The main surgical treatment of ED involves insertion of a penile implant (also called penile prostheses). Because penile vascular surgery is not recommended for aging males who have failed oral PDE5 inhibitors, ICI or IU therapies, implants are the next step for these patients. Although placement of a penile implant is a surgery which carries risks, they have the highest rates of success and satisfaction among ED treatment options.
This mineral is needed for a healthy sex life and a deficiency is linked to low testosterone levels which contributes to weaker erections. Zinc supplements can significantly improve matters in the bedroom. Food items loaded with Zinc can include oysters, shellfish, nuts and seeds. Erectile dysfunction and loss of interest in sex life can be caused by many physical and psychological reasons. Keep yourself healthy by consuming these vitamins and a healthy diet that is high in fibre and nutrients. Try to ignore OTC medicines like I-Arginine and other pills, and start including these fresh vegetables, apples, oats and whole grains in your daily life. 
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.

Carlo Adrian Cañon is a graduate of Bachelor of Secondary Education major in English from Southern Leyte State University-Tomas Oppus in the Philippines. He has written numerous articles on a variety of topics on men’s health, fitness, and product reviews. He is contributing to consumerhealthdigest.com for men sexual health category. You can follow him on: LinkedIn.
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.
Yohimbe bark (pronounced yoh-heem-buh) is an herbal supplement associated with anti-aging effects. It is used to naturally treat erectile dysfunction, low libido, hormonal imbalances and symptoms like low energy. Yohimbe has a long history of use in Western Africa, where the plant originates. It’s still grown there today, especially for its apparent aphrodisiac abilities.

[notice color=’#ebebeb’]Vitamin B2 (riboflavin) takes an active part in the production of certain hormones and erythrocytes and in the synthesis of ATP, a so-called life fuel. In addition, it protects the human retina from excessive exposure to UV radiation, ensures the dark adaptation of the human eye, increases visual acuity and perception of colour and light. Riboflavin is needed for tissue growth and tissue regeneration.[/notice]

Counselling or sex therapy (58% of people find this works for them) –mind-related causes of erectile dysfunction can affect anyone. They are more likely if you experience erectile dysfunction at a younger age. Talking to a counsellor or therapist can help some people overcome erectile dysfunction related to these problems, possibly for good. They can also help you if your erectile dysfunction is causing you stress, as this can make matters worse.
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.
In addition to lowering low-density and total cholesterol along with triglycerides, increasing high-density lipoprotein cholesterol (HDL-C) has become one of the principal objectives for treating hyperlipidemia. Considerable evidence has shown that even a minor improvement in HDL-C levels may significantly reduce cardiovascular risk. For example, it has been found that an increase of 1 mg/dl in HDL-C levels results in a parallel reduction in coronary artery disease risk by 2% in men and 3% in women. Moreover, HDL-C helps to transport oxidized cholesterol from peripheral tissues where it instigates atherosclerosis to the liver for excretion. Furthermore, HDL-C has potential anti-inflammatory, anti-thrombotic and anti-oxidant effects.
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.
We have presented objective evidence that yohimbine has a positive effect in men with organic erectile dysfunction. This is contrary to the blanket statement of the American Urological Association in their clinical guidelines for erectile dysfunction, which states: ‘Based on the data to date, yohimbine does not appear to be effective for erectile dysfunction and, thus, it should not be recommended as treatment for the standard patient.’17 Our data strongly suggest that yohimbine treatment should be revisited. Our study was observational with dose-escalation just to see if there was any rationale to expect any effect in men with organic erectile dysfunction, especially in men who do not have the risk factor of tobacco abuse. The next step would be a double-blind, placebo-controlled study using yohimbine in smokers vs non-smokers to verify the current observation. We believe that our data justify such a trial. Yohimbine will never be a first-line drug for erectile dysfunction, but may be useful in subsets of men with mild disease or few risk factors. Yohimbine might also be useful in combination therapy with other treatment modalities such as sildenafil and intraurethral alprostadil, when they do not produce adequate effects alone, as has already been shown with naloxone39 or trazedone.40
Minor side effects associated with erectile dysfunction medications include indigestion, runny nose and skin flushes. Sildenafil may cause temporary changes in your vision, and vardenafil may cause muscle aches and back pain. More serious side effects include hearing loss and erections that last longer than four hours. If you have cardiovascular problems, including a history of heart attacks or strokes, high or low blood pressure or vision problems such as retinitis pigmentosa, it may prove unsafe for you to take sildenafil, vardenafil or tadalafil. These medications may also interact poorly with some antibiotics, blood thinners and medications to prevent seizures and heart rhythm disorders.

