Dietary supplements are another avenue that patients can explore when it comes to treating their ED. Many products exist on the market but be warned that they may not have the scientific proof that can support claims of better erections. In one study done on multiple supplements that were proven to not work, it was found that patients found improvement in their ED 25 percent of the time. This suggests that supplements that do not work have a "placebo effect." This means that if a patient believes the medication truly works, he will notice improvements in his symptoms. This is a psychological phenomenon and can also be considered a root of why ED can occur. Depression or anxiety are two common reasons for ED and if patients take supplements that they believe will help them, they may have more confidence in sustaining an erection. 
Poor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones.
In a study done to determine if vitamin D supplementation would actually help patients with ED, 143 patients with ED were tested to determine vitamin D levels. It was found that of these cases, 46 percent of patients suffered from substantial vitamin D deficiency and only 20 percent were found to have adequate levels of vitamin D. In these cases, it was also determined that inadequate arterial blood flow was the root cause of ED more commonly in patients with low vitamin D levels.  Vitamin D supplementation can improve both these parameters.
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.
Many products contain undocumented “fillers” that can cause allergic reactions. In recent years, the FDA has found over 300 herbal products that contain hidden, deceptively labeled, or dangerous ingredients4. And since 2015, the FDA has released public warnings on more than 160 ED supplements and “male enhancement” products found to contain dangerous ingredients and contaminants5 . An independent study of FDA data, conducted in 2018, found almost 800 herbal supplements that contained unlisted ingredients6.
Impotence, or erectile dysfunction (ED), is the inability for a man to sustain an erection long enough for normal, satisfying sexual intercourse. To understand the underlying causes of impotence, it helps to know the basics about how an erection develops, along with potential problems that get in the way. Erections begin in the brain with a thought related to sexual desire. Then a chemical message travels from the brain to the penis. Blood flow to the penis increases as blood vessels leading to the reproductive system relax and allow for increased circulation.
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).
Opioids are used for chronic pain or for recreational use, and there is currently an epidemic of opioid addiction in the United States. Opioids induce ED by inhibiting gonado-tropin-releasing hormone (GnRH), which leads to a decrease in the production of luteinizing hormone (LH). Decreased levels of LH, in turn, inhibit production of testosterone, which – in both men and women – can cause depression and sexual dysfunction.9
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.
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.