A study in the Journal of Sexual Medicine found that a large percentage of men with ED also have low levels of vitamin D. If you’re experiencing ED, you may want to have your level of vitamin D checked. Other symptoms of a low vitamin D level may be too subtle to notice. However, if you have serious vitamin D deficiency, you may have bone pain or muscle weakness. Vitamin D levels can be checked with a simple blood test and for most people corrected with a supplement.
Following the breakthrough in ED treatment using PDE5-inhibitors, Western medicine has now moved on to a new frontier of regenerative medicine, with stem cell and gene therapy leading the way (25). There is a practical need for novel therapy as a significant portion of diabetic or post-prostatectomy ED patients do not respond to oral pharmacotherapy. To date, stem cells derived from different sites including adipose tissue-derived stem cells, bone marrow mesenchymal stem cells and muscle-derived stem cells have been investigated using animal models for ED, to study their effects on neural, vascular, endothelial or smooth muscle regeneration (25,26).
There are currently two models of the inflatable penile prosthesis (IPP), namely, the two-piece IPP vs. the three-piece IPP. The three-piece IPP consists of a pair of corporal cylinders, a scrotal pump and an abdominal reservoir filled with saline. Owing to the presence of the reservoir, the corporal cylinders can be completely deflated to give the patient the physiological flaccid state when not in use, and likewise a maximally turgid state when inflated (21). The two-piece IPP lacks an abdominal reservoir and is often offered in patients with whom placement of reservoir is challenging or not possible such as following radical cysto-prostatectomy with orthotopic ileal neobladder creation, or patients who had previous open book fracture of the pelvis with metal implants. The concept of ectopic reservoir placement has allowed many of these men the option for three-piece IPP placement (22). Technological advances have improved mechanical reliability, reduced prosthesis infection risk and offered excellent patient and partner satisfaction rate (23).
Contrary to popular belief, the penis does not have a mind of its own. To make it a fine and upstanding specimen, your neurons must be co-ordinated with military precision. You need thiamine, aka vitamin B1, for a healthy nervous system, so eat pork to help fire your swimmers in the right direction. Can’t or don’t eat pig? Get your B from beans and wholemeal bread.
The penile roots are enveloped by two pelvic floor muscles, the bulbocavernosus (BC) and the ischiocavernosus (IC). The IC muscle is the “erector muscle” and the BC muscle the “ejaculator muscle.” The BC and IC muscles are responsible for the ability to lift one’s erect penis up and down (wag the penis) as they are contracted and relaxed. Although not muscles of glamour, they are certainly muscles of “amour.” Although unseen and behind-the-scenes, hidden from view, these often unrecognized and misunderstood muscles have vital functions in addition to erection and ejaculation. When the pelvic floor muscles are not functioning optimally, one loses the potential for full erectile rigidity. Like other skeletal muscles, they can undergo “disuse atrophy,” becoming thinner, flabbier and less functional with aging, weight gain, sedentary lifestyles, poor posture, chronic straining and other forms of trauma, including pelvic surgery (e.g., prostatectomy). Exercising them can enhance sexual health; maintain sexual health; help prevent the occurrence of ED in the future; and help manage ED. Specifically, pelvic floor exercises can be beneficial with respect to the following spectrum of issues: ED; ejaculation issues including premature ejaculation; urinary incontinence; overactive bladder; post-void dribbling; and bowel urgency and incontinence. One of the challenges of pelvic floor training is that most men do not know where their pelvic muscles are located, what they do, how to exercise them, and what benefits exercising them may confer. In fact, many men don’t even know that they have pelvic floor muscles. Because they are out of sight, they are often out of mind and not considered when it comes to exercise and fitness. However, although concealed from view, they deserve serious respect as they are responsible for vital functions that can be enhanced when intensified by training. Pelvic floor muscle training before and after prostate cancer surgery can facilitate the resumption of urinary control and sexual function after surgery. Pelvic floor training is also useful for men who suffer with stress urinary incontinence following prostatectomy. This is a spurt-like urinary leakage that occurs at times of increased abdominal pressure, such as with sports and other high impact activities. Pelvic floor contractions on demand are a technique in which the pelvic muscles are braced and briskly engaged at the time or just before any activity that triggers the stress incontinence. When practiced diligently, this can ultimately become an automatic behavior and the incontinence improved, if not resolved.
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:

Following the breakthrough in ED treatment using PDE5-inhibitors, Western medicine has now moved on to a new frontier of regenerative medicine, with stem cell and gene therapy leading the way (25). There is a practical need for novel therapy as a significant portion of diabetic or post-prostatectomy ED patients do not respond to oral pharmacotherapy. To date, stem cells derived from different sites including adipose tissue-derived stem cells, bone marrow mesenchymal stem cells and muscle-derived stem cells have been investigated using animal models for ED, to study their effects on neural, vascular, endothelial or smooth muscle regeneration (25,26).


