*all photos are models and not actual patients.If you are interested in a prescription product, Hims will assist in setting up a visit for you with an independent physician who will evaluate whether or not you are an appropriate candidate for the prescription product and if appropriate, may write you a prescription for the product which you can fill at the pharmacy of your choice.

The severity of ED has been correlated with the extent of CVD. Banks et al reported that the risk of future CV events increased progressively according to ED severity.28 This was shown in both men with and without known CVD at baseline and after controlling for confounders. Solomon and colleagues found an inverse correlation between international index of erectile function (IIEF) scores and plaque burden seen on coronary angiography.29 In addition, Yaman et al demonstrated a significant correlation between ED severity on IIEF questionnaires and coronary artery calcification.30


Taking large daily doses of zinc, for a short-term period of time, may be of benefit for men with certain health conditions. According to MayoClinic.com, taking 4.5 to 24 milligrams of zinc in lozenge form every 1 to 2 hours may help reduce symptoms of the common cold. Other high dosages of zinc used in research studies include 12 to 150 milligrams per day to improve immune function in elderly men, 66 milligrams of zinc to increase sperm counts in subfertile men and 220 milligrams of zinc daily for sexual dysfunction in men, reports MayoClinic.com. However, don’t take these high doses of zinc unless supervised by a medical professional, and avoid taking them longer than your doctor recommends.
These prescription drugs increase the levels of nitric oxide in your blood. Nitric oxide is a vasodilator, meaning it makes your blood vessels widen to help increase the blood flow. These drugs are especially effective at widening the blood vessels in your penis. More blood in your penis makes it much easier for you to get and maintain an erection when you are sexually aroused.
L-arginine, an amino acid that is naturally present in the body and helps make nitric oxide, supports a successful erection. Nitric oxide is responsible for making the blood vessels relax, which helps sustain an erection for men. A 1999 study, observed the effects of six weeks of high-dose (5 grams/day) orally administered nitric oxide (NO) donor L-arginine on men with organic ED. Thirty-one percent of those who took 5 grams/day of L-arginine experienced significant improvements in sexual function. Burns told Medical Daily, “l-arginine and deer antler velvet” have been the most popular go-to natural treatments for men.
But in this case, zinc is much harder to absorb. This explains a decrease in testosterone levels in vegetarians. Slippery jack mushrooms, button mushrooms, beef liver, and fish are also rich in zinc. They are followed by breadstuffs, egg yolk, rabbit, chicken, beans, tea, and cocoa. In addition, zinc is found in onions, garlic, and rice. And a very small amount of zinc is available in fruits, vegetables, and milk.

Red Ginseng — One small randomized trial found evidence that red ginseng may offer modest improvements in ED symptoms (as compared with placebo). A meta-anaylsis published in the British Journal of Clinical Pharmacology states, “Traditionally red ginseng has been used to restore and enhance normal well-being, and is often referred to as an adaptogenic….Possible mechanisms of action of red ginseng include hormonal effects similar to those of testosterone. Others have postulated that red ginseng might induce relaxation of the smooth muscles.”  (5)
If you can achieve erection on your own, but you then are unable to keep it while with your partner, it could be related to anxiety, stress, or any sort of relationship issue. There has been extensive research conducted into all potential contributors to erectile dysfunction, including increased use of Internet pornography, assuming that excessive use of internet pornography can change the way the brain perceives arousal, therefore changing the desired response. Dan Savage also explores this topic on his love and sex advice podcast, the Savage Lovecast. If your dysfunction is related to anxiety, stress, or relationship issues, it may be time to explore therapy with a sex-positive provider, or even meditation.

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So, in establishing physiology, pharmacology, clinical results and safety, zinc is a good choice when you look at cost and side effect profile as well as ease of availability and interaction profile with other meds and other medical conditions.  Having said all of this, there is no bulletproof evidence out there guaranteeing that increasing your zinc consumption either in food or via a supplement will improve ED or increase libido.  Even if a patient experiences an increase in testosterone from such a supplementation, this is not a certain gateway to resolution of theses symptoms as there is more to it than just one hormone level.  However for those that are experiencing problems in these areas, it is certainly worth a try for them.  The patient should be mindful however that supplements should be treated like any other medication and trying to increase your testosterone shouldn’t be done without consultation with your doctor and pharmacist.  You should also check for any interactions with any meds or medical conditions before trying any supplement as well.
Another common reason for failures of oral therapy is the absence of sexual or genital stimulation prior to attempting sexual intercourse. These medicines facilitate an erection by increasing blood flow to the penis, but they do not act as an aphrodisiac or as an initiator of the erection. A man who is not “in the mood” or does not have adequate physical stimulation will not respond with an erection.
Carlo Adrian Cañon is a graduate of Bachelor of Secondary Education major in English from Southern Leyte State University-Tomas Oppus in the Philippines. He has written numerous articles on a variety of topics on men’s health, fitness, and product reviews. He is contributing to consumerhealthdigest.com for men sexual health category. You can follow him on: LinkedIn.
3. Testosterone replacement. Before oral medications like Viagra, testosterone was routinely used to treat erectile dysfunction as it is central in the male sexual response, including the desire for sex and the process of getting an erection. Testosterone can be administered in a number of ways, for example orally, by means of an injection, skin patch, or subcutaneous (under the skin) pellet. 

