Cavallini, G., Modenini, F., Vitali, G., & Koverech, A. (2005, November). Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology, 66(5), 1080-5. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429505006515
Physical and emotional stress — whether over-exercising, under-sleeping or just dealing with everyday stressors like work and a busy schedule — causes an increase in “stress hormones,” including cortisol and adrenaline. Stress can lower desire for sex. This is because stress can contribute to fatigue or preoccupation with other tasks. It can also significantly affect blood flow by increasing inflammation.
The search for a cure for erectile dysfunction (ED) dates back way before the introduction of Viagra in the 1990s. Natural aphrodisiacs, from ground rhinoceros horn topa chocolate, have long been used to increase libido, potency, or sexual pleasure. These natural remedies are also popular because they’re said to have fewer side effects than prescribed medications.
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.
When considering vitamin supplementation for erectile dysfunction, one of the first vitamins that you may come across in literature would be Vitamin D. This is a vitamin that can be easily obtained through many types of dairy products like milk, cheese, and yogurt and is also in abundance if you live in a tropical climate. Sunlight is able to give us a natural dose of vitamin D daily. [6] Although vitamin D is usually associated with improving bone strength and prevention osteoporosis, another valuable feat of vitamin D is the fact that it helps reduce atherosclerosis. Studies confirm that there is a similar underlying mechanism that occurs between conditions like cardiovascular disease and erectile dysfunction. As blood vessels are damaged and filled with plaques, the diameter for blood to flow through is gradually reduced. After a few years, the amount of blood may be reduced substantially. Vitamin D is able to help activate cells that remove some of these dangerous plaques and delay the onset of ED. [7]
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
While Western medicine emphases the link between cardiovascular function and ED, TCM places importance on liver and kidney ailments as causative factor for development of ED. Western medicine involves a step-wise approach by targeting the relevant organ systems to treat various clinical symptoms; but TCM focuses on restoring the balance between various organs to achieve harmony and holistic approach to inner sense (4). The following article reviews our current understanding regarding the philosophical approach, and evaluates the evidence surrounding various ED therapies between mainstream Western medicine and TCM (see Table 1).
If impotence affects you or someone you love, don’t lose hope. You may be suffering from a medical or emotional issue that is causing low libido or impotence — possibly interfering with both your confidence and relationship — but the good news is there are effective natural remedies for impotence that can help reverse this problem in most men. Around 70 percent of ED cases are resolved with natural impotence remedies that can help restore your sexual health.
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In this study, 78 patients aged 25 to 50 suffering from mild to moderate erectile dysfunction were given this supplement. This study lasted 12 weeks and the size and duration of the erection was the focus of the study. At the conclusion of the study, it was determined that this supplement made a significant difference compared to the controls on parameters like sexual desire, intercourse satisfaction, orgasmic function and overall satisfaction. Side effects were mild and similar to those observed in the control group. Once the trail finished, 90 percent of those taking the VXP supplement wished to continue taking the product because of the impact they observed. [11] 
Intensive lifestyle changes that include a Mediterranean type diet, circuit-type resistance training, with 15- to 60-second rest between sessions has shown to improve erectile score in a randomized trial. Men in the intervention group had a significant decrease in glucose, insulin, low-density lipoprotein cholesterol, triglycerides, and blood pressure, and a substantial increase in HDL cholesterol.15

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.

Clinical practice in TCM has been an exemplary case of customized treatment with holism epitomizes the essence of TCM. TCM encompasses these aspects, taking a holistic approach to patient’s problem and these methods combine body, mind and spirit, and healings are achieved via the concept of energy rather than matter, as in modern medicine. Compared to the complexity of modern science, which is the basis of Western medicine, this concept is easily understood and comprehended, and is readily accepted because of its holistic approach.


