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.

Yohimbe. Before Viagra and the other prescription erectile dysfunction drugs became available, doctors sometimes prescribed a derivative of the herb yohimbe (yohimbine hydrochloride) to their patients suffering from ED. But experts say the medication is not particularly effective, and it can cause jitteriness and other problems. "It's not a great drug," says McCullough. "And I suspect the herb is not as potent as the pharmaceutical version." What's more, evidence shows that yohimbe is associated with high blood pressure, anxiety, headache, and other health problems. Experts discourage its use.
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.
Overall, men with a higher total intake of fruit saw a 14 percent reduced risk of ED, whereas men who consumed foods rich in anthocynanin, flavones, and flavanones, had a 10 percent reduced risk of ED. What’s more, consumping several servings of these foods each week is as beneficial for your manhood as briskly walking for five hours each week. But, if you really want to reap the benefits, men who exercised and consumed flavanoid-rich foods experienced a whopping 21 percent reduced risk of erectile dysfunction.

Nature’s ultimate example of truth in advertising, chili peppers bring the heat. They contain capsaicin, a natural chemical that lends spicy food its pleasurable pain and has serious fat-burning and libido-revving benefits. Research has shown that it boosts testosterone and increases circulation — all good news for your erection and what you do with it. Capsaicin also boosts the release of endorphins, which in turn stimulate desire.

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


Need a snack? Choose nuts, researchers from Turkey suggest. After 17 men with ED ate 100 grams of pistachios for three weeks, they all reported a significant improvement in their erectile function, ability to orgasm, libido, sexual satisfaction, and overall happiness in life. As a bonus, they all had higher HDL, or “good,” cholesterol and lower LDL, or “bad,” cholesterol, too.
Mirroring the micronutrient synergy approach that has been pioneered by scientists at the Dr. Rath Research Institute, research has shown that the combination of arginine and pycnogenol, an extract from French maritime pine bark, can correct ED in 80 percent of patients after just two months. After a period of three months, the researchers found that an impressive 92.5 percent of patients were experiencing normal erectile function without any side effects.
Sure, it’s good for your cholesterol, but did you know red wine can benefit your manhood? Red wine contains nitric oxide, which helps relax the arteries and increase blood flow in the genitals, and the compound quercetin, which helps block the enzyme that triggers your body to push away testosterone, allowing you to maintain high levels of testosterone—and a strong erection well past foreplay.
Penile implants - are generally used if physical damage (like an accident) makes the anatomical parts needed for an erection not work. These are inserted by surgery and can provide a permanent treatment choice if others fail to work. The implants can be semi-rigid or inflatable. They can be pretty expensive and are not usually available on the NHS.
org/posts/Mens-Health/Too-much-porn-masturbation-cause-ED/show/183203 On GOOGLE VIDEO find “Erectile Dysfunction And Porn” - watch the video series. Here’s a Psychology Today article on it Porn-Induced Sexual Dysfunction Is A Growing Problem http://www.psychologytoday.com/blog/cupids-poisoned-arrow/201107/porn-induced-sexual-dysfunction-is-growing-problem PS - all the other factors listed are irrelevant at age 21.
Usually patients will try less invasive alternatives to treat impotence before opting for surgery. These alternatives may include supplements, herbs, lifestyle changes and even medications. In cases where other treatments do not work to resolve ED, surgery might be a last-resort option. Surgery involves implanting a penile prosthesis. This is a saline-filled silicone device or a malleable device. Although the likelihood of serious side effects is considered to be low, certain risks are associated with surgery to correct erectile dysfunction. These side effects may include: anesthetic risk, device infection, and device malfunction or mechanical failure. Some studies have found that five years following surgery around 10–20 percent of men experience device malfunction and failure. Infection rates are low. Around one percent of men who opt for this type of surgery get an infection.

ED is caused by vascular, hormonal, neurogenic, pharmacological, or psycho-genic factors. Performance anxiety where the person fears failing in a sexual scenario is a common psychogenic cause for ED.3 Neurogenic causes are related to diseases like Alzheimer's, Parkinson's, stroke or spinal cord injuries. Radical removal of the prostate (also called prostatectomy) is the cause of nerve-related ED as nerve injury is possible despite advances in surgical methods.4
If i do attain an erection i feel like im going to loose it (weak erection mainly) has anybody had or heard of a reversal to address erection issues/ erectile dysfunction, and if so has it worked to fix the issues?? Im considering paying for a reversal, just worry it may make my issues worse, whereby i could potentially not get an erection permanently. is anybody aware of a successful reversal to fix erection issues post vasectomy ??
Reiter, W. J., Pycha, A., Schatzl, G., Pokorny, A., Gruber, D. M., Huber, J. C., & Marberger, M. (1999, March). Dehydroepiandrostone in the treatment of erectile dysfunction: A prospective, double-blind, randomized, placebo-controlled study [Abstract]. Urology, 53(3), 590-594. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429598005718

DHEA. Testosterone is essential for a healthy libido and normal sexual function, and erectile dysfunction sufferers known to have low testosterone improve when placed on prescription testosterone replacement therapy. Similarly, studies have shown that taking over-the-counter supplements containing DHEA, a hormone that the body converts to testosterone and estrogen, can help alleviate some cases of ED. But DHEA can cause problems, including suppression of pituitary function, acne, hair loss and its long-term safety is unknown, says McCullough. For this reason, many experts discourage use of the supplements.