Being as of a common condition as it is, there is no reason why you should be ashamed of asking for help to treat erectile dysfunction. It seems as men are still unaware of how common but how easily treatable this condition is. You can choose from the variety of natural remedies, such as changing your diet, routine, habits, exercising or you can choose from the variety of products available on the market to treat this condition. The point of this article is to raise awareness on the topic of erectile dysfunction and the importance and beneficial effects of exercising as a way to treat erectile dysfunction. We understand how overwhelmed you could feel from hearing all those people’s opinions on the topic and sharing their stories. That is why we choose some of the best exercises you can perform in order to improve your health. Do not hesitate to ask for help. A few changes in your diet and routine is all that is separating you from an improving your health in general.

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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.
It’s hard to concentrate on what’s happening in the bedroom when you’re thinking about problems at work. For many men, it’s psychological issues like anxiety rather than physical ones that contribute to E.D. Chronic stress has also been linked to heart disease, high blood pressure, depression, and more. Find a way of blowing off steam that works for you (I like exercise and meditation) and stick to it.
Yohimbe bark (pronounced yoh-heem-buh) is an herbal supplement associated with anti-aging effects. It is used to naturally treat erectile dysfunction, low libido, hormonal imbalances and symptoms like low energy. Yohimbe has a long history of use in Western Africa, where the plant originates. It’s still grown there today, especially for its apparent aphrodisiac abilities.
Not only will regular exercise burn calories and lower stress, it may lower your risk of ED. Before you start working out, check with your doctor about the best program for you. Think of exercises you're likely to enjoy and will want to continue on a daily basis, whether it's 30 minutes in the morning on a stationary bike while watching the news, a kick-boxing class, or a brisk after-dinner walk around the neighborhood with a friend.
Men typically have higher zinc needs than women, which can make them more vulnerable to zinc deficiencies. In men, zinc is also needed to support healthy prostate and penile function. Keep in mind that excessive amounts of zinc can be harmful so it is best to follow package directions on the supplement you choose, should you decide to supplement with the mineral.
To evaluate the patients' response clinically in the office, a simple grading system was used.27 The patients were asked about the quality of their erections, which were graded as follows: grade 1, tumescence but no rigidity; grade 2, tumescence with minimal rigidity; grade 3, rigidity sufficient for sexual intercourse; and grade 4, fully rigid erection. At the end of the study, patients were graded as to whether they thought they had improved enough to have satisfactory regular intercourse, which is defined as success in 75% of attempts. The degree of subjective improvement in intercourse was used to classify patients as ‘responders’ vs ‘nonresponders’ in subsequent analyses. A log was kept by the couple of their sexual activity, and it was taken to the clinic for review by the clinical investigator.

Researchers in London set out to find out if the claims about Yohimbe were true. Could the bark of a tree actually increase libido and improve impotence? They performed a double-blind trial using yohimbine for the treatment of erection inadequacy. Men, aged 18-70 years, seeking help for the secondary erection inadequacy for 6 months or longer, took part in the trial. None of the participants had any serious psychiatric disease, hypertension or liver insufficiency. Half of the men were given 5.4mg of yohimbine, the other half a placebo, for 8 weeks. Patients were assessed in 4-week intervals. After 8 weeks of treatment, 37 percent said they had good erections, as compared to only 13% in the placebo group. After the 8-week treatment, the placebo group was given the yohimbine as well, results for improved stimulated erection after the second 8-week trial increased to a total of 42 percent overall.
Making sure you have healthy ways of coping with stress is part of maintaining good sexual health. If necessary, you may want to look into consulting a medical professional about the best way to manage your emotions and keep your stress levels in check. One study found that participants with ED who underwent an eight-week stress management program emerged with significantly improved symptoms. It might also be a good idea to address any relationship issues that could be leading to anxiety in the bedroom.
This is one B team you want to get on pronto: A recent report from Harvard University highlighted a study that has linked low levels of B12 to erectile dysfunction. A causal link hasn’t been nailed down, but the B vitamin is used by every system in the body, particularly in cell metabolism and the production of blood — two essential factors in getting and keeping a quality erection.

