For many men, stopping smoking is an erectile dysfunction remedy, particularly when ED is the result of vascular disease, which occurs when blood supply to the penis becomes restricted because of blockage or narrowing of the arteries. Smoking and even smokeless tobacco can also cause the narrowing of important blood vessels and have the same negative impact. 

Yohimbe is taken by mouth to arouse sexual excitement, for erectile dysfunction (ED), sexual problems caused by medications for depression called selective-serotonin reuptake inhibitors (SSRIs), and general sexual problems in both men and women. It is also used for athletic performance, weight loss, exhaustion, chest pain, high blood pressure, low blood pressure that occurs when standing up, diabetic nerve pain, and for depression along with certain other medications.
We studied the involvement of zinc in the sexual behavioral response of male rats. The study design employed a rat model to predict the human sexual response to elemental zinc supplementation. Rats were used because they are very social and copulate under a variety of circumstances, regardless of the presence of a human experimenter. They are practical (small and easy to handle) and certain tissues and neuroendocrine systems are strikingly similar to humans.[13]
The RigiScan™ portable home monitor recorded nocturnal penile tumescence and rigidity testing. The monitor's quantitative analysis software quantitates various parameters of tumescence and rigidity, which includes the area under the curve over time slept, reported as tumescence activity units and rigidity activity units. The reproducibility and accuracy of this technique have been reported.28 Baseline normal values were used as previously reported,29 Rigidity had to be at least 60% at the base and 50% at the tip and maintained for at least 10 min. At least half of the episodes had to meet these criteria, with a minimum of three or four episodes per night. Tumescence had to achieve a height of 3 cm at the base and 2 cm at the tip.
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.
I recently treated a young twenty-something man with a primary complaint of erectile dysfunction. When he started to notice this issue, he attempted to treat it by performing lots of kegels. (If you haven’t heard of kegel exercises, they’re done by repeatedly contracting and relaxing the muscles that form part of the pelvic floor, as if you were trying to stop peeing mid-stream.) I found this man’s story interesting because, as we discovered, in his case the kegels actually did more harm than good. We found that once he stopped kegeling and allowed his pelvic muscles to relax, his erections became stronger and he was able to ejaculate without any issues.
Vitamin B5 (Pantothenic acid) is irreplaceable if you wish to increase life expectancy. Vitamin B5 has a positive impact on the nervous system and intestinal motility. Calcium pantothenate is a form of vitamin B5 that has a powerful anabolic effect, enhances the synthesis of steroid hormones, and takes part in the synthesis of coenzyme A. In addition, calcium pantothenate helps release energy from foods. So, to a large extent, it improves your body’s endurance and stamina, as well as increases human tolerance to different loads.
Yohimbe bark is an herbal supplement. Its species name is Pausinystalia yohimbe. Yohimbe comes from the bark of the evergreen Corynanthe yohimbe tree, which is in the plant family called Rubiaceae. The active ingredient in yohimbe, called yohimbine, is also used to make certain medications. Civilizations in Western Africa have used it for centuries. Today it’s studied for its ability to help treat conditions including erectile dysfunction/impotence, diabetes, depression, hypotension, and overuse of certain medications.
Antioxidants  boost nitric oxide production and prevent NO breakdown. Ascorbic acid has direct effects on the bioactivity of NO, and augments NO production in a variety of body processes. The effects are actually synergistic with Vitamin E. Both vitamins are not usually measured, and a reasonable dose of Vitamin C is 500 to 1,000 mg daily. Vitamin E supplementation should be limited to <400 IU per day because of potential adverse long-term health effects of higher doses.
"The problem with alternative treatments for any medical problem, including erectile dysfunction, is that until you have about 20 well-controlled studies over several years, you really don't know what you are working with," cautions Richard Harris, MD, a urologist at Gottlieb Memorial Hospital, part of the Loyola University Health System in Chicago.

