One of the main actions of yohimbe bark is alpha-2 antagonism (this is why it’s also sometimes called an “alpha-2 blocker”). This means that it can impact sympathetic nervous system activity and increase the release of adrenaline (or noradrenaline). This is because it blocks alpha-2 receptors in the brain stem. (4) Other types of alpha-2 agonists medications work in a similar way. They affect the central nervous system by altering release of certain neurotransmitters and dilating blood vessels. This increases alertness, circulation and other physiological processes.
A conflicting study of 22 subjects found that a 100mg daily dose of yohimbine for 30 days did not significantly improve penile rigidity. Three subjects experienced a notable increase in penile rigidity and twelve subject experience a partial increase in rigidity. [13] These findings do not completely discount the use of yohimbine to treat erectile dysfunction, but do suggest the compound's effects, even at very high dosages, will cause varying responses across a similar population.
A physical exam checks your total health. Examination focusing on your genitals (penis and testicles) is often done to check for ED. Based on your age and risk factors, the exam may also focus on your heart and blood system: heart, peripheral pulses and blood pressure. Based on your age and family history your doctor may do a rectal exam to check the prostate. These tests are not painful. Most patients do not need a lot of testing before starting treatment.
Usually there will not be a specific treatment that will lead to the improvement of erectile dysfunction. However, there are treatments that will allow erections to happen and can be used to allow sexual activity to take place. There are three main types of treatments: non-invasive treatments such as tablet medicines and external devices (e.g. vacuum device); penile injections; or for men who have not had success with other treatments, surgery may be an option.
Poor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones. 
When it comes to keeping your gut healthy and immunity strong, consuming fermented foods and probiotic supplements is essential. Probiotic foods and supplements fortify the ‘good’ bacteria that live in the gut – the all-important microbiome – which in turn protects the gut wall, regulates inflammation, and assists with hormone and neurotransmitter production. Also essential… View Article
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If you have symptoms of ED, it’s important to check with your doctor before trying any treatments on your own. This is because ED can be a sign of other health problems. For instance, heart disease or high cholesterol could cause ED symptoms. With a diagnosis, your doctor could recommend a number of steps that would likely improve both your heart health and your ED. These steps include lowering your cholesterol, reducing your weight, or taking medications to unclog your blood vessels.
In a study with human subjects, Kruger et al. have reported that acute changes in the normal physiological levels of PRL led to a significantly prolonged ejaculatory latency, but minor reductions of sexual drive and function.[19] Although zinc induced elevation of PRL was not an acute effect, findings similar to the human study (prolongation of ejaculation and mild reduction of libido index with medium dose of zinc) were observed in this study. However, the prolongation of ejaculatory latency may not be merely due to effects of elevated PRL because elevated PRL levels are known to be associated with the negative aspects of sexual activities (decreased sexual desire and frequency of sexual intercourse).[20]
Several studies have shown that erectile dysfunction is somehow linked to problems with cardiovascular health — which one comes first has been the question. It makes sense; the penis becomes erect through a complex system of blood vessels and spongy tissue called the corpora cavernosa — this is where the blood gets trapped, causing the erection. When problems arise through this system, whether they’re caused in the brain or through problems with the blood vessels, the penis can’t get erect.
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.
In conceiving the potential solutions to issues around erectile dysfunction, it’s really helpful to understand clearly how an erection is achieved and completed. To achieve an erection, there needs to be some form of stimulation, either from touch or some sort of audiovisual stimuli.  Once the stimulation occurs, chemical messengers are released and blood starts to fill into the penis. In terms of the musculature, the bulbospongiosus and ischiocavernosus muscles need to be relaxed so blood can fill the area completely. Then the bulbospongiosus needs to contract to keep the blood in the penis. The erection ‘completes’ with the rhythmic contraction of the bulbospongiosus muscle.
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?

Because cholesterol is a building block for testosterone, drugs that interfere with cholesterol production can lower levels of this hormone (Journal of Sexual Medicine, April, 2010). French and Dutch researchers have reported that decreased libido and erectile dysfunction may be associated with statin-type drugs (British Journal of Clinical Pharmacology, Sept. 2004; Drug Safety, July, 2009).
The number of animals ejaculating within 15 minutes was significantly reduced in 5 mg zinc treated group (one out of eight). However, all intromitted rats ejaculated between 20-30 minutes when observation was continued. Ejaculatory latency was significantly high in this group compared to controls; 711.60 Sec (SEM 85.47) vs. 489.50 Sec (SEM 67.66), P < 0.05. Similarly, they showed a significantly higher frequency of penile thrusting compared to controls; 26.50 (SEM 6.17) vs. 52.80 (SEM 11.28), P < 0.05 [Table 1].

This scenario raises a key concern for us (and should for you as well) about what is recommended to treat erectile dysfunction. I performed a quick Google search on kegels as treatment for the pelvic floor, and found hundreds of websites instructing men to perform kegels to ameliorate erectile dysfunction, have longer and stronger erections – a quick and easy fix. I found a few sites instructing men to perform anywhere from 50-100 repetitions per day (insanity). I discovered a new book called Male Pelvic Fitness, a “user manual to your man parts
The Florida Sexual History Questionnaire, a 20-item questionnaire that assesses interest and desire for sexual activity, sexual development, current sexual behaviors, and satisfaction with current sexual activity, was used to assess male sexual dysfunction. Individuals responded to each question by choosing one of six ordinally scaled response categories, with higher scores representing better functioning. Scores on the Florida Sexual History Questionnaire have been shown to significantly discriminate between men with and without impotence25 and between men with primary organic and primary psychogenic erectile dysfunction.26 According to Geisser et al,25 the Florida Sexual History Questionnaire has high internal consistency as well as split-half reliability. Chronbach's alpha has been reported to be as high as 0.90, and Spearman Brown's coefficient is reported to be 0.86.

Shindel, A. W., Xin, Z.-C., Lin, G., Fandel, T. M., Huang, Y.-C., Banie, L., … Lue, T. F. (2010, February 5). Erectogenic and neurotrophic effects of icariin, a purified extract of horny goat weed (Epimedium spp.) in vitro and in vivo. The Journal of Sexual Medicine, 7(4), 1518-1528. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2009.01699.x/full
A conflicting study of 22 subjects found that a 100mg daily dose of yohimbine for 30 days did not significantly improve penile rigidity. Three subjects experienced a notable increase in penile rigidity and twelve subject experience a partial increase in rigidity. [13] These findings do not completely discount the use of yohimbine to treat erectile dysfunction, but do suggest the compound's effects, even at very high dosages, will cause varying responses across a similar population.
Due to its ability to inhibit actions of the sympathetic nervous system, yohimbe can help to bring blood pressure levels back to balance. This is is why it’s used to sometimes increase blood flow, such as to tissues of the reproductive organs.  Or, also why it’s used to treat hypotension (abnormally low blood pressure). It may also be helpful for stimulating nerves and treating fatigue or symptoms of depression.
What's to know about erectile dysfunction? Erectile dysfunction (ED) is a condition in which a man regularly finds it difficult to get or keep a firm erection. ED can be caused by psychological, physical, and medical reasons. This article looks at many of the causes, symptoms, and treatment options, which include medication, surgery, exercise, and diet. Read now
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