Cherries are rich in anthocyanins, plant chemicals which clean your arteries of plaque, keeping them open for business. That has a direct effect on blood flow below the belt. So make them a regular snack: One cup clocks in at fewer than 100 calories and boasts B vitamins, cancer-fighting flavonoids and three grams of fiber. For more essential fat-blasters for your kitchen, stock up on these 9 Best Flat-Belly Superfoods!
The fowl most associated with belt-loosening feasts is lean, high in protein and the single best food source of arginine, the amino acid. Researchers at the NYU School of Medicine gave L-arginine to a group of impotent men, and found that six out of 15 men receiving the amino acid claimed an improved ability to achieve erections, while none of the 15 men in the placebo group reported any benefit. Additionally, the bird is rich in DHA omega-3 acids, which have been shown to boost brain function, improve your mood and turn off fat genes, actually preventing fat cells from growing! Just make sure you buy white meat only, as dark contains too much fat. And steer clear of prepackaged, sliced lunchmeat—those turkeys are strictly jive.

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.

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.


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.
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

The treatment of ED using TCM ties in with the treatment of late-onset hypogonadism (LOH). LOH occurs due to the breakdown in coordination between the heart and the kidneys, deficiencies of the spleen and kidney (yang), deficiencies of the liver and kidney (yin) and deficiencies of the kidney (yin and yang). The endocrine function of the pituitary and gonads becomes disordered with age due to a depression of overall function. This results in accumulation of free radicals and other toxins that cannot be relieved solely with male hormone supplementation. Warm yang can energize kidneys to benefit the body, remove toxins, invigorate qi and promote blood circulation. Free radicals are removed, blood fat regulated, cardio-cerebral blood flow improved and again the key here is to improve the function of the digestive, respiratory and endocrine systems, hence regulating the body in every aspect holistically (28).
To correct ED, Cellular Medicine takes a different approach to that of conventional medicine. In the absence of psychological causes, the primary cause of ED is cellular dysfunction as a result of micronutrient deficiency. In this respect, ED is essentially no different to any chronic disease. To successfully resolve the problem, it is necessary to resupply the body’s cells with optimum levels of micronutrients.

Prescription drugs called “oral phosphodiesterase-5 (PDE5) inhibitors” are considered the “first-line non-invasive treatment” options for patients with ED. These include the drugs that go by brand names: Sildenafil, Vardenafil or Tadalafil. They work by helping the smooth muscle cells lining the blood vessels that supply the penis with blood to work properly. This allows a man to maintain an erection more easily.
Issues relate to 'autoimmune type manifestations, joint pains, fatigue issues, rashes, sun-sensitivity, erectile dysfunction,libido issues, lack of energy and motivation, dry eye and sjogren's like symptoms, neuropathy for some, insomnia, etc. Any potential medications, therapies, or ways to approach these problems will be explored with great interest. Other questions involved 're-treatment' for relapsers, and issues around optimal dosing, and the role of Ribavirin.
Hard men have healthy hearts, so eat bananas for potassium, which is great for your heart and circulation. Getting enough potassium helps keep your sodium levels under control, stopping your blood pressure from hitting the roof and reducing your risk of heart problems. If you eat too much salt and don’t like bananas, get your potassium from oranges or jacket potatoes (the mineral’s in the skin).
While ED may seem like a monumental problem on its own, it is usually a sign of a bigger health issue. It is important to isolate and address underlying issues and support overall health by cleaning up your diet, maintaining healthy blood sugar balance, quitting smoking, regularly moving your body, and managing stress appropriately. Along with these healthy lifestyle changes, a carefully chosen natural supplement routine can offer additional support so you can regain your vitality and get on with enjoying your life.
Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He’s a practicing Gastroenterologist and Hepatologist with a focus on Men’s and Women’s Health, and a regular contributor to Women’s health, Shape and Prevention Magazine.

Sometimes low libido or sexual dysfunction can occur due to low testosterone levels. But that doesn’t necessarily mean you need a testosterone supplement. Your body usually can produce adequate testosterone, but it needs downtime to convert precursor hormones into testosterone. If you’re burning the candle at both ends, your body will convert those precursors into cortisol instead. So rest, relax, and allow your body to build up its testosterone stores.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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.


