These drugs facilitate erection by inhibiting the PDE5 enzyme, by blocking the degradation of cyclic guanosine monophosphate (cGMP) in the cavernous smooth muscles. This inhibition results in the prolonged activity of cGMP, which further decreases intracellular calcium concentrations, maintains smooth muscle relaxation and, hence, results in rigid penile erections.
If seafood isn’t your thing — or the Casanova Breakfast Plan doesn’t work with your budget — know that fortified breakfast cereals are also good sources of B12. According to the USDA, healthy cereals such as Kellogg’s All-Bran, Special K, Smart Start and Whole Grain Total provide a full day’s allowance. Check the nutrition facts and opt for whole grains, which can help lower cholesterol levels. Having high cholesterol can lead to atherosclerosis, or clogged and constricted arteries, which inhibits blood flow. That’s dangerous for your heart, but guess which artery-rich organ you’ll probably notice it in first?
Tiffany La Forge is a professional chef, recipe developer, and food writer who runs the blog Parsnips and Pastries. Her blog focuses on real food for a balanced life, seasonal recipes, and approachable health advice. When she’s not in the kitchen, Tiffany enjoys yoga, hiking, traveling, organic gardening, and hanging out with her corgi, Cocoa. Visit her at her blog or on Instagram.
There is no single cause for erectile dysfunction. Achieving an erection involves a complex series of physiological events; in order for an erection to occur, the body is required to coordinate nervous system responses with tactile sensations, emotional triggers, and signals from certain hormones. If any of these events are disrupted, impotence is likely to occur.
According to the FDA (Food and Drug Administration), many of these products sold on the internet contain potentially harmful compounds. And they aren’t listed on the label. In an investigation, the FDA found that one-third of these online supplements were laced with undisclosed ingredients. This includes sildenafil—the active ingredient in Viagra. Doctors prescribe Viagra to some patients, but it’s not safe for everyone. The drug could interact with other medications and lower your blood pressure to dangerous levels. This makes ordering supplements online risky. You don’t know whether they contain sildenafil or other ingredients that could harm your health. 
Qigong is a form of breathing exercises commonly practised in Asia to maintain health (53). In a cross-sectional population-based comparison study in Taiwan, individuals practising Qigong demonstrate higher SF-36 scores in the domains of physical functioning, role limitations due to physical problems, bodily pain, general health and vitality (54). Techniques to concentrate the energy or qi in the pelvis or genitals are regularly practised, but the effects of Qigong on ED have not been studied.
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.
Your doctor may also choose to lower your dose of certain medications. Or your provider may switch the type of drug you’re taking if it’s interfering with your sex life. Some medicines used for managing blood pressure, insomnia, anxiety, depression, seizures and prostate problems increase the risk for erectile dysfunction. Beta-blockers (for high blood pressure), SSRIs (often used to treat depression) and the class of drugs called benzodiazepines (like Ativan, Xanax, Librium and Valium) are commonly tied to ED. You may want to speak to your doctor about this.
Move a muscle, but we're not talking about your biceps. A strong pelvic floor enhances rigidity during erections and helps keep blood from leaving the penis by pressing on a key vein. In a British trial, three months of twice-daily sets of Kegel exercises (which strengthen these muscles), combined with biofeedback and advice on lifestyle changes — quitting smoking, losing weight, limiting alcohol — worked far better than just advice on lifestyle changes.

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. 
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