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.
"Evidence that foods can help with ED is probably related to a vascular connection," says Firouz Daneshgari, MD, professor and chairman of the department of urology at Case Western Reserve University School of Medicine and University Hospitals Case Medical Center in Cleveland. "Erectile problems are usually due to not having a good blood supply to the penis, so foods that are good for your vascular system may also help prevent ED." Should you eat more of the foods containing these key nutrients?
In a study done to determine if vitamin D supplementation would actually help patients with ED, 143 patients with ED were tested to determine vitamin D levels. It was found that of these cases, 46 percent of patients suffered from substantial vitamin D deficiency and only 20 percent were found to have adequate levels of vitamin D. In these cases, it was also determined that inadequate arterial blood flow was the root cause of ED more commonly in patients with low vitamin D levels. [8] Vitamin D supplementation can improve both these parameters. 
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Picture this: Draw one circle about the diameter of a Number 2 pencil and another circle that is smaller and about the diameter of a stirrer in a drink side by side. The larger circle is the approximate diameter of a good-sized coronary artery. The smaller circle is approximately the diameter of the pudendal artery, the major blood supply to the penis.
With the advent of the “little blue pill” men’s sexual health has been thrust into the public eye and now, rather than worrying in embarrassed silence about “performance” issues, men are able to openly seek the help they need to function at their best. This is good news for the 30 million American men who suffer from erectile dysfunction or ED.1 And because 70 percent of ED cases are physiological in nature (it’s not just in your head) and often a sign of some other serious health issue, it is wise to address and correct the underlying physical imbalances that are hindering performance in the first place, ensuring both shortterm happiness and long-term health.

Wine – especially red wine – is a great source of the antioxidant phytochemical resveratrol, which helps open the arteries by enhancing the production of nitric oxide. Nitric oxide allows the blood vessels to expand, and this is how Viagra works. But while the little blue pill only works on tiny blood vessels, resveratrol helps your main arteries too. Make sure you stop at one or two glasses of wine – too much alcohol leads to the dreaded droop.
But you really do not need any medications like I-Arginine and others to solve your erection problems. Many researches suggest that if you try natural solutions and home remedies rather than going for medications, you will have a healthy and satisfying sex. These vitamins and supplements with surely  help in treating  your ED (erectile dysfunction) and other penis related problems.
Yohimbe. Before Viagra and the other prescription erectile dysfunction drugs became available, doctors sometimes prescribed a derivative of the herb yohimbe (yohimbine hydrochloride) to their patients suffering from ED. But experts say the medication is not particularly effective, and it can cause jitteriness and other problems. "It's not a great drug," says McCullough. "And I suspect the herb is not as potent as the pharmaceutical version." What's more, evidence shows that yohimbe is associated with high blood pressure, anxiety, headache, and other health problems. Experts discourage its use.
Deer velvet is a covering found on the growing bone and cartilage of deer’s antlers. In Eastern medicine, deer velvet is sought after for its Chinese medicinal properties which include boosting one’s endurance and improving one’s immunity. People have also used deer velvet as an aphrodisiac or to treat ED. The randomized double-blind placebo-controlled study on deer velvet by Conaglen et al. (31), no benefit but this study was underpowered involving healthy participants with no sexual dysfunction.
As men age, their estrogen levels gradually rise, while testosterone levels fall. Anti-cancer coupounds called indoles can help strike a balance. Cruciferous vegetables like broccoli are rich in indoles, which boost testosterone production by breaking down and flushing the system of excess estrogen, which inhibits the production of male sex hormones. In one study, supplementing with indole-3-carbinol from cruciferous vegetables for just 7 days cut the estrogen hormone estradiol in half for men. Another study found indole supplementation significantly increased urinary excretion of estrogens.
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.
In a 2005 study, three months of twice-daily sets of kegel exercises combined with biofeedback and advice on lifestyle changes, such as quitting smoking, losing weight, and limiting alcohol, worked far better than just giving the participants advice. “Wearing tight pants will affect impotence along with some other medical conditions like diabetes and heart disease,” which can also affect a man’s degree of impotence, Dr. Jennifer Burns, specializing in family practice with an emphasis on gastrointestinal health at the BienEtre Center, told Medical Daily.

