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.
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.

No matter what erectile dysfunction treatment or treatments (whether herbal remedies or not) a man ultimately decides upon, experts say it's important to eat healthily and to avoid smoking and heavy drinking. Moreover, adequate exercise, stress reduction, and sleep can improve erectile dysfunction in many. In addition, says Lamm, "A loving, receptive, and responsive partner is a home run. After all, this is still a couple's issue."
The art of acupuncture has become the new treatment for everything from back pain, depression, and even ED. Impotence could be more of a state of mind, and acupuncture may help. Through this alternative therapy, fine needles are placed in various parts of the body to relieve pain or stress. Although there are many mixed studies for acupuncture and ED, many tend to confirm positive results. A 1999 study found acupuncture improved the quality of erection and even restored sexual activity in 39 percent of participants.
The vacuum device is approved by USA Food and Drug Administration (FDA) for treatment of ED since 1982. Vacuum therapy (VT) works by creating a negative pressure environment around the penis through the use of a cylindrical housing attached to a pump mechanism, which can be manually-operated or battery-operated. Vacuum draws mixed arterial and venous blood into the corporal bodies and distends the corporal sinusoids to create an erected penis. If a pre-loaded constriction band is applied over the base of the penis to prevent outflow of blood and maintain tumescence for intercourse, it is considered a vacuum constriction device (VCD). It is recommended that the constriction band be removed within 30 mins to return the penis to its flaccid state, as prolonged application of the constriction band can compromise both arterial and venous blood flow (7). Some minor side effects associated with VCD are penile discomfort, coldness, numbness, bruising and pain on ejaculation. Major side effects such as penile skin necrosis, gangrene, urethral injury and Peyronie’s disease are very rare (8).
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.
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.

Mirja Holtrop wuchs in Aachen auf und studierte Informatik und Public Relations. Nachdem sie einige Jahre als Marketing Assistentin gearbeitet hatte, schloss sie sich der Rath Foundation an und ging nach Südafrika. Dort absolvierte sie an der Universität von Kapstadt ein Pädagogikstudium und publizierte 2004 ihr erstes Buch, “Das Geheimnis der Zellen.”
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.
Studies show that just 30 minutes of walking each day can be beneficial to those fighting ED. One Harvard study linked 30 minutes of walking per day with a 41 percent drop in the risk of erectile dysfunction. Some research shows that moderate exercise can help restore sexual performance in men who are middle-aged, obese, and have been diagnosed with ED.
Ginkgo Biloba is promoted to treat conditions ranging from hypertension to Alzheimer’s dementia. There is evidence that shows improvement of memory enhancements in the geriatric population (47), improvement in terms of cognitive function via effect on cerebral vasculature (48), improvement of claudication distance and cutaneous ulcers in patients with peripheral vascular disease (49). Ginkgo Biloba extract is proposed to induce NO in endothelial cells and thus causing relaxation of vascular smooth muscles. Animal studies have reported relaxation of rabbit corpus cavernosal smooth muscle cells with the use of Ginkgo Biloba (50). Adverse effects include headaches, major bleeding (in patient who are taking warfarin concurrently) and seizures with reported fatality (36).
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.
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.
3. Testosterone replacement. Before oral medications like Viagra, testosterone was routinely used to treat erectile dysfunction as it is central in the male sexual response, including the desire for sex and the process of getting an erection. Testosterone can be administered in a number of ways, for example orally, by means of an injection, skin patch, or subcutaneous (under the skin) pellet. 
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]
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.

Encouraging evidence suggests that ginseng may be an effective herbal treatment for ED. However, further, larger, and high-quality studies are required before firm conclusions can be drawn. Promising (although very preliminary) results have also been generated for some herbal formulations. Overall, more research in the field, adhering to the CONSORT statement extension for reporting trials, is justified before the use of herbal products in ED can be recommended.
Through supplementing with the micronutrients and plant extracts described in this article, and taking advantage of their synergistic effects, many men have found ED can successfully be treated and normal erectile function restored. As always, therefore, if you have any questions about the use of the Cellular Medicine approach, please feel free to contact us.