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.

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.
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.
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.
Having your current medication checked – if you are taking medication already, it could be that your erection problems are a side effect. Have a doctor check whether this is the cause of your problems and if it is, you might be able to switch medications and then find that your erectile dysfunction goes away completely – or at least improves. Medications that can cause erection problems include:

Gutiérrez-González, Enrique; Castelló, Adela; Fernández-Navarro, Pablo; Castaño-Vinyals, Gemma; Llorca, Javier; Salas-Trejo, Dolores; Salcedo-Bellido, Inmaculada; Aragonés, Nuria; Fernández-Tardón, Guillermo; Alguacil, Juan; Gracia-Lavedan, Esther; García-Esquinas, Esther; Gómez-Acebo, Inés; Amiano, Pilar; Romaguera, Dora; Kogevinas, Manolis; Pollán, Marina; Pérez-Gómez, Beatriz. “Dietary Zinc and Risk of Prostate Cancer in Spain: MCC-Spain Study.” Nutrients. Jan 2019, 11(1).
lung issues, neuropathy, arthritis, vision problems, thyroid dysfunction, erectile dysfunction etc. etc. are all due to depression. I think you are dead wrong! ALL of these are documented potential side effects of interferon, in the literature. Its just that the literature does not indicate that the problems might persist long term in a significant group of patients. How are you so certain that the interferon has nothing to do with these problems again????
In one study, men with a Vitamin D deficiency were nearly 33% more likely to have ED. But you don’t need that much sun exposure to get a healthy amount of Vitamin D. As little as 15–20 minutes a day is enough. Taking Vitamin D is a good idea, especially if you are over 65. Vitamin D can also help if you’re obese or dark-skinned (dark skin limits the amount of Vitamin D you naturally, produce)
To correct ED, Cellular Medicine takes a different approach to that of conventional medicine. In the absence of psychological causes, the primary cause of ED is cellular dysfunction as a result of micronutrient deficiency. In this respect, ED is essentially no different to any chronic disease. To successfully resolve the problem, it is necessary to resupply the body’s cells with optimum levels of micronutrients.
These “sea pistachios,” as Kimmy Schmidt called them, are no joke.They’re one of the richest food sources of erection-enhancing Vitamin B12 you can find. The boner-boosting bivalves are also high in L-arginine, an amino acid that converts to nitric oxide (NO), the Marvin Gaye of naturally occurring gases: It causes blood vessels to relax and facilitate blood flow, helping you get and stay hard. Additionally, clams are high in muscle-building protein.

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).
SSRI's *sinus tachycardia, * myocardial infarction, * junctional rhythms and * trigeminy * anhedonia * apathy * nausea/vomiting * drowsiness or somnolence * headache * bruxism * extremely vivid or strange dreams * dizziness * fatigue * mydriasis (pupil dilation) * urinary retention * changes in appetite * changes in sleep * weight loss/gain (measured by a change in bodyweight of 7 pounds) * increased risk of bon

Diaclina (also known as Panzer’s Darkling Beetle), Korean bug are used as aphrodisiacs in China, Korea and Southeast Asia. These are consumed either whole or as compounds within capsules. It is felt that the aphrodisiac properties come by stimulating the urogenital structures. Flies have been studied for their aphrodisiac effects, including Spanish fly, Chinese cantharide, and Eastern-Indian cantharide (32). The active compound found in the dried and mashed up bodies of these flies is cantharidin, which is a pheromone produced in the accessory glands of the male flies’ genitals. Cantharidin, stimulates the urogenital tract, causing pelvic hyperemia and possibly erections. As cantharidin is toxic and its safety dose not well determined, its use cannot be recommended. Cantharidin is lethal at high doses and exposure can lead to gastrointestinal and urogenital hemorrhage as well as acute renal failure.
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During sexual stimulation, sexual thoughts, or nocturnal erections, the neurotransmitter nitric oxide (NO) is released from the endothelial cells and the parasympathetic nerve terminal causing relaxation of two cylinder-like muscles called the corpora carvenosum. Nitric oxide influences an increase in concentrations of cyclic guanosine monophosphate (cGMP), which after numerous pathways triggers smooth muscle relaxation, and simultaneous closing of small veins traps blood in the cavernosal muscles, keeping blood in the cavernosal tissues that cause and maintain an erection. 

