Guay and Spark observed independently (unpublished data) that yohimbine was associated with a very poor response in cigarette smokers. This is believed to be relevant, because studies several decades ago may have included a large percentage of smokers, which only recently has been recognized as a risk factor for erectile dysfunction. We tested this hypothesis by studying nonsmoking men with documented organic impotence and by judging whether any possible effect might be related to adrenal or testicular hormones, which, to our knowledge, has not been studied.
Although you should steer clear of supplements advertised online, research shows certain vitamins and herbs can help ED. They may help improve the health of your blood vessels, increase blood flow to the penis, and boost erectile function. If other treatments have failed, you’re not a candidate for ED medications, or you’re looking for a more natural approach, ask your doctor whether these supplements could be right for you. Here are three to discuss with your doctor:
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.
To locate the muscles these exercises engage, try to stop and restart the flow of urine mid-stream. Just do this once, because if you do it too much it can affect the passage of urine. Once you’ve located these muscles, you can tighten and draw the muscles in, feeling them lift upward. Hold for a count of five, then release. It’s recommended that men do 8 to 10 repetitions, resting in between. Ideally, each series of 8 to 10 should be followed by 5 to 10 quick squeezes and releases, and men should work up to doing the whole process four or five times per day for best results.
There’s evidence to show that Yohimbine may have some small effect in helping aid weight loss. In 1991, there was a study of 20 overweight women on diet of 1,000 calories per day. Each was given 20 mg of Yohimbine a day, and lost 3 pounds more than those who weren’t taking any. Any weight loss drug should, however, always be taken alongside a healthy diet and exercise.
As an alpha-2 antagonist, yohimbine promotes sympathetic activity. According to a number of studies, yohimbe can increase blood pressure. This is why it’s useful for things like erectile dysfunction or diabetic nerve problems. Yohimbine is sometimes used to treat low blood pressure and symptoms like dizziness when standing up. It works by dilating blood vessels and acting on the sympathetic nervous system. However, it’s important to point out that increased blood pressure can also be a problem for some people, especially those with existing cardiovascular problems, people taking blood pressure medications, or those who already have high blood pressure.
Yohimbe has been shown to be an alpha-adrenoceptor blocker. This action reduces the effects of hormones that increase the constriction of blood vessels as a person ages. Yohimbe also increases production of norepinephrine, which plays a role in achieving erection during sexual arousal. Yohimbe increases the amount of adrenaline that reaches the nerve endings, enhancing sexual sensations and allowing for a more satisfying sexual experience. Yohimbe has been shown to support sexual longevity.
Researchers at Johns Hopkins University last year looked at 3,400 healthy Americans and found that men who were vitamin D deficient were 32% more likely to have trouble getting it up than those with sufficient levels, even after adjusting for other ED risk factors. In fact, the connection is so common, Walker says D levels are something he always checks in ED patients. Why? The sunshine vitamin is crucial for keeping the endothelial cells that line blood vessels healthy. Without enough of the stuff, blood flow is inhibited, affecting everything from your heart to your hard-on.
This study was designed to test the hypothesis that hydrochlorothiazide a diuretic used to treat hypertension depletes body zinc and thereby cause sexual dysfunction. Serum zinc and sexual dysfunction were measured in 39 middle aged hypertensive men who had been taking hydrochlorothiazide in average daily doses of between 25 and 50 mg daily for at least six months, and a control group of 27 unmedicated middle aged normotensive men. The medicated group had a higher incidence of sexual dysfunction (56 pc) as compared to 11 pc in the control group. The use of hydrochlorothiazide did affect serum zinc levels significantly in 20 patients. Sexual dysfunction occurred more often in older and overweight patients (p < 0.004). Three of the normotensive men experienced sexual dysfunction probably related to old age. Twenty two of the 39 on hydrochlorothiazide and experiencing sexual dysfunction were divided into two groups of 11 patients. Bloods were taken from the 27 normotensive and 22 hypertensive men receiving hydrochlorothiazide for the analyses of zinc. Subsequently one group of the patients were supplemented with zinc 500 mg daily for 30 days while the other group was supplemented with magnesium chloride 1 g daily for 30 days. The normotensive men were not treated. After 30 days, bloods were again taken from the three groups of analyses for zinc and magnesium. Serum zinc was significantly decreased (p < 0.05) by hydrochlorothiazide and a non significant decrease in serum magnesium (p = ns) was observed. After supplementation with zinc, the serum zinc levels returned to normal only in eight patients. There was improvement in the symptoms of sexual dysfunction in five patients. Two patients gained weight. Hydrochlorothiazide decreased serum zinc levels (p < 0.05) and was unchanged with magnesium supplementation but the serum magnesium returned to normal values. Improvement of symptoms of sexual dysfunction was positive in one patient. This study shows that low serum zinc levels may be associated with sexual dysfunction but the definitive role of zinc in the pathogenesis of sexual dysfunction will remain controversial.
It's also important to remember that your mental health plays as much a part of your sexual ability as your physical health. Stress and other mental health concerns can cause or make erectile dysfunction worse. Minor health problems may slow your sexual response, but the accompanying anxiety that comes with the slow sexual response can shut things down entirely.
Yohimbine also helps to increase levels of the coenzyme NAD (or nicotinamide adenine dinucleotide). This affects metabolism, cognitive processes, and detoxification of drugs in the body. NAD is not currently used to treat cognitive or mood-related disorders on its own, but has been shown in some studies to potentially have uses for preventing neurodegenerative diseases including Parkinson’s disease or Alzheimer’s. However on the other hand, studies have found that because it can increase anxiety in some patients, yohimbine may actually worsen mental illness in some patients, including those with Parkinson’s. (15) For this reason, it’s important for anyone taking mood-altering medications, or who has a history of any cognitive or mood disorder, to work with a professional while taking or starting any new herbal treatments.
If you’ve been to the health food store lately, you’ve seen shelves lined with vitamins and “organic” supplements, each claiming to boost immunity, revitalize organ function, or “promote health.” And it’s working. Supplements are currently a $30 billion industry in the US, with more than 90,000 products on the market, and vitamin use is on the rise. In fact, a recent survey in Journal of American Medicine Association showed that “52% of US adults reported use of at least 1 supplement product.”