There is no guaranteed, permanent way to ‘cure’ ED – partly because, age is a factor that affects ED the older you are, the more likely you are to get ED symptoms. This might mean that even if you have successfully kept your erectile dysfunction under control in the past, you may get ED symptoms again as you get older. Also, there are lots of factors that cause ED. So, one factor that doesn’t affect you right now might do in the future. 

Sildenafil, vardenafil and tadalafil increase the amount of nitric oxide in your body. Your body contains nitric oxide naturally, which is a gas that relaxes blood vessels. Medications to treat erectile dysfunction relax blood vessels in a man’s penis to help obtain and maintain an erection. Some medications that treat high blood pressure, high cholesterol and heart disease also relax your blood vessels. If you take niacin while you also take medications to treat erectile dysfunction, your blood pressure could drop drastically. You could faint or develop other health problems.

Yohimbe is commonly taken to increase sexual excitement and to reduce sexual problems such as symptoms of erectile dysfunction (ED), also called impotence. Research shows that yohimbe may be capable of increasing blood flow to the penis or vagina. It also increases nerve impulses that play a role in orgasm. Due to how yohimbine affects blood vessels, it can cause relaxation of the penile tissue and engorgement of blood. This helps a man to maintain an erection. These effects are beneficial for both sexes when it comes to experiencing sexual satisfaction.
It promotes the formation of red blood cells, enhances cellular metabolism, supports brain function, improves sexual function in men, and contributes to the healthy sperm production. This is because vitamin B12 is required for the formation and duplication of DNA which, in turn, is responsible for the healthy sperm production. And vitamin B12 deficiency affects genetic material the sperm carries.
Response to yohimbine was not dependent on patient age. Patients who showed a positive response had fewer medical risk factors overall, although the small number of patients was not large enough to provide statistical significance. The positive clinical response was verified subjectively both by the formal questionnaire and by the in-office clinical encounter. The positive response was verified objectively by measuring nocturnal penile tumescence and rigidity with the RigiScan™ home monitor. The trend of the baseline penile erectile response was better in the responders, suggesting that use of yohimbine might be more effective in patients who have less severe erectile dysfunction. Some authors have questioned the effect of yohimbine on penile activity, but either inadequate doses of yohimbine were used or only tumescence was measured,21,32 often in an office setting where anxiety and embarrassment might affect results.
Male erectile dysfunction (ED) has been defined as the persistent inability to attain and/or maintain an erection sufficient for sexual performance (1). ED is very common, and its prevalence as well as severity increases with age (2). It has been recognized that the major cause of ED is atherosclerosis affecting the pelvic vasculature (3). The presence of ED has been known to predict future cardiovascular disease, and early detection may allow timely modification of remediable risk factors, or lead to the diagnosis of occult cardiovascular disease (4, 5).