On any matter relating to your health or well-being, please check with an appropriate health professional. No statement herein is to be construed as a diagnosis, treatment, preventative, or cure for any disease, disorder or abnormal physical state. The statements herein have not been evaluated by the Foods and Drugs Administration or Health Canada. Dr. Marchione and the doctors on the Bel Marra Health Editorial Team are compensated by Bel Marra Health for their work in creating content, consulting along with formulating and endorsing products.
The medications also require a healthy endothelium and healthy arteries capable of providing increased blood flow to work. If the sex organ arteries the size of a swizzle stick are severely diseased, there will be no “bada-boom bada-bing” an hour after taking them. These medications only work by enhancing the natural effects of a healthy endothelium.
Impotence, or erectile dysfunction (ED), is the inability for a man to sustain an erection long enough for normal, satisfying sexual intercourse.  To understand the underlying causes of impotence, it helps to know the basics about how an erection develops, along with potential problems that get in the way. Erections begin in the brain with a thought related to sexual desire. Then a chemical message travels from the brain to the penis. Blood flow to the penis increases as blood vessels leading to the reproductive system relax and allow for increased circulation.

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.
The Aztecs referred to avocados as testicles because of their scrotum-like appearance. They were onto something. The green fruit is rich in potassium, vitamin B6 and vitamin E, nutrients that have been associated with increased libido. Plus, avocados’ good monounsaturated fats protect your heart and boost circulation, while their abundant minerals and carotenoids supply energy and stamina. For some creative ways to consume the fruit, check out our 10 avocado recipes for weight loss.
The brew is rich in compounds called catechins, which have been shown to blast away belly fat and speed the liver’s capacity for turning fat into energy. But that’s not all: Catechins also boost desire by promoting blood flow to your nether region. “Catechins kill off free radicals that damage and inflame blood vessels, increasing their ability to transport blood,” says Cassie Bjork, RD, LD of Healthy Simple Life. “Catechins also cause blood vessel cells to release nitric oxide, which increases the size of the blood vessels, leading to improved blood flow,” she explains. Blood flow to the genitals = feeling of excitement, so sipping the stuff will, well, make you want to get it on. Bjork suggests drinking four cups a day to feel the full effects. Pick up one of our 5 favorite teas for weight loss.
Some scholarly minds believe it wasn’t an apple, but a pomegranate with which Eve tempted Adam in the Garden of Eden. She was smart: A recent study published in the International Journal of Impotence Research discovered that pomegranate juice, rich in antioxidants that support blood flow, can help improve erectile dysfunction. Though this study was funded by POM Wonderful, animal studies have also shown that the elixir improves long-term erectile response, so it’s definitely worth a shot–literally. Knock a shot back or water your juice down a bit: One cup of tart POM Wonderful packs 31 grams of sugar.
When considering vitamin supplementation for erectile dysfunction, one of the first vitamins that you may come across in literature would be Vitamin D. This is a vitamin that can be easily obtained through many types of dairy products like milk, cheese, and yogurt and is also in abundance if you live in a tropical climate. Sunlight is able to give us a natural dose of vitamin D daily. [6] Although vitamin D is usually associated with improving bone strength and prevention osteoporosis, another valuable feat of vitamin D is the fact that it helps reduce atherosclerosis. Studies confirm that there is a similar underlying mechanism that occurs between conditions like cardiovascular disease and erectile dysfunction. As blood vessels are damaged and filled with plaques, the diameter for blood to flow through is gradually reduced. After a few years, the amount of blood may be reduced substantially. Vitamin D is able to help activate cells that remove some of these dangerous plaques and delay the onset of ED. [7]
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 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.
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