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.


Regular cardiovascular exercise can not only improve erectile function, it can boost energy levels, lower blood pressure, and improve muscle tone. Furthermore, by reducing body fat and stress, regular cardio can improve a person’s self-image, improve sleep, and result in a more rested overall feeling. For maximum benefit, 20 to 30 minutes of cardiovascular exercise four or five times a week is ideal, and it may take time to work up to this. It’s smart to discuss this with your doctor if you have been living a sedentary lifestyle or haven’t had a physical in a while. The key to sticking with cardio is choosing an activity you enjoy so it won’t feel like a chore. Great choices in the cardiovascular exercise include:

I was impressed with the questionnaire to make sure the meds I requested were right for me and the follow up email from the prescribing doctor to see if I needed any support. The meds came promptly, were well packaged and are comfortably in date - I thought they might be very near their sell by date but I was wrong to be suspicious. If I ever need this service again I wouldn't hesitate.


Yohimbine's powerful effects on blood flow explain why it's been used in traditional African medicine to increase sexual desire in both genders as well as improve the strength of erections in males. [1] Yohimbine's powerful stimulant properties may also benefit athletic performance on and off the field. The body absorbs and expels yohimbine rapidly.
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Data from the Florida Sexual History Questionnaire collected at each time period (baseline, 5.4 mg tid and 10.8 mg tid) are presented in Table 6. Three patients (two responders and one nonresponder) did not complete the entire questionnaire for each study period and were excluded from the analyses. Thus, data in the table and statistical analyses are based on the responses of seven responders and eight nonresponders.
Those consuming yohimbine lost nearly 30% more fat and experienced 31% greater reductions in body fat percentage compared to those in the placebo group. Neither group reported negative side effects from a twice-daily dosing of 10mg of Yohimbine HCL. These findings indicate that the powerful fat loss effects of yohimbine apply to even the most seasoned athletes with already low levels of body fat.

