Dan practices a unique blend of conventional and holistic medicine, drawing on his extensive experience with integrative techniques like healing touch, guided imagery and yoga. By fostering an understanding of the deep connections between body, mind and spirit, Dan seeks to help every patient unlock his or her own innate healing ability. He received his MD from the Hahnemann College of Medicine and completed his residency in family practice through UCSF. Dan is a fellow of the Wilderness Medical Society, is a clinical instructor at UCSF, and is certified with both the American Board of Family Medicine and the American Board of Holistic Medicine. Dan is a One Medical Group provider and sees patients in our San Francisco offices.
To understand the physiology of erectile dysfunction, we need to know erection first. An erection occurs when impulses from the brain and genital nerves cause blood to fill the two chambers known as the corpora cavernosa in the male penis. This causes the penis to expand and stiffen. Anything that blocks these impulses or restricts blood flow to the penis can result in ED. This block may be caused by psychological, neurologic, hormonal, arterial, or cavernosal impairment or even from a combination of all these factors.3
To achieve and maintain an erection, healthy blood vessels and an optimum blood flow are essential. Significantly, therefore, Dr. Rath’s research has proven that specific micronutrients play key roles in maintaining the structural integrity of blood vessels and optimizing blood flow. Such micronutrients include vitamins C and E, the amino acids lysine and proline, and the mineral copper.
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

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.
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.
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:

The article discusses erectile dysfunction (ED) with the special emphasis on epidemiology, as well as the currently available medical treatments. Describing treatment methods authors paid special attention to natural therapies (as Panax ginseng, Tribulus terrestris, Vaccinium macrocarpon), because taking into consideration their safety profile, they appear to be an important alternative to therapies with synthetic molecules. From substances of natural origin, extract from the fruit of Tribulus terrestris ranks itself high on in collation at the end. The results of most clinical trials and experiments clearly demonstrate its effectiveness in improving sexual function in men.
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:

Classic dietary staples, like the chicken breast, may not have the Instagram presence of say, maca, but they earn a place on plates much longer. Simply put, their health benefits continue to stack up. In addition to a hefty amount of arginine — only turkey has more — a 3-ounce cooked chicken breast contains only 142 calories and 3 grams of fat, but an impressive 26 grams of protein. That’s more than half of the day’s recommended allowance. Plus, it’s rich in B vitamins to rev your metabolism and energy levels. (And if you’re looking to treat erectile dysfunction, those B vitamins definitely don’t hurt.)
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.

Cherries are rich in anthocyanins, plant chemicals which clean your arteries of plaque, keeping them open for business. That has a direct effect on blood flow below the belt. So make them a regular snack: One cup clocks in at fewer than 100 calories and boasts B vitamins, cancer-fighting flavonoids and three grams of fiber. For more essential fat-blasters for your kitchen, stock up on these 9 Best Flat-Belly Superfoods!
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.
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.

These drugs facilitate erection by inhibiting the PDE5 enzyme, by blocking the degradation of cyclic guanosine monophosphate (cGMP) in the cavernous smooth muscles. This inhibition results in the prolonged activity of cGMP, which further decreases intracellular calcium concentrations, maintains smooth muscle relaxation and, hence, results in rigid penile erections.


Doctors will often recommend certain medications for ED including Viagra, Cialis, and Levitra. These medications can treat ED for many men. But these medications may be unsafe for some men to take, or they don’t help relieve symptoms. In such cases, testosterone replacement therapy is another helpful option. This is prescribed when ED is caused by reduced levels of testosterone.
Wu, Guoyao; Collins, Julie K; Perkins-Veazie, Penelope; Siddiq, Muhammad; Dolan, Kirk D; Kelly, Katherine A; Heaps, Cristine L; Meininger, Cynthia J. “Dietary Supplementation with Watermelon Pomace Juice Enhances Arginine Availability and Ameliorates the Metabolic Syndrome in Zucker Diabetic Fatty Rats.” The Journal of Nutrition. Dec 2007. Volume 137, Issue 12, Pages 2680–2685.

Other factors that “stress” the body can also increase your risk for ED. These include: substance abuse, using marijuana, smoking cigarettes, depression, anxiety and low self esteem. Cigarette smoking — or using nicotine — leads to constricted blood vessels, which has negative effects for sexual health. Other mental/emotional obstacles can cause less desire for sex and decrease testosterone. Several ways to help manage stress include:


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).
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.
10 ways of knowing that you are properly squeezing your pelvic floor muscles (PFM): 1) The base of your penis retracts inwards towards the pubic bone as you contract your PFM. 2) The testes rise towards the groin as you contract your PFM. 3) When you place your index and middle fingers in the midline between the scrotum and anus you feel these muscles tighten as you contract your PFM. 4) You can pucker your anus (not the gluteal muscles) as you contract your PFM. You feel the anus tighten and pull up and in, known as “anal wink.” 5) You get the same feeling as you do when you are ejaculating when you contract your PFM. 6) When you touch your erect penis, you feel the erectile cylinders surge with blood as you contract your PFM. 7) You can make your erect penis elevate (lift and point) as you contract your PFM. 8) You can stop your urinary stream completely when you contract your PFM. 9) You can push out the last few drops of urine that remain after completing urination when you contract your PFM. 10) After pursuing PFM training, you notice improvements in erectile rigidity and durability as well as better quality ejaculations, ejaculatory control and improvement in urinary control.

Yohimbine is an indole alkaloid derived from the bark of the African yohimbe tree (33). Yohimbine has been noted to treat fatigue, depression, diabetes, and sexual dysfunction. A meta-analysis of seven placebo-controlled trials (34) deemed yohimbine superior to placebo for the treatment of ED with rare adverse events. The proposed mechanism of action (35) is via the inhibition of central alpha-2-adrenergic receptors, decreasing central inhibition of arousal, and increasing penile nerve stimulation resulting in increased NO. Common side effects include headache, sweating, agitation, hypertension and insomnia. Contraindications include patients on tricyclic antidepressants, anti-hypertensives and central nervous system stimulants.
While ED may seem like a monumental problem on its own, it is usually a sign of a bigger health issue. It is important to isolate and address underlying issues and support overall health by cleaning up your diet, maintaining healthy blood sugar balance, quitting smoking, regularly moving your body, and managing stress appropriately. Along with these healthy lifestyle changes, a carefully chosen natural supplement routine can offer additional support so you can regain your vitality and get on with enjoying your life.
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.”

In addition, when research has shown a nutrient such as zinc or niacin to improve sexual function, it's usually in people who are deficient in it. So, before you stock up on over-the-counter nutritional supplements for ED, speak with your doctor. He can test you for deficiencies and steer you toward the most effective and safest way to treat your erectile dysfunction. 
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