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.
The use of shock wave therapy has revolutionized the treatment of many aspects of medicine. High intensity extracorporeal shockwave therapy has been used for the treatment of nephro-urolithiasis while medium intensity shockwave therapy is used by orthopaedic surgeons to treat joint pain as well as tendinitis. Low intensity shockwaves therapy was first noted to improve ischaemia-induced myocardial dysfunction in animal studies when low intensity shockwaves were applied to porcine myocardium (13). Shockwaves induces a localized stress on cell membranes in the same way that shear stress affects endothelial cell membranes (14) and this triggers the release of angiogenic factors, such as increased NO production through increased activity of endothelial NO synthase (eNOS) and neuronal NO synthase (nNOS), platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) (15). These shockwaves also cause membrane hyperpolarization (16), activation of the Ras signaling pathway, non-enzymatic synthesis of NO and induction of stress fibers and intercellular gaps (17).
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.
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).
The role of the practitioner providing a naturopathic treatment plan is to first identify the cause of the individual's ED. If the cause is psychogenic (i.e. performance anxiety, depression, relationship problems), referral to a psychotherapist should be considered. Organic causes like metabolic syndrome, insulin resistance, or diabetes type II can be properly treated with lifestyle medicine and other numerous nutritional prescriptions beyond the scope of this article to discuss.
Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. The One Medical Group entities and 1Life Healthcare, Inc. make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.
Another common cause of ED for many men is stress. When the body is under stress—either mental or physical—the sympathetic nervous system kicks in, releasing a cascade of stress hormones. Chronic stress leads to elevated levels of these hormones, which can lead to weight gain around the middle, and remember, those excess fat cells convert testosterone to estrogen. Stress also reduces sexual drive and leaves very little physical energy for sex. If chronic stress is a problem, try these supplements:
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. 
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.
Eating spinach, a green rich in appetite-suppressing compounds, can not only make you look better naked but increase blood flow below the belt. “Spinach is rich in magnesium, a mineral that decreases inflammation in blood vessels, increasing blood flow,” explains Cassie Bjork, RD, LD of Healthy Simple Life. “Increased blood flow drives blood to the extremities, which, like Viagra, can increase arousal and make things more pleasurable,” says Tammy Nelson Ph.D. Spinach is also rich in folate, which increases blood flow to the nether regions, helping to protect you against age-related sexual issues. For 150+ recipes that will make your belly flat—and your member look bigger—buy the brand-new book from Abs Diet creator David Zinczenko: Zero Belly Cookbook!
She is ‘a pile of mashed potatoes’, her breasts are a ‘tragedy’, she looks terrible in clothes but even worse when nude, wanted surgery for ‘a quick fix’ because she is too lazy to exercise, she has never looked worse, etc … and you are faking erectile dysfunction because you do not want to talk about the fact that you are still crying over a breast reduction that you didn’t want her to get.
According to the Cleveland Clinic, “because erectile dysfunction is caused by a complex set of psychosocial, neurologic, and vascular factors, a specific cause in a patient may remain ambiguous.” The root causes are often related to a blockage or dysfunction of blood vessels. For example, ED can be due to conditions like atherosclerosis or diabetes, hormonal imbalances or problems related to mental health. It’s been found that common causes typically include one or more of the following factors: (2)
Picture this: Draw one circle about the diameter of a Number 2 pencil and another circle that is smaller and about the diameter of a stirrer in a drink side by side. The larger circle is the approximate diameter of a good-sized coronary artery. The smaller circle is approximately the diameter of the pudendal artery, the major blood supply to the penis.
Penile vibratory stimulator is a battery operated device with oscillating discs that can provide excitation of afferent penile nerves at various regulated frequency and amplitudes. PVS has been utilised to activate the ejaculatory reflex for patients with spinal cord injury above T10 seeking to collect retrogradely ejaculated semen in fertility treatment (10). The Viberect is a vibratory stimulation handheld device approved by FDA for treatment of ED. It is clamp-shaped with two oscillating discs facing each other near the tips, and the glans penis is placed between the two oscillating discs to receive concurrent dorsal and ventral stimulation at adjustable frequencies and amplitudes.
Just because a product claims to be natural doesn't mean it's safe. Many herbal remedies and dietary supplements can cause side effects and dangerous interactions when taken with certain medications. Talk to your doctor before you try an alternative treatment for erectile dysfunction — especially if you're taking medications or you have a chronic health problem such as heart disease or diabetes.
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