This African tree bark extract sends blood flow to the genitals, says herbalist Ed Smith, a founding member of the American Herbalists Guild, who adds a warning that yohimbe can cause nervousness and raise already-existing high blood pressure (so avoid taking it if you have heart or kidney disease), and can also negatively interact with antidepressants.
The role of the practitioner providing a naturopathic treatment plan is to first identify the cause of the individual's ED. If the cause is psychogenic (i.e. performance anxiety, depression, relationship problems), referral to a psychotherapist should be considered. Organic causes like metabolic syndrome, insulin resistance, or diabetes type II can be properly treated with lifestyle medicine and other numerous nutritional prescriptions beyond the scope of this article to discuss.
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.
When other treatments haven’t helped, a penile implant may be the right solution. A penile implant is a medical device that is surgically placed into a penis to mimic the look and performance of a natural erection9. Implants are custom-fitted to your anatomy. Sensitivity and the ability to ejaculate aren’t typically affected either, so you’ll be able to have an orgasm normally (unless you have a medical condition that prevents this)7.
A 2000 study conducted at the Institute of Sexology in (where else?) Paris found that muira puama, a Brazilian shrub traditionally used in South African folk medicine as an aphrodisiac, increased libido in a majority of men who complained of impotence and a lack of desire. Other studies show this happy-making herb also counteracts chronic stress, depression and nervous exhaustion.

In TCM, the meridian system is thought to represent a path through which the life energy qi flows and as discussed in earlier section, the “Jing” (kidney) qi plays an important role in penile erection. Acupuncture helps to correct the imbalances to relieve physical symptoms by stimulating various meridian points. The Shensu (BL23), Zusanli (ST36) and Neiguan (PC6) points represents important acupoints for penis stimulation and thus has a positive homeostatic effect on the autonomic nervous system, and potentially modulate NO release (55,56). While some studies have showed up to a third of patients reported improvement in penile erection and sexual activity, systematic review showed insufficient data to conclude that acupuncture is an effective intervention for treating ED (56,57). Therefore, further scientific research is required to investigate whether there are specific benefits of acupuncture for men with ED before acupuncture can be accepted as evidence-based practice.


Conventional impotence treatments typically involve the use of medications which work with the body's natural chemistry in order to promote the ability to have an erection. Oral medications such as Viagra, Levitra and Cialis are commonly prescribed; injectable medications such as the impotence drug Caverject are also used for treating male impotence.
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The following products are considered to be alternative treatments or natural remedies for Erectile Dysfunction. Their efficacy may not have been scientifically tested to the same degree as the drugs listed in the table above. However there may be historical, cultural or anecdotal evidence linking their use to the treatment of Erectile Dysfunction.
27. Haahr MK, Jensen CH, Toyserkani NM, et al. Safety and Potential Effect of a Single Intracavernous Injection of Autologous Adipose-Derived Regenerative Cells in Patients with Erectile Dysfunction Following Radical Prostatectomy: An Open-Label Phase I Clinical Trial. EBioMedicine 2016;5:204-10. 10.1016/j.ebiom.2016.01.024 [PMC free article] [PubMed] [CrossRef]
This tasty green nut may be more than a great snack. A study published in the International Journal of Impotence Research examined how eating pistachios affected ED. Measurements were taken before men were put on a nut-heavy diet and after. Consuming pistachios for several weeks showed improvement in several parameters of ED, including improved International Index of Erectile Function scores for study participants.
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.
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.
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

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:
Yohimbine: The main component of an African tree bark, yohimbine is probably one of the most problematic of all natural remedies for ED. Some research suggests that yohimbine can improve a type of sexual dysfunction that is linked with a drug used to treat depression. However, studies have linked yohimbine to a number of side effects, which can include anxiety, increased blood pressure, and a fast, irregular heartbeat. Like all natural remedies, yohimbine should only be used after advice and under supervision from a doctor.
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