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.
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Acupuncture. Though acupuncture has been used to treat male sexual problems for centuries, the scientific evidence to support its use for erectile dysfunction is equivocal at best. In 2009, South Korean scientists conducted a systematic review of studies on acupuncture for ED. They found major design flaws in all of the studies, concluding that "the evidence is insufficient to suggest that acupuncture is an effective intervention for treating ED."
Korean red ginseng, also known as Asian ginseng or Chinese ginseng, is believed to be a highly effective natural remedy for treating ED. It is a traditional Asian remedy for sexual dysfunction and is widely used in the United States. Studies have shown that red ginseng can have significant therapeutic effects on penile rigidity and girth, libido, and patient satisfaction. It also has a reassuring safety profile, making it one of the most popular and proven natural remedy for ED.12
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.
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.
By far the most common cause of ED is vascular dysfunction. When the arteries that supply the penis with blood to achieve and maintain an erection are blocked or hardened, or the lining of these arteries are damaged, blood flow is reduced. Vascular dysfunction not only affects the small arteries of the penis, but the larger coronary arteries of the heart too. Astute doctors now recognize that ED may actually be an early warning sign of impending cardiovascular disease, showing up several years before a cardiovascular event like a heart attack or stroke.2 To maintain healthy vascular function, and in turn, normal erectile function, consider these supplements:
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!
Jelqing is penile massage technique of ancient Arabic origin (52). Men who practise jelqing will stretch their penises while in a semi-erected state and repeatedly milk their penises from base to glans, with their thumb and index finger touching to form an “OK” hand sign around their penile shaft. This massage can be done daily with the aim to achieve greater penile length and harder erections. Unwanted side effects of bruising, pain and fibrosis had been reported. No studies have been done to evaluate the efficacy of jelqing objectively.
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.
The lack of strong scientific proof that vitamin supplementation can improve erectile function doesn’t stop companies from selling vitamins, herbal supplements, and other products with the promise that they will do the job. ED is often treatable with prescription medications or medical procedures, so be careful not to get taken by a manufacturer’s empty promises.
Do not exceed 1 capsule in 24 hours. This is only intended for those 18 and over. Do not use if you are pregnant, nursing, or intend on becoming pregnant. If you have any current heart issues, such as but not limited to, hypertension, heart disease, and high cholesterol do not use. If you have any other medical issues such as prostate cancer and prostate enlargement do not take. Do not take this product if you're on any medications such as MAOI's or nitrates. Consult with your physician or health care provider to using the product.
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.
In total, 24 RCTs, including 2080 patients with ED, were identified. Among these, 12 evaluated monopreparations (five ginseng [n = 399], three saffron [n = 397], two Tribulus terrestris [n = 202], and one each Pinus pinaster [n = 21] and Lepidium meyenii [n = 50]), seven evaluated formulations (n = 544), and five investigated dietary supplements in combination with pure compounds (n = 410). Ginseng significantly improved erectile function (International Index of Erectile Function [IIEF]-5 score: 140 ginseng, 96 placebo; standardized mean difference [SMD] 0.43; 95% confidence interval [CI] 0.15-0.70; P < 0.01; I2 = 0), P. pinaster and L. meyenii showed very preliminary positive results, and saffron and T. terrestris treatment produced mixed results. Several herbal formulations were associated with a decrease of IIEF-5 or IIEF-15, although the results were preliminary. The quality of the included studies varied, with only seven having a prevalent low risk of bias. The median methodological quality Jadad score was three out of a maximum of five. Adverse events were recorded in 19 of 24 trials, with no significant differences between placebo and verum in placebo-controlled studies.
It can’t be stressed enough — a healthy diet and lifestyle has numerous benefits, including in the bedroom. ED is linked to cardiovascular disease and diabetes, so eating a Mediterranean-style diet rich in fresh fruits and vegetables, healthy fats, and whole grains can reduce your chance of developing heart problems and, in turn, can alleviate your ED.
Ginkgo biloba. Known primarily as a treatment for cognitive decline, ginkgo has also been used to treat erectile dysfunction -- especially cases caused by the use of certain antidepressant medications. But the evidence isn't very convincing. One 1998 study published in the Journal of Sex & Marital Therapy found that it did work. But a more rigorous study, published in Human Pharmacology in 2002, failed to replicate this finding. "Ginkgo has come out of fashion in the past few years," says Ronald Tamler, MD, assistant professor of medicine and codirector of the men's health program at Mount Sinai Medical Center in New York City. "That's because it doesn't do much. I can say that in my practice, I have not seen ginkgo work -- ever."
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.
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.
There are many different treatment options for erectile dysfunction but your individual diagnosis will determine which treatment option is right for you. It is important to realize that not all treatment options will work for everyone. A doctor who has specialized in men’s sexual health (typically a urologist) will be the most qualified to discuss all of your treatment options with you. Many specialists will often encourage you to schedule additional follow up appointments to review how your treatment is working for you or if a different option may be more beneficial.
