Most importantly, herbal supplements are not well regulated in the United States.  Studies have shown that 40-50% of herbal supplements do not even contain the supposed main ingredient, and many contain substances that are not listed which may have dangerous side effects2.  Another study found that over two thirds of the products tested had substituted other plant species for the plants listed on the label, and a third of products also contained other fillers or contaminants3.  A study by the New York State Attorney General of herbal products sold at GNC, Target, Walgreens, and Walmart found that four out of every five products didn’t contain the ingredient they claimed!  Fourteen US states and territories have petitioned Congress to regulate the herbal supplements industry.
If you can't take one of these oral medications, your physician may have you try Caverject (alprostadil for injection), a hormone that you inject into your penis using a fine needle, or Muse (alprostadil urogenital), a tiny suppository that you insert into the tip of the penis. Both of these will bring on an erection within five to 15 minutes without sexual stimulation.
During sexual stimulation, sexual thoughts, or nocturnal erections, the neurotransmitter nitric oxide (NO) is released from the endothelial cells and the parasympathetic nerve terminal causing relaxation of two cylinder-like muscles called the corpora carvenosum. Nitric oxide influences an increase in concentrations of cyclic guanosine monophosphate (cGMP), which after numerous pathways triggers smooth muscle relaxation, and simultaneous closing of small veins traps blood in the cavernosal muscles, keeping blood in the cavernosal tissues that cause and maintain an erection.
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!
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)
Erectile dysfunction (ED) is a common occurrence in society with a prevalence of about 26 cases per 1,000 patients [1]. This equates to about 150 million cases of ED worldwide. It is a condition where patients are unable to maintain adequate blood flow into their penis to sustain an erection. As a person ages, the probability of having ED grow but no age group is safe from this condition. In a study of Romanian men, it was determined that about 3 percent of males aged 15 to 25, 7 percent of males aged 25 to 45 and 22 percent of males 45 to 65 had ED [2]. Once a man reaches 70, ED can be seen in 84 percent of the elderly. In most cases, ED is a condition that manifests because of a much larger systemic disease. Some of the most common risk factors include cardiovascular disease, hypertension, diabetes mellitus, tobacco use, hyperlipidemia, metabolic syndrome or depression [3].
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.
"The problem with alternative treatments for any medical problem, including erectile dysfunction, is that until you have about 20 well-controlled studies over several years, you really don't know what you are working with," cautions Richard Harris, MD, a urologist at Gottlieb Memorial Hospital, part of the Loyola University Health System in Chicago.
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"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."
Researchers discovered men who regularly consumed flavanoid-rich foods—especially those with anthocyanins, flavones, and flavanones—experienced a significantly reduced risk of the disorder than those who did not. Good news since the foods are already popular in American diets. Lead researcher Aedin Cassidy says, “…the top sources of anthocyanins, flavones and flavanones consumed in the U.S. are strawberries, blueberries, red wine, apples, pears and citrus products.”
Tufan capsules are regarded as the best ED pills because these also resolve problem of ED by improving health of male genital organs. These best ED pills relieve problem of enlarged and inflamed prostate gland, enlargement and inflammation of prostate cause involuntary loss of semen and also reduce a male’s pleasure during lovemaking to make him uninterested in lovemaking and bring episodes of ED. These herbal ED pills are reckoned as the best ED pills as these increase semen volume and enhance a male’s potency and virility. Tufan capsules not only provide natural erectile dysfunction treatment but also bless a male with renewed virility, vitality and vigor to make love. These capsules increase number of sperms and make a male capable of achieving fatherhood easily, these also allow a male to take woman to higher level of ecstasy each time to work as the best ED pills.
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."

When other treatments haven’t helped, a penile implant may be the right solution. A penile implant is a medical device that is surgically placed into a penis to mimic the look and performance of a natural erection9. Implants are custom-fitted to your anatomy. Sensitivity and the ability to ejaculate aren’t typically affected either, so you’ll be able to have an orgasm normally (unless you have a medical condition that prevents this)7.

Yohimbe. Before Viagra and the other prescription erectile dysfunction drugs became available, doctors sometimes prescribed a derivative of the herb yohimbe (yohimbine hydrochloride) to their patients suffering from ED. But experts say the medication is not particularly effective, and it can cause jitteriness and other problems. "It's not a great drug," says McCullough. "And I suspect the herb is not as potent as the pharmaceutical version." What's more, evidence shows that yohimbe is associated with high blood pressure, anxiety, headache, and other health problems. Experts discourage its use.
Erectile dysfunction can occur for various reasons. A health condition, an emotional or relationship problem, a certain medication, smoking, drugs, and alcohol all have the potential to cause ED. Some people want a quick fix, so they rush to their doctor hoping to get medication, not knowing that there are natural home remedies for erectile dysfunction.
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.
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.
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. 
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