Do not exceed 1 capsule in 24 hours. This is only intended for those 18 and over. Do not use if you are pregnant, nursing, or intend on becoming pregnant. If you have any current heart issues, such as but not limited to, hypertension, heart disease, and high cholesterol do not use. If you have any other medical issues such as prostate cancer and prostate enlargement do not take. Do not take this product if you're on any medications such as MAOI's or nitrates. Consult with your physician or health care provider to using the product.
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. 
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.
I mentioned taking herbs and supplements to treat erectile dysfunction, so I want to add a note of caution about using so-called “natural male enhancement” pills. The Food and Drug Administration (FDA) recalls dozens (if not hundreds) of these products each year for containing the active ingredient in medications used to treat ED. When you buy those products from the internet, or even from a retail store, you have no real way of knowing what you’re ingesting. The active ingredient in drugs like Viagra, Cialis, and Levitra can negatively interact with other medications, so it’s essential that you take them with medical supervision.

Antioxidants  boost nitric oxide production and prevent NO breakdown. Ascorbic acid has direct effects on the bioactivity of NO, and augments NO production in a variety of body processes. The effects are actually synergistic with Vitamin E. Both vitamins are not usually measured, and a reasonable dose of Vitamin C is 500 to 1,000 mg daily. Vitamin E supplementation should be limited to <400 IU per day because of potential adverse long-term health effects of higher doses.
Another potential cause of ED is prediabetes and diabetes—35-50 percent of men with diabetes also have ED. Chronically elevated blood sugar damages the arteries (there’s the vascular connection again) and nerves, including those that stimulate the penis. Prediabetes and diabetes are also generally accompanied by excess weight, especially around the mid-section. These excess fat cells convert testosterone into estrogen, negatively altering the testosterone to estrogen ratio. This excess estrogen, independent of prediabetes and diabetes, interferes with the hormonal cascade necessary to produce and maintain an erection. Although many men may reach for a testosterone booster, a more effective means is to improve the body’s metabolism and elimination of estrogen and to lose excess weight around the middle. To support healthy blood sugar balance and estrogen metabolism try:

Sexual dysfunction has been evaluated in ancient literature of TCM in terms of subjective sensation and the actual sexual performance (3). In TCM, methods and matters related to direct sexual activity is described in terms of “ten motions”, “seven impairments” and “eight benefits”, which asserted that the ideal intensity and frequency of sexual activity should be moderate. TCM is all about balance, to achieve better overall regulation of the yin and the yang. The aim of treatment of ED using TCM is not for the end point of a penile erection but rather for a natural and harmonious sex life. TCM aims to achieve regulation in terms of the man’s anxiety, fatigability, changing hormonal levels, insomnia and gastroparesis. Medicine to invigorate qi can enhance physical fitness, and medicine to warm the kidneys can regulate sex hormones, increase libido, invigorate the spleen, regulate the stomach and improve general well-being (3). Medications used to treat a “stagnated liver” provide tranquilization and helps to stabilize the mind, hence improving mental processes and emotional wellness. As a result, the patient’s overall condition and quality of life is improved.
Saw palmetto. Saw palmetto comes from the fruit of a small palm tree. It has been used to treat symptoms in men with an enlarged prostate gland, such as difficulty urinating, and it has been recommended to treat ED caused by an enlarged prostate. However, several recent clinical trials did not show that saw palmetto works any better on an enlarged prostate than a placebo does. "There is no evidence that saw palmetto should be used to treat erectile dysfunction," says Dr. Gilbert. Like ginkgo biloba, saw palmetto can interact with some prescription medications.
"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."

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].
Another potential cause of ED is prediabetes and diabetes—35-50 percent of men with diabetes also have ED. Chronically elevated blood sugar damages the arteries (there’s the vascular connection again) and nerves, including those that stimulate the penis. Prediabetes and diabetes are also generally accompanied by excess weight, especially around the mid-section. These excess fat cells convert testosterone into estrogen, negatively altering the testosterone to estrogen ratio. This excess estrogen, independent of prediabetes and diabetes, interferes with the hormonal cascade necessary to produce and maintain an erection. Although many men may reach for a testosterone booster, a more effective means is to improve the body’s metabolism and elimination of estrogen and to lose excess weight around the middle. To support healthy blood sugar balance and estrogen metabolism try:
Contrary to popular belief, the penis does not have a mind of its own. To make it a fine and upstanding specimen, your neurons must be co-ordinated with military precision. You need thiamine, aka vitamin B1, for a healthy nervous system, so eat pork to help fire your swimmers in the right direction. Can’t or don’t eat pig? Get your B from beans and wholemeal bread.
“Celery contains androsterone, a male pheromone released through perspiration, which limited research has shown to increase flirty behavior among females,” says dietitian Keri Gans, author of The Small Change Diet. Ingesting the androsterone can boost also boost male arousal, and cause a dude’s body to send off scents and signals that make him more desirable to women, according to Alan Hirsch, M.D., author of Scentsational Sex.
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.
There are currently two models of the inflatable penile prosthesis (IPP), namely, the two-piece IPP vs. the three-piece IPP. The three-piece IPP consists of a pair of corporal cylinders, a scrotal pump and an abdominal reservoir filled with saline. Owing to the presence of the reservoir, the corporal cylinders can be completely deflated to give the patient the physiological flaccid state when not in use, and likewise a maximally turgid state when inflated (21). The two-piece IPP lacks an abdominal reservoir and is often offered in patients with whom placement of reservoir is challenging or not possible such as following radical cysto-prostatectomy with orthotopic ileal neobladder creation, or patients who had previous open book fracture of the pelvis with metal implants. The concept of ectopic reservoir placement has allowed many of these men the option for three-piece IPP placement (22). Technological advances have improved mechanical reliability, reduced prosthesis infection risk and offered excellent patient and partner satisfaction rate (23).

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.
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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