Arginine. The amino acid L-arginine, which occurs naturally in food, boosts the body's production of nitric oxide, a compound that facilitates erections by dilating blood vessels in the penis. Studies examining L-arginine's effectiveness against impotence have yielded mixed results. A 1999 trial published in the online journal BJU International found that high doses of L-arginine can help improve sexual function, but only in men with abnormal nitric oxide metabolism, such as that associated with cardiovascular disease. In another study, published in 2003 in the Journal of Sex & Marital Therapy, Bulgarian scientists reported that ED sufferers who took L-arginine along with the pine extract pycnogenol saw major improvements in sexual function with no side effects. Arginine can be helpful, says Geo Espinosa, ND, director of the Integrative Urological Center at NYU Langone Medical Center. Espinosa says that men with known cardiovascular problems should take it only with a doctor's supervision; L-arginine can interact with some medications.
SOURCES: John P. Mulhall, MD, associate professor and director of sexual medicine, departments of urology, Weill Medical College of Cornell University and Memorial Sloan-Kettering Cancer Center, New York. Frank Sommer, MD, chief of andrology, department of urology, University of Cologne, Cologne, Germany. American Urological Association's 99th Annual Meeting, San Francisco, May 8-13, 2004.
The number of intromissions in the 5 mg/day group was comparable with controls. On the other hand number of penile thrusting was significantly increased with the same dose. These are indications of unimpaired erectile function due to supplemented zinc. Our observations also confirmed the lack of aberrant sexual behavior which is indicative of uninhibited penile tactile sensations.[15] Sexual behavior may also be changed with motor weaknesses and incoordination.[12] Supplementation with zinc did not impair muscle strength or coordination when tested with bar and bridge tests, indicating that prolongation of ejaculation was not mediated through these mechanisms.
You may also perform these exercises anywhere and anytime. Just take note in your calendar if you sometimes have problems remembering. On the other hand, aerobic exercises may also improve your cardiovascular health, aside from just your male sexual health. By doing so, you can also experience an improved capability of achieving and maintaining erection.
In their extensive review, Bassil and coworkers summarise the benefits and risks, with benefits such as improvement of sexual function, bone density, muscle strength, cognition and overall improvement in quality of life. Among the risks that have been suggested include erythrocytosis, liver toxicity, worsening of sleep apnoea and cardiac function, possibly increasing symptoms of benign prostatic hyperplasia (BPH). They also note that although a possibility of stimulation of prostate cancer has been hypothesised, no scientific or clinical evidence exists to this possible risk.38
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.
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
In the end, open and honest communication with your therapist will yield the best course of action. If you do decide to try pelvic floor PT, a comprehensive evaluation will determine what exactly is going on with your muscles. They may be tight and weak or they could have poor coordination. So my advice for those suffering from erectile dysfunction is this: before you try kegels, make an appointment with your pelvic floor therapist.
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).

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Many products contain undocumented “fillers” that can cause allergic reactions.  In recent years, the FDA has found over 300 herbal products that contain hidden, deceptively labeled, or dangerous ingredients4. And since 2015, the FDA has released public warnings on more than 160 ED supplements and “male enhancement” products found to contain dangerous ingredients and contaminants5 .   An independent study of FDA data, conducted in 2018, found almost 800 herbal supplements that contained unlisted ingredients6.
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.

Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and did not always improve when the medication was stopped. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.
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.

