These medications don’t work for everyone but they are easy to use and work for around 60% of people who try them. They work by making it easier to get an erection by reducing the effect of (inhibiting) the chemical PDE-5. This chemical is used in the body to make sure there isn’t too much blood in the penis during an erection, but if you have erectile dysfunction then this chemical ends up over-compensating.
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:
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.
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
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.
There are currently two models of the inflatable penile prosthesis (IPP), namely, the two-piece IPP vs. the three-piece IPP. The three-piece IPP consists of a pair of corporal cylinders, a scrotal pump and an abdominal reservoir filled with saline. Owing to the presence of the reservoir, the corporal cylinders can be completely deflated to give the patient the physiological flaccid state when not in use, and likewise a maximally turgid state when inflated (21). The two-piece IPP lacks an abdominal reservoir and is often offered in patients with whom placement of reservoir is challenging or not possible such as following radical cysto-prostatectomy with orthotopic ileal neobladder creation, or patients who had previous open book fracture of the pelvis with metal implants. The concept of ectopic reservoir placement has allowed many of these men the option for three-piece IPP placement (22). Technological advances have improved mechanical reliability, reduced prosthesis infection risk and offered excellent patient and partner satisfaction rate (23).
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.
I developed joint and muscle pain, periods of extreme fatigue, skin reactions, sun sensitivity, my blood pressure became above normal for the first time in my life, I have developed metabolic syndrome, high blood sugar (as in pre-diabetes), erectile dysfunction, recurring welt-like mouth and cheek sores, lots of gum loss, and bone thinning! I struggle with energy and motivation issues, and I often feel like my lungs burn when I workout or do aerobic exercise.

Erectile dysfunction (ED) is defined as the persistent inability to attain and maintain an erection that is sufficient to permit satisfactory sexual performance (1). The current pharmaco-therapeutic research in ED focuses on underlying endothelial dysfunction as the root cause for ED and introduction of phosphodiesterase type 5 inhibitors to potentiate nitric oxide (NO) action and cavernosal smooth muscle vasodilation, has revolutionized modern ED treatment over the past two decades (2). In contrast to Western Medicine, the traditional and complementary medicine (TCM) aims at restoration and better overall bodily regulation with medicine to invigorate qi (energy) in vital organs such as kidney, spleen and liver; to enhance physical fitness, increase sexual drive, stabilize the mind and improve the overall situation resulting in natural and harmonious sexual life (3).


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.
Tiffany La Forge is a professional chef, recipe developer, and food writer who runs the blog Parsnips and Pastries. Her blog focuses on real food for a balanced life, seasonal recipes, and approachable health advice. When she’s not in the kitchen, Tiffany enjoys yoga, hiking, traveling, organic gardening, and hanging out with her corgi, Cocoa. Visit her at her blog or on Instagram.

Admit it or not, when it comes to our sex life, we all want it exciting, sometimes wild and most of all, something that lasts longer. Unfortunately, stress and everyday chores have impacted our sexual desires the most, causing various issues, one of which is erectile dysfunction. And believe it, men cannot go soft when it is about satisfying your partner!
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.

