There are many different body parts that play an important role for a man to get and maintain an erection during sexual intercourse. Beyond the physical causes that can lead to ED, it has been reported that 20% of ED is related to psychological causes.2 With so many possibilities leading to erectile dysfunction, it becomes particularly important to find a specialist who can correctly diagnosis the direct cause of your ED and find a treatment option that is right for you.
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.
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.

This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.


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).

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
There is no single cause for erectile dysfunction. Achieving an erection involves a complex series of physiological events; in order for an erection to occur, the body is required to coordinate nervous system responses with tactile sensations, emotional triggers, and signals from certain hormones. If any of these events are disrupted, impotence is likely to occur.
Enlargement of the prostate gland, another condition that occurs with increasing frequency in men as they age, can also cause ED. In a 2012 Swiss study, 82 men with moderate to severe symptoms of prostate enlargement, who were also experiencing problems such as ED or loss of libido, took 320 mg of saw palmetto extract daily for 8 weeks. At the end of the study, the men’s ‘International Prostate Symptom Score’ (IPSS), a method of measuring prostate health based on a questionnaire, was reduced by an average of 51 percent. In addition, their ED, libido, and other sexual functions had also improved by an average of over 40 percent. Unlike the drug approaches used in conventional medicine, which can even cause ED as a side effect, saw palmetto is very effective in treating prostate problems and is free from side effects.
He might have been introduced to it by some of his pals (if that is so you might need to make him understand that some of his friends are a bad influence and stop befriending these kids). 7. PIED ( porn induced erectile dysfunction- it is a new condition that most men who were watching porn for some time get it sooner or later, some REALY scary stuff for a man!). Your son sounds like a decent kid who is crying for help.
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.

The vacuum device is approved by USA Food and Drug Administration (FDA) for treatment of ED since 1982. Vacuum therapy (VT) works by creating a negative pressure environment around the penis through the use of a cylindrical housing attached to a pump mechanism, which can be manually-operated or battery-operated. Vacuum draws mixed arterial and venous blood into the corporal bodies and distends the corporal sinusoids to create an erected penis. If a pre-loaded constriction band is applied over the base of the penis to prevent outflow of blood and maintain tumescence for intercourse, it is considered a vacuum constriction device (VCD). It is recommended that the constriction band be removed within 30 mins to return the penis to its flaccid state, as prolonged application of the constriction band can compromise both arterial and venous blood flow (7). Some minor side effects associated with VCD are penile discomfort, coldness, numbness, bruising and pain on ejaculation. Major side effects such as penile skin necrosis, gangrene, urethral injury and Peyronie’s disease are very rare (8).

By far the most common cause of ED is vascular dysfunction. When the arteries that supply the penis with blood to achieve and maintain an erection are blocked or hardened, or the lining of these arteries are damaged, blood flow is reduced. Vascular dysfunction not only affects the small arteries of the penis, but the larger coronary arteries of the heart too. Astute doctors now recognize that ED may actually be an early warning sign of impending cardiovascular disease, showing up several years before a cardiovascular event like a heart attack or stroke.2 To maintain healthy vascular function, and in turn, normal erectile function, consider these supplements:


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
Peanuts contain a trove the amino acid L-arginine, which is one of the building blocks of nitric oxide, which aids your efforts under the covers. They also help reduce cholesterol levels. The less cholesterol you have in your system, the easier it is for blood to circulate throughout your body and down, which can help you maintain a firmer erection longer.
By far the most common cause of ED is vascular dysfunction. When the arteries that supply the penis with blood to achieve and maintain an erection are blocked or hardened, or the lining of these arteries are damaged, blood flow is reduced. Vascular dysfunction not only affects the small arteries of the penis, but the larger coronary arteries of the heart too. Astute doctors now recognize that ED may actually be an early warning sign of impending cardiovascular disease, showing up several years before a cardiovascular event like a heart attack or stroke.2 To maintain healthy vascular function, and in turn, normal erectile function, consider these supplements:
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
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.
Studies show that just 30 minutes of walking each day can be beneficial to those fighting ED. One Harvard study linked 30 minutes of walking per day with a 41 percent drop in the risk of erectile dysfunction. Some research shows that moderate exercise can help restore sexual performance in men who are middle-aged, obese, and have been diagnosed with ED.
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.
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.
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.
Vitamins and minerals are used in systems all over the body. Everywhere from your cardiovascular to your nervous system. It’s a lot to understand. So to help dispel some of the myths and outlandish claims, we’ll take a look at how five common vitamins and nutrients affect one very specific aspect of men’s health—erections. Turns out, vitamins can do more than just ward off the common cold.
Pay attention to your vascular health. High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the heart (causing heart attack), in the brain (causing stroke), and leading to the penis (causing ED). An expanding waistline also contributes. Check with your doctor to find out whether your vascular system — and thus your heart, brain, and penis — is in good shape or needs a tune-up through lifestyle changes and, if necessary, medications.
Size matters, so get slim and stay slim. A trim waistline is one good defense — a man with a 42-inch waist is 50% more likely to have ED than one with a 32-inch waist. Losing weight can help fight erectile dysfunction, so getting to a healthy weight and staying there is another good strategy for avoiding or fixing ED. Obesity raises risks for vascular disease and diabetes, two major causes of ED. And excess fat interferes with several hormones that may be part of the problem as well.
How men can improve their sexual performance Many men want to know how to enhance their own and their partners’ sexual satisfaction. However, placing too much emphasis on performance can lead to anxiety. Certain lifestyle changes can help to reduce sexual anxiety, improve erectile dysfunction, and increase stamina. In this article, we describe 13 methods to try. Read now
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