Since endothelial dysfunction, CVD and ED are closely associated in epidemiological studies, the question for clinicians is whether to recommend the man presenting with ED undergo a cardiovascular (CV) evaluation. Clearly, based on numerous studies, ED can be considered at least a ‘marker’ for possible further vascular disease or CVD.15 In their report, Vlachopoulos and coworkers make the point that the man presenting with ED, the clinician, is offered an opportunity to attempt to improve the health of the man by addressing lifestyle modification, and consider further vascular evaluation owing to the clear relationship between endothelial dysfunction, ED and CVD.19


The substance that gives hot peppers their kick can also give you some kick in the pants: Studies have associated the natural chemical with increased testosterone levels. In animal studies, capsaicin has also shown to increase the size of sex organs, while simultaneously decreasing belly fat. A 2014 study from France also found that men who ate more spicy food had higher testosterone levels than those who ate less. You can consume capsaicin via peppers, chili powder or a cayenne supplement.
General health. If you have liver or kidney problems, Viagra’s effects could last for longer, although it might not be safe to take Viagra with these conditions. The reason it lasts longer is because the tablet will take longer to be broken down by your body, this means there is a bigger risk of having more serious side effects. You must always mention these conditions during a doctor assessment for Viagra treatment
Sildenafil (Viagra) is an oral agent recently approved by the United States FDA for the treatment of erectile dysfunction. Its major mode of action is inhibition of the enzyme PDE5. Inhibiting this enzyme allows the cyclic GMP to stay around longer, thus maintaining erection. Viagra is not an aphrodisiac, it is not effective without sexual stimulation. It mainly enhances the normal physiologic erection.
There are a number of reasons a man may not achieve the desired result from an oral erectile dysfunction drug. In some cases, a man may experience drug side effects severe enough to outweigh any potential benefit of taking the drug. Possible side effects of these drugs include headache, facial flushing, nasal congestion, and transient abnormal vision. (In October 2007, the FDA added a warning about sudden hearing loss to the package labels of oral erectile dysfunction drugs. While it’s not absolutely clear that the drugs can cause sudden hearing loss, a number of cases have been reported in men within hours or days of taking one of the drugs.)
Ginkgo biloba. Known primarily as a treatment for cognitive decline, ginkgo has also been used to treat erectile dysfunction -- especially cases caused by the use of certain antidepressant medications. But the evidence isn't very convincing. One 1998 study published in the Journal of Sex & Marital Therapy found that it did work. But a more rigorous study, published in Human Pharmacology in 2002, failed to replicate this finding. "Ginkgo has come out of fashion in the past few years," says Ronald Tamler, MD, assistant professor of medicine and codirector of the men's health program at Mount Sinai Medical Center in New York City. "That's because it doesn't do much. I can say that in my practice, I have not seen ginkgo work -- ever."
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.

It is important that you exercise, not only to combat ED but also to maintain your general health. Any aerobic exercise such as running, cycling or swimming will be great for improving your overall health and fitness. These kinds of exercise improves your cardiovascular health, which is important to help you treat your ED. You may also find it helpful to review your general lifestyle and reduce factors which could be contributing to your ED, such as smoking, drinking alcohol and eating unhealthy foods.


When Viagra (sildenafil) hit the market in 1998, some men thought it was the long-awaited answer to their problems. Many rushed to doctor's offices to give it a try. According to the Grey Clinic in Indianapolis, which specializes in erectile dysfunction, 17% of men between 18 and 55 experience occasional impotence, while 6% have regular erectile difficulties. For men over 55, that number jumps to about one in three. Some common causes of impotence are diabetes, heart disease, and psychological problems. It also frequently occurs after prostate cancer surgery.
The number of intromissions in the 5 mg/day group was comparable with controls. On the other hand number of penile thrusting was significantly increased with the same dose. These are indications of unimpaired erectile function due to supplemented zinc. Our observations also confirmed the lack of aberrant sexual behavior which is indicative of uninhibited penile tactile sensations.[15] Sexual behavior may also be changed with motor weaknesses and incoordination.[12] Supplementation with zinc did not impair muscle strength or coordination when tested with bar and bridge tests, indicating that prolongation of ejaculation was not mediated through these mechanisms.

