ICI Alprostadil may be used as a mixture with two other drugs to treat ED. This combination therapy called "bimix or trimix" is stronger than alprostadil alone and has become standard treatment for ED. Only the Alprostadil ingredient is FDA approved for ED. The amount of each drug used can be changed based on the severity of your ED, by an experienced health professional. You will be trained by your health professional on how to inject, how much to inject and how to safely raise the drug's dosage if necessary.
When given orally, yohimbine reaches peak levels in 10–15 min, and the half-life is 0.6 h. The efficacy of yohimbine in sexual function has been questioned, perhaps because of early questionable multidrug preparations.10,11 Yohimbine has been shown to have some effect on psychologic erectile dysfunction12,13 and in reversing fluoxetine-induced sexual dysfunction.14
Depending on dosage, yohimbine can either increase or decrease blood pressure Small doses can increase blood pressure. Higher doses can lead to a potentially dangerous drop in blood pressure. Higher doses of oral yohimbine may have numerous side effects, such as rapid heart rate, overstimulation, unusual blood pressure, cold sweating, and insomnia.
There are two things that need to be looked at in recommending a supplement for a medical condition: what is the physiology of the medical condition and what is the pharmacology of the supplement you are using.  There then is a search for a link between the two that leads to a tie in with a therapeutic approach.  In some ways this is like a logic course that says A causes B, B causes C therefor A causes C.  We then must apply this to the scientific method and finally the ultimate test: clinical response and safety.  This is often made out to be the gold standard for our typical Rx meds that I dispense every day, but often ridiculed when it crosses the barbed wired “nutraceutical” boarder.  If it is a nutrient then we must be getting the right amount in our food after all right?  Regardless of 1)what the real amount is in the food we eat, not to mention 2)the depletion that may be taking place of that nutrient due to a prescription drug we are taking (an absolute science based cause and effect) – we blindly accept what our food has in it and the level our bodies maintain – this is an incorrect assumption.  In fact it is quite ironic that the anti-nutraceutical court is still hanging onto this assumption when both are established by science.

You may find that using a vacuum device requires some practice or adjustment. Using the device may make your penis feel cold or numb and have a purple color. You also may have bruising on your penis. However, the bruises are most often painless and disappear in a few days. Vacuum devices may weaken ejaculation but, in most cases, the devices do not affect the pleasure of climax, or orgasm.
Associated risks/scrutiny: “A dose of yohimbine that’s too big could drop your blood pressure, cause dizziness, facial flushing and nausea,” warns Fratellone. Yohimbine and yohimbe bark may also increase heart rate and raise blood pressure. “No one should experiment with herbs without talking to their doctor,” reminds Fratellone. “If you’re taking Flomax and you start taking yohimbe, you’re going to dilate your penal vessels and you’ll pee more.” Other potential interactions between yohimbe and other drugs and herbs should be considered. Some of these combinations may be dangerous.

Long prescribed for women who want to restore muscle tone after childbirth, pelvic floor exercises, also known as Kegel exercises, can benefit men significantly too. A study by researchers at the University of West of England in Bristol showed that pelvic floor exercises can help men with erectile dysfunction and premature ejaculation. Furthermore, experts think these exercises can make orgasms stronger. Once learned, pelvic floor exercises can be done any time, even while doing other things.
In the end, the data from the Hong Kong study suggest that niacin alone can improve the erectile function of subjects with dyslipidemia suffering from ED. This is the first time this conclusion has appeared in the literature. Once again, the effect of niacin is clinically significant in those with moderate to severe ED. Further, because of the close relationship between ED and dyslipidemia, niacin could prove to be an important therapy for managing both conditions. Who knows? There may even be other benefits. Future studies will further refine the indications and benefits of niacin in patients with ED.
So what causes erectile dysfunction?  Sometimes it is a circulation problem.  Sometimes it is a low testosterone issue.  Sometimes it is not.  Testosterone (T) supplementation can help ED and low libido in cases of low T and even if there is a normal T level at baseline, ED can be helped.  In cases where thyroid under or overactivity is causing T levels to be less than optimal.  Aging is also a problem as T levels drop after mid 20’s and as adipose tissue increases and aromatase enzyme conversion of T to Estrogen correspondingly increases.  This causes an unfavorable E:T ratio which equates to low T.
One of the best methods that you can do in order to locate your pelvic floor is to stop your urine in mid-stream several times. These muscles that you clench are the ones that you have to exercise on. In order to perform repetition on Kegel exercises, you can squeeze your pelvic muscles, holding the position for 5 seconds, and then relaxing. You may repeat this for about 10 to 20 times, two to three times in a day. You may also want to do this while in different positions such as standing, sitting, lying down, sitting in a chair, as well as standing.
Those looking to crank up their body's fat-burning to the next level may stack yohimbine HCL with ephedrine HCL and caffeine, creating the ECY stack. Yohimbine is a powerful stimulant that acts on different metabolic pathways compared to caffeine and ephedrine. The most common dosage for each compound in this stack is 5mg of yohimbine HCL, 200mg caffeine, and 25mg ephedrine HCL two to three times per day.
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The group treated with the lower concentration of zinc (1 mg/day) did not show an alteration in any of the observed parameters. However, supplementation with a dose of 5 mg/day per rat caused substantial prolonged ejaculatory latency and increased in number of penile thrusting. The other parameters studied remained unchanged indicating uninterrupted libido, sex vigor and performance. Majority of male rats (75 %) showed the prominent actions of sexual behaviour (mount, intromission and penile thrusting) and did not ejaculate within the 15-minute observation period.

Few men want to talk about their inability to get or maintain an erection, however, erectile dysfunction can have a profound impact on relationships and self-esteem. Fortunately, trouble in the bedroom doesn't necessarily mean you're dealing with erectile dysfunction. Most men will have problems with an erection at some point in their sexual history. But one bad day in the bedroom doesn't mean major sexual health problems. So how can you know if you're dealing with erectile dysfunction?
Test was terminated after 15 minutes of observation or after ejaculation (whichever occurred first). Ejaculatory latencies were taken as 15 minutes when animals showed intromissions but failed to ejaculate during the test period. After analyzing the results, the following tests were performed with the group that indicated significantly positive effects compared to the controls:
However, you might actually be better off going one step back in the chain reaction and taking an L-citrulline supplement. While your body converts L-arginine to nitric oxide, it also metabolizes it too fast when the amino acid is taken in an oral supplement, according to a 2011 study from the University of Foggia in Italy. L-citrulline, which the body converts to L-arginine, is actually a better option to follow the same metabolic pathway and serve as a treatment for ED, the same study found.
Vitamins and minerals are used in systems all over the body. Everywhere from your cardiovascular to your nervous system. It’s a lot to understand. So to help dispel some of the myths and outlandish claims, we’ll take a look at how five common vitamins and nutrients affect one very specific aspect of men’s health—erections. Turns out, vitamins can do more than just ward off the common cold.
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