Penile prosthesis implant remains the most effective and permanent treatment for ED. Penile prosthesis implants can be broadly divided into malleable and inflatable prostheses (20). Malleable penile prosthesis, also known as semi-rigid prosthesis, does not allow for (physiological) flaccid state of the penis. The patient can bend the prosthesis upwards for sexual intercourse and downwards for concealment. Although the angle of prosthesis concealment has improved with recent devices, however due to the constant rigid state of the penis, they are still less comfortable compared to their inflatable counterparts, are more likely to cause social embarrassment and associated with higher risk of implant erosions (21). However, malleable prosthesis still has its place for the treatment of ED as these implants are easier to handle, easier to place and would benefit patients with impaired manual dexterity.
There are currently two models of the inflatable penile prosthesis (IPP), namely, the two-piece IPP vs. the three-piece IPP. The three-piece IPP consists of a pair of corporal cylinders, a scrotal pump and an abdominal reservoir filled with saline. Owing to the presence of the reservoir, the corporal cylinders can be completely deflated to give the patient the physiological flaccid state when not in use, and likewise a maximally turgid state when inflated (21). The two-piece IPP lacks an abdominal reservoir and is often offered in patients with whom placement of reservoir is challenging or not possible such as following radical cysto-prostatectomy with orthotopic ileal neobladder creation, or patients who had previous open book fracture of the pelvis with metal implants. The concept of ectopic reservoir placement has allowed many of these men the option for three-piece IPP placement (22). Technological advances have improved mechanical reliability, reduced prosthesis infection risk and offered excellent patient and partner satisfaction rate (23).

While carrots have always been touted for their benefits for the eyes, studies reveal that carotenoids, vitamins, and minerals present in carrots act as antioxidants, anticarcinogens, and immune enhancers. Carrots also boast of antihypertensive, hepatoprotective, renoprotective, and wound healing benefits as well as cardio- and hepatoprotective, antibacterial, antifungal, anti-inflammatory, and analgesic effects. Studies on male rats have shown that carrots can exert an effect on fertility by elevating testosterone levels in them.10
The following products are considered to be alternative treatments or natural remedies for Erectile Dysfunction. Their efficacy may not have been scientifically tested to the same degree as the drugs listed in the table above. However there may be historical, cultural or anecdotal evidence linking their use to the treatment of Erectile Dysfunction.
Classic dietary staples, like the chicken breast, may not have the Instagram presence of say, maca, but they earn a place on plates much longer. Simply put, their health benefits continue to stack up. In addition to a hefty amount of arginine — only turkey has more — a 3-ounce cooked chicken breast contains only 142 calories and 3 grams of fat, but an impressive 26 grams of protein. That’s more than half of the day’s recommended allowance. Plus, it’s rich in B vitamins to rev your metabolism and energy levels. (And if you’re looking to treat erectile dysfunction, those B vitamins definitely don’t hurt.)
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.’”
This ancient whole grain is a great addition to your pantry if you’re suffering from quinoa fatigue, but it’ll also help you if things are drooping in the bedroom. Rich in manganese and iron, it also contains all eight essential amino acids, which boost energy levels. And for grains with as much protein as teff and quinoa, click here for Protein-Packed Power Grains!

