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ED is caused by vascular, hormonal, neurogenic, pharmacological, or psycho-genic factors. Performance anxiety where the person fears failing in a sexual scenario is a common psychogenic cause for ED.3 Neurogenic causes are related to diseases like Alzheimer's, Parkinson's, stroke or spinal cord injuries. Radical removal of the prostate (also called prostatectomy) is the cause of nerve-related ED as nerve injury is possible despite advances in surgical methods.4

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. 
Men can judge themselves pretty harshly when it comes to their performance in between the sheets. The unsettling fear of not being able to rise to the occasion becomes a reccurring nightmare for men that is often equated with failure, loss of dignity, and masculinity. If you suffer from erectile dysfunction (ED), don’t be so hard on yourself, since impotence can almost always be improved with treatment, without having to rely on Viagra or other medications. Whether you suffer from ED, or hope to prevent the condition, here are six tips to overcome impotence without the side effects of the little blue pill.
Pomegranate juice. Drinking antioxidant-rich pomegranate juice has been shown to have numerous health benefits, including a reduced risk for heart disease and high blood pressure. Does pomegranate juice also protect against ED? No proof exists, but results of a study published in 2007 were promising. The authors of this small-scale pilot study called for additional research, saying that larger-scale studies might prove pomegranate juice's effectiveness against erectile dysfunction. "I tell my patients to drink it," says Espinosa. "It could help ED, and even if it doesn't, it has other health benefits."
Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).
In addition to being leaner and lower in calories than conventional cuts, grass-fed beef offers a host of benefits, from muscle-building to fat-burning to heart protection. You can add assistance in the bedroom to its list of good qualities; it’s an excellent source of Vitamin B12. A recent report from Harvard University highlighted a study that has linked low levels of B12 to erectile dysfunction. So, eat up! Bonus: It’s one of the healthy fats that actually makes you skinny.

There are so many potential reasons a man might develop erectile dysfunction (ED), it's nearly impossible to generalize the best ways to treat it. What works for one man may not work for another simply because they are having problems for different reasons. That said, it may encouraging to hear that there are a variety of options that may be considered, from psychological counseling to lifestyle changes, medications to treatments and devices.

Encouraging evidence suggests that ginseng may be an effective herbal treatment for ED. However, further, larger, and high-quality studies are required before firm conclusions can be drawn. Promising (although very preliminary) results have also been generated for some herbal formulations. Overall, more research in the field, adhering to the CONSORT statement extension for reporting trials, is justified before the use of herbal products in ED can be recommended.
It’s no secret that oily coldwater fish like wild salmon, sardines, and tuna are overflowing with omega-3 fatty acids, but here’s something you may not know: The nutrient not only benefits your heart but also raises dopamine levels in the brain. This spike in dopamine improves circulation and blood flow, triggering arousal. There’s more: “Dopamine will make you feel more relaxed and connected to your partner, which makes intercourse more fun,” says Tammy Nelson. Just make sure you’re ordering the right kind by reading this special report: 8 Mistakes You’re Making When Buying Salmon!

Sure, it’s good for your cholesterol, but did you know red wine can benefit your manhood? Red wine contains nitric oxide, which helps relax the arteries and increase blood flow in the genitals, and the compound quercetin, which helps block the enzyme that triggers your body to push away testosterone, allowing you to maintain high levels of testosterone—and a strong erection well past foreplay.

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.
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.
10 ways of knowing that you are properly squeezing your pelvic floor muscles (PFM): 1) The base of your penis retracts inwards towards the pubic bone as you contract your PFM. 2) The testes rise towards the groin as you contract your PFM. 3) When you place your index and middle fingers in the midline between the scrotum and anus you feel these muscles tighten as you contract your PFM. 4) You can pucker your anus (not the gluteal muscles) as you contract your PFM. You feel the anus tighten and pull up and in, known as “anal wink.” 5) You get the same feeling as you do when you are ejaculating when you contract your PFM. 6) When you touch your erect penis, you feel the erectile cylinders surge with blood as you contract your PFM. 7) You can make your erect penis elevate (lift and point) as you contract your PFM. 8) You can stop your urinary stream completely when you contract your PFM. 9) You can push out the last few drops of urine that remain after completing urination when you contract your PFM. 10) After pursuing PFM training, you notice improvements in erectile rigidity and durability as well as better quality ejaculations, ejaculatory control and improvement in urinary control.
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.
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.

