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:
"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.
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
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.

If impotence affects you or someone you love, don’t lose hope. You may be suffering from a medical or emotional issue that is causing low libido or impotence — possibly interfering with both your confidence and relationship — but the good news is there are effective natural remedies for impotence that can help reverse this problem in most men. Around 70 percent of ED cases are resolved with natural impotence remedies that can help restore your sexual health.
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).
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.
In TCM, the meridian system is thought to represent a path through which the life energy qi flows and as discussed in earlier section, the “Jing” (kidney) qi plays an important role in penile erection. Acupuncture helps to correct the imbalances to relieve physical symptoms by stimulating various meridian points. The Shensu (BL23), Zusanli (ST36) and Neiguan (PC6) points represents important acupoints for penis stimulation and thus has a positive homeostatic effect on the autonomic nervous system, and potentially modulate NO release (55,56). While some studies have showed up to a third of patients reported improvement in penile erection and sexual activity, systematic review showed insufficient data to conclude that acupuncture is an effective intervention for treating ED (56,57). Therefore, further scientific research is required to investigate whether there are specific benefits of acupuncture for men with ED before acupuncture can be accepted as evidence-based practice.
Another natural treatment for erectile dysfunction to consider would be vitamin E. This is a vitamin that has been linked to chronic diseases in the past due to the antioxidant effects of this vitamin. Considering ED could be a manifestation of another chronic condition, it makes sense that vitamin E may have a role in reducing the symptoms of the disease. As a person ages, it is natural for the body to undergo more oxidative stress and damage as cells do not function as well as they once did. Rats who were given supplemental vitamin E were found to have reduced levels of oxidative damage to their tissues and had levels of NO and other factors that help induce an erection more similar to younger rats compared to rats without vitamin E supplementation. If patients incorporate vitamin E into their vitamins and dietary supplements for ED, their ED should improve. [9]
Quien és mas macho? A recent study by French researchers found that men who eat the most spicy foods tend to have higher testosterone levels than those with milder palates. Study authors attribute the T-boosting effects in part to capsaicin, a compound in chilies that previous research has associated with increased testosterone levels. Seriously spicy serrano peppers are also packed with quercetin, a nutrient shown to boost testosterone levels in the body by reducing the amount that’s otherwise flushed out by the kidneys. Capsaicin, the compound that makes tabasco sauce hot, releases chemicals that increase heart rate, mirror signs of arousal and rev up things.
Males gain erection due to hydraulic effect of blood, when brain senses arousal it rushes blood towards male genital organ where blood is absorbed by tissues which grow stiff and bigger to cause erection. Males having hindrances in this process due to poor sensation, blocked blood vessels, weak nerves, weak tissues or lethargic reproductive system are unable to gain erection. Tufan are reckoned as the best ED pills as these remove all sorts of hindrances to provide natural erectile dysfunction treatment, and as these are herbal ED pills hence do not cast any side effects.

A 2000 study conducted at the Institute of Sexology in (where else?) Paris found that muira puama, a Brazilian shrub traditionally used in South African folk medicine as an aphrodisiac, increased libido in a majority of men who complained of impotence and a lack of desire. Other studies show this happy-making herb also counteracts chronic stress, depression and nervous exhaustion.
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.
Much of the evidence shows high rates of vitamin D deficiency in patients with erectile dysfunction. In fact, one study of 3,400 participants found that men with vitamin D deficiency were 32% more likely to have trouble with erections when all other risk factors were controlled for. It’s a little on the nose that you need vitamin D for your “D,” but hey—science can be funny too.
With the advent of the “little blue pill” men’s sexual health has been thrust into the public eye and now, rather than worrying in embarrassed silence about “performance” issues, men are able to openly seek the help they need to function at their best. This is good news for the 30 million American men who suffer from erectile dysfunction or ED.1 And because 70 percent of ED cases are physiological in nature (it’s not just in your head) and often a sign of some other serious health issue, it is wise to address and correct the underlying physical imbalances that are hindering performance in the first place, ensuring both shortterm happiness and long-term health.

In TCM, the meridian system is thought to represent a path through which the life energy qi flows and as discussed in earlier section, the “Jing” (kidney) qi plays an important role in penile erection. Acupuncture helps to correct the imbalances to relieve physical symptoms by stimulating various meridian points. The Shensu (BL23), Zusanli (ST36) and Neiguan (PC6) points represents important acupoints for penis stimulation and thus has a positive homeostatic effect on the autonomic nervous system, and potentially modulate NO release (55,56). While some studies have showed up to a third of patients reported improvement in penile erection and sexual activity, systematic review showed insufficient data to conclude that acupuncture is an effective intervention for treating ED (56,57). Therefore, further scientific research is required to investigate whether there are specific benefits of acupuncture for men with ED before acupuncture can be accepted as evidence-based practice.
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.
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.
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.
The diagnosis of erectile dysfunction requires a comprehensive sexual and medical history that include a validated questionnaire, the Sexual Health Inventory for Men (SHIM), and asking if they experience a rigid erection at night, in the morning, or during masturbatory approaches. The presence of rigid morning or night erections, or rigid erections at any sexual thought suggests a mainly psychogenic cause. Conversely, erectile dysfunction with a gradual onset, progressive course, or long duration suggests a predominantly organic cause.
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.
Medicines like I-Arginine and viagra, can fix your problems for hours but vitamins and amino acids will cure erection problems for long term. Remember, not to take vitamins and medications (I-Arginine) at the same time as it can react in your body. Discuss your doctor before adding any vitamin to your routine. Apart for I-Arginine and other pills, here we have given some vitamins to quick fix your problem and have a better sex life.
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."
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).
Long considered an aphrodisiac by the Chinese, ginseng may do more than just rev your engine. A 2013 South Korean study found that taking the herb for just a few weeks improved guys’ performance in the bedroom, including helping them last longer before finishing. Meanwhile, a study in Spermatogenesis found that ginseng can also help make for harder, longer-lasting erections and improve testosterone levels, which in turn boosts libido. “Ginseng is a promising herbal therapy for ED because it helps promote relaxation of smooth muscle in the penis, increase dopamine levels in the brain, and increase pressure in the cavernosal nerves of the penis which helps nitric oxide synthesis,” Walker explains.
The use of penile support device such as penile cast worn externally during intercourse has been tried to provide length and rigidity to the penile shaft (24). Each device can be customised to the patient’s penile size and provided an option for patients who are seeking non-pharmaceutical/non-invasive treatment, or have end-organ failure who may not be candidates for, or unable to afford, penile prosthesis implant.
Antioxidants  boost nitric oxide production and prevent NO breakdown. Ascorbic acid has direct effects on the bioactivity of NO, and augments NO production in a variety of body processes. The effects are actually synergistic with Vitamin E. Both vitamins are not usually measured, and a reasonable dose of Vitamin C is 500 to 1,000 mg daily. Vitamin E supplementation should be limited to <400 IU per day because of potential adverse long-term health effects of higher doses.
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.
Erectile dysfunction supplements and other natural remedies have long been used in Chinese, African and other cultures. But unlike prescription medications for erectile dysfunction, such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis, Adcirca) and avanafil (Stendra), erectile dysfunction herbs and supplements haven't been well-studied or tested. Some can cause side effects or interact with other medications. And the amount of the active ingredient can vary greatly from product to product.
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