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.
"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.
For example, you’ll often hear that watermelon is a great remedy for ED. This belief seems to come from a study done in 20075, which showed that consuming watermelon could raised levels of L-arginine in the bloodstream. L-arginine is used in the production of nitric oxide (NO), which is a key to healthy erections (see our article, “How Do Erections Work“). However, the study did not show that consuming watermelon actually improved erections. Also, the subjects consumed the equivalent of three eight-ounce glasses of watermelon juice per day!
Contrary to popular belief, the penis does not have a mind of its own. To make it a fine and upstanding specimen, your neurons must be co-ordinated with military precision. You need thiamine, aka vitamin B1, for a healthy nervous system, so eat pork to help fire your swimmers in the right direction. Can’t or don’t eat pig? Get your B from beans and wholemeal bread.
The medications also require a healthy endothelium and healthy arteries capable of providing increased blood flow to work. If the sex organ arteries the size of a swizzle stick are severely diseased, there will be no “bada-boom bada-bing” an hour after taking them. These medications only work by enhancing the natural effects of a healthy endothelium.
Porn induced erectile dysfunction occurs if the blood flow to the penis is not enough. This may happen because of unhealthy blood vessels. Many male aging studies show that a healthy food and ED risk decrease are interrelated. Thus, the consumption of fruits, vegetables, and whole grains reduces the ED symptoms, while the consumption of red meat and refined grains increases them.
I mentioned taking herbs and supplements to treat erectile dysfunction, so I want to add a note of caution about using so-called “natural male enhancement” pills. The Food and Drug Administration (FDA) recalls dozens (if not hundreds) of these products each year for containing the active ingredient in medications used to treat ED. When you buy those products from the internet, or even from a retail store, you have no real way of knowing what you’re ingesting. The active ingredient in drugs like Viagra, Cialis, and Levitra can negatively interact with other medications, so it’s essential that you take them with medical supervision.
Safety Warning Do not use this product if you take any other medications or have any medical condition such as heart disease, high blood pressure, seizures, stroke, cancer, liver failure, severe headaches, allergies or any other condition. Consult a physician if you have heart problems before taking this pill. Do not exceed recommended daily intake. Consult your doctor before taking this pill. Stop using immediately if undesirable effects develop. Keep out of the reach of children. DO NOT take if you are pregnant, have high blood pressure, diabetic, or have any heart disease/problem. Store this product in a cool and dry place. Do not take this pill with anything that may have nitrate in it. If you are currently under treatment for ANY medical conditions, please consult your physician before taking this pill. — Before taking this or any other supplement, always consult with a medical professional to ensure there will be no adverse interactions with existing medications. Please use caution if you have sensitivity to any of the listed ingredients. Because of the purity of this product, in rare circumstances, individuals consuming this product may experience allergic reactions, digestive distress, upset stomach, diarrhea, constipation, heartburn, gas, headaches, dizziness, jitters, stomach pain, sickness, nausea, fatigue, changes in blood pressure, bloating, irritation, sleeplessness, pain or discomfort. Because of the potency and purity of this Ginseng extract, the capsules are not meant to be opened, as they will have a bitter and seemingly "salty" taste and smell. If any of these symptoms persist, discontinue use immediately and contact a licensed medical doctor or professional. Please contact us for a complete refund if any of the effects of this product are too strong to tolerate. Do not use if seal around cap is broken or missing. Do not exceed recommended dose. Pregnant or nursing mothers, children under the age of 18, and individuals with known medical condition should consult a physician before using this or any dietary supplement. Please use caution if you have sensitivity to any of the listed ingredients. Consumption of herbal ingredients may cause allergies to certain individuals, please check with your physician before taking any herbal supplements. If you have a history of allergies to herbal ingredients, do not consume this product. Possible side effects include dizziness, headache, nausea, vomiting, constipation, and diarrhea.
Some studies show that watermelon may have effects on erectile dysfunction that are similar to the ED drug Viagra and may also increase sexual desire. Watermelon is rich in beneficial ingredients known as phytonutrients. Phytonutrients are also antioxidants. One of their benefits is that they relax the blood vessels that supply an erection. Although watermelon is 92 percent water, the other 8 percent may work wonders for your heart and your sexual enjoyment.
How common is impotence? According to findings from several studies, including “The Massachusetts Male Aging Study,” overall prevalence for men between 40–70 years old is around 52 percent (or around 30 percent of all men between 18–60 years old). That’s right — nearly half of all men over 40 experience erectile dysfunction symptoms at some point. Not surprisingly, research demonstrates that impotence is increasingly prevalent with age. Around 40 percent of men in their 40s experience sexual dysfunction. Up to 70 percent of men in their 70s experience ED. (1) Every year more than 617,000 new cases of impotence occur in the United States alone.
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.