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.

Older age. A man’s risk increases past the age of 40, as age is the variable most strongly associated with impotence. This is due to changing hormones, higher risk for heart problems and those affecting circulation, and decreased sexual desire that often occurs with increasing age. For example, based on findings from the National Health and Social Life Survey, it’s been found that “men between 50–60 years old are more than 3 times as likely to experience erection problems and to report low sexual desire compared to men aged 18 to 29 years.” (3)
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.

Red Ginseng — One small randomized trial found evidence that red ginseng may offer modest improvements in ED symptoms (as compared with placebo). A meta-anaylsis published in the British Journal of Clinical Pharmacology states, “Traditionally red ginseng has been used to restore and enhance normal well-being, and is often referred to as an adaptogenic….Possible mechanisms of action of red ginseng include hormonal effects similar to those of testosterone. Others have postulated that red ginseng might induce relaxation of the smooth muscles.”  (5)


Males suffer with slow, weak, soft or no erection at all due to various reasons, an occasional episode of erection failure is not a problem but if it occurs frequently it is relationship-breaker and hurts a male’s self-esteem badly. This can make a male depressed and completely disenchanted towards lovemaking. Tufan capsules are the best ED pills which provide fast, effective and safe natural erectile dysfunction treatment in a short time. These are herbal ED pills hence are safe for males of all ages and can be used without medical prescription.


This IKEA-cafeteria staple can actually help you put things together in the bedroom. In addition to packing four times your daily requirement of Vitamin B12 in one average-sized filet, herring is also rich in magnesium, which boosts testosterone and keeps sperm healthy and viable. On top of that, oily fish like herring are sky-high in vitamin D, which can help you get and keep it up. In a recent study published in the Journal of Sexual Medicine, Italian researchers examined 143 men with ED; 80% had suboptimal levels of the nutrient, and the men with severe ED had a 24% lower level of D than those with a mild form of the condition. The theory is that low levels of D promote dysfunctional blood vessels and a shortage of nitric oxide.
In this study, 78 patients aged 25 to 50 suffering from mild to moderate erectile dysfunction were given this supplement. This study lasted 12 weeks and the size and duration of the erection was the focus of the study. At the conclusion of the study, it was determined that this supplement made a significant difference compared to the controls on parameters like sexual desire, intercourse satisfaction, orgasmic function and overall satisfaction. Side effects were mild and similar to those observed in the control group. Once the trail finished, 90 percent of those taking the VXP supplement wished to continue taking the product because of the impact they observed. [11] 

Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for intercourse. Because ED can have a strong psychological component, counseling with a psychotherapist or sex therapist often works. However, more often ED is a symptom of cardiovascular disease and diabetes, both of which can impair blood supply to the penis. In addition, many medications interfere with sexual functioning.
Your doctor may also choose to lower your dose of certain medications. Or your provider may switch the type of drug you’re taking if it’s interfering with your sex life. Some medicines used for managing blood pressure, insomnia, anxiety, depression, seizures and prostate problems increase the risk for erectile dysfunction. Beta-blockers (for high blood pressure), SSRIs (often used to treat depression) and the class of drugs called benzodiazepines (like Ativan, Xanax, Librium and Valium) are commonly tied to ED. You may want to speak to your doctor about this.
Shape up. Because ED is often linked with restricted blood flow to the penis, keep your heart and arteries in good condition by maintaining a healthy weight, and following a diet high in fruits, vegetables and whole grains. Avoid saturated fats and trans fats. Regular aerobic exercise can improve blood flow to the genitals and reduce any stress that contributes to your ED.
Eastern medicine should be fully exploited, and integrated with modern medicine to combine the advantages of both TCM and Western medicine. More research should be conducted into the efficacy and safety of TCM, and integration of TCM and Western medicine may provide promising breakthroughs in future clinical treatment. This strategy may allow for the development of new therapeutic strategies based on concepts of TCM and integrated medicine. There is a need for multimodal therapy and holistic approach to treat men (and their partners) with ED through complementary use of herbal supplements and modern drug to optimize underlying medical comorbidities; acupuncture, exercise or massage to reduce stress and strengthen the body; introduction and escalation of various medical therapy with use of mechanical therapy to further enhance penile erection; and lastly surgical intervention in suboptimal or refractory ED cases.
Yohimbine. This chemical is found in the bark of an African tree called yohimbe. It has been used as a male aphrodisiac in Africa, and under medical supervision it has been used as a prescription drug to treat ED. Supplements made from yohimbe bark are also available without a prescription, but they can be life-threatening if used at high doses, according to the Natural Medicines Comprehensive Database. The supplement can interact in a harmful way with certain drugs, such as blood pressure medications, and should be avoided by anyone with liver, kidney, heart, or diabetes problems or problems with anxiety or depression. Like DHEA, yohimbine should not be taken without a doctor's supervision.
Like garlic, onions too help treat ED. In a study conducted on male rats, fresh onion juice was found to have improved copulatory behavior and cured medicine-induced sexual dysfunction.8 They are also believed to help treat involuntary loss of semen during sleep or other times. Studies also show that like garlic, onions too offer some protection against testicular oxidative damage and spermiotoxicity.9
And what about L-citrulline? Watermelon has the highest concentration in nature (particularly the white rind), followed by onions and garlic. Just one standard serving of yellow watermelon provides enough L-citrulline to boost sexual performance. My advice is that you might want to stick to watermelon and not onions and garlic to boost your nitric oxide production before going on a date!
How alpha are you? Well, how many shakes of hot sauce can you handle? A recent study from France found men who have a taste for spicy foods tend to have higher testosterone levels than those who can’t handle the heat. Of the 114 male participants surveyed, researchers saw a clear correlation between frequent hot-sauce usage and higher T-levels. Study authors suggest the findings may be due in part to capsaicin—the fiery compound in chili pepper that previous studies have associated with increased testosterone levels. In animal studies, capsaicin has also shown to increase the size of certain organs, while simultaneously decreasing belly fat. Speaking of getting hot, don’t miss the 8 Foods For Her Better Than Female Viagra!
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).
So, how to increase the sexual potency? Firstly, get rid of bad food habits and revise your diet consuming more foods rich in zinc, protein, vitamins, and essential fatty acids. Often, the opponents of vegetarian diet and raw food diet argue that vegetarianism/veganism and sex are incompatible. Moreover, they assert that abstinence from meat leads to a substantial decrease in male potency. Allegedly, to make a sex life active, the male diet must necessarily include meat. And more is better. In fact, this is not true. The main thing is to ensure that you get all essential nutrients from food. And the foods of plant origin are a great source of these nutrients. Let’s consider the issue in more detail.
When considering vitamin supplementation for erectile dysfunction, one of the first vitamins that you may come across in literature would be Vitamin D. This is a vitamin that can be easily obtained through many types of dairy products like milk, cheese, and yogurt and is also in abundance if you live in a tropical climate. Sunlight is able to give us a natural dose of vitamin D daily. [6] Although vitamin D is usually associated with improving bone strength and prevention osteoporosis, another valuable feat of vitamin D is the fact that it helps reduce atherosclerosis. Studies confirm that there is a similar underlying mechanism that occurs between conditions like cardiovascular disease and erectile dysfunction. As blood vessels are damaged and filled with plaques, the diameter for blood to flow through is gradually reduced. After a few years, the amount of blood may be reduced substantially. Vitamin D is able to help activate cells that remove some of these dangerous plaques and delay the onset of ED. [7]

You might spice up your love life by adding some chili peppers to your diet. The stuff in cayennes, jalapenos, habaneros, and other peppers that give them their heat relaxes the arteries -- and that helps blood flow to the heart and other organs, including the penis. Chilies can also help lower blood pressure and cholesterol and prevent blood clots.

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.

Lycopene is one of those phytonutrients that is good for circulation and good for sexual issues. Lycopene is found in deep red fruits like tomatoes and pink grapefruits. Some studies show that lycopene may be absorbed best when mixed with oily foods like avocados and olive oil. So you might want to make yourself an ED-fighting salad. Research also shows that antioxidants like lycopene help fight male infertility and prostate cancer.


