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.

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] 
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).
Pumpkin seeds are one of the best dietary sources of zinc and magnesium—essential minerals shown to boost testosterone levels and growth factor hormone, especially when combined. In fact, college football players who took a nightly zinc-magnesium supplement showed a 30 percent increase in testosterone levels and a 13 to 16 percent increase in leg strength, one eight-week trial found. The seeds are also a rich source polyunsaturated fatty acids shown to boost prostaglandins — hormone-like substances that play a key role in feeling turned on. Grab some, or choose any of these 50 Best Snacks for Weight Loss!
Another potential cause of ED is prediabetes and diabetes—35-50 percent of men with diabetes also have ED. Chronically elevated blood sugar damages the arteries (there’s the vascular connection again) and nerves, including those that stimulate the penis. Prediabetes and diabetes are also generally accompanied by excess weight, especially around the mid-section. These excess fat cells convert testosterone into estrogen, negatively altering the testosterone to estrogen ratio. This excess estrogen, independent of prediabetes and diabetes, interferes with the hormonal cascade necessary to produce and maintain an erection. Although many men may reach for a testosterone booster, a more effective means is to improve the body’s metabolism and elimination of estrogen and to lose excess weight around the middle. To support healthy blood sugar balance and estrogen metabolism try:

A recent study found that men with erectile dysfunction who ate pistachio nuts every day for three weeks experienced significant improvement in sexual issues, including ED, sexual desire, and overall sexual satisfaction. The benefits of pistachios for erection problems may be due to a protein called arginine, which may help relax blood vessels. "This is another example of how good circulation is good for sexual health, which is good news because I eat a lot of pistachios," says Dr. Daneshgari.
If you bike a lot and have a very narrow saddle on your bicycle, consider switching to a "no-nose seat" which is wider at the back than a conventional saddle, allowing more of your weight to be distributed to the sitting bones. Make sure the seat is level or angled slightly downward and at a height that allows your knee to be just slightly bent at the bottom of the pedal cycle. Raising the handlebars on your bike so that you're sitting upright may also help.
Ginseng, specifically “red ginseng,” is known as the “herbal Viagra” that helps puts to rest men’s bedroom woes. Red ginseng is when the root has been steamed and then dried. The ginseng root is the part of the plant that is mostly used as a natural remedy when in its supplement form. However, the plant must be grown for a minimum of five years before it can be used. In a 2008 review, seven studies on red ginseng and ED, ranging in dosages from 600 to 1,000 milligrams three times a day, were found to provide evidence for the effectiveness of the herb in ED treatment.
Jacka, Felice N.; O’Neil, Adrienne; Opie, Rachelle; Itsiopoulos, Catherine; Cotton, Sue; Mohebbi, Mohammedreza; Castle, David; Dash, Sarah; Mihalopoulos, Cathrine; Chatterton, Mary Lou; Brazionis, Laima; Dean, Olivia M; Hodge Allison M; Berk, Michael. “A randomised controlled trial of dietary improvement for adults with major depression.” BMC Medicine. Jan 2017.
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.
It’s no secret that oily coldwater fish like wild salmon, sardines, and tuna are overflowing with omega-3 fatty acids, but here’s something you may not know: The nutrient not only benefits your heart but also raises dopamine levels in the brain. This spike in dopamine improves circulation and blood flow, triggering arousal. There’s more: “Dopamine will make you feel more relaxed and connected to your partner, which makes intercourse more fun,” says Tammy Nelson. Just make sure you’re ordering the right kind by reading this special report: 8 Mistakes You’re Making When Buying Salmon!
Peanuts contain a trove the amino acid L-arginine, which is one of the building blocks of nitric oxide, which aids your efforts under the covers. They also help reduce cholesterol levels. The less cholesterol you have in your system, the easier it is for blood to circulate throughout your body and down, which can help you maintain a firmer erection longer.
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. 
Pay attention to your vascular health. High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the heart (causing heart attack), in the brain (causing stroke), and leading to the penis (causing ED). An expanding waistline also contributes. Check with your doctor to find out whether your vascular system — and thus your heart, brain, and penis — is in good shape or needs a tune-up through lifestyle changes and, if necessary, medications.
Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for intercourse. Because ED can have a strong psychological component, counseling with a psychotherapist or sex therapist often works. However, more often ED is a symptom of cardiovascular disease and diabetes, both of which can impair blood supply to the penis. In addition, many medications interfere with sexual functioning.
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.

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According to the FDA (Food and Drug Administration), many of these products sold on the internet contain potentially harmful compounds. And they aren’t listed on the label. In an investigation, the FDA found that one-third of these online supplements were laced with undisclosed ingredients. This includes sildenafil—the active ingredient in Viagra. Doctors prescribe Viagra to some patients, but it’s not safe for everyone. The drug could interact with other medications and lower your blood pressure to dangerous levels. This makes ordering supplements online risky. You don’t know whether they contain sildenafil or other ingredients that could harm your health. 
While Western medicine emphases the link between cardiovascular function and ED, TCM places importance on liver and kidney ailments as causative factor for development of ED. Western medicine involves a step-wise approach by targeting the relevant organ systems to treat various clinical symptoms; but TCM focuses on restoring the balance between various organs to achieve harmony and holistic approach to inner sense (4). The following article reviews our current understanding regarding the philosophical approach, and evaluates the evidence surrounding various ED therapies between mainstream Western medicine and TCM (see Table 1).
"This is the first study to look at the association between flavonoids and erectile dysfunction, which affects up to half of all middle-aged and older men," said lead researcher, Professor Aedin Cassidy. "Men who regularly consumed foods high in these flavonoids were less likely to suffer erectile dysfunction. In terms of quantities, we're talking just a few portions a week."
Another potential cause of ED is prediabetes and diabetes—35-50 percent of men with diabetes also have ED. Chronically elevated blood sugar damages the arteries (there’s the vascular connection again) and nerves, including those that stimulate the penis. Prediabetes and diabetes are also generally accompanied by excess weight, especially around the mid-section. These excess fat cells convert testosterone into estrogen, negatively altering the testosterone to estrogen ratio. This excess estrogen, independent of prediabetes and diabetes, interferes with the hormonal cascade necessary to produce and maintain an erection. Although many men may reach for a testosterone booster, a more effective means is to improve the body’s metabolism and elimination of estrogen and to lose excess weight around the middle. To support healthy blood sugar balance and estrogen metabolism try:
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!
A number of nonprescription products claim to be herbal forms of Viagra. Some of these products contain unknown amounts of ingredients similar to those in prescription medications, which can cause dangerous side effects. Some actually contain the real drug, which should be given by prescription only. Although the Food and Drug Administration has banned many of these products, some potentially dangerous erectile dysfunction remedies remain on the market.
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