Enlargement of the prostate gland, another condition that occurs with increasing frequency in men as they age, can also cause ED. In a 2012 Swiss study, 82 men with moderate to severe symptoms of prostate enlargement, who were also experiencing problems such as ED or loss of libido, took 320 mg of saw palmetto extract daily for 8 weeks. At the end of the study, the men’s ‘International Prostate Symptom Score’ (IPSS), a method of measuring prostate health based on a questionnaire, was reduced by an average of 51 percent. In addition, their ED, libido, and other sexual functions had also improved by an average of over 40 percent. Unlike the drug approaches used in conventional medicine, which can even cause ED as a side effect, saw palmetto is very effective in treating prostate problems and is free from side effects.

Another natural treatment for erectile dysfunction to consider would be vitamin E. This is a vitamin that has been linked to chronic diseases in the past due to the antioxidant effects of this vitamin. Considering ED could be a manifestation of another chronic condition, it makes sense that vitamin E may have a role in reducing the symptoms of the disease. As a person ages, it is natural for the body to undergo more oxidative stress and damage as cells do not function as well as they once did. Rats who were given supplemental vitamin E were found to have reduced levels of oxidative damage to their tissues and had levels of NO and other factors that help induce an erection more similar to younger rats compared to rats without vitamin E supplementation. If patients incorporate vitamin E into their vitamins and dietary supplements for ED, their ED should improve. [9]
L-arginine. L-arginine is an important amino acid that the body needs to build proteins. Because L-arginine has been shown to improve blood flow, some alternative practitioners have recommended that the supplements be used to treat ED. The Natural Medicines Comprehensive Database, which is a reliable authority on alternative medicines, says L-arginine is possibly effective for treating erectile dysfunction. But Harris warns that "although this supplement could improve blood flow, side effects can be dangerous." L-arginine can cause an allergic reaction or worsen asthma in some people; it can also lower blood pressure.
In addition, when research has shown a nutrient such as zinc or niacin to improve sexual function, it's usually in people who are deficient in it. So, before you stock up on over-the-counter nutritional supplements for ED, speak with your doctor. He can test you for deficiencies and steer you toward the most effective and safest way to treat your erectile dysfunction. 
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To achieve and maintain an erection, healthy blood vessels and an optimum blood flow are essential. Significantly, therefore, Dr. Rath’s research has proven that specific micronutrients play key roles in maintaining the structural integrity of blood vessels and optimizing blood flow. Such micronutrients include vitamins C and E, the amino acids lysine and proline, and the mineral copper.
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Tribulus terrestris is a dicotyledonous herbal plant of the Zygophyllaceae family, used to increase serum testosterone levels, which has only been shown in animal studies (40). A prospective, randomized, double blind study of 30 men showed that Tribulus terrestris was not more effective than placebo on improving IIEF scores or serum total testosterone (41). Two accounts of hepato-nephrotoxicity have been reported in young men who ingested high doses of this herbal medication (42,43).

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In total, 24 RCTs, including 2080 patients with ED, were identified. Among these, 12 evaluated monopreparations (five ginseng [n = 399], three saffron [n = 397], two Tribulus terrestris [n = 202], and one each Pinus pinaster [n = 21] and Lepidium meyenii [n = 50]), seven evaluated formulations (n = 544), and five investigated dietary supplements in combination with pure compounds (n = 410). Ginseng significantly improved erectile function (International Index of Erectile Function [IIEF]-5 score: 140 ginseng, 96 placebo; standardized mean difference [SMD] 0.43; 95% confidence interval [CI] 0.15-0.70; P < 0.01; I2 = 0), P. pinaster and L. meyenii showed very preliminary positive results, and saffron and T. terrestris treatment produced mixed results. Several herbal formulations were associated with a decrease of IIEF-5 or IIEF-15, although the results were preliminary. The quality of the included studies varied, with only seven having a prevalent low risk of bias. The median methodological quality Jadad score was three out of a maximum of five. Adverse events were recorded in 19 of 24 trials, with no significant differences between placebo and verum in placebo-controlled studies.
When it comes to scientific development, in Western medicine, an analytic approach is often used to identify and resolve medical challenges. A hypothesis is first derived through general observations of a phenomenon. A research plan is then carefully designed and data collected. Once sufficient data is collected, critical statistical evaluations are done and conclusions are drawn (4). Every aspects of a disease entity are studied from macroscopic to microscopic views, down to the cellular and molecular levels. The deep understanding of the role of cGMP-specific phosphodiesterase type 5 enzymes in ED and the use of phosphodiesterase-5 inhibitors in treatment of ED exemplifies the success of this approach.
In fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.
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