In a prospective human phase 1 open-label and single-arm study reported by Haahr et al. (27), 17 men with refractory post radical prostatectomy ED were given a single intracavernosal injection of autologous adipose-derived regenerative cells (ADRCs) freshly isolated after a liposuction. The procedures were well-tolerated and over a 6-month follow-up period, 8 of 17 men showed improvement of their erectile function.
According to historians, ancient Egyptians used garlic to boost their stamina. While they didn’t have modern-day science to confirm that it actually worked, they were most certainly onto something. Researchers have confirmed that consuming the plant helps stop the formation of new fatty deposits, called nanoplaques, inside arterial walls. Yup, that includes the arteries leading to your penis, too. Keep your heart healthy and your erections strong by adding the kitchen staple to your weekly dishes.
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. 
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.
Encouraging evidence suggests that ginseng may be an effective herbal treatment for ED. However, further, larger, and high-quality studies are required before firm conclusions can be drawn. Promising (although very preliminary) results have also been generated for some herbal formulations. Overall, more research in the field, adhering to the CONSORT statement extension for reporting trials, is justified before the use of herbal products in ED can be recommended.
The Epimedium plant is a flowering perennial found throughout Asia and parts of the Mediterranean. Horny Goat Weed’s active ingredient is icariin, a falvonol glycoside and reputed to improve cardiovascular function, hormone regulation, modulation of immunological function and antitumor activity (44). Icariin has also been shown to have a PDE5i effect. Animal studies have been carried out showing improvements in penile hemodynamic parameters. There is one report of tachyarrhythmia and hypomania with the use of this herb (45).
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.
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.
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.
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:
For many men, stopping smoking is an erectile dysfunction remedy, particularly when ED is the result of vascular disease, which occurs when blood supply to the penis becomes restricted because of blockage or narrowing of the arteries. Smoking and even smokeless tobacco can also cause the narrowing of important blood vessels and have the same negative impact.