter nutritional supplements for ED, speak with your doctor. He can test you for deficiencies and steer you toward the most effective and safest way to treat your erectile dysfunction. 
A variety of personal habits and lifestyle choices have been linked to ED. In some ways, this is a good thing, since habits can be broken and choices reconsidered. What's more, many of the lifestyle factors that contribute to sexual problems are ones that affect overall health and well-being, both physical and mental. Addressing these factors, therefore, can have benefits beyond improving erectile dysfunction.

Taking zinc in supplement form is just one of many treatments for those looking for help with ED. Many men use supplements either to replace prescription medications like Viagra and Cialis, or to enhance the effectiveness of these medications. Some other natural supplements aimed at relieving ED symptoms include Korean red ginseng, L-Arginine, carnitine, and DHEA.

The research found that most of the men were overcoming erectile dysfunction naturally. The remission rate of those with erectile dysfunction was 29% which is high. This shows that many of these factors affecting men are actionable providing them an opportunity to do something about their condition. "Even when medication to help with erectile function is required it is likely to be considerably more effective if lifestyle factors are also addressed says Dr. Sean Martin lead author of the research paper. 
The efficacy of sildenafil in almost every subgroup of patients with ED is more than established. Response rates in elderly men (≥65 years) are comparable with general population regardless of age (Wagner et al 2001). No differences in response rates were demonstrated in ethnic groups (Young et al 2002). In type 1 diabetic patients, 66.6% reported improved erections (GAQ) and 63% reported successful intercourse attempts compared with 28.6% and 33% by those taking placebo, respectively (Stuckey et al 2003). In another multicenter, randomized, double-blind, placebo-controlled, flexible dose-escalation study in diabetic patients, 56% of patients reported improved erections and 61% reported at least 1 successful intercourse attempt compared with 10% and 22% in the placebo group, respectively (Rendell et al 1999). Diabetic patients are one of the most difficult to treat subgroups (Behrend et al 2005). In patients after bilateral nerve-sparing radical prostatectomy, 76% responded to sildenafil (defined as successful vaginal intercourse) (Raina et al 2004). A favorable response to sildenafil in patients with ischemic heart disease (GEQ and IIEF Q3 and Q4) who were receiving b-blockers and/or angiotensin-converting enzyme inhibitors and/or calcium channel blockers has been observed (Olsson and Persson 2001). Similar results presented in patients with hypertension (taking different or multiple antihypertensive drugs). High efficacy rates presented in patients on chronic dialysis for renal failure (lower doses and longer intervals between treatments are usually required) (Chen et al 2001; Mahon et al 2005), after renal transplantation (Prieto Castro et al 2001; Sharma et al 2006), in spinal cord injuries (Derry et al 2002; Deforge et al 2006) and patients with depression (treated with selective serotonin reuptake inhibitors [SSRIs] or not) (Seidman et al 2001; Nurnberg et al 2002) or patients treated with antipsychotic agents (Gopalakrishnan et al 2006).
The idea of using low-energy shock waves to treat erectile dysfunction comes from studies that show that these types of shocks help heart blood vessels regrow, a process called revascularization. Shock wave therapy may also work on the penis, and there have been some promising results, but it’s not currently an approved ED treatment. "It’s similar to the type of shock waves used to break up kidney stones, and it may cause revascularization,” says Bennett. “However, there are not yet any good controlled studies to recommend it to patients."
Though higher doses of zinc reduce libido, supplementation with a medium dose (5 mg/day) has some beneficial effect on the sexual competence of adult male rats. The major significant effects of this dose of zinc are prolongation of ejaculatory latency without disturbing sexual arousability, motivation, penile erection and sex vigor. Also, the partner preference index of the 5 mg/day group was positive and comparable to the controls. A positive partner preference index is indicative of unchanged sexual interest of males.[16] These results confirmed that libido and sexual interest are not affected by zinc supplementation with a 5 mg/day dose. However, mild reduction in percentage of intromission was observed in this group and it is postulated that this may be situational rather than an effect of supplemented zinc. This is based on our observation where mild rejection by the females at the initial phase of the behavior led some males to refrain from sexual activity.

In fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.
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