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.
Ginkgo biloba. Known primarily as a treatment for cognitive decline, ginkgo has also been used to treat erectile dysfunction -- especially cases caused by the use of certain antidepressant medications. But the evidence isn't very convincing. One 1998 study published in the Journal of Sex & Marital Therapy found that it did work. But a more rigorous study, published in Human Pharmacology in 2002, failed to replicate this finding. "Ginkgo has come out of fashion in the past few years," says Ronald Tamler, MD, assistant professor of medicine and codirector of the men's health program at Mount Sinai Medical Center in New York City. "That's because it doesn't do much. I can say that in my practice, I have not seen ginkgo work -- ever."
Despite the name, horny goat weed actually helps improve your erection, not libido.  Botanically known as epimedium, this herb has been used by the Chinese for centuries to treat, among other things, low libido and erectile dysfunction. “A growing body of research shows that isolated icariin—the extract of epimedium—inhibits the enzyme phosphodiesterase-5 (PDE-5) and significantly increases nitric oxide synthase, helping to improve erectile function,” says Fisch. In fact, this is the same mechanism that Viagra works through (but the herb comes with a way better name).
This African tree bark extract sends blood flow to the genitals, says herbalist Ed Smith, a founding member of the American Herbalists Guild, who adds a warning that yohimbe can cause nervousness and raise already-existing high blood pressure (so avoid taking it if you have heart or kidney disease), and can also negatively interact with antidepressants.
To correct ED, Cellular Medicine takes a different approach to that of conventional medicine. In the absence of psychological causes, the primary cause of ED is cellular dysfunction as a result of micronutrient deficiency. In this respect, ED is essentially no different to any chronic disease. To successfully resolve the problem, it is necessary to resupply the body’s cells with optimum levels of micronutrients.

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).
Tufan capsules are the best pills for natural ED treatment, these capsules possess renowned herbs which address all the possible causes of the problem and provide effective treatment in a short time. The herbs present in these herbal ED pills possess varied properties; all of these collectively provide complete natural treatment and work as the best ED pills.

Personally, I think you are right. My husband had no problems with erectile dysfunction,until porn entered his life, and it was all downhill (way down), from there. When he finally quit porn, it actually took 2 yrs for my husband to completely regain function and be able to keep an erection. My husband is 59 yrs old, and I guess the older you are, the more difficult it is to regain function from Porn ED. Many people easily dismiss the idea that porn may be THEE problem. They shouldn't.
Warnings: Keep out of reach of children. Not intended for persons under 18 years of age. Do not use if you are pregnant or nursing or at risk of or being treated for high blood pressure and heart disease. *Disclaimer: The statements appearing on this listing have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease or conditions but rather a dietary supplement intended for nutritional support. Individual results may vary.
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.
"The problem with alternative treatments for any medical problem, including erectile dysfunction, is that until you have about 20 well-controlled studies over several years, you really don't know what you are working with," cautions Richard Harris, MD, a urologist at Gottlieb Memorial Hospital, part of the Loyola University Health System in Chicago.
If you search the Internet, you’ll find lists of specific foods that are supposed to be good for erectile dysfunction.  We’ve researched this topic extensively, searching databases of clinical studies, and found no evidence that these foods provide significant benefits from men with ED.  (We suspect that most of the sites on the web are simply copying lists from one another.)

There are so many potential reasons a man might develop erectile dysfunction (ED), it's nearly impossible to generalize the best ways to treat it. What works for one man may not work for another simply because they are having problems for different reasons. That said, it may encouraging to hear that there are a variety of options that may be considered, from psychological counseling to lifestyle changes, medications to treatments and devices.
I developed joint and muscle pain, periods of extreme fatigue, skin reactions, sun sensitivity, my blood pressure became above normal for the first time in my life, I have developed metabolic syndrome, high blood sugar (as in pre-diabetes), erectile dysfunction, recurring welt-like mouth and cheek sores, lots of gum loss, and bone thinning! I struggle with energy and motivation issues, and I often feel like my lungs burn when I workout or do aerobic exercise.
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.

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.
Size matters, so get slim and stay slim. A trim waistline is one good defense — a man with a 42-inch waist is 50% more likely to have ED than one with a 32-inch waist. Losing weight can help fight erectile dysfunction, so getting to a healthy weight and staying there is another good strategy for avoiding or fixing ED. Obesity raises risks for vascular disease and diabetes, two major causes of ED. And excess fat interferes with several hormones that may be part of the problem as well.
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:
Persons with metabolic syndrome can be identified by a distinct pattern of abdominal obesity (waist circumference >40 inches in men), atherogenic dyslipidemia (triglycerides ≥150 mg per 100 ml, HDL <40 mg per 100 ml, small LDL particles and normal or slightly elevated LDL), hypertension (≥130/85 mm Hg), insulin resistance (fasting blood glucose ≥10 0 mg per 100 ml), and elevated levels of prothrombotic and proinflammatory markers. Metabolic syndrome and insulin resistance are closely linked to ED. In one recently conducted study of 120 men with ED and no evidence of diabetes, 40% of patients fulfilled strict criteria for metabolic syndrome, and 73% were insulin resistant.12
Leafy green vegetables, like celery and spinach, may increase circulation because of their high concentration of nitrates. Beet juice has been found to be really high in nitrates. Nitrates are vasodilators, which means they open up blood vessels and increase blood flow. Many years before the U.S. Food and Drug Administration approved the first ED drug in 1998, several case reports on the beneficial effects of nitrates for erectile dysfunction had already been published. The ED drugs used today are based on the relaxing effects of nitrates on the blood vessels that supply the penis.
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.