Overall, men with a higher total intake of fruit saw a 14 percent reduced risk of ED, whereas men who consumed foods rich in anthocynanin, flavones, and flavanones, had a 10 percent reduced risk of ED. What’s more, consumping several servings of these foods each week is as beneficial for your manhood as briskly walking for five hours each week. But, if you really want to reap the benefits, men who exercised and consumed flavanoid-rich foods experienced a whopping 21 percent reduced risk of erectile dysfunction.
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
According to the Cleveland Clinic, “because erectile dysfunction is caused by a complex set of psychosocial, neurologic, and vascular factors, a specific cause in a patient may remain ambiguous.” The root causes are often related to a blockage or dysfunction of blood vessels. For example, ED can be due to conditions like atherosclerosis or diabetes, hormonal imbalances or problems related to mental health. It’s been found that common causes typically include one or more of the following factors: (2)
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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.
org/posts/Mens-Health/Too-much-porn-masturbation-cause-ED/show/183203 On GOOGLE VIDEO find “Erectile Dysfunction And Porn” - watch the video series. Here’s a Psychology Today article on it Porn-Induced Sexual Dysfunction Is A Growing Problem http://www.psychologytoday.com/blog/cupids-poisoned-arrow/201107/porn-induced-sexual-dysfunction-is-growing-problem PS - all the other factors listed are irrelevant at age 21.
Opioids are used for chronic pain or for recreational use, and there is currently   an epidemic of opioid addiction in the United States. Opioids induce ED by inhibiting gonado-tropin-releasing hormone (GnRH), which leads to a decrease in the production of luteinizing hormone (LH). Decreased levels of LH, in turn, inhibit production of testosterone, which – in both men and women – can cause depression and sexual dysfunction.9
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.
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:
Experts feel that treating erectile dysfunction on your own, without consulting a doctor, is unsafe. "If you have ED, the first thing you need is a diagnosis," says impotence expert Steven Lamm, MD, a New York City internist and the author of The Hardness Factor (Harper Collins) and other books on male sexual health. He says men with severe erectile dysfunction probably need one of the prescription ED drugs, which include Levitra (vardenafil) and Cialis (tadalafil) as well as Viagra. But, he says, mild ED -- including the feeling that "you're not as hard as you could be" -- often responds to natural remedies.
Get your vitamins from whole foods and not through artificial supplements! Vibrantly colorful fruits such as berries (strawberries, blackberries, blueberries and raspberries) contain abundant anthocyanins. Tomatoes and tomato products are rich in lycopenes. Cruciferous vegetables (broccoli, cauliflower, Brussel sprouts, kale and cabbage) and dark green leafy vegetables are fiber-rich and contain lutein and numerous healthy phytochemicals. A healthy diet should include protein sources incorporating fish, lean poultry and plant-based proteins such as legumes, nuts, and seeds. Include fish that have anti-inflammatory omega-3 fatty acids like salmon, sardines, and trout. Healthy fats (preferably of vegetable origins like olives, avocados, seeds and nuts) are preferred. An ideal diet that is both heart-healthy and prostate-healthy is the Mediterranean diet. Follow, "Let food be your medicine” by Socrates.
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.

I developed joint and muscle pain, periods of extreme fatigue, skin reactions, sun sensitivity, my blood pressure became above normal for the first time in my life, I have developed metabolic syndrome, high blood sugar (as in pre-diabetes), erectile dysfunction, recurring welt-like mouth and cheek sores, lots of gum loss, and bone thinning! I struggle with energy and motivation issues, and I often feel like my lungs burn when I workout or do aerobic exercise.
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.
There’s a reason chocolate became a gift given before amorous activity. Cacao increases levels of the mood-boosting hormone serotonin, which can lower stress levels, boosting desire and making it easier to reach orgasm. And that’s not all: Cocoa also increases blood flow through the arteries and relaxes blood vessels, sending blood to all the right regions, which can boost pleasure.
The natural remedy to ED is a healthy lifestyle that can “reverse” ED naturally, as opposed to “managing” it. Since ED can be considered a “chronic disease,” healthy lifestyle choices can reverse it, prevent its progression and even prevent its onset. Since sexual functioning is based upon many body components working harmoniously (central and peripheral nervous system, hormone system, blood vessel system, smooth and skeletal muscles), the first-line approach is to nurture every cell, tissue and organ in the body. This translates to achieving “fighting” weight, adopting a smart heart-healthy and penis-healthy diet (whole foods, nutrient-dense, calorie-light, avoiding processed and refined junk foods), exercising moderately, losing the tobacco habit, consuming alcohol in moderation, stress reduction (yoga, meditation, massage, hot baths, whatever it takes, etc.), and getting adequate quantity and quality of sleep. Aside from general exercises (cardio, core, strength and flexibility training), specific pelvic floor muscle exercises (“man-Kegels”) are beneficial to improve the strength, power and endurance of the penile “rigidity” muscles. If a healthy lifestyle can be adopted, sexual function will often improve dramatically, in parallel to overall health improvements. Since many medications have side effects that negatively impact sexual function, a bonus of lifestyle improvement is potentially needing lower dosages or perhaps eliminating medications (blood pressure, cholesterol, diabetic meds, etc.), which can further improve sexual function. Eat real food and avoid refined, over-processed, nutritionally-empty foods and be moderate with the consumption of animal fats and dairy. Processed meats and charred meats should be avoided. A healthy diet should include whole grains and plenty of vegetables and fruits, particularly those that contain powerful antioxidants, vitamins, minerals and fiber.
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.
Tiffany La Forge is a professional chef, recipe developer, and food writer who runs the blog Parsnips and Pastries. Her blog focuses on real food for a balanced life, seasonal recipes, and approachable health advice. When she’s not in the kitchen, Tiffany enjoys yoga, hiking, traveling, organic gardening, and hanging out with her corgi, Cocoa. Visit her at her blog or on Instagram.
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.