Handful of things can cause erectile dysfunction, but healthy vitamins supply for erection will make your sex life very soothing and romantic. Healthy blood vessels are necessary for good circulation, as blood is pumped around the body to carry nutrients to the cells. Vitamins can help the blood vessels to dilate or open so blood can fill the manhood. 
The sunshine vitamin will brighten things up in the bedroom. In a recent study published in the Journal of Sexual Medicine, Italian researchers found that of 143 men with erectile dysfunction, 80% had less-than-optimal levels of D, and the men with severe ED had, on average, a 24% lower level of D than with a milder condition. They theorize that low levels of D damage blood vessels and lead to a shortage of nitric oxide.
Testosterone levels generally decrease as an individual ages. This is normal and natural, but it can lead to erectile problems for some people because androgenic hormones such as testosterone play an important part in regulating the function of tissues in the penis and testicles. One study found that supplementing with testosterone gel improved both the libido and erectile function of participants with low testosterone between the ages of 32 and 84.
The response to yohimbine did not vary with patient age; the responders were 60.3 y of age vs 60.0 for the nonresponders (Table 4; P=0.106). The number of medical risk factors was slightly higher in the nonresponders (2.3 per person) compared with the responders (1.8 per person), but this difference was not significant (P=0.346). Documenting the quality of the men's erections in the office with a simple grading system showed a significant difference at the end of the study between responders and nonresponders. For the responders, the value was 3.0 compared with 1.9 for the nonresponders (P<0.001). This result correlated with the overall sexual satisfaction of patients who stated whether or not they were able to engage in regular sexual intercourse.
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.
Erectile dysfunction supplements and other natural remedies have long been used in Chinese, African and other cultures. But unlike prescription medications for erectile dysfunction, such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis, Adcirca) and avanafil (Stendra), erectile dysfunction herbs and supplements haven't been well-studied or tested. Some can cause side effects or interact with other medications. And the amount of the active ingredient can vary greatly from product to product.
A variety of personal habits and lifestyle choices have been linked to ED. In some ways, this is a good thing, since habits can be broken and choices reconsidered. What's more, many of the lifestyle factors that contribute to sexual problems are ones that affect overall health and well-being, both physical and mental. Addressing these factors, therefore, can have benefits beyond improving erectile dysfunction.
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.
But in this case, zinc is much harder to absorb. This explains a decrease in testosterone levels in vegetarians. Slippery jack mushrooms, button mushrooms, beef liver, and fish are also rich in zinc. They are followed by breadstuffs, egg yolk, rabbit, chicken, beans, tea, and cocoa. In addition, zinc is found in onions, garlic, and rice. And a very small amount of zinc is available in fruits, vegetables, and milk.

None of the parameters showed a significant difference between controls and the group treated with 1 mg of zinc. The percentage of males who engaged in intromission (% intromitted), was significantly reduced in 10 mg/day zinc group; only three animals showed the particular behavior. Similarly percentage of rats which ended up with ejaculation significantly decreased with the high dose (two out of eight). Libido index of the highest zinc treated group was significantly low compared to controls; (38 % vs. 88 %, P < 0.05). Number of mounts and intromissions was also significantly decreased in the same group; Number of mounts: 1.58 (SEM 3.16) vs. 11.0 (SEM 1.59) and number of intromissions 2.13 (SEM 4.27) vs. 11.0 (SEM 1.59), P < 0.05).


We have presented objective evidence that yohimbine has a positive effect in men with organic erectile dysfunction. This is contrary to the blanket statement of the American Urological Association in their clinical guidelines for erectile dysfunction, which states: ‘Based on the data to date, yohimbine does not appear to be effective for erectile dysfunction and, thus, it should not be recommended as treatment for the standard patient.’17 Our data strongly suggest that yohimbine treatment should be revisited. Our study was observational with dose-escalation just to see if there was any rationale to expect any effect in men with organic erectile dysfunction, especially in men who do not have the risk factor of tobacco abuse. The next step would be a double-blind, placebo-controlled study using yohimbine in smokers vs non-smokers to verify the current observation. We believe that our data justify such a trial. Yohimbine will never be a first-line drug for erectile dysfunction, but may be useful in subsets of men with mild disease or few risk factors. Yohimbine might also be useful in combination therapy with other treatment modalities such as sildenafil and intraurethral alprostadil, when they do not produce adequate effects alone, as has already been shown with naloxone39 or trazedone.40
It is common for a healthy older man to still want sex and be able to have sex within appropriate limitations. Understanding what is normal in older age is important to avoid frustration and concern. Older men and their partners often value being able to continue sexual activity and there is no age where the man is ‘too old’ to think about getting help with his erection or other sexual problems.
Ginseng, specifically “red ginseng,” is known as the “herbal Viagra” that helps puts to rest men’s bedroom woes. Red ginseng is when the root has been steamed and then dried. The ginseng root is the part of the plant that is mostly used as a natural remedy when in its supplement form. However, the plant must be grown for a minimum of five years before it can be used. In a 2008 review, seven studies on red ginseng and ED, ranging in dosages from 600 to 1,000 milligrams three times a day, were found to provide evidence for the effectiveness of the herb in ED treatment.
Men, aged 40–80 y, were recruited from new consultations seen for erectile dysfunction at the Lahey Clinic Center for Sexual Function. Patients were screened by history and physical examination and by evaluation of nocturnal penile tumescence and rigidity with the RigiScan™ (Timm Medical Technologies, Inc., Minneapolis, USA). Candidates completed a sexual questionnaire and had morning blood tests for luteinizing hormone (LH), free testosterone, cortisol, dehydroepiandrosterone sulfate and androstenedione. Inclusion criteria included normal initial serum testosterone and prolactin levels and the presence of an organic cause of erectile dysfunction manifested by abnormal nocturnal tumescence and rigidity testing with the RigiScan™ monitor. Active smokers and men with concurrent major psychiatric problems were excluded. No other treatment for erectile dysfunction was permitted during the study. Yohimbine hydrochloride (supplied by Palisades Pharmaceuticals, Palisades, NJ, USA) was started at a dose of 5.4 mg three times a day (tid) for 4 weeks, after which the sex questionnaire was administered again and blood tests, nocturnal penile tumescence and rigidity testing were repeated. The dose of yohimbine then was increased to 10.8 mg tid for 4 additional weeks followed by a third administration of the sex questionnaire and final measurements of hormone levels and nocturnal penile tumescence and rigidity monitoring.