Researchers discovered men who regularly consumed flavanoid-rich foods—especially those with anthocyanins, flavones, and flavanones—experienced a significantly reduced risk of the disorder than those who did not. Good news since the foods are already popular in American diets. Lead researcher Aedin Cassidy says, “…the top sources of anthocyanins, flavones and flavanones consumed in the U.S. are strawberries, blueberries, red wine, apples, pears and citrus products.”
This treat may have perks below the belt. An ounce a few times a week can help your ticker -- and what’s good for your heart could be good for other parts, too. Chocolate is rich in flavanols, plant nutrients that can increase blood flow and lower blood pressure. It also helps your body make more of nitric oxide, which can help with erections and is in many ED medications.
Ditto on the rubbing of the pants. Quite uncomfortable. When mine gets really bad, my testicles have a pins and needles like sensation, and shrink up as well. They also ache when hanging though, this is very odd that our symptoms match up so well. But "nothing is wrong with us". Well, thats what i was told at least. The urologist said "thats your penis' natural reaction to cold or adrenaline.
She is ‘a pile of mashed potatoes’, her breasts are a ‘tragedy’, she looks terrible in clothes but even worse when nude, wanted surgery for ‘a quick fix’ because she is too lazy to exercise, she has never looked worse, etc … and you are faking erectile dysfunction because you do not want to talk about the fact that you are still crying over a breast reduction that you didn’t want her to get.

In total, 24 RCTs, including 2080 patients with ED, were identified. Among these, 12 evaluated monopreparations (five ginseng [n = 399], three saffron [n = 397], two Tribulus terrestris [n = 202], and one each Pinus pinaster [n = 21] and Lepidium meyenii [n = 50]), seven evaluated formulations (n = 544), and five investigated dietary supplements in combination with pure compounds (n = 410). Ginseng significantly improved erectile function (International Index of Erectile Function [IIEF]-5 score: 140 ginseng, 96 placebo; standardized mean difference [SMD] 0.43; 95% confidence interval [CI] 0.15-0.70; P < 0.01; I2 = 0), P. pinaster and L. meyenii showed very preliminary positive results, and saffron and T. terrestris treatment produced mixed results. Several herbal formulations were associated with a decrease of IIEF-5 or IIEF-15, although the results were preliminary. The quality of the included studies varied, with only seven having a prevalent low risk of bias. The median methodological quality Jadad score was three out of a maximum of five. Adverse events were recorded in 19 of 24 trials, with no significant differences between placebo and verum in placebo-controlled studies.