The pilot study by Vardi et al. (18) showed that LIESWT was effective in treating men with ED, suggesting a physiologic impact of LIESWT on cavernosal hemodynamics. The LIESWT is an effective penile rehabilitation tool that improves erectile function and potentially reverses underlying ED. Recent meta-analysis (19) of 14 studies showed that LiESWT could significantly improve the International Index of Erectile Function (IIEF) [mean difference: 2.00; 95% confidence interval (CI), 0.99–3.00; P<0.0001] and Erection Hardness Score (EHS) (risk difference: 0.16; 95% CI, 0.04–0.29; P=0.01). In addition, the therapeutic efficacy was noted to last for at least 3 months. LiESWT has been cited to a potential cure for ED, unlike other well established non-surgical methods of treatment (i.e., PDE5i, ICI and VED) being on demand treatments.
Turns out that good ol’ P.B. is an aphrodisiac in disguise. It’s rich in two nutrients that are key to good bedroom performance: Niacin (with a quarter of your recommended daily value in two tablespoons) and vitamin E (75% of your DV in that same serving). In a study printed in the Journal of Sexual Health, men suffering from impotence who took a niacin supplement reported a significant improvement in their bedroom prowess compared to men who took a placebo. Peanut butter is also a good source of folate, which improves sperm quality. Click here to see our top 16 Nut Butters for Muscle Building and Weight Loss!
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.

Researchers discovered men who regularly consumed flavanoid-rich foods—especially those with anthocyanins, flavones, and flavanones—experienced a significantly reduced risk of the disorder than those who did not. Good news since the foods are already popular in American diets. Lead researcher Aedin Cassidy says, “…the top sources of anthocyanins, flavones and flavanones consumed in the U.S. are strawberries, blueberries, red wine, apples, pears and citrus products.”
Some natural viagra supplements have been shown to increase nitric oxide levels and increase blood flow to the penis. But there are no true natural alternatives to prescription ED medication, like Viagra. But healthy food and (some) vitamins and supplements can improve your overall health and blood flow. And anything that improves blood flow can treat some of the causes of erectile dysfunction (as well as making you healthier).
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.
In one study, men with a Vitamin D deficiency were nearly 33% more likely to have ED. But you don’t need that much sun exposure to get a healthy amount of Vitamin D. As little as 15–20 minutes a day is enough. Taking Vitamin D is a good idea, especially if you are over 65. Vitamin D can also help if you’re obese or dark-skinned (dark skin limits the amount of Vitamin D you naturally, produce)
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
Turns out that good ol’ P.B. is an aphrodisiac in disguise. It’s rich in two nutrients that are key to good bedroom performance: Niacin (with a quarter of your recommended daily value in two tablespoons) and vitamin E (75% of your DV in that same serving). In a study printed in the Journal of Sexual Health, men suffering from impotence who took a niacin supplement reported a significant improvement in their bedroom prowess compared to men who took a placebo. Peanut butter is also a good source of folate, which improves sperm quality. Click here to see our top 16 Nut Butters for Muscle Building and Weight Loss!
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.
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Derived from the bark of a West African evergreen tree, yohimbe was the go-to ‘script for a wonky willy prior to the advent of wonder drugs like Viagra, Walker says. “Yohimbe enhances sexual performance both by blocking certain neurotransmitters in the brain and by increasing the release of nitric oxide in the cavernosal nerves of the penis,” he explains. And it pairs well with other erection-friendly tablets: A 2010 study in the Iranian Journal of Psychiatry found that a combination of yohimbe and L-arginine successfully helps guys get it up. However, yohimbe also has a handful of side effects, including elevated blood pressure and anxiety, so definitely talk to your doctor before you start on the supp.

According to the FDA (Food and Drug Administration), many of these products sold on the internet contain potentially harmful compounds. And they aren’t listed on the label. In an investigation, the FDA found that one-third of these online supplements were laced with undisclosed ingredients. This includes sildenafil—the active ingredient in Viagra. Doctors prescribe Viagra to some patients, but it’s not safe for everyone. The drug could interact with other medications and lower your blood pressure to dangerous levels. This makes ordering supplements online risky. You don’t know whether they contain sildenafil or other ingredients that could harm your health. 
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.
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.

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.


