How common is impotence? According to findings from several studies, including “The Massachusetts Male Aging Study,” overall prevalence for men between 40–70 years old is around 52 percent (or around 30 percent of all men between 18–60 years old). That’s right — nearly half of all men over 40 experience erectile dysfunction symptoms at some point. Not surprisingly, research demonstrates that impotence is increasingly prevalent with age. Around 40 percent of men in their 40s experience sexual dysfunction. Up to 70 percent of men in their 70s experience ED. (1) Every year more than 617,000 new cases of impotence occur in the United States alone.
Yohimbine is an indole alkaloid derived from the bark of the African yohimbe tree (33). Yohimbine has been noted to treat fatigue, depression, diabetes, and sexual dysfunction. A meta-analysis of seven placebo-controlled trials (34) deemed yohimbine superior to placebo for the treatment of ED with rare adverse events. The proposed mechanism of action (35) is via the inhibition of central alpha-2-adrenergic receptors, decreasing central inhibition of arousal, and increasing penile nerve stimulation resulting in increased NO. Common side effects include headache, sweating, agitation, hypertension and insomnia. Contraindications include patients on tricyclic antidepressants, anti-hypertensives and central nervous system stimulants.
The use of shock wave therapy has revolutionized the treatment of many aspects of medicine. High intensity extracorporeal shockwave therapy has been used for the treatment of nephro-urolithiasis while medium intensity shockwave therapy is used by orthopaedic surgeons to treat joint pain as well as tendinitis. Low intensity shockwaves therapy was first noted to improve ischaemia-induced myocardial dysfunction in animal studies when low intensity shockwaves were applied to porcine myocardium (13). Shockwaves induces a localized stress on cell membranes in the same way that shear stress affects endothelial cell membranes (14) and this triggers the release of angiogenic factors, such as increased NO production through increased activity of endothelial NO synthase (eNOS) and neuronal NO synthase (nNOS), platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) (15). These shockwaves also cause membrane hyperpolarization (16), activation of the Ras signaling pathway, non-enzymatic synthesis of NO and induction of stress fibers and intercellular gaps (17).
Red Ginseng — One small randomized trial found evidence that red ginseng may offer modest improvements in ED symptoms (as compared with placebo). A meta-anaylsis published in the British Journal of Clinical Pharmacology states, “Traditionally red ginseng has been used to restore and enhance normal well-being, and is often referred to as an adaptogenic….Possible mechanisms of action of red ginseng include hormonal effects similar to those of testosterone. Others have postulated that red ginseng might induce relaxation of the smooth muscles.”  (5)
"This is the first study to look at the association between flavonoids and erectile dysfunction, which affects up to half of all middle-aged and older men," said lead researcher, Professor Aedin Cassidy. "Men who regularly consumed foods high in these flavonoids were less likely to suffer erectile dysfunction. In terms of quantities, we're talking just a few portions a week."

If the condition is not treated immediately, it can lead to scarring and permanent erectile dysfunction. Long lasting erections may associated with pain due to the lack of oxygen to the penis because the penis is filled with oxygen deplete venous blood. Peyronie’s disease (a scarring of some of the deep tissues in the penis) can have a localized area of pain but usually involves a lump and some deviation of the erection to the affected side.
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.)
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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. 

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.
A study published in May 2014 in The Journal of Sexual Medicine found that some men can reverse erectile dysfunction with healthy lifestyle changes, such as exercise, weight loss, a varied diet, and good sleep. The Australian researchers also showed that even if erectile dysfunction medication is required, it's likely to be more effective if you implement these healthy lifestyle changes.
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