While the rationale behind why it would work is airtight, the research on arginine’s actual effect on erectile dysfunction is slim, points out Charles Walker, M.D., assistant professor of urology and cofounder of the Cardiovascular and Sexual Health clinic at Yale University. But given its solid safety profile, minimal side effects, and potential benefit on heart disease, it’s worth a try, he adds, especially when taken in conjunction with other herbs on this list, which studies have shown can be more effective.
In a recent study, moderate-intensity exercise such as walking briskly and light cycling was shown to boost mood for up to 12 hours. Exercising every day might be best to lift your mood, but strive for at least 5 days a week. Another study showed exercise can improve your body image, regardless of body weight or shape. And feeling good about your body is a great start toward making the bedroom a happier place.
The results, published earlier this month, show that the 80 men in the study with moderate or severe erectile dysfunction (ED) and high cholesterol reported an improvement in their ability to maintain an erection after supplementing their diet with niacin. The 80 men who took a placebo pill, who also began the study with only mild ED, did not experience a change in their symptoms, the researchers said.
Response to yohimbine was not dependent on patient age. Patients who showed a positive response had fewer medical risk factors overall, although the small number of patients was not large enough to provide statistical significance. The positive clinical response was verified subjectively both by the formal questionnaire and by the in-office clinical encounter. The positive response was verified objectively by measuring nocturnal penile tumescence and rigidity with the RigiScan™ home monitor. The trend of the baseline penile erectile response was better in the responders, suggesting that use of yohimbine might be more effective in patients who have less severe erectile dysfunction. Some authors have questioned the effect of yohimbine on penile activity, but either inadequate doses of yohimbine were used or only tumescence was measured,21,32 often in an office setting where anxiety and embarrassment might affect results.
I am so grateful Jacqui, I am seeing my girlfriend tomorrow and feel like the problem is pretty much gone! I can't believe it I thought I was broken!!! I have searched on sooo many sites and got so much bad advice and feel like posting the link of your site on all of those others. As this is a horrible problem and your method will work for me - so guys need to know this! Many, many thanks for the help.
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.
When men are given supplemental testosterone it can have positive effects on erectile dysfunction as well as the “grumpy old men” syndrome of low energy, loss of drive, low libido, and loss of endurance as well as “man boobs”.  Zinc has a direct effect on the two main enzyme systems that act on testosterone: conversion of testosterone to estrogen via aromatase and the conversion of testosterone to DHT by 5 alpha reductase.   Zinc blocks the testosterone to estrogen pathway leading to more testosterone.  It turns out that only at really high zinc levels does zinc inhibit the 5 alpha reductase enzyme so when we give mild to moderate zinc supplements, DHT actually increases because there is more testosterone to feed into this pathway.   This actually benefits things because DHT has 2-3 times the times the androgen receptor affinity than testosterone.  In any case, we see an increase of testosterone and androgenic activity from DHT with zinc supplements and whether a guy has low or normal T to begin with, there is a positive change in erectile dysfunction and libido in some men due to the increased androgenic activity and less estrogen pulling in the opposite direction.  Conversely we see testosterone levels drop when a diet is low in Zinc as well as a drop in DHT.  It is important to note that this effect of increased testosterone with zinc supplementation, while well established, does not always lead to an improvement of ED and increased Libido.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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