Males suffer with ED due to hormonal imbalance. Tufan capsules are the best ED pills as these can resolve the problem occurring due to hormonal fluctuations as well. These herbal ED pills provide natural treatment by suppressing hormonal fluctuations induced by insomnia, stress, medicines, health conditions, age and bad habits. When males have hormonal secretion in right quantity and proper balance they are able to maintain optimum functions of reproductive system and keep at bay problems like ED. Males leading stressful life, unable to exercise, inactive during the day and taking medicines or in habit of alcohol, smoking etc., easily exhaust their reproductive system, Tufan are reckoned as the best ED pills as these capsules alleviate the problem by handling all these causes effectively.
"Just because there is evidence doesn't mean it's good evidence," says Andrew McCullough, MD, associate professor of clinical urology at New York University Langone Medical Center in New York City, and one of the original clinical investigators for the ED drug Viagra (sildenafil). "And before men with ED start down the naturopathic route, it's smart to make sure that there isn't some underlying medical condition that needs to be corrected." Moreover, it is estimated that 30 million American men have erectile dysfunction, and 70% of cases are a result of a potentially deadly condition like atherosclerosis, kidney disease, vascular disease, neurological disease, or diabetes. Additionally, ED can also be caused by certain medications, surgical injury, and psychological problems.
Quassinoids isolated from Tongkat Ali have been reputed to be anti-tumor, anti-malarial, anti-amoebic and anti-inflammatory. Its leaves are used for washing itches, its fruits for the treatment of dysentery, its bark used as a vermifuge, the taproots used for treatment of hypertension and the root bark for treatment of diarrhea and fever. The roots extracts are used for sexual dysfunction, aging, malaria, cancer, diabetes, anxiety, aches, constipation, exercise recovery, fever, increased energy, increased strength, leukemia, osteoporosis, stress and syphilis. Animal studies done on middle age sex rats showed enhancement of the sexual qualities in terms of hesitation time among middle aged rats (46).
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.
Another potential cause of ED is prediabetes and diabetes—35-50 percent of men with diabetes also have ED. Chronically elevated blood sugar damages the arteries (there’s the vascular connection again) and nerves, including those that stimulate the penis. Prediabetes and diabetes are also generally accompanied by excess weight, especially around the mid-section. These excess fat cells convert testosterone into estrogen, negatively altering the testosterone to estrogen ratio. This excess estrogen, independent of prediabetes and diabetes, interferes with the hormonal cascade necessary to produce and maintain an erection. Although many men may reach for a testosterone booster, a more effective means is to improve the body’s metabolism and elimination of estrogen and to lose excess weight around the middle. To support healthy blood sugar balance and estrogen metabolism try:
According to legend, Casanova — the Tinder master of his time — regularly ate a breakfast of 50 oysters. Turns out he could’ve doubled as a nutritionist if he’d been able to get out of the sack. In addition to being high in B12, oysters contain more zinc than any other food source ( almost five times your daily DV). This nutrient is essential for testosterone production, and when your T levels droop, so does your business. Like other bivalves, oysters are high in D-aspartic acid, an amino acid that has been shown to temporarily boost low testosterone levels and improve sperm quality in infertile men.
Hard men have healthy hearts, so eat bananas for potassium, which is great for your heart and circulation. Getting enough potassium helps keep your sodium levels under control, stopping your blood pressure from hitting the roof and reducing your risk of heart problems. If you eat too much salt and don’t like bananas, get your potassium from oranges or jacket potatoes (the mineral’s in the skin).
Impotence, or erectile dysfunction (ED), is the inability for a man to sustain an erection long enough for normal, satisfying sexual intercourse.  To understand the underlying causes of impotence, it helps to know the basics about how an erection develops, along with potential problems that get in the way. Erections begin in the brain with a thought related to sexual desire. Then a chemical message travels from the brain to the penis. Blood flow to the penis increases as blood vessels leading to the reproductive system relax and allow for increased circulation.

According to legend, Casanova — the Tinder master of his time — regularly ate a breakfast of 50 oysters. Turns out he could’ve doubled as a nutritionist if he’d been able to get out of the sack. In addition to being high in B12, oysters contain more zinc than any other food source ( almost five times your daily DV). This nutrient is essential for testosterone production, and when your T levels droop, so does your business. Like other bivalves, oysters are high in D-aspartic acid, an amino acid that has been shown to temporarily boost low testosterone levels and improve sperm quality in infertile men.
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).
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