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.
These “sea pistachios,” as Kimmy Schmidt called them, are no joke.They’re one of the richest food sources of erection-enhancing Vitamin B12 you can find. The boner-boosting bivalves are also high in L-arginine, an amino acid that converts to nitric oxide (NO), the Marvin Gaye of naturally occurring gases: It causes blood vessels to relax and facilitate blood flow, helping you get and stay hard. Additionally, clams are high in muscle-building protein.
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] 
The most common adverse events associated with all of the PDE-5 inhibitors10 are headaches in 16% of men; flushing in 10% of men; dyspepsia (7%); nasal congestion (4%), and visual disturbances/color sensitivity in about 3%. Tadalafil distinguishes itself from vardenafil and sildenafil by the relative lack of visual side effects. It does, however, have an additional possible adverse effect, which is back pain and/or myalgia.11
Males suffering with ED, even after proper persuasion and in appropriate circumstances are unable to gain optimum stiffness to penetrate a woman, even if a male achieves stiffness he tends to lose it very quickly without performing lovemaking for satisfactory duration. All of these are symptoms of ED and also growing impotency in a male. Impotency can be severely hurtful to male’s pride and ego and make him depressed. Tufan herbal ED pills alleviate this condition by providing natural erectile dysfunction treatment; these best ED pills resolve the problem in male of any age in a short time.
Regular consumption of various types of cabbage, such as white cabbage, cauliflower, broccoli, and Brussels sprouts help get rid of the excess amount of estrogen, a female hormone. The increased estrogen levels interfere with the testosterone production. By the way, red radish and white turnips have the same effect as cabbage. In addition, to cleanse the body of toxins leading to high estrogen levels, it’s necessary to add a sufficient amount of high-fiber foods to your diet. These foods include most fresh fruits and vegetables.
Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor's OK. Medications for erectile dysfunction do not work in all men and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:

Males suffer with ED due to unhealthy lifestyle, poor diet, ageing, diseases and bad habits like alcoholism, smoking, drug use and abusive sexual behavior. Long term treatments and surgeries also cause this problem in some males. Tufan herbal ED pills provide fast, safe and effective natural erectile dysfunction treatment and resolve it handling all these reasons of the problem, these are reckoned as the best ED pills due to their herbal ingredients which are renowned remedies for treating debilities and weaknesses related to male reproductive system. These herbal ED pills are so effective that these can even reverse the effects of aging and keep a male active in bed for longer period in life. These ED pills are completely free of side effects as well.


The treatment of ED using TCM ties in with the treatment of late-onset hypogonadism (LOH). LOH occurs due to the breakdown in coordination between the heart and the kidneys, deficiencies of the spleen and kidney (yang), deficiencies of the liver and kidney (yin) and deficiencies of the kidney (yin and yang). The endocrine function of the pituitary and gonads becomes disordered with age due to a depression of overall function. This results in accumulation of free radicals and other toxins that cannot be relieved solely with male hormone supplementation. Warm yang can energize kidneys to benefit the body, remove toxins, invigorate qi and promote blood circulation. Free radicals are removed, blood fat regulated, cardio-cerebral blood flow improved and again the key here is to improve the function of the digestive, respiratory and endocrine systems, hence regulating the body in every aspect holistically (28).
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.
Sometimes low libido or sexual dysfunction can occur due to low testosterone levels. But that doesn’t necessarily mean you need a testosterone supplement. Your body usually can produce adequate testosterone, but it needs downtime to convert precursor hormones into testosterone. If you’re burning the candle at both ends, your body will convert those precursors into cortisol instead. So rest, relax, and allow your body to build up its testosterone stores.

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.

Poor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones. 

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