If other options sound boring, maybe you should consider a fun, revved-up option like salsa dancing. You and your partner can lose yourself in the music, and it’s an intense exercise that engages the senses, combining cardio, balance, and coordination. Plus salsa dancing is great for keeping weight under control because it burns a lot of calories. Furthermore, it’s an activity that can build self-confidence, and if you’re single, the classes can be terrific for meeting new people. Regular exercise doesn’t have to be drudgery, and there are many types of dance classes that can seriously improve fitness and help you address erectile dysfunction.
At his last visit, Mr. Jones was prescribed Imdur (isosorbide mononitrate) to help with his heart condition. Reading through the notes, it looks like the Imdur worked. He was feeling better, so much better that he wanted to start having sex with his wife again. And here was the problem: Mr. Jone’s doctor had renewed his Cialis prescription. Quickly, I went from a moment of elation to consternation.
Low levels of zinc can be the cause for a variety of health-related problems. Zinc is a key mineral that cells use to metabolize nutrients. Immune function, DNA and protein production, and cell division are all related to zinc levels in the body. Zinc also enables the male body to produce testosterone. Because of this, your levels of zinc may affect erectile dysfunction.
For centuries, men have tried all sorts of natural remedies for erectile dysfunction (ED) -- the repeated inability to get or maintain an erection firm enough for sexual intercourse. But do they really work? It is simply not scientifically known at this point. Furthermore, you take these remedies at your own risk, because their safety profiles have not been established. What follows are commentaries by experts and reviews in the field of alternative treatments that are available over the counter for erectile dysfunction and impotence.
Commercials for drugs to improve “low T,” or testosterone, the male hormone, are now vying for airtime, but they address desire, not performance. "Male hormone is not an approved treatment for erectile dysfunction," notes Bennett. "It may be used to increase desire in men who have low testosterone, but it doesn’t improve blood flow to an erection." A doctor can do a blood test to check you for low testosterone, but it is a rare cause of ED. Hormone therapy with injections, patches, or gels applied to the skin may improve mood and sex drive, but it likely won’t fix any mechanical issues. Also, testosterone drugs should not be used by men with prostate cancer. Side effects include acne, breast enlargement, prostate enlargement, and fluid retention.

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).


It is important to understand that ED is frequently, if not usually, directly related to endothelial dysfunction, and that the release of NO by the vasculature of the penile arteries is directly related to the function of intact, healthy endothelium. In the face of endothelial dysfunction, the process of erection fails to occur in a normal fashion.16
While balancing your sexual focus is singularly the most important aspect of solving a sexual dysfunction challenge, it's important to also address the physical component. This is especially true if you are over 40, or suffer from erectile dysfunction. Exercise increases blood flow and helps your body eliminate toxins. As well as this, exercise also improves your strength, stamina and form.
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.
"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.
For many men, stopping smoking is an erectile dysfunction remedy, particularly when ED is the result of vascular disease, which occurs when blood supply to the penis becomes restricted because of blockage or narrowing of the arteries. Smoking and even smokeless tobacco can also cause the narrowing of important blood vessels and have the same negative impact. 
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

Watts and coworkers, in their review article, make several points about this ED/CAD nexus. Endothelial dysfunction is present in both CVD and ED, and is linked through the NO mechanism. The authors note that PDE5 inhibitors improve endothelial function and have a salutary effect on both CVD and ED. Both ED and cardiac disease respond to modifications in lifestyle as well as pharmacologic manipulation. These authors also report that the presence of ED gives the clinician an opportunity to assess CVD and prevention as well.20


"Erectile dysfunction can be a very serious issue because it's a marker of underlying cardiovascular disease, and it often occurs before heart conditions become apparent. Therefore, men should consider improving their weight and overall nutrition, exercise more, drink less alcohol and have a better night's sleep, as well as address risk factors such as diabetes, high blood pressure and cholesterol.
After two hours of zinc treatment, male rats were individually caged and kept for 15 minutes for adaptation. One estrous (receptive) and one diestrous (nonreceptive) female were introduced to each cage and the duration of physical contact with each female was recorded for 15 minutes. Partner preference index (PPI) was calculated as the difference between the time spent with estrous female and diestrous female. Positive indices indicate their positive sexual interest.[12]
"Erections are good for your penis, and probably good for mental health. Taking medication for erections may also be good for a man's overall health. This is the first study to look at long-term treatment to improve erectile function in men, but the sample is too small to definitively answer the question. We really need a big study with a long follow-up to know the answers." Mulhall, who was not involved in the study, is an associate professor and director of sexual medicine in the departments of urology at Weill Medical College of Cornell University and Memorial Sloan-Kettering Cancer Center in New York.
Other factors that “stress” the body can also increase your risk for ED. These include: substance abuse, using marijuana, smoking cigarettes, depression, anxiety and low self esteem. Cigarette smoking — or using nicotine — leads to constricted blood vessels, which has negative effects for sexual health. Other mental/emotional obstacles can cause less desire for sex and decrease testosterone. Several ways to help manage stress include:
The Institute of Medicine recommends cumulative daily vitamin D intake of 600 international units (IU) for adults between 18 and 70 years of age , and 800 IU for those over 80. A 3oz serving of salmon contains about 450IU, while an 8oz. glass of milk only has about 100IU. Low vitamin D levels may be an independent, potentially modifiable risk for ED, so it’s worth taking Vitamin D supplements for your “D.” However, keep your daily vitamin D supplement intake below 4,000IU, as too much vitamin D can be toxic.
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.
Getting too little zinc in your diet may result in a deficiency, which can cause hair loss, impaired immune function, poor would healing and impotence in men, according to the Office of Dietary Supplements. Low zinc levels in men are linked to low sperm and male infertility, according to a study published in the journal Scientific Reports in March 2016. Due to the high number of elderly people who are deficient in zinc, Oregon State University suggests elderly men take a daily zinc supplement containing the zinc RDA, or 11 milligrams of zinc, daily.
A study published in May 2014 in The Journal of Sexual Medicine found that some men can reverse erectile dysfunction with healthy lifestyle changes, such as exercise, weight loss, a varied diet, and good sleep. The Australian researchers also showed that even if erectile dysfunction medication is required, it's likely to be more effective if you implement these healthy lifestyle changes.
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