“One important danger that men need to know about if they are using ED drugs recreationally is drug dependence. Men who take the drugs for longer and larger erections may find that they actually develop ED without the drugs. This could mean having to use more aggressive treatments like injections or implants to treat ED in the future,” warned DeSouza.
"Just because there is evidence doesn't mean it's good evidence," says Andrew McCullough, MD, associate professor of clinical urology at New York University Langone Medical Center in New York City, and one of the original clinical investigators for the ED drug Viagra (sildenafil). "And before men with ED start down the naturopathic route, it's smart to make sure that there isn't some underlying medical condition that needs to be corrected." Moreover, it is estimated that 30 million American men have erectile dysfunction, and 70% of cases are a result of a potentially deadly condition like atherosclerosis, kidney disease, vascular disease, neurological disease, or diabetes. Additionally, ED can also be caused by certain medications, surgical injury, and psychological problems.

So what’s the problem? Well, if you really listen to the advertisements on television for erectile dysfunction (ED) medications, ignoring the blue tinted jazz from Viagra or the bathtubs in the sunset from Cialis, you may have heard the line “Do not take if you take nitrates for chest pain, as it may cause an unsafe drop in blood pressure.” You see Viagra, Cialis, and Levitra belong to the same drug class called Phosphodiesterase 5 Inhibitors (abbreviated as PDE-5 inhibitors), and they all share the same interaction with nitrates. Many patients wonder how bad can a ‘drop in blood pressure’ be. The answer, as we learned after Viagra came out, is this reaction could lead to heart attack in patients and potentially cause death, leading to a black box warning for the whole class of drugs like Viagra.
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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.
Our bodies are designed to be active and in motion. By keeping active and engaging in regular aerobic exercise, you increase the blood flow to your muscles, and your penis along the way. One of the most interesting things about increasing your blood flow is that it becomes a signal to your blood vessels to grow and get wider. It benefits your brain, your heart, and your erection. The principle of "use it or lose it" is the best advise one can follow. In fact, if you don't engage in sexual activity at least once or twice a week, it would be beneficial to masturbate. This not only helps with prostate health, but encourages the blood vessels that contribute to your erection to maintain their patency and flow. 
For oral erectile dysfunction medicines to work as desired, they must be used properly in the first place. This means taking the medicine 30–45 minutes before engaging in sexual intimacy; taking the drug on an empty stomach or at least avoiding a heavy or high-fat meal before taking the drug (this is especially important when using sildenafil); and engaging in adequate genital stimulation before attempting intercourse. Drinking small amounts of alcohol (one to two drinks) should not compromise the effectiveness of erectile dysfunction medicines, but larger amounts of alcohol can diminish a man’s ability to have an erection.
Aerobic exercise — which means "with oxygen" — consists of continuous, repetitive movements that increase your heart rate and get healthy oxygen into all your muscles by increasing blood flow that supports the heart and blood vessels (and in turn, prevents ED). In fact, research suggests that regular aerobic exercise can lower the risk for erectile dysfunction by about 40 percent.
Similar results were presented by other studies. Incorrect administration accounted for 81% of sildenafil failures referred by primary care physicians (Atiemo et al 2003). Reasons included administration after heavy meals, lack of sexual stimulation, short timing to intercourse, and too few attempts for intercourse. The authors were able to salvage 41.5% of nonresponders after reeducation as measured by the General Assessment Question (GAG) and Sexual Health Inventory for Men (SHIM) scores. Gruenwald and colleagues (2006) showed that counseling and dose adjustment were directly influential in achieving an excellent response to a second trial of sildenafil in patients with ED who had previously failed treatment with the drug, and obviated their needing to seek more invasive measures. In this study, 38% of the included patients did not receive any explanations or counseling whatsoever from the prescribing physician. After proper instruction, erectile function domain scores increased significantly and overall 23.6% of the patients had a normal IIEF EF domain score (≥26) at the end of the study.
Viagra can be used long-term without having a negative effect on your health. However, you should still get regular doctor assessments for your Viagra treatment in case your health situation changes and it’s no longer safe for you. This involves answering questions about your erectile dysfunction, other medications, and general health which a doctor can then review.
This no.1 penis strengthening exercise is essential for helping to correct erectile dysfunction problems and can lead to mind-blowing orgasms. The download instructions (see link above) also contain important information regarding a common mistake that men make, especially when doing Kegel exercises. Kegel Exercises are not the best treatment for premature ejaculation! However, a slight modification to a common Kegel exercise can make it become more beneficial in overcoming PE and ED. See the above instructions for detailed explanation.

