Eastern medicine should be fully exploited, and integrated with modern medicine to combine the advantages of both TCM and Western medicine. More research should be conducted into the efficacy and safety of TCM, and integration of TCM and Western medicine may provide promising breakthroughs in future clinical treatment. This strategy may allow for the development of new therapeutic strategies based on concepts of TCM and integrated medicine. There is a need for multimodal therapy and holistic approach to treat men (and their partners) with ED through complementary use of herbal supplements and modern drug to optimize underlying medical comorbidities; acupuncture, exercise or massage to reduce stress and strengthen the body; introduction and escalation of various medical therapy with use of mechanical therapy to further enhance penile erection; and lastly surgical intervention in suboptimal or refractory ED cases.
According to Daneshgari, "Your best bet is to eat a healthy diet that is good for your heart and your circulation." Other foods that are good for your circulation include cranberries, apples, peanuts, onions, tea, and red wine. Chances are, if you take good care of your vascular health, you will avoid many of the common causes of erectile dysfunction.
Tribulus terrestris is a dicotyledonous herbal plant of the Zygophyllaceae family, used to increase serum testosterone levels, which has only been shown in animal studies (40). A prospective, randomized, double blind study of 30 men showed that Tribulus terrestris was not more effective than placebo on improving IIEF scores or serum total testosterone (41). Two accounts of hepato-nephrotoxicity have been reported in young men who ingested high doses of this herbal medication (42,43).
There are so many potential reasons a man might develop erectile dysfunction (ED), it's nearly impossible to generalize the best ways to treat it. What works for one man may not work for another simply because they are having problems for different reasons. That said, it may encouraging to hear that there are a variety of options that may be considered, from psychological counseling to lifestyle changes, medications to treatments and devices.

A variety of personal habits and lifestyle choices have been linked to ED. In some ways, this is a good thing, since habits can be broken and choices reconsidered. What's more, many of the lifestyle factors that contribute to sexual problems are ones that affect overall health and well-being, both physical and mental. Addressing these factors, therefore, can have benefits beyond improving erectile dysfunction.
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. 
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.
Dan practices a unique blend of conventional and holistic medicine, drawing on his extensive experience with integrative techniques like healing touch, guided imagery and yoga. By fostering an understanding of the deep connections between body, mind and spirit, Dan seeks to help every patient unlock his or her own innate healing ability. He received his MD from the Hahnemann College of Medicine and completed his residency in family practice through UCSF. Dan is a fellow of the Wilderness Medical Society, is a clinical instructor at UCSF, and is certified with both the American Board of Family Medicine and the American Board of Holistic Medicine. Dan is a One Medical Group provider and sees patients in our San Francisco offices.
Ginseng, specifically “red ginseng,” is known as the “herbal Viagra” that helps puts to rest men’s bedroom woes. Red ginseng is when the root has been steamed and then dried. The ginseng root is the part of the plant that is mostly used as a natural remedy when in its supplement form. However, the plant must be grown for a minimum of five years before it can be used. In a 2008 review, seven studies on red ginseng and ED, ranging in dosages from 600 to 1,000 milligrams three times a day, were found to provide evidence for the effectiveness of the herb in ED treatment.
Another age-old therapy for ED is acupuncture. This is an ancient Chinese treatment where thin needles are inserted into specific points of the body to relieve all kinds of illnesses. Acupuncture has been used to treat ED for years. Studies show that acupuncture improves erection as well as in the treatment of erectile dysfunction with psychological cause.18
When it comes to scientific development, in Western medicine, an analytic approach is often used to identify and resolve medical challenges. A hypothesis is first derived through general observations of a phenomenon. A research plan is then carefully designed and data collected. Once sufficient data is collected, critical statistical evaluations are done and conclusions are drawn (4). Every aspects of a disease entity are studied from macroscopic to microscopic views, down to the cellular and molecular levels. The deep understanding of the role of cGMP-specific phosphodiesterase type 5 enzymes in ED and the use of phosphodiesterase-5 inhibitors in treatment of ED exemplifies the success of this approach.
The definition of erectile dysfunction (ED) is the inability to obtain or maintain an erection firm enough for sexual intercourse. Historically, admitting to having ED was considered taboo and downright embarrassing until the advent of sildenafil citrate (Viagra) in 1998. Sildenafil liberated men from the stigma of having ED, and it opened a conversation about a problem that has existed for centuries. Up to 10% of men younger than forty suffer from ED and upwards of 60% by age 69.1
For example, you’ll often hear that watermelon is a great remedy for ED.  This belief seems to come from a study done in 20075, which showed that consuming watermelon could raised levels of L-arginine in the bloodstream.  L-arginine is used in the production of nitric oxide (NO), which is a key to healthy erections (see our article, “How Do Erections Work“).  However, the study did not show that consuming watermelon actually improved erections.  Also, the subjects consumed the equivalent of three eight-ounce glasses of watermelon juice per day!
For patients who failed oral medical therapy or unable to tolerate the side effects, intracavernosal injection of vasoactive agents can often provide effective alternative. Various vasoactive agents such as alprostadil, papaverine or phentolamine have been used either as single agent or combination agents to potentiate the NO release and cavernosal smooth muscle vasodilation. However, intracavernosal injection therapy has high attrition rate and can be associated pain especially with alprostadil injection (2). The practice of isolating compounds and understanding its pharmacological attributes before using it as a drug therapy has been a strength of Western medicine.
B-vitamin complex helps to support normal energy production and is also essential for supporting the normal functioning of the body during times of stress. Stress quickly depletes the body’s reserves of the B vitamins. Look for a B-complex containing 20-50 mg of vitamins B1, B2, and B3. The other B vitamins should be included in their relative proportions.
The polyphenol- and antioxidant-rich pomegranate is said to aid blood circulation, help reduce stress, reduce oxidative stress in diabetics, is anticarcinogenic, anti-inflammatory, and much more. It is also believed to effectively protect men against erectile dysfunction and even male infertility. A study using a rabbit model of ED measured the effect of pomegranate juice concentrate on intracavernous blood flow and penile erection. The study found that consuming 3.87 mL pomegranate juice concentrate daily for eight weeks significantly increased intracavernous blood flow and smooth muscle relaxation, probably because of its antioxidant effect. No wonder then that pomegranate juice is yet another popular natural remedy for ED.11
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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