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.
Eastern medicine should be fully exploited, and integrated with modern medicine to combine the advantages of both TCM and Western medicine. More research should be conducted into the efficacy and safety of TCM, and integration of TCM and Western medicine may provide promising breakthroughs in future clinical treatment. This strategy may allow for the development of new therapeutic strategies based on concepts of TCM and integrated medicine. There is a need for multimodal therapy and holistic approach to treat men (and their partners) with ED through complementary use of herbal supplements and modern drug to optimize underlying medical comorbidities; acupuncture, exercise or massage to reduce stress and strengthen the body; introduction and escalation of various medical therapy with use of mechanical therapy to further enhance penile erection; and lastly surgical intervention in suboptimal or refractory ED cases.
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.

For centuries, men have tried all sorts of natural remedies for erectile dysfunction (ED) -- the repeated inability to get or maintain an erection firm enough for sexual intercourse. But do they really work? It is simply not scientifically known at this point. Furthermore, you take these remedies at your own risk, because their safety profiles have not been established. What follows are commentaries by experts and reviews in the field of alternative treatments that are available over the counter for erectile dysfunction and impotence.
Long considered an aphrodisiac by the Chinese, ginseng may do more than just rev your engine. A 2013 South Korean study found that taking the herb for just a few weeks improved guys’ performance in the bedroom, including helping them last longer before finishing. Meanwhile, a study in Spermatogenesis found that ginseng can also help make for harder, longer-lasting erections and improve testosterone levels, which in turn boosts libido. “Ginseng is a promising herbal therapy for ED because it helps promote relaxation of smooth muscle in the penis, increase dopamine levels in the brain, and increase pressure in the cavernosal nerves of the penis which helps nitric oxide synthesis,” Walker explains.
Shape up. Because ED is often linked with restricted blood flow to the penis, keep your heart and arteries in good condition by maintaining a healthy weight, and following a diet high in fruits, vegetables and whole grains. Avoid saturated fats and trans fats. Regular aerobic exercise can improve blood flow to the genitals and reduce any stress that contributes to your ED.
Acupuncture. Though acupuncture has been used to treat male sexual problems for centuries, the scientific evidence to support its use for erectile dysfunction is equivocal at best. In 2009, South Korean scientists conducted a systematic review of studies on acupuncture for ED. They found major design flaws in all of the studies, concluding that "the evidence is insufficient to suggest that acupuncture is an effective intervention for treating ED."
Nettle root extracts are known for their ability to restore normal production of important sex hormones, such as testosterone. The primary action of nettle root is linked to its action on the glands that produce testosterone. Nettle root contains serotonin and acetylcholine, both of which directly stimulate testosterone production and boost the functioning of these vital glands.
Nitric oxide is made internally from L-arginine, which is an amino acid found in red meat, poultry, fish, and dairy products. In other words, L-arginine is the building block for nitric oxide, which is essential for erections. A lack of one can lead to a lack of the other. However, there’s a problem when it comes to treating L-arginine deficiency with supplements.
The Aztecs referred to avocados as testicles because of their scrotum-like appearance. They were onto something. The green fruit is rich in potassium, vitamin B6 and vitamin E, nutrients that have been associated with increased libido. Plus, avocados’ good monounsaturated fats protect your heart and boost circulation, while their abundant minerals and carotenoids supply energy and stamina. For some creative ways to consume the fruit, check out our 10 avocado recipes for weight loss.
It can’t be stressed enough — a healthy diet and lifestyle has numerous benefits, including in the bedroom. ED is linked to cardiovascular disease and diabetes, so eating a Mediterranean-style diet rich in fresh fruits and vegetables, healthy fats, and whole grains can reduce your chance of developing heart problems and, in turn, can alleviate your ED.
Quien és mas macho? A recent study by French researchers found that men who eat the most spicy foods tend to have higher testosterone levels than those with milder palates. Study authors attribute the T-boosting effects in part to capsaicin, a compound in chilies that previous research has associated with increased testosterone levels. Seriously spicy serrano peppers are also packed with quercetin, a nutrient shown to boost testosterone levels in the body by reducing the amount that’s otherwise flushed out by the kidneys. Capsaicin, the compound that makes tabasco sauce hot, releases chemicals that increase heart rate, mirror signs of arousal and rev up things.