During sexual stimulation, sexual thoughts, or nocturnal erections, the neurotransmitter nitric oxide (NO) is released from the endothelial cells and the parasympathetic nerve terminal causing relaxation of two cylinder-like muscles called the corpora carvenosum. Nitric oxide influences an increase in concentrations of cyclic guanosine monophosphate (cGMP), which after numerous pathways triggers smooth muscle relaxation, and simultaneous closing of small veins traps blood in the cavernosal muscles, keeping blood in the cavernosal tissues that cause and maintain an erection.
The pilot study by Vardi et al. (18) showed that LIESWT was effective in treating men with ED, suggesting a physiologic impact of LIESWT on cavernosal hemodynamics. The LIESWT is an effective penile rehabilitation tool that improves erectile function and potentially reverses underlying ED. Recent meta-analysis (19) of 14 studies showed that LiESWT could significantly improve the International Index of Erectile Function (IIEF) [mean difference: 2.00; 95% confidence interval (CI), 0.99–3.00; P<0.0001] and Erection Hardness Score (EHS) (risk difference: 0.16; 95% CI, 0.04–0.29; P=0.01). In addition, the therapeutic efficacy was noted to last for at least 3 months. LiESWT has been cited to a potential cure for ED, unlike other well established non-surgical methods of treatment (i.e., PDE5i, ICI and VED) being on demand treatments.

If ED continues to be a problem even after making certain lifestyle changes, talk with your doctor. ED is an uncomfortable subject for many men to discuss, but it’s treatable in most cases, so there’s no reason to avoid getting help. Doctors see patients every day about ED, so you’re simply one of millions of men dealing with this common condition.
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.

Energy-boosting goji berries have been used for thousands of years in Chinese medicine to help increase energy and enhance the release of hormones. Goji increases the body’s ability to handle stress and support healthy mood, mind and memory—all while giving you the get-up-and-go energy needed to get your workout to the next level,” says Dr. Lindsey Duncan, celebrity nutritionist (he’s worked with Tony Dorsett and Reggie Bush). “Goji is also beneficial for increasing blood flow, which helps to oxygenate all of the cells and tissues of the body, which increases your drive—that’s why they call goji the ‘Viagra of China.’”

Regular consumption of various types of cabbage, such as white cabbage, cauliflower, broccoli, and Brussels sprouts help get rid of the excess amount of estrogen, a female hormone. The increased estrogen levels interfere with the testosterone production. By the way, red radish and white turnips have the same effect as cabbage. In addition, to cleanse the body of toxins leading to high estrogen levels, it’s necessary to add a sufficient amount of high-fiber foods to your diet. These foods include most fresh fruits and vegetables.


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.

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Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing some men to function normally. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections.
L-arginine, or arginine, is an amino acid found in red meat, poultry, fish, and dairy products that helps expand blood vessels and increase blood flow. “The body uses this semi-essential amino acid as the primary building block for nitric oxide,” explains Harry Fisch, M.D., clinical professor of urology and reproductive medicine at Weill Cornell Medical College/New York Presbyterian Hospital.
The fowl most associated with belt-loosening feasts is lean, high in protein and the single best food source of arginine, the amino acid. Researchers at the NYU School of Medicine gave L-arginine to a group of impotent men, and found that six out of 15 men receiving the amino acid claimed an improved ability to achieve erections, while none of the 15 men in the placebo group reported any benefit. Additionally, the bird is rich in DHA omega-3 acids, which have been shown to boost brain function, improve your mood and turn off fat genes, actually preventing fat cells from growing! Just make sure you buy white meat only, as dark contains too much fat. And steer clear of prepackaged, sliced lunchmeat—those turkeys are strictly jive.
There’s a reason chocolate became a gift given before amorous activity. Cacao increases levels of the mood-boosting hormone serotonin, which can lower stress levels, boosting desire and making it easier to reach orgasm. And that’s not all: Cocoa also increases blood flow through the arteries and relaxes blood vessels, sending blood to all the right regions, which can boost pleasure.
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.
The polyphenol- and antioxidant-rich pomegranate is said to aid blood circulation, help reduce stress, reduce oxidative stress in diabetics, is anticarcinogenic, anti-inflammatory, and much more. It is also believed to effectively protect men against erectile dysfunction and even male infertility. A study using a rabbit model of ED measured the effect of pomegranate juice concentrate on intracavernous blood flow and penile erection. The study found that consuming 3.87 mL pomegranate juice concentrate daily for eight weeks significantly increased intracavernous blood flow and smooth muscle relaxation, probably because of its antioxidant effect. No wonder then that pomegranate juice is yet another popular natural remedy for ED.11
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.
However, you might actually be better off going one step back in the chain reaction and taking an L-citrulline supplement. While your body converts L-arginine to nitric oxide, it also metabolizes it too fast when the amino acid is taken in an oral supplement, according to a 2011 study from the University of Foggia in Italy. L-citrulline, which the body converts to L-arginine, is actually a better option to follow the same metabolic pathway and serve as a treatment for ED, the same study found.
And what about L-citrulline? Watermelon has the highest concentration in nature (particularly the white rind), followed by onions and garlic. Just one standard serving of yellow watermelon provides enough L-citrulline to boost sexual performance. My advice is that you might want to stick to watermelon and not onions and garlic to boost your nitric oxide production before going on a date!

There have been some studies to suggest that a placebo effect that improves ED may work for some men. One study found that men taking an oral placebo pill showed as much improvement in ED symptoms as men who took actual medication to improve ED. Conversely, men who were given therapeutic suggestions to improve ED did not see signs of symptom improvement.
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