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.
Besides PDE5 inhibitors and among second-line therapies are VCDs which are clear plastic chambers placed over the penis, tightened against the lower abdomen with a mechanism to create a vacuum inside the chamber. This directs blood into the penis. If an adequate erection occurs inside the chamber, the patient slips a small constriction band off the end of the VCD and onto the base of the penis. An erection beyond 30 min is not recommended. These devices can be a bit cumbersome, but are very safe.40
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.
In another group of patients suffering from zinc deficiencies, erectile dysfunction was a common complaint among these patients. Patients on hemodialysis due to chronic kidney failure are likely to have depleted levels of many electrolytes. In one study, 100 patients on hemodialysis had their levels of zinc, testosterone, and sex hormones FSH and LH checked before and after zinc supplementation. Patients were instructed to consume 250 milligrams daily of zinc sulfate supplement for 6 weeks. At the conclusion of the study, researchers determined that although there was not a significant alteration in FSH levels, patients noticed a significant difference in LH, testosterone and zinc levels after supplementation. [11] Patients reported improvements in sexual function, but a concrete connection could not be established.

This mineral is needed for a healthy sex life and a deficiency is linked to low testosterone levels which contributes to weaker erections. Zinc supplements can significantly improve matters in the bedroom. Food items loaded with Zinc can include oysters, shellfish, nuts and seeds. Erectile dysfunction and loss of interest in sex life can be caused by many physical and psychological reasons. Keep yourself healthy by consuming these vitamins and a healthy diet that is high in fibre and nutrients. Try to ignore OTC medicines like I-Arginine and other pills, and start including these fresh vegetables, apples, oats and whole grains in your daily life. 

Erection is a complex physiological process in which vascular factors play a pre-eminent role. Therapeutic options for men with arteriogenic erectile dysfunction (ED) are mainly administration of phosphodiesterase type 5 inhibitors, intracavernous injections of vasoactive agents (for example, prostaglandin El, papaverine/phentolamine, or triple drug), intraurethral administration of prostaglandin El, and administration of centrally acting drugs (11, 12). However, all of these methods circumvent the patient's problem temporarily, and patients are not cured of impotence, they will remain dependent on these treatments for the remainder of their sexually active lives. An effective treatment that cures the problem permanently is needed where penile revascularization and exercise remain treatment options for such patients. However, due to the complexity of penile revascularization such as cost ineffectiveness, unavailability of experts, side effects of surgery and high failure rates among the elderly (13) have left people with ED at the mercy of exercise.
Intracavernosal injections remain an excellent treatment option with proven efficacy and safety over time. Baniel and colleagues (2001) treated sildenafil non-responders after radical prostatectomy with intracavernosal injections of vasoactive drugs with 85% success rate. Shabsigh and colleagues (2000) were able to salvage sildenafil non responders with intracavernosal injections of alprostadil. More than 85% improvement in Q3 and Q4 of the IIEF was recorded (Shabsigh et al 2000). The tri-mix combination (papaverine, phentolamine, alprostadil) is certainly the more efficacious drug treatment for erectile dysfunction and can be used in severe cases of erectile dysfunction when intravernous alprostadil fails or it is not preferable due to side effects.
For obvious reasons, ED can be a sensitive subject, one that until relatively recently men were more likely to try to hide than to deal with. Fortunately, a deeper understanding of the variety of causes of erectile dysfunction has led to medications, therapies, and other treatments that can be more individualized and more likely to be effective—and more open discussion about addressing the concern.
Magnesium helps regulate levels of calcium, zinc, and other vitamins and minerals. It also helps the body produce energy and contributes to proper organ function. Most people don’t develop a genuine magnesium deficiency, even if they don’t get enough of the mineral in their diets, according to the University of Maryland Medical Center. A true magnesium deficiency, however, may increase the risk of erectile dysfunction.
SOURCES: Gary Wittert M.D., professor, head of the discipline of medicine, director, Freemasons Foundation Centre for Men's Health, University of Adelaide, and senior consultant endocrinologist, Royal Adelaide Hospital, Australia; David B. Samadi, M.D., chairman, department of urology, chief of robotic surgery, Lenox Hill Hospital, New York; March 28, 2014, Journal of Sexual Medicine
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