Information on this website is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information on this website for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. Any third party offering or advertising on this website does not constitute an endorsement by Andrew Weil, M.D. or Healthy Lifestyle Brands.
L-arginine is an amino acid that is necessary for the lining of the blood vessels to produce nitric oxide. Nitric oxide allows the blood vessels to relax, thus improving blood flow throughout the body, including to the penis. Studies on L-arginine and erectile dysfunction have used between 2,000-5,000 mg a day in divided doses.ii Supplemental arginine is best taken on an empty stomach.3
Diseases like diabetes, cardiovascular disease, atherosclerosis, kidney disease, obesity, multiple sclerosis, and depression, and activities like bicycling, smoking, alcohol or drug abuse can impair blood flow or nerve impulses throughout the body. Surgery, as well as certain medications, can also result in ED. However, this may be a temporary problem.4
Usually patients will try less invasive alternatives to treat impotence before opting for surgery. These alternatives may include supplements, herbs, lifestyle changes and even medications. In cases where other treatments do not work to resolve ED, surgery might be a last-resort option. Surgery involves implanting a penile prosthesis. This is a saline-filled silicone device or a malleable device. Although the likelihood of serious side effects is considered to be low, certain risks are associated with surgery to correct erectile dysfunction. These side effects may include: anesthetic risk, device infection, and device malfunction or mechanical failure. Some studies have found that five years following surgery around 10–20 percent of men experience device malfunction and failure. Infection rates are low. Around one percent of men who opt for this type of surgery get an infection.
Yohimbine. This chemical is found in the bark of an African tree called yohimbe. It has been used as a male aphrodisiac in Africa, and under medical supervision it has been used as a prescription drug to treat ED. Supplements made from yohimbe bark are also available without a prescription, but they can be life-threatening if used at high doses, according to the Natural Medicines Comprehensive Database. The supplement can interact in a harmful way with certain drugs, such as blood pressure medications, and should be avoided by anyone with liver, kidney, heart, or diabetes problems or problems with anxiety or depression. Like DHEA, yohimbine should not be taken without a doctor's supervision.
Spice up your love life with chillies. When your face flushes after eating a curry, that’s the blood vessels expanding thanks to the effect of the chillies. And it’s not just the blood vessels in your face that get the boost. Biologically speaking a hard-on is simple hydraulics – more liquid (blood) being forced into little tubes (blood vessels) in your penis – so what you need is a strong heart and smooth, healthy pipework.
DHEA. Testosterone is essential for a healthy libido and normal sexual function, and erectile dysfunction sufferers known to have low testosterone improve when placed on prescription testosterone replacement therapy. Similarly, studies have shown that taking over-the-counter supplements containing DHEA, a hormone that the body converts to testosterone and estrogen, can help alleviate some cases of ED. But DHEA can cause problems, including suppression of pituitary function, acne, hair loss and its long-term safety is unknown, says McCullough. For this reason, many experts discourage use of the supplements.
The diagnosis of erectile dysfunction requires a comprehensive sexual and medical history that include a validated questionnaire, the Sexual Health Inventory for Men (SHIM), and asking if they experience a rigid erection at night, in the morning, or during masturbatory approaches. The presence of rigid morning or night erections, or rigid erections at any sexual thought suggests a mainly psychogenic cause. Conversely, erectile dysfunction with a gradual onset, progressive course, or long duration suggests a predominantly organic cause.
In addition to being leaner and lower in calories than conventional cuts, grass-fed beef offers a host of benefits, from muscle-building to fat-burning to heart protection. You can add assistance in the bedroom to its list of good qualities; it’s an excellent source of Vitamin B12. A recent report from Harvard University highlighted a study that has linked low levels of B12 to erectile dysfunction. So, eat up! Bonus: It’s one of the healthy fats that actually makes you skinny.
Most importantly, herbal supplements are not well regulated in the United States.  Studies have shown that 40-50% of herbal supplements do not even contain the supposed main ingredient, and many contain substances that are not listed which may have dangerous side effects2.  Another study found that over two thirds of the products tested had substituted other plant species for the plants listed on the label, and a third of products also contained other fillers or contaminants3.  A study by the New York State Attorney General of herbal products sold at GNC, Target, Walgreens, and Walmart found that four out of every five products didn’t contain the ingredient they claimed!  Fourteen US states and territories have petitioned Congress to regulate the herbal supplements industry.
Erectile dysfunction can occur for various reasons. A health condition, an emotional or relationship problem, a certain medication, smoking, drugs, and alcohol all have the potential to cause ED. Some people want a quick fix, so they rush to their doctor hoping to get medication, not knowing that there are natural home remedies for erectile dysfunction.
Yohimbe. Before Viagra and the other prescription erectile dysfunction drugs became available, doctors sometimes prescribed a derivative of the herb yohimbe (yohimbine hydrochloride) to their patients suffering from ED. But experts say the medication is not particularly effective, and it can cause jitteriness and other problems. "It's not a great drug," says McCullough. "And I suspect the herb is not as potent as the pharmaceutical version." What's more, evidence shows that yohimbe is associated with high blood pressure, anxiety, headache, and other health problems. Experts discourage its use.

"This is the first study to look at the association between flavonoids and erectile dysfunction, which affects up to half of all middle-aged and older men," said lead researcher, Professor Aedin Cassidy. "Men who regularly consumed foods high in these flavonoids were less likely to suffer erectile dysfunction. In terms of quantities, we're talking just a few portions a week."
Processed Foods tend to have fat, salt, and sugar added to them, as well as preservatives and other chemical additives that can be harmful to your health. Processed foods include frozen foods, canned foods, processed meats, and many snack foods. Some research links eating processed foods to depression, which is something that can cause erectile dysfunction.
Leafy green vegetables, like celery and spinach, may increase circulation because of their high concentration of nitrates. Beet juice has been found to be really high in nitrates. Nitrates are vasodilators, which means they open up blood vessels and increase blood flow. Many years before the U.S. Food and Drug Administration approved the first ED drug in 1998, several case reports on the beneficial effects of nitrates for erectile dysfunction had already been published. The ED drugs used today are based on the relaxing effects of nitrates on the blood vessels that supply the penis.