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).
There’s no bedroom bummer quite like having to fly at half mast, but your penis problems are likely more common than you think: As many as 30 million American men suffer from erectile dysfunction, and one in four who seek treatment for ED are actually under the age of 40, according to a study in The Journal of Sexual Medicine. We all know there’s a little blue pill that can fix the failure to launch—but you don’t necessarily have to fill a ‘script to save your stiffy.
Sure, it’s good for your cholesterol, but did you know red wine can benefit your manhood? Red wine contains nitric oxide, which helps relax the arteries and increase blood flow in the genitals, and the compound quercetin, which helps block the enzyme that triggers your body to push away testosterone, allowing you to maintain high levels of testosterone—and a strong erection well past foreplay.

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).
Qigong is a form of breathing exercises commonly practised in Asia to maintain health (53). In a cross-sectional population-based comparison study in Taiwan, individuals practising Qigong demonstrate higher SF-36 scores in the domains of physical functioning, role limitations due to physical problems, bodily pain, general health and vitality (54). Techniques to concentrate the energy or qi in the pelvis or genitals are regularly practised, but the effects of Qigong on ED have not been studied.
Erectile dysfunction (ED) is a common condition characterized by difficulty in getting or maintaining an erection. While the likelihood that a man will experience this problem increases with age, it often occurs alongside and as a result of other conditions such as heart disease, high blood pressure, high cholesterol, diabetes, or prostate disease. As with other health problems, however, the pharmaceutical drugs prescribed by conventional medicine to treat ED can cause serious side effects. Fortunately, therefore, use of the Cellular Medicine approach can help resolve ED safely and naturally.  
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).
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
Recent University of Texas findings suggest that men who drink two to three cups of java a day—or 85 to 170 milligrams of caffeine from other beverages—are 42 percent less likely to have erectile dysfunction than those who consume up to seven milligrams of the stimulant daily. And those who throw back four to seven cups were 39 percent less likely to have the condition than their less jittery counterparts. The trend holds true among overweight, obese and hypertensive men, but not for those with diabetes, a condition that often causes the issue. So, how exactly does drinking coffee keep things going strong? The scientists say that the stimulant triggers a series of reactions in the body that ultimately increase blood flow south. And get the abs you want—quickly—and melt up to 10 pounds in one week with our new diet plan, The 7-Day Flat-Belly Tea Cleanse!
Classic dietary staples, like the chicken breast, may not have the Instagram presence of say, maca, but they earn a place on plates much longer. Simply put, their health benefits continue to stack up. In addition to a hefty amount of arginine — only turkey has more — a 3-ounce cooked chicken breast contains only 142 calories and 3 grams of fat, but an impressive 26 grams of protein. That’s more than half of the day’s recommended allowance. Plus, it’s rich in B vitamins to rev your metabolism and energy levels. (And if you’re looking to treat erectile dysfunction, those B vitamins definitely don’t hurt.)
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.
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.

Well I thought this treatment was going to be a piece of cake before I started. I do remember the doctor asking me over and over do I think I want to start treatment. But my levels was high and I want this illness gone, so I decided to go with it. Make sure you take all the right vitamins to cut back on side effects. That was my big mistake but it seemed like any vitamin I took made my symptoms worst.
Erectile dysfunction can occur as a side effect of medication taken for another health condition. Common culprits are high blood pressure meds, antidepressants, some diuretics, beta-blockers, heart medication, cholesterol meds, antipsychotic drugs, hormone drugs, corticosteroids, chemotherapy, and medication for male pattern baldness, among others.
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