To understand the physiology of erectile dysfunction, we need to know erection first. An erection occurs when impulses from the brain and genital nerves cause blood to fill the two chambers known as the corpora cavernosa in the male penis. This causes the penis to expand and stiffen. Anything that blocks these impulses or restricts blood flow to the penis can result in ED. This block may be caused by psychological, neurologic, hormonal, arterial, or cavernosal impairment or even from a combination of all these factors.3
In a prospective human phase 1 open-label and single-arm study reported by Haahr et al. (27), 17 men with refractory post radical prostatectomy ED were given a single intracavernosal injection of autologous adipose-derived regenerative cells (ADRCs) freshly isolated after a liposuction. The procedures were well-tolerated and over a 6-month follow-up period, 8 of 17 men showed improvement of their erectile function.
The use of shock wave therapy has revolutionized the treatment of many aspects of medicine. High intensity extracorporeal shockwave therapy has been used for the treatment of nephro-urolithiasis while medium intensity shockwave therapy is used by orthopaedic surgeons to treat joint pain as well as tendinitis. Low intensity shockwaves therapy was first noted to improve ischaemia-induced myocardial dysfunction in animal studies when low intensity shockwaves were applied to porcine myocardium (13). Shockwaves induces a localized stress on cell membranes in the same way that shear stress affects endothelial cell membranes (14) and this triggers the release of angiogenic factors, such as increased NO production through increased activity of endothelial NO synthase (eNOS) and neuronal NO synthase (nNOS), platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) (15). These shockwaves also cause membrane hyperpolarization (16), activation of the Ras signaling pathway, non-enzymatic synthesis of NO and induction of stress fibers and intercellular gaps (17).
The natural remedy to ED is a healthy lifestyle that can “reverse” ED naturally, as opposed to “managing” it. Since ED can be considered a “chronic disease,” healthy lifestyle choices can reverse it, prevent its progression and even prevent its onset. Since sexual functioning is based upon many body components working harmoniously (central and peripheral nervous system, hormone system, blood vessel system, smooth and skeletal muscles), the first-line approach is to nurture every cell, tissue and organ in the body. This translates to achieving “fighting” weight, adopting a smart heart-healthy and penis-healthy diet (whole foods, nutrient-dense, calorie-light, avoiding processed and refined junk foods), exercising moderately, losing the tobacco habit, consuming alcohol in moderation, stress reduction (yoga, meditation, massage, hot baths, whatever it takes, etc.), and getting adequate quantity and quality of sleep. Aside from general exercises (cardio, core, strength and flexibility training), specific pelvic floor muscle exercises (“man-Kegels”) are beneficial to improve the strength, power and endurance of the penile “rigidity” muscles. If a healthy lifestyle can be adopted, sexual function will often improve dramatically, in parallel to overall health improvements. Since many medications have side effects that negatively impact sexual function, a bonus of lifestyle improvement is potentially needing lower dosages or perhaps eliminating medications (blood pressure, cholesterol, diabetic meds, etc.), which can further improve sexual function. Eat real food and avoid refined, over-processed, nutritionally-empty foods and be moderate with the consumption of animal fats and dairy. Processed meats and charred meats should be avoided. A healthy diet should include whole grains and plenty of vegetables and fruits, particularly those that contain powerful antioxidants, vitamins, minerals and fiber.

It’s the truth: You reach a certain age where having sex isn’t as easy or satisfying as it used to be. Many factors can contribute to erectile dysfunction (ED) — anything from smoking to cardiovascular disease to general stress — and you shouldn’t be shy about discussing any erectile problems with your doctor. If there’s an underlying health condition causing your troubles, treating the cause may get you back to top form in no time.
Coffee / Caffeine.  A study found that men who consume the equivalent of 2-3 cups of coffee per day have a 39% lower incidence of erectile dysfunction than men who do not drink coffee11. Although the study showed a correlation between drinking coffee and  a lowered incidence of ED, it did not demonstrate a causative relationship.  Note that consuming larger amounts of coffee can raise stress and adrenaline levels, and can actually contribute to ED.
A daily dose of niacin improves erectile function, particularly in men with high cholesterol, according to a 2011 study in The Journal of Sexual Medicine. The vitamin helps increase blood flow and reduce inflammation—one of the underlying causes of both high cholesterol and erectile dysfunction. “Vitamin B3 is also used to make sex hormones and other important chemical-signal molecules,” says Fisch. Like many of the others on our list, this tablet is most powerful when taken in conjunction with others: A cocktail of propionyl, L-carnitine, L-arginine, and niacin taken for three months improved 40% of erections in a study from researchers at Sapienza University of Rome in Italy.

Older age. A man’s risk increases past the age of 40, as age is the variable most strongly associated with impotence. This is due to changing hormones, higher risk for heart problems and those affecting circulation, and decreased sexual desire that often occurs with increasing age. For example, based on findings from the National Health and Social Life Survey, it’s been found that “men between 50–60 years old are more than 3 times as likely to experience erection problems and to report low sexual desire compared to men aged 18 to 29 years.” (3)
Impotence, also called erectile dysfunction (ED), can be a very frustrating problem. Some men are able to achieve an erection but are not able to maintain one. Others are not able to achieve one at all. Causes of impotence can be both physiological (affecting mostly the body and organs) or psychological (affecting the mind). Luckily, there are natural remedies for impotence you can try.

Forgetfulness. Illness. Sadness Treatment of Pseudo Dementia For the treatment of pseudo dementia first find out the sign and symptoms of the disease. If the depression treated immediately then the sign of pseudo dementia will clear. Use antidepressant to cure the pseudo dementia. Screening tool test help to identify the root cause of the pseudo dementia. Blood test help to the physician to find out the neurological disorders.
Another common cause of ED for many men is stress. When the body is under stress—either mental or physical—the sympathetic nervous system kicks in, releasing a cascade of stress hormones. Chronic stress leads to elevated levels of these hormones, which can lead to weight gain around the middle, and remember, those excess fat cells convert testosterone to estrogen. Stress also reduces sexual drive and leaves very little physical energy for sex. If chronic stress is a problem, try these supplements:
Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. The One Medical Group entities and 1Life Healthcare, Inc. make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.
If you have symptoms of ED, it’s important to check with your doctor before trying any treatments on your own. This is because ED can be a sign of other health problems. For instance, heart disease or high cholesterol could cause ED symptoms. With a diagnosis, your doctor could recommend a number of steps that would likely improve both your heart health and your ED. These steps include lowering your cholesterol, reducing your weight, or taking medications to unclog your blood vessels.
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