The article discusses erectile dysfunction (ED) with the special emphasis on epidemiology, as well as the currently available medical treatments. Describing treatment methods authors paid special attention to natural therapies (as Panax ginseng, Tribulus terrestris, Vaccinium macrocarpon), because taking into consideration their safety profile, they appear to be an important alternative to therapies with synthetic molecules. From substances of natural origin, extract from the fruit of Tribulus terrestris ranks itself high on in collation at the end. The results of most clinical trials and experiments clearly demonstrate its effectiveness in improving sexual function in men.
Leafy green vegetables, like celery and spinach, may increase circulation because of their high concentration of nitrates. Beet juice has been found to be really high in nitrates. Nitrates are vasodilators, which means they open up blood vessels and increase blood flow. Many years before the U.S. Food and Drug Administration approved the first ED drug in 1998, several case reports on the beneficial effects of nitrates for erectile dysfunction had already been published. The ED drugs used today are based on the relaxing effects of nitrates on the blood vessels that supply the penis.

Yohimbine is an indole alkaloid derived from the bark of the African yohimbe tree (33). Yohimbine has been noted to treat fatigue, depression, diabetes, and sexual dysfunction. A meta-analysis of seven placebo-controlled trials (34) deemed yohimbine superior to placebo for the treatment of ED with rare adverse events. The proposed mechanism of action (35) is via the inhibition of central alpha-2-adrenergic receptors, decreasing central inhibition of arousal, and increasing penile nerve stimulation resulting in increased NO. Common side effects include headache, sweating, agitation, hypertension and insomnia. Contraindications include patients on tricyclic antidepressants, anti-hypertensives and central nervous system stimulants.


Recent University of Texas findings suggest that men who drink two to three cups of java a day—or 85 to 170 milligrams of caffeine from other beverages—are 42 percent less likely to have erectile dysfunction than those who consume up to seven milligrams of the stimulant daily. And those who throw back four to seven cups were 39 percent less likely to have the condition than their less jittery counterparts. The trend holds true among overweight, obese and hypertensive men, but not for those with diabetes, a condition that often causes the issue. So, how exactly does drinking coffee keep things going strong? The scientists say that the stimulant triggers a series of reactions in the body that ultimately increase blood flow south. And get the abs you want—quickly—and melt up to 10 pounds in one week with our new diet plan, The 7-Day Flat-Belly Tea Cleanse!
If you’re looking for a way to simultaneously boost your libido and calm those pre-date jitters, pour yourself a glass of red wine. According to a study printed in Nutrition Journal, vino could elevate your testosterone levels. In lab tests, researchers found that quercetin, a compound in wine, blocks an enzyme that causes the body to excrete testosterone, thereby increasing the amount of T circulating in the blood. Wine’s rich antioxidant profile also triggers nitric oxide production, which relaxes artery walls. This increases blood flow down south, creating feelings of erotic excitement. For some great picks for your next tipple, check out our 16 best wines for weight loss.
This treat may have perks below the belt. An ounce a few times a week can help your ticker -- and what’s good for your heart could be good for other parts, too. Chocolate is rich in flavanols, plant nutrients that can increase blood flow and lower blood pressure. It also helps your body make more of nitric oxide, which can help with erections and is in many ED medications.
Ginkgo biloba may increase blood flow to the penis. Researchers discovered the effect of gingko on ED when male participants in a memory enhancement study reported improved erections. Another trial saw improvement in sexual function in 76 percent of the men who were on antidepressant medication. This is why researchers believe that ginkgo may be effective for men who are experiencing ED due to medication.

A combination of yohimbine and L-arginine is shown to significantly improve erectile function in people with ED. L-arginine is an amino acid that helps expand blood vessels. It’s regarded as safe and effective for ED but can cause side effects like nausea, diarrhea, and stomach cramps. Avoid taking L-arginine with Viagra, nitrates, or any high blood pressure medications.