Our bodies are designed to be active and in motion. By keeping active and engaging in regular aerobic exercise, you increase the blood flow to your muscles, and your penis along the way. One of the most interesting things about increasing your blood flow is that it becomes a signal to your blood vessels to grow and get wider. It benefits your brain, your heart, and your erection. The principle of "use it or lose it" is the best advise one can follow. In fact, if you don't engage in sexual activity at least once or twice a week, it would be beneficial to masturbate. This not only helps with prostate health, but encourages the blood vessels that contribute to your erection to maintain their patency and flow. 
Penile erection is a hemodynamic process involving increased arterial inflow and restricted venous outflow, coordinated with corpus cavernosum and penile arterial smooth muscle relaxation. Any problem in this mechanism results in Erectile Dysfunction and its etiology is generally multifactorial. This study is aimed at determining the objective outcome of aerobic training in the management of Erectile Dysfunction of arterogenic origin using Meta analysis.

The substance that gives hot peppers their kick can also give you some kick in the pants: Studies have associated the natural chemical with increased testosterone levels. In animal studies, capsaicin has also shown to increase the size of sex organs, while simultaneously decreasing belly fat. A 2014 study from France also found that men who ate more spicy food had higher testosterone levels than those who ate less. You can consume capsaicin via peppers, chili powder or a cayenne supplement.
Cavallini, G., Modenini, F., Vitali, G., & Koverech, A. (2005, November). Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology, 66(5), 1080-5. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429505006515

Instead of injecting a medicine, some men insert a suppository of alprostadil into the urethra. A suppository is a solid piece of medicine that you insert into your body where it dissolves. A health care professional will prescribe a prefilled applicator for you to insert the pellet about an inch into your urethra. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes.
Aids in fat loss: Yohimbe and other alkaloids in the bark extract are said to block specific receptors that actually inhibit fat loss. A three-week study in 1991 observed 20 obese females on 1,000-calorie diets. They were given 20 mg of yohimbe each day and lost three pounds more than the group receiving placebos. Not a drastic weight loss, but enough to give experts hope that yohimbe can help with weight loss. Other studies have found that yohimbe increases the amount of non-esterified fatty acids, a result of fat breaking down. More research is needed. Most other studies in the field are done using the drug yohimbine. Extracted chemicals are not the same as yohimbe bark. Studies with yohimbine are expected to give different results than studies that used the raw plant.
When stimulated by the nerves, the spongy tissue arranges itself in such a way that more blood can be stored in the penis. The veins running through the outer sheath of the penis then compress which stops the blood from leaving the penis. As the blood is stopped from flowing out, the penis fills with blood and stretches within the outer casing, giving an erection.

Several studies (15–17) have shown an inverse relationship between physical activity levels and biomarkers of inflammation in both the healthy individuals and subjects with cardiovascular condition. Studies (18–21) have also reported the role of exercise in the management of erectile dysfunction. The majority of these studies are subjective, retrospective case series and non randomized non controlled studies. However, randomized controlled trials (RCTs) are generally accepted as the most valid method for determining the efficacy of a therapeutic intervention, because the biases associated with other experimental designs can be avoided (22). Therefore, the purpose of the present Meta analysis study was to determine the role and effect of aerobic exercise in the management of erectile dysfunction in randomized controlled trials.


The positive response in our patients was enhanced with the higher dose of yohimbine, a phenomenon noted previously.20,21 We agree that several weeks of therapy are needed before clinical effects are seen,21,22 and that some responders may be able to take yohimbine only on demand before sexual activity.39 Yohimbine is effective in a subset of men with organic erectile dysfunction, especially nonsmokers, and it deserves a place in our therapeutic armamentarium. When yohimbine is ineffective alone, it may be useful in combination with other treatment modalities, as has been shown with naloxone39 or trazodone.40
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