Pelvic floor PT is a proven and effective treatment for erectile dysfunction. A study in 2006 involved 146 men with mean age of 42 with pelvic pain; 92% of these men had sexual dysfunction.  Treatment consisted of trigger point release and relaxation training, which led to improvement in symptoms by 77-87% – it’s notable that kegels were not part of this study.
The role of the endothelium in ED has been noted for a number of years and the overlapping of ED and other conditions, especially coronary heart disease, CVD, affecting endothelial function/dysfunction, is clearly present. The endothelial cell is now known to affect vascular tone and impact the process of atherosclerosis, and impacting ED, CVD and peripheral vascular disease.16

Can apple cider vinegar treat erectile dysfunction? Apple cider vinegar is thought to have many health benefits, but can it help treat erectile dysfunction (ED)? ED can result from cardiovascular problems, diabetes, and other factors. Apple cider vinegar may help improve symptoms of conditions related to ED. Find out how it may help, and how to use it safely. Read now
Some men wonder about testosterone as an alternative for ED. The answer is that, unless testosterone plasma levels are at a low-level, adding more testosterone in a ‘normal’ individual won’t accomplish much, as clinical trials have shown. The other issue is that men with a cardiac history, adding testosterone to their therapy could prove highly risk to their health. If a patient does have low testosterone levels, it is possible to use testosterone supplements which come different formulation such as a topical ointment.
That’s no joke. Like every part of the body, the male repro system needs the right nutrients for optimal health, from function to fertility. Studies have isolated several nutrients that are particularly beneficial. You can get them through these best foods for your penis, or these best proteins for your penis, but we’ve broken them down here by nutrient in case you want to ensure you’re getting enough. (And if you do decide to go the supplement route, as always, talk to your doctor and never exceed recommended dosages.)

Although the term ‘treatment failure’ to oral drugs is widely used, there is no precise definition of what exactly means. Treatment failure may be due to medication, clinician and patient issues (Table ​(Table3).3). Based on these issues a definition of a non-responder to oral pharmacotherapy is proposed: “an inadequate erectile response after at least 4 attempts of the highest tolerated drug dose in accordance with manufacturer’s guidelines with respect to timing relative to meals, alcohol ingestion, use of concomitant medications, and adequate sexual stimulation/arousal” (Carson et al 2004).


Erectile dysfunction is a common occurrence in men with diabetes. The incidence of erectile dysfunction increases progressively with age, from 5% in men age 20 to 75% in men over age 65. The cause of erectile dysfunction in men with diabetes is usually related to a decrease in the blood supply to the penis as well as to injury to the nerves that are responsible for the erection mechanism. A decrease in testosterone production has also been identified as the cause in some men with diabetes.
Besides these reasons for inappropriate intake of sildenafil, one of the most common causes of discontinuation of a drug that is considered as treatment failure is the lack of follow-up of the patients. Erectile dysfunction is a chronic disease. Follow-up visits are essential to improve physician–patient communication, solve treatment problems that may have occurred, identify any change in potency status or new medical conditions and offer continuing education to patients and their partners. These essential aspects in managing ED patients can be easily remembered by the acronym, FAST (Follow-up of patients, Adjustment of time of administration, Sexual stimulation, and Titration to the maximum tolerated dose) (Hatzichristou 2002).