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 recent study in the journal Circulation found that flavonoids in dark chocolate improve circulation. That could be good for erection problems that are due to poor circulation. Flavonoids are naturally-occurring antioxidants that protect plants from toxins and help repair cell damage. Studies show that flavonoids and other antioxidants have similar effects on people. They may help lower blood pressure and decrease cholesterol, both of which are factors that contribute to erectile dysfunction.
Ginseng is the most common ingredient among top-selling supplements for men’s sexual health (36). The English word ginseng derives from the Chinese term renshen. Ren means “person” and shen means “plant root”. This plant has been named in this manner as its roots resemble the lower limbs of a human, Traditionally, ginseng has been used to restore and enhance the normal well-being of the body. The effects are due to ginseng’s reactions with the central nervous system, metabolism, immune function and cardiovascular system. The principal active compounds are triterpene saponins known as ginsenosides. Animal studies have suggested that specific ginsenosides may be responsible for ginseng-mediated effects on copulatory behavior (37). Ginsenoside induces smooth muscle relaxation by hyperpolarizing the smooth muscle membrane via activation of large-conductance KCa channels (38).
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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.
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] 
In Eastern medicine, animal products are commonly used for their perceived health benefits. The philosophy “like nourishes like”, suggests that consuming the organ of an animal will bring benefits to the corresponding organ in one’s body is a common belief. Men seeking greater potency have turned to eating penises from goats, bull, deer, horses, seals and other mammals in the form of cooked dishes or herbal preparations. While there is no scientific evidence supporting this practice, the cultural beliefs remain strong and supplements containing extracts from animal penises are readily available in the form of capsules, often mixed with herbal compounds pitching similar erectogenic properties. A significant proportion of these potency-inducing supplements in Asia have been found to contain PDE5-inhibitors substrates such as tadalafil and sildenafil (30). However uncontrolled use of illicit PDE5-inhibitors under the guise of natural supplements remains a health threat to the general public.
ED is often treated with psychotherapy, behavior modification techniques, oral medications, locally injected drugs, vacuum devices, and sometimes even surgically implanted devices. In rare cases, surgery of the blood vessels may be necessary. In most cases, even when a physical cause is identified, emotional or psychological factors play a role as well.
Gutiérrez-González, Enrique; Castelló, Adela; Fernández-Navarro, Pablo; Castaño-Vinyals, Gemma; Llorca, Javier; Salas-Trejo, Dolores; Salcedo-Bellido, Inmaculada; Aragonés, Nuria; Fernández-Tardón, Guillermo; Alguacil, Juan; Gracia-Lavedan, Esther; García-Esquinas, Esther; Gómez-Acebo, Inés; Amiano, Pilar; Romaguera, Dora; Kogevinas, Manolis; Pollán, Marina; Pérez-Gómez, Beatriz. “Dietary Zinc and Risk of Prostate Cancer in Spain: MCC-Spain Study.” Nutrients. Jan 2019, 11(1).
For centuries, men have tried all sorts of natural remedies for erectile dysfunction (ED) -- the repeated inability to get or maintain an erection firm enough for sexual intercourse. But do they really work? It is simply not scientifically known at this point. Furthermore, you take these remedies at your own risk, because their safety profiles have not been established. What follows are commentaries by experts and reviews in the field of alternative treatments that are available over the counter for erectile dysfunction and impotence.
Men looking to boost their sperm quality should head to the fish counter, research suggests. Sperm size and shape — one marker used to evaluate male infertility — was better in men who ate the most white meat fish as compared to men who ate the least, a study published in The Journal of Nutrition showed. And total sperm count was about 34 percent higher among men who ate the most dark meat fish, like salmon and tuna, than men who ate the least amount of fish. Meanwhile, men who reported eating one to three servings of processed meat had worse sperm morphology (shape) than men who ate the fewest servings. Click here to discover How Tilapia is Worse Than Bacon!!!
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.
Processed Foods tend to have fat, salt, and sugar added to them, as well as preservatives and other chemical additives that can be harmful to your health. Processed foods include frozen foods, canned foods, processed meats, and many snack foods. Some research links eating processed foods to depression, which is something that can cause erectile dysfunction.
For obvious reasons, ED can be a sensitive subject, one that until relatively recently men were more likely to try to hide than to deal with. Fortunately, a deeper understanding of the variety of causes of erectile dysfunction has led to medications, therapies, and other treatments that can be more individualized and more likely to be effective—and more open discussion about addressing the concern.
While generally thought of as a problem affecting only older men, a study published in 2013 found that one in four men with newly diagnosed ED at a clinic in Italy were younger than 40 years old. With other research suggesting over half of all men between the ages of 40 and 70 now suffer from some degree of ED, and estimates showing the total cost of orthodox treatment in the United States could reach $15 billion if all men affected sought treatment, solutions that address the condition’s primary cause are urgently needed.
Saw palmetto. Saw palmetto comes from the fruit of a small palm tree. It has been used to treat symptoms in men with an enlarged prostate gland, such as difficulty urinating, and it has been recommended to treat ED caused by an enlarged prostate. However, several recent clinical trials did not show that saw palmetto works any better on an enlarged prostate than a placebo does. "There is no evidence that saw palmetto should be used to treat erectile dysfunction," says Dr. Gilbert. Like ginkgo biloba, saw palmetto can interact with some prescription medications.

B-vitamin complex helps to support normal energy production and is also essential for supporting the normal functioning of the body during times of stress. Stress quickly depletes the body’s reserves of the B vitamins. Look for a B-complex containing 20-50 mg of vitamins B1, B2, and B3. The other B vitamins should be included in their relative proportions.
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."
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
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.
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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.
L-arginine, an amino acid that is naturally present in the body and helps make nitric oxide, supports a successful erection. Nitric oxide is responsible for making the blood vessels relax, which helps sustain an erection for men. A 1999 study, observed the effects of six weeks of high-dose (5 grams/day) orally administered nitric oxide (NO) donor L-arginine on men with organic ED. Thirty-one percent of those who took 5 grams/day of L-arginine experienced significant improvements in sexual function. Burns told Medical Daily, “l-arginine and deer antler velvet” have been the most popular go-to natural treatments for men.
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.

Honey, unlike table sugar, is packed with beneficial compounds like quercetin, which has been shown to aid athletic endurance and ward off depression.. Honey also has a less dramatic impact on your blood-sugar levels than regular sugar, so it won’t send your body into fat-storage mode the way the white stuff can. Try adding some honey to your afternoon tea or morning bowl of oatmeal, but don’t go overboard; the sweet nectar has 17 g of sugar and 64 calories per tablespoon, so too much honey can make you heavy, rather than horny.

It’s the truth: You reach a certain age where having sex isn’t as easy or satisfying as it used to be. Many factors can contribute to erectile dysfunction (ED) — anything from smoking to cardiovascular disease to general stress — and you shouldn’t be shy about discussing any erectile problems with your doctor. If there’s an underlying health condition causing your troubles, treating the cause may get you back to top form in no time.
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.
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