SSRI's *sinus tachycardia, * myocardial infarction, * junctional rhythms and * trigeminy * anhedonia * apathy * nausea/vomiting * drowsiness or somnolence * headache * bruxism * extremely vivid or strange dreams * dizziness * fatigue * mydriasis (pupil dilation) * urinary retention * changes in appetite * changes in sleep * weight loss/gain (measured by a change in bodyweight of 7 pounds) * increased risk of bon

The development of PDE5-inhibitors is a clear example of how Western medicine approached the problem of ED differently from Eastern medicine. The erectogenic effect of sildenafil (Viagra®) was discovered by accident when patients undergoing heart clinical trials reported better erections as a side effect after taking sildenafil. This observation led to further elucidation of the NO/cGMP signalling pathway and development of PDE5-inhibitors as a first-line therapy in ED (5).


Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject Impulse, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include papaverine, alprostadil and phentolamine. Often these combination medications are known as bimix (if two medications are included) or trimix (if three are included).
Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing some men to function normally. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections.
Despite the name, horny goat weed actually helps improve your erection, not libido.  Botanically known as epimedium, this herb has been used by the Chinese for centuries to treat, among other things, low libido and erectile dysfunction. “A growing body of research shows that isolated icariin—the extract of epimedium—inhibits the enzyme phosphodiesterase-5 (PDE-5) and significantly increases nitric oxide synthase, helping to improve erectile function,” says Fisch. In fact, this is the same mechanism that Viagra works through (but the herb comes with a way better name).
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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]
The pilot study by Vardi et al. (18) showed that LIESWT was effective in treating men with ED, suggesting a physiologic impact of LIESWT on cavernosal hemodynamics. The LIESWT is an effective penile rehabilitation tool that improves erectile function and potentially reverses underlying ED. Recent meta-analysis (19) of 14 studies showed that LiESWT could significantly improve the International Index of Erectile Function (IIEF) [mean difference: 2.00; 95% confidence interval (CI), 0.99–3.00; P<0.0001] and Erection Hardness Score (EHS) (risk difference: 0.16; 95% CI, 0.04–0.29; P=0.01). In addition, the therapeutic efficacy was noted to last for at least 3 months. LiESWT has been cited to a potential cure for ED, unlike other well established non-surgical methods of treatment (i.e., PDE5i, ICI and VED) being on demand treatments.
Size matters, so get slim and stay slim. A trim waistline is one good defense — a man with a 42-inch waist is 50% more likely to have ED than one with a 32-inch waist. Losing weight can help fight erectile dysfunction, so getting to a healthy weight and staying there is another good strategy for avoiding or fixing ED. Obesity raises risks for vascular disease and diabetes, two major causes of ED. And excess fat interferes with several hormones that may be part of the problem as well.
The brew is rich in compounds called catechins, which have been shown to blast away belly fat and speed the liver’s capacity for turning fat into energy. But that’s not all: Catechins also boost desire by promoting blood flow to your nether region. “Catechins kill off free radicals that damage and inflame blood vessels, increasing their ability to transport blood,” says Cassie Bjork, RD, LD of Healthy Simple Life. “Catechins also cause blood vessel cells to release nitric oxide, which increases the size of the blood vessels, leading to improved blood flow,” she explains. Blood flow to the genitals = feeling of excitement, so sipping the stuff will, well, make you want to get it on. Bjork suggests drinking four cups a day to feel the full effects. Pick up one of our 5 favorite teas for weight loss.

This IKEA-cafeteria staple can actually help you put things together in the bedroom. In addition to packing four times your daily requirement of Vitamin B12 in one average-sized filet, herring is also rich in magnesium, which boosts testosterone and keeps sperm healthy and viable. On top of that, oily fish like herring are sky-high in vitamin D, which can help you get and keep it up. In a recent study published in the Journal of Sexual Medicine, Italian researchers examined 143 men with ED; 80% had suboptimal levels of the nutrient, and the men with severe ED had a 24% lower level of D than those with a mild form of the condition. The theory is that low levels of D promote dysfunctional blood vessels and a shortage of nitric oxide.
These medications don’t work for everyone but they are easy to use and work for around 60% of people who try them. They work by making it easier to get an erection by reducing the effect of (inhibiting) the chemical PDE-5. This chemical is used in the body to make sure there isn’t too much blood in the penis during an erection, but if you have erectile dysfunction then this chemical ends up over-compensating.