Also called vacuum devices, penile pumps are devices that are placed over the penis to draw blood into the shaft. Once the vacuum creates an erection, the retaining band is slid down to the lower end of the penis and the pump is removed. An erection typically will last long enough for intercourse but your penis may be cold to the touch and the rubber band may restrict ejaculation.22


Get your vitamins from whole foods and not through artificial supplements! Vibrantly colorful fruits such as berries (strawberries, blackberries, blueberries and raspberries) contain abundant anthocyanins. Tomatoes and tomato products are rich in lycopenes. Cruciferous vegetables (broccoli, cauliflower, Brussel sprouts, kale and cabbage) and dark green leafy vegetables are fiber-rich and contain lutein and numerous healthy phytochemicals. A healthy diet should include protein sources incorporating fish, lean poultry and plant-based proteins such as legumes, nuts, and seeds. Include fish that have anti-inflammatory omega-3 fatty acids like salmon, sardines, and trout. Healthy fats (preferably of vegetable origins like olives, avocados, seeds and nuts) are preferred. An ideal diet that is both heart-healthy and prostate-healthy is the Mediterranean diet. Follow, "Let food be your medicine” by Socrates.
It hits where it hurts the most – your member. Erectile dysfunction or ED is a spoiler in bed and can shatter your ego irreparably. ED, also called impotence, is the inability of a man to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse.1 Men who cannot get or maintain an erection that lasts long enough or is rigid enough to complete sexual intercourse are considered to have erectile dysfunction.
 I developed joint and muscle pain, periods of extreme fatigue, skin reactions, sun sensitivity, my blood pressure became above normal for the first time in my life, I have developed metabolic syndrome, high blood sugar (as in pre-diabetes), erectile dysfunction, recurring welt-like mouth and cheek sores, lots of gum loss, and bone thinning! I struggle with energy and motivation issues, and I often feel like my lungs burn when I workout or do aerobic exercise.

Ginseng. Korean red ginseng has long been used to stimulate male sexual function, but few studies have tried systematically to confirm its benefits. In one 2002 study involving 45 men with significant ED, the herb helped alleviate symptoms of erectile dysfunction and brought "enhanced penile tip rigidity." Experts aren't sure how ginseng might work, though it's thought to promote nitric oxide synthesis. "I would recommend ginseng [for men with ED]," says Espinosa. Discuss with your doctor before taking it since ginseng can interact with drugs you may already be taking and cause allergic reactions.
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.
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.
The phrase “use it before you lose it” can be applied when it comes to helping men with ED regain normal erectile function. Pelvic exercises, more commonly known as kegel exercises, are used to promote urinary continence and sexual health. They help to strengthen the bulbocavernosus muscle, which does three things: allows the penis to engorge with blood during erection, it pumps during ejaculation, and it helps empty the urethra after urination, according to Healthline.
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