Despite the proven long-term efficacy of PDE5i, it has been suggested that tachyphylaxis to this therapy may develop. Long-term treatment with PDE5i and excessive cGMP accumulation may up-regulate PDE5 (El-Galley et al 2001). Such hypothesis however, has not been proven in the existing clinical trials with chronic PDE5i therapy (Behr-Roussel et al 2005; Musicki et al 2005). Currently, there are no evidence-based data to support tachyphylaxis in patients treated with sildenafil or any other PDE5i.


medicines called alpha-blockers such as Hytrin (terazosin
HCl), Flomax (tamsulosin HCl), Cardura (doxazosin
mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl),
 Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin).
Alpha-blockers are sometimes prescribed for prostate
problems or high blood pressure. In some patients, the use
of Sildenafil with alpha-blockers can lead to a drop in blood pressure or to fainting

Starving cancer stem cells of vitamin B2 (riboflavin) depletes their energy and puts them into a state of "suspended animation," researchers reported. To accomplish this, the researchers used drug screening to identify a compound called diphenyleneiodonium chloride (DPI). The compound, which inhibits vitamin B2, reduced mitochondrial energy production in cancer stem cells by 90%. DPI is not only potent but highly selective, so it may not produce the toxic effects of current chemotherapeutic cancer treatments, researchers predicted. How does it work? Here's what they discovered.
Finally, there are NO-releasing polymers that are capable of delivering NO in a pharmacologically useful way. Such compounds include compounds that release NO upon being metabolised and compounds that release NO spontaneously in aqueous solution. Initial animal studies suggest that cavernosal injections of NO polymers can significantly improve erectile function.48
Being as of a common condition as it is, there is no reason why you should be ashamed of asking for help to treat erectile dysfunction. It seems as men are still unaware of how common but how easily treatable this condition is. You can choose from the variety of natural remedies, such as changing your diet, routine, habits, exercising or you can choose from the variety of products available on the market to treat this condition. The point of this article is to raise awareness on the topic of erectile dysfunction and the importance and beneficial effects of exercising as a way to treat erectile dysfunction. We understand how overwhelmed you could feel from hearing all those people’s opinions on the topic and sharing their stories. That is why we choose some of the best exercises you can perform in order to improve your health. Do not hesitate to ask for help. A few changes in your diet and routine is all that is separating you from an improving your health in general.
Call this the Marvin Gaye of amino acids: L-arginine converts to nitric oxide (NO), a naturally occuring gas that causes blood vessels to relax and facilitate blood flow, helping you get and stay hard. You can find plenty of the nutrient in oysters, but in supplement form, the Mayo Clinic says that 400-6,000 milligrams is the maximum dose. And these are the best foods for arginine!
Chlamydia and erectile dysfunction: What's the link? Some people who have chlamydia also experience erectile dysfunction (ED), which involves problems getting or maintaining an erection. Chlamydia can infect the prostate gland, leading to prostatitis, pain, and ED. In this article, learn more about the link between this common infection and ED, and treatments for both. Read now

Based on the benefits of this supplement, it appears that patients will clearly benefit from supplementation if levels of zinc are low. In North America, it may be less common due to diets so taking zinc may not necessarily help patients who already have adequate levels of zinc if their levels are within normal limits. Many studies prove that zinc has at least an indirect impact on erectile dysfunction and supplementation will improve in those patients so I would advise considering zinc supplementation for erectile dysfunction if it is determined that your plasma levels of zinc are low. 


Non-arteritic anterior ischemic optic neuropathy (NAION) is characterized by acute ischemia of the anterior portion of the optic nerve in the absence of provable arteritis, which may result in visual field defect or vision loss. No effective treatment is available and prevention is limited to the treatment of risk factors mainly aiming at decreasing the risk of a similar event in the fellow eye. Numerous risk factors have been reported for NAION, mainly cardiovascular risk factors, including hypertension, diabetes, and hypercholesterolemia. Lastly, the potential relationship between non-arteritic anterior ischemic optic neuropathy (NAION) and PDE5i use has raised important questions and a strong reaction not only among regulatory agencies, but also within the scientific community and mass media as well.
This led to nausea, dizziness, hallucinations, and a five-day throbber that could have cost him his life. But you needn't take handfuls of the stuff for bad things to happen. In 2007, the wife of a 50-year-old Italian construction worker spiked her husband's wine with just two Viagra which resulted in him suffering a near-fatal heart attack. There are many other reports of people dying from a heart attack as a result of taking Viagra, but one gentleman nearly suffered a fate worse than death after trying to impress his wife by super-dosing. Gentil Ramírez Polanía, a Colombian farmer in his mid-60s scarfed a bunch of the stuff and impressed his woman with a multi-day hard on before checking himself into a hospital with an inflamed, fractured and gangrenous penis. Only emergency surgery managed to save Polanía's life and his penis although, sadly, it was not quite the same as it once was.
The art of acupuncture has become the new treatment for everything from back pain, depression, and even ED. Impotence could be more of a state of mind, and acupuncture may help. Through this alternative therapy, fine needles are placed in various parts of the body to relieve pain or stress. Although there are many mixed studies for acupuncture and ED, many tend to confirm positive results. A 1999 study found acupuncture improved the quality of erection and even restored sexual activity in 39 percent of participants.
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