Another common cause of ED for many men is stress. When the body is under stress—either mental or physical—the sympathetic nervous system kicks in, releasing a cascade of stress hormones. Chronic stress leads to elevated levels of these hormones, which can lead to weight gain around the middle, and remember, those excess fat cells convert testosterone to estrogen. Stress also reduces sexual drive and leaves very little physical energy for sex. If chronic stress is a problem, try these supplements:
Selenium is a trace mineral found in Brazil nuts that plays an important role in hormone health. You only need a tiny bit for healthy sperm, but a tiny deficiency can be catastrophic for reproductive health. In one study, men who had lower testosterone and were infertile also had significantly lower selenium levels than the fertile group. Supplementing with the mineral improved chances of successful conception by 56 percent. And a second study that included 69 infertile men with low levels of the mineral, found selenium supplementation could significantly improve sub-par sperm motility associated with testosterone deficiency. Moreover, 11 percent of the men successfully impregnated their partners during the trial!
27. Haahr MK, Jensen CH, Toyserkani NM, et al. Safety and Potential Effect of a Single Intracavernous Injection of Autologous Adipose-Derived Regenerative Cells in Patients with Erectile Dysfunction Following Radical Prostatectomy: An Open-Label Phase I Clinical Trial. EBioMedicine 2016;5:204-10. 10.1016/j.ebiom.2016.01.024 [PMC free article] [PubMed] [CrossRef]

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?
Cavallini, G., Modenini, F., Vitali, G., & Koverech, A. (2005, November). Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology, 66(5), 1080-5. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429505006515
Erectile dysfunction supplements and other natural remedies have long been used in Chinese, African and other cultures. But unlike prescription medications for erectile dysfunction, such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis, Adcirca) and avanafil (Stendra), erectile dysfunction herbs and supplements haven't been well-studied or tested. Some can cause side effects or interact with other medications. And the amount of the active ingredient can vary greatly from product to product.
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.
Ginkgo biloba. Known primarily as a treatment for cognitive decline, ginkgo has also been used to treat erectile dysfunction -- especially cases caused by the use of certain antidepressant medications. But the evidence isn't very convincing. One 1998 study published in the Journal of Sex & Marital Therapy found that it did work. But a more rigorous study, published in Human Pharmacology in 2002, failed to replicate this finding. "Ginkgo has come out of fashion in the past few years," says Ronald Tamler, MD, assistant professor of medicine and codirector of the men's health program at Mount Sinai Medical Center in New York City. "That's because it doesn't do much. I can say that in my practice, I have not seen ginkgo work -- ever."
Selenium is a trace mineral found in Brazil nuts that plays an important role in hormone health. You only need a tiny bit for healthy sperm, but a tiny deficiency can be catastrophic for reproductive health. In one study, men who had lower testosterone and were infertile also had significantly lower selenium levels than the fertile group. Supplementing with the mineral improved chances of successful conception by 56 percent. And a second study that included 69 infertile men with low levels of the mineral, found selenium supplementation could significantly improve sub-par sperm motility associated with testosterone deficiency. Moreover, 11 percent of the men successfully impregnated their partners during the trial!
A recent study found that men with erectile dysfunction who ate pistachio nuts every day for three weeks experienced significant improvement in sexual issues, including ED, sexual desire, and overall sexual satisfaction. The benefits of pistachios for erection problems may be due to a protein called arginine, which may help relax blood vessels. "This is another example of how good circulation is good for sexual health, which is good news because I eat a lot of pistachios," says Dr. Daneshgari.
Leafy green vegetables, like celery and spinach, may increase circulation because of their high concentration of nitrates. Beet juice has been found to be really high in nitrates. Nitrates are vasodilators, which means they open up blood vessels and increase blood flow. Many years before the U.S. Food and Drug Administration approved the first ED drug in 1998, several case reports on the beneficial effects of nitrates for erectile dysfunction had already been published. The ED drugs used today are based on the relaxing effects of nitrates on the blood vessels that supply the penis.

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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