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.
However, you might actually be better off going one step back in the chain reaction and taking an L-citrulline supplement. While your body converts L-arginine to nitric oxide, it also metabolizes it too fast when the amino acid is taken in an oral supplement, according to a 2011 study from the University of Foggia in Italy. L-citrulline, which the body converts to L-arginine, is actually a better option to follow the same metabolic pathway and serve as a treatment for ED, the same study found.
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.
A daily dose of niacin improves erectile function, particularly in men with high cholesterol, according to a 2011 study in The Journal of Sexual Medicine. The vitamin helps increase blood flow and reduce inflammation—one of the underlying causes of both high cholesterol and erectile dysfunction. “Vitamin B3 is also used to make sex hormones and other important chemical-signal molecules,” says Fisch. Like many of the others on our list, this tablet is most powerful when taken in conjunction with others: A cocktail of propionyl, L-carnitine, L-arginine, and niacin taken for three months improved 40% of erections in a study from researchers at Sapienza University of Rome in Italy.
Ginkgo biloba. Ginkgo is an herb that is used in Chinese medicine that’s thought to improve blood flow. "Any ED treatment that improves blood flow may help," explains Dr. Harris. "An erection is just blood in and blood out." However, the evidence that ginkgo can improve blood flow in ED is limited, and most experts say the jury is still out. In addition, ginkgo can increase the risk for bleeding problems if combined with certain medications, such as warfarin (Coumadin).

DHEA. DHEA, or dehydroepiandrosterone, is a natural hormone that the body uses to make the male hormone testosterone. DHEA and testosterone decrease with age, just as ED increases with age, so it seems that taking DHEA might protect against ED. But Harris says that "it is unlikely that taking DHEA would raise your testosterone enough to make much difference." DHEA should not be used by people with liver problems; it also has many side effects.
The average normal level at your age is over 600 ng/dL and the current thinking from the AACE guidelines is that levels under 325 ng/dL are the new treatment (or further diagnosis at least) indicated. If you have symptoms be sure your doctor knows about them because this is a piece they need to know. Try to find out if your form of Hypogonadism is primary or secondary.
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.
L-arginine is an amino acid that is necessary for the lining of the blood vessels to produce nitric oxide. Nitric oxide allows the blood vessels to relax, thus improving blood flow throughout the body, including to the penis. Studies on L-arginine and erectile dysfunction have used between 2,000-5,000 mg a day in divided doses.ii Supplemental arginine is best taken on an empty stomach.3

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
ED is caused by vascular, hormonal, neurogenic, pharmacological, or psycho-genic factors. Performance anxiety where the person fears failing in a sexual scenario is a common psychogenic cause for ED.3 Neurogenic causes are related to diseases like Alzheimer's, Parkinson's, stroke or spinal cord injuries. Radical removal of the prostate (also called prostatectomy) is the cause of nerve-related ED as nerve injury is possible despite advances in surgical methods.4
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.
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.
6. Have you suffered from testicular atrophy? 7. Have you suffered from erectile dysfunction? 8. Do you experience pain in your penis? 9. If so, describe the pain. 10. Is there any one incident which you feel might have acted as the trigger for this condition? 11. Has the rate of shrinkage increased or decreased over the years? 12. Do you drink? 13. Do you notice any worsening of symptoms as a result of drinking? 14. Do you smoke? 15.
In Western medicine approach, health and disease are clearly divided entities. The emphasis is on protection of the individual body from disease or how to replace the body’s lost functions. Antibiotic therapy is used to combat harmful bacteria during infections, exogenous synthetic hormones are used to replace hormone-deficient individuals and artificial prostheses are applied when an organ loses its functions. This is very different from the holistic Eastern approach where the treatment entity is taken as a whole, and the objective is to seek harmony between different bodily systems.
DHEA. DHEA, or dehydroepiandrosterone, is a natural hormone that the body uses to make the male hormone testosterone. DHEA and testosterone decrease with age, just as ED increases with age, so it seems that taking DHEA might protect against ED. But Harris says that "it is unlikely that taking DHEA would raise your testosterone enough to make much difference." DHEA should not be used by people with liver problems; it also has many side effects.
These drugs facilitate erection by inhibiting the PDE5 enzyme, by blocking the degradation of cyclic guanosine monophosphate (cGMP) in the cavernous smooth muscles. This inhibition results in the prolonged activity of cGMP, which further decreases intracellular calcium concentrations, maintains smooth muscle relaxation and, hence, results in rigid penile erections.
While these side effects mainly create discomfort, some individuals are at risk for more serious, even life-threatening reactions to these drugs. Some men have reported fainting after taking impotence medications, and priapism (a painful condition involving an erection that does not subside after more than four hours) has also occurred as an effect of impotence drugs. This condition can lead to permanent nerve damage; injectable drugs may also cause irreversible damage to the penis if used incorrectly.
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.
"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?
Treatment options vary and depend on the most likely underlying condition. Patients can benefit from taking drugs like Viagra or other vasodilators in order to try to increase blood flow to the penis but these medications can interact with a number of other medications that patients may already be taking and these cross-reactions are very dangerous [5]. To reduce the chances of this from happening, patients may turn to natural treatments for erectile dysfunction. In this article, we will explore some of the vitamins and dietary supplements for ED and why they may be good options for you to consider. 
For centuries, men have tried all sorts of natural remedies for erectile dysfunction (ED) -- the repeated inability to get or maintain an erection firm enough for sexual intercourse. But do they really work? It is simply not scientifically known at this point. Furthermore, you take these remedies at your own risk, because their safety profiles have not been established. What follows are commentaries by experts and reviews in the field of alternative treatments that are available over the counter for erectile dysfunction and impotence.

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If you can't take one of these oral medications, your physician may have you try Caverject (alprostadil for injection), a hormone that you inject into your penis using a fine needle, or Muse (alprostadil urogenital), a tiny suppository that you insert into the tip of the penis. Both of these will bring on an erection within five to 15 minutes without sexual stimulation.
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