Peanuts contain a trove the amino acid L-arginine, which is one of the building blocks of nitric oxide, which aids your efforts under the covers. They also help reduce cholesterol levels. The less cholesterol you have in your system, the easier it is for blood to circulate throughout your body and down, which can help you maintain a firmer erection longer.
The pilot study by Vardi et al. (18) showed that LIESWT was effective in treating men with ED, suggesting a physiologic impact of LIESWT on cavernosal hemodynamics. The LIESWT is an effective penile rehabilitation tool that improves erectile function and potentially reverses underlying ED. Recent meta-analysis (19) of 14 studies showed that LiESWT could significantly improve the International Index of Erectile Function (IIEF) [mean difference: 2.00; 95% confidence interval (CI), 0.99–3.00; P<0.0001] and Erection Hardness Score (EHS) (risk difference: 0.16; 95% CI, 0.04–0.29; P=0.01). In addition, the therapeutic efficacy was noted to last for at least 3 months. LiESWT has been cited to a potential cure for ED, unlike other well established non-surgical methods of treatment (i.e., PDE5i, ICI and VED) being on demand treatments.

For patients who failed oral medical therapy or unable to tolerate the side effects, intracavernosal injection of vasoactive agents can often provide effective alternative. Various vasoactive agents such as alprostadil, papaverine or phentolamine have been used either as single agent or combination agents to potentiate the NO release and cavernosal smooth muscle vasodilation. However, intracavernosal injection therapy has high attrition rate and can be associated pain especially with alprostadil injection (2). The practice of isolating compounds and understanding its pharmacological attributes before using it as a drug therapy has been a strength of Western medicine.


The B vitamin folic acid is good for cardiovascular health. Keeping your blood flowing smoothly is a key to preventing and even treating erectile dysfunction (ED). After all, ED is often an early warning sign of heart problems. In particular, some men have high levels of homocysteine, which can contribute to heart problems. Findings show that eating foods high in folate and taking folic acid supplements may help lower high homocysteine levels. Lots of foods contain folic acid, including spinach, tomatoes, and orange juice. But most of us don’t get enough of these heart healthy foods in our daily diet. To boost folic acid, look for a supplement with about 525 milligrams (mg) of this vitamin. That’s good advice for everyone, and might help with your ED. Research suggests that for some men with ED and high homocysteine levels, taking folic acid may be a key to helping ED medications like Viagra perform well.
Nature’s ultimate example of truth in advertising, chili peppers bring the heat. They contain capsaicin, a natural chemical that lends spicy food its pleasurable pain and has serious fat-burning and libido-revving benefits. Research has shown that it boosts testosterone and increases circulation — all good news for your erection and what you do with it. Capsaicin also boosts the release of endorphins, which in turn stimulate desire.

The natural remedy to ED is a healthy lifestyle that can “reverse” ED naturally, as opposed to “managing” it. Since ED can be considered a “chronic disease,” healthy lifestyle choices can reverse it, prevent its progression and even prevent its onset. Since sexual functioning is based upon many body components working harmoniously (central and peripheral nervous system, hormone system, blood vessel system, smooth and skeletal muscles), the first-line approach is to nurture every cell, tissue and organ in the body. This translates to achieving “fighting” weight, adopting a smart heart-healthy and penis-healthy diet (whole foods, nutrient-dense, calorie-light, avoiding processed and refined junk foods), exercising moderately, losing the tobacco habit, consuming alcohol in moderation, stress reduction (yoga, meditation, massage, hot baths, whatever it takes, etc.), and getting adequate quantity and quality of sleep. Aside from general exercises (cardio, core, strength and flexibility training), specific pelvic floor muscle exercises (“man-Kegels”) are beneficial to improve the strength, power and endurance of the penile “rigidity” muscles. If a healthy lifestyle can be adopted, sexual function will often improve dramatically, in parallel to overall health improvements. Since many medications have side effects that negatively impact sexual function, a bonus of lifestyle improvement is potentially needing lower dosages or perhaps eliminating medications (blood pressure, cholesterol, diabetic meds, etc.), which can further improve sexual function. Eat real food and avoid refined, over-processed, nutritionally-empty foods and be moderate with the consumption of animal fats and dairy. Processed meats and charred meats should be avoided. A healthy diet should include whole grains and plenty of vegetables and fruits, particularly those that contain powerful antioxidants, vitamins, minerals and fiber.
Supplement factsAmount500mg*Serving size: 1 Capsule 500mgServings per container: 1Cordyceps Sinensis 50mgAged Garlic extract 40mgMushroom Extract 40mgCodonopsis 60mg Proprietary Blend 310mg Proprietary Blend: Carthamus, Cinnamon Bark, Ginko Biloba, Red-Berried Weeds, Rehmannia, Tribulus Terrestris extract, Wild Yam extract.Other ingredients:Magnesium stearate, silicon dioxide, Gelatin, Glycerin. *Daily values not established.
Just because a product claims to be natural doesn't mean it's safe. Many herbal remedies and dietary supplements can cause side effects and dangerous interactions when taken with certain medications. Talk to your doctor before you try an alternative treatment for erectile dysfunction — especially if you're taking medications or you have a chronic health problem such as heart disease or diabetes.
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