Like garlic, onions too help treat ED. In a study conducted on male rats, fresh onion juice was found to have improved copulatory behavior and cured medicine-induced sexual dysfunction.8 They are also believed to help treat involuntary loss of semen during sleep or other times. Studies also show that like garlic, onions too offer some protection against testicular oxidative damage and spermiotoxicity.9
Experts feel that treating erectile dysfunction on your own, without consulting a doctor, is unsafe. "If you have ED, the first thing you need is a diagnosis," says impotence expert Steven Lamm, MD, a New York City internist and the author of The Hardness Factor (Harper Collins) and other books on male sexual health. He says men with severe erectile dysfunction probably need one of the prescription ED drugs, which include Levitra (vardenafil) and Cialis (tadalafil) as well as Viagra. But, he says, mild ED -- including the feeling that "you're not as hard as you could be" -- often responds to natural remedies.

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.
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.
The diagnosis of erectile dysfunction requires a comprehensive sexual and medical history that include a validated questionnaire, the Sexual Health Inventory for Men (SHIM), and asking if they experience a rigid erection at night, in the morning, or during masturbatory approaches. The presence of rigid morning or night erections, or rigid erections at any sexual thought suggests a mainly psychogenic cause. Conversely, erectile dysfunction with a gradual onset, progressive course, or long duration suggests a predominantly organic cause.
Warnings: Keep out of reach of children. Not intended for persons under 18 years of age. Do not use if you are pregnant or nursing or at risk of or being treated for high blood pressure and heart disease. *Disclaimer: The statements appearing on this listing have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease or conditions but rather a dietary supplement intended for nutritional support. Individual results may vary.
ED can be caused by a handful of things, but one thing’s for sure: You need a healthy supply of the neurotransmitter nitric oxide (NO) to get and maintain an erection. NO is produced in nerve tissue and helps jolt your Johnson by relaxing the smooth muscle so blood can fill the penis. After the initial release of NO, your body releases a cascade of chemicals—including more of the neurotransmitter—to help keep you hard and happy, according to a study in the Proceedings of the National Academy of Sciences.
Double down on the marinara to protect your manhood. Men who eat over 10 servings of tomatoes each week have an 18 percent lower risk of developing prostate cancer — the result of lycopene, an antioxidant which fights off toxins that can cause DNA and cell damage — a study in the journal Cancer Epidemiology, Biomarkers and Prevention found. A previous study found the garden vegetable could also improve sperm morphology (shape); men with the highest tomato intake contributed to between 8 and 10 percent more ‘normal’ sperm.
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. 
Ginkgo biloba may increase blood flow to the penis. Researchers discovered the effect of gingko on ED when male participants in a memory enhancement study reported improved erections. Another trial saw improvement in sexual function in 76 percent of the men who were on antidepressant medication. This is why researchers believe that ginkgo may be effective for men who are experiencing ED due to medication.

Mirroring the micronutrient synergy approach that has been pioneered by scientists at the Dr. Rath Research Institute, research has shown that the combination of arginine and pycnogenol, an extract from French maritime pine bark, can correct ED in 80 percent of patients after just two months. After a period of three months, the researchers found that an impressive 92.5 percent of patients were experiencing normal erectile function without any side effects.
"Just because there is evidence doesn't mean it's good evidence," says Andrew McCullough, MD, associate professor of clinical urology at New York University Langone Medical Center in New York City, and one of the original clinical investigators for the ED drug Viagra (sildenafil). "And before men with ED start down the naturopathic route, it's smart to make sure that there isn't some underlying medical condition that needs to be corrected." Moreover, it is estimated that 30 million American men have erectile dysfunction, and 70% of cases are a result of a potentially deadly condition like atherosclerosis, kidney disease, vascular disease, neurological disease, or diabetes. Additionally, ED can also be caused by certain medications, surgical injury, and psychological problems.
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:
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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