The definition of erectile dysfunction (ED) is the inability to obtain or maintain an erection firm enough for sexual intercourse. Historically, admitting to having ED was considered taboo and downright embarrassing until the advent of sildenafil citrate (Viagra) in 1998. Sildenafil liberated men from the stigma of having ED, and it opened a conversation about a problem that has existed for centuries. Up to 10% of men younger than forty suffer from ED and upwards of 60% by age 69.1
Wu, Guoyao; Collins, Julie K; Perkins-Veazie, Penelope; Siddiq, Muhammad; Dolan, Kirk D; Kelly, Katherine A; Heaps, Cristine L; Meininger, Cynthia J. “Dietary Supplementation with Watermelon Pomace Juice Enhances Arginine Availability and Ameliorates the Metabolic Syndrome in Zucker Diabetic Fatty Rats.” The Journal of Nutrition. Dec 2007. Volume 137, Issue 12, Pages 2680–2685.
For example, you’ll often hear that watermelon is a great remedy for ED.  This belief seems to come from a study done in 20075, which showed that consuming watermelon could raised levels of L-arginine in the bloodstream.  L-arginine is used in the production of nitric oxide (NO), which is a key to healthy erections (see our article, “How Do Erections Work“).  However, the study did not show that consuming watermelon actually improved erections.  Also, the subjects consumed the equivalent of three eight-ounce glasses of watermelon juice per day!
The boner-boosting ingredient in eggs is choline, a powerful natural chemical that not only burns fat but can help set your pants afire. Choline triggers the production of nitric oxide (NO), which relaxes arteries and enables blood flow to do its thing. Bonus: Eggs are high in vitamins B5 and B6, which help balance hormone levels and fight stress, two undoubtedly helpful factors in the bedroom. To pack on more muscle, eat these essential 20 Foods With the Highest Amounts of Protein!
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.
On any matter relating to your health or well-being, please check with an appropriate health professional. No statement herein is to be construed as a diagnosis, treatment, preventative, or cure for any disease, disorder or abnormal physical state. The statements herein have not been evaluated by the Foods and Drugs Administration or Health Canada. Dr. Marchione and the doctors on the Bel Marra Health Editorial Team are compensated by Bel Marra Health for their work in creating content, consulting along with formulating and endorsing products.
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.
According to legend, Casanova — the Tinder master of his time — regularly ate a breakfast of 50 oysters. Turns out he could’ve doubled as a nutritionist if he’d been able to get out of the sack. In addition to being high in B12, oysters contain more zinc than any other food source ( almost five times your daily DV). This nutrient is essential for testosterone production, and when your T levels droop, so does your business. Like other bivalves, oysters are high in D-aspartic acid, an amino acid that has been shown to temporarily boost low testosterone levels and improve sperm quality in infertile men.

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).


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.
According to the Cleveland Clinic, “because erectile dysfunction is caused by a complex set of psychosocial, neurologic, and vascular factors, a specific cause in a patient may remain ambiguous.” The root causes are often related to a blockage or dysfunction of blood vessels. For example, ED can be due to conditions like atherosclerosis or diabetes, hormonal imbalances or problems related to mental health. It’s been found that common causes typically include one or more of the following factors: (2)
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!

A daily dose of niacin improves erectile function, particularly in men with high cholesterol, according to a 2011 study in The Journal of Sexual Medicine. The vitamin helps increase blood flow and reduce inflammation—one of the underlying causes of both high cholesterol and erectile dysfunction. “Vitamin B3 is also used to make sex hormones and other important chemical-signal molecules,” says Fisch. Like many of the others on our list, this tablet is most powerful when taken in conjunction with others: A cocktail of propionyl, L-carnitine, L-arginine, and niacin taken for three months improved 40% of erections in a study from researchers at Sapienza University of Rome in Italy.
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.
Treatment options vary and depend on the most likely underlying condition. Patients can benefit from taking drugs like Viagra or other vasodilators in order to try to increase blood flow to the penis but these medications can interact with a number of other medications that patients may already be taking and these cross-reactions are very dangerous [5]. To reduce the chances of this from happening, patients may turn to natural treatments for erectile dysfunction. In this article, we will explore some of the vitamins and dietary supplements for ED and why they may be good options for you to consider. 
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.

Shindel, A. W., Xin, Z.-C., Lin, G., Fandel, T. M., Huang, Y.-C., Banie, L., … Lue, T. F. (2010, February 5). Erectogenic and neurotrophic effects of icariin, a purified extract of horny goat weed (Epimedium spp.) in vitro and in vivo. The Journal of Sexual Medicine, 7(4), 1518-1528. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2009.01699.x/full
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