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Need a snack? Choose nuts, researchers from Turkey suggest. After 17 men with ED ate 100 grams of pistachios for three weeks, they all reported a significant improvement in their erectile function, ability to orgasm, libido, sexual satisfaction, and overall happiness in life. As a bonus, they all had higher HDL, or “good,” cholesterol and lower LDL, or “bad,” cholesterol, too.
Men looking to boost their sperm quality should head to the fish counter, research suggests. Sperm size and shape — one marker used to evaluate male infertility — was better in men who ate the most white meat fish as compared to men who ate the least, a study published in The Journal of Nutrition showed. And total sperm count was about 34 percent higher among men who ate the most dark meat fish, like salmon and tuna, than men who ate the least amount of fish. Meanwhile, men who reported eating one to three servings of processed meat had worse sperm morphology (shape) than men who ate the fewest servings. Click here to discover How Tilapia is Worse Than Bacon!!!
The Epimedium plant is a flowering perennial found throughout Asia and parts of the Mediterranean. Horny Goat Weed’s active ingredient is icariin, a falvonol glycoside and reputed to improve cardiovascular function, hormone regulation, modulation of immunological function and antitumor activity (44). Icariin has also been shown to have a PDE5i effect. Animal studies have been carried out showing improvements in penile hemodynamic parameters. There is one report of tachyarrhythmia and hypomania with the use of this herb (45).
If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction. Long lasting erections may associated with pain due to the lack of oxygen to the penis because the penis is filled with oxygen deplete venous blood. Peyronie’s disease (a scarring of some of the deep tissues in the penis) can have a localized area of pain but usually involves a lump and some deviation of the erection to the affected side.
Erectile dysfunction (ED) is the inability to get an erection or to keep one that's firm enough or that lasts long enough for a man to have a satisfying sexual experience. Occasional bouts of ED aren't unusual. In fact, as many as one in five men deal with erectile dysfunction to some degree. Symptoms, of course, are rather obvious. And while age can be a risk factor, so can medication use, health conditions, lifestyle factors (like smoking), and other concerns. Treatment is available and may involve prescriptions, habit changes, or other options.
While there isn’t a lot of scientific evidence that supports using herbs to increase sexual urges, most of these supplements won’t hurt you. Try classic libido-enhancing herbs like maca, tribulus, rhodiola, ginseng, omega-3s, DHEA, and L-arginine. But be sure to consult your doctor first if you take blood thinners or other medications for heart health.
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The development of PDE5-inhibitors is a clear example of how Western medicine approached the problem of ED differently from Eastern medicine. The erectogenic effect of sildenafil (Viagra®) was discovered by accident when patients undergoing heart clinical trials reported better erections as a side effect after taking sildenafil. This observation led to further elucidation of the NO/cGMP signalling pathway and development of PDE5-inhibitors as a first-line therapy in ED (5).
"Evidence that foods can help with ED is probably related to a vascular connection," says Firouz Daneshgari, MD, professor and chairman of the department of urology at Case Western Reserve University School of Medicine and University Hospitals Case Medical Center in Cleveland. "Erectile problems are usually due to not having a good blood supply to the penis, so foods that are good for your vascular system may also help prevent ED." Should you eat more of the foods containing these key nutrients?
If i do attain an erection i feel like im going to loose it (weak erection mainly) has anybody had or heard of a reversal to address erection issues/ erectile dysfunction, and if so has it worked to fix the issues?? Im considering paying for a reversal, just worry it may make my issues worse, whereby i could potentially not get an erection permanently. is anybody aware of a successful reversal to fix erection issues post vasectomy ??

ED is often treated with psychotherapy, behavior modification techniques, oral medications, locally injected drugs, vacuum devices, and sometimes even surgically implanted devices. In rare cases, surgery of the blood vessels may be necessary. In most cases, even when a physical cause is identified, emotional or psychological factors play a role as well.
According to legend, Casanova — the Tinder master of his time — regularly ate a breakfast of 50 oysters. Turns out he could’ve doubled as a nutritionist if he’d been able to get out of the sack. In addition to being high in B12, oysters contain more zinc than any other food source ( almost five times your daily DV). This nutrient is essential for testosterone production, and when your T levels droop, so does your business. Like other bivalves, oysters are high in D-aspartic acid, an amino acid that has been shown to temporarily boost low testosterone levels and improve sperm quality in infertile men.

Nature’s ultimate example of truth in advertising, chili peppers bring the heat. They contain capsaicin, a natural chemical that lends spicy food its pleasurable pain and has serious fat-burning and libido-revving benefits. Research has shown that it boosts testosterone and increases circulation — all good news for your erection and what you do with it. Capsaicin also boosts the release of endorphins, which in turn stimulate desire.
Poor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones. 
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