"Erectile dysfunction can be a very serious issue because it's a marker of underlying cardiovascular disease, and it often occurs before heart conditions become apparent. Therefore, men should consider improving their weight and overall nutrition, exercise more, drink less alcohol and have a better night's sleep, as well as address risk factors such as diabetes, high blood pressure and cholesterol.
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The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
Although not proven, it is likely that erectile dysfunction can be prevented by good general health, paying particular attention to body weight, exercise, and cigarette smoking. For example, heart disease and diabetes are problems that can cause erectile dysfunction, and both are preventable through lifestyle changes such as sensible eating and regular exercise. Furthermore, early diagnosis and treatment of associated conditions like diabetes, hypertension and high cholesterol may prevent or delay erectile dysfunction, or stop the erectile dysfunction from getting more serious.
Kegel exercises are very effective, simple and affordable methods in enhancing the strength of your muscles. These muscles are the ones that are involved in your sexual function. If you are unsure of the information that you read online, the best option is to talk with your doctor about your condition in order to avail of the best treatment methods for you.
Alprostadil is injected into the side of penis with a very fine needle. It's of great value to have the first shot in the doctor's office before doing this on your own. Self-injection lessons should be given in your doctor's office by an experienced professional. The success rate for getting an erection firm enough to have sex is as high as 85% with this treatment. Many men who do not respond to oral PDE5 inhibitors can be ‘rescued' with ICI.
These are not currently approved by the FDA for ED management, but they may be offered through research studies (clinical trials). Patients who are interested should discuss the risks and benefits (informed consent) of each, as well as costs before starting any clinical trials. Most therapies not approved by the FDA are not covered by government or private insurance benefits.
Although not every study has shown that yohimbe can have slimming effects, certain other studies have found positive results. One study found that yohimbine significantly increased mean weight loss in overweight female patients following a low-energy diet. (12) Possible mechanisms of action include: boosting lipolysis (the breakdown of fats and other lipids by releasing fatty acids into the blood) both during and following exercise, regulating insulin secretion, and reducing appetite. (13)
Vitamin C has been associated with higher sperm counts. You can get it naturally from strawberries, raspberries and blueberries, which are anthocyanins, colorful plant chemicals which help keep your arteries unclogged, boosting circulation and erection quality. In supplement stores, you’ll find all manner of megadoses — steer clear of those; they might do more harm than good.
Partner preference index in both 5 mg zinc treated group and controls was positive. In the control group, time spent by males, with estrous and diestrous females, was 21.75 sec. (SEM 2.26) and 13.62 sec. (SEM 1.05) respectively. In the zinc treated group they spent 20.87 sec. (2.09 SEM) with estrous and 14.37 sec. (SEM 0.70) with diestrous females. The PPI of controls and zinc treated group was 8.12 Sec. (SEM 2.32) and 6.50 Sec. (SEM 1.76) respectively. There was no significant difference between the two groups, P > 0.05.
Hypercholesterolemia (high cholesterol) is one of the main risk factors in the development of atherosclerosis, a condition that with the development of statins over the last 20 years has become more treatable, but not without consequences. Statins have been shown to reduce the incidence of cardiovascular events by 25–40%, yet this reduction is no big deal, especially considering that many patients need additional therapy to reach more optimal lipid levels and prevent cardiovascular events.
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.
It is important that you exercise, not only to combat ED but also to maintain your general health. Any aerobic exercise such as running, cycling or swimming will be great for improving your overall health and fitness. These kinds of exercise improves your cardiovascular health, which is important to help you treat your ED. You may also find it helpful to review your general lifestyle and reduce factors which could be contributing to your ED, such as smoking, drinking alcohol and eating unhealthy foods.
Vitamin B12 can be found only in the products of animal origin. That is, the greatest amount of this vitamin is available in by-products (liver, kidneys, and heart). The other vitamin B12 rich foods include cheese, seafood (crabs, salmon fish, and sardines), meat, and poultry. Vitamin B12 deficiency declares itself by diarrhea, decreased appetite, tingling tongue, burning tongue, low stomach acid, altered skin sensation, and impairment of sensation in the extremity muscles.
How it works: Rhodiola works in supporting our adrenal glands by preventing the breakdown of too much dopamine and serotonin during stressful times, leaving enough for us to remain buoyant and energized. What’s extra fun about Rhodiola is that it works fast – in 30 minutes – to change your energy levels and focus – so pop one before you think you want to get frisky.
The number of intromissions in the 5 mg/day group was comparable with controls. On the other hand number of penile thrusting was significantly increased with the same dose. These are indications of unimpaired erectile function due to supplemented zinc. Our observations also confirmed the lack of aberrant sexual behavior which is indicative of uninhibited penile tactile sensations.[15] Sexual behavior may also be changed with motor weaknesses and incoordination.[12] Supplementation with zinc did not impair muscle strength or coordination when tested with bar and bridge tests, indicating that prolongation of ejaculation was not mediated through these mechanisms.
Although not direct proof of cause and effect, the positive results that we report in half of the men in the current study may reinforce our clinical observation with objective RigiScan™ data that use of yohimbine might be associated with better effects in nonsmokers. We30 reported that cessation of smoking may rapidly improve nocturnal erectile activity and found that nicotine was not the noxious agent in our study. We postulated that carbon monoxide might create a hypoxic environment in the penis. This effect probably was mediated through restoration of nitric oxide activity.31
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.
Three types of medications to treat erectile dysfunction -- sildenafil, vardenafil and tadalafil -- may cause low blood pressure. Niacin, used to treat conditions such as high cholesterol and hardening of the arteries, can also lower your blood pressure. If you take medications to treat male impotence, ask your doctor before combining it with niacin.
"The problem with alternative treatments for any medical problem, including erectile dysfunction, is that until you have about 20 well-controlled studies over several years, you really don't know what you are working with," cautions Richard Harris, MD, a urologist at Gottlieb Memorial Hospital, part of the Loyola University Health System in Chicago.
Whether you’re looking to bulk up, or are just concerned about having enough protein to keep your body strong and healthy, zinc is an absolute must have! When we eat protein, it gets broken down by the body into amino acids, and then resynthesized into the different proteins needed by the body, and zinc is a vital part of this process. So even if you are eating lots of protein, without zinc you won’t be able to use it properly!
Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), dextromethorphan, donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.
*all photos are models and not actual patients.If you are interested in a prescription product, Hims will assist in setting up a visit for you with an independent physician who will evaluate whether or not you are an appropriate candidate for the prescription product and if appropriate, may write you a prescription for the product which you can fill at the pharmacy of your choice.
Ancient Incans consumed this energizing Peruvian plant before battle or a bout of sex, Chris Kilham, an ethnobotanist at the University of Massachusetts at Amherst, told Outside Online. Maca increases sexual appetite, stamina, endurance, and fertility. One 2008 study conducted at the Depression Clinical and Research Program at Massachusetts General Hospital in Boston found that maca helped people with antidepressant-induced sexual dysfunction to regain their libidos.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The lack of strong scientific proof that vitamin supplementation can improve erectile function doesn’t stop companies from selling vitamins, herbal supplements, and other products with the promise that they will do the job. ED is often treatable with prescription medications or medical procedures, so be careful not to get taken by a manufacturer’s empty promises.

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.
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.
Three of the randomized studies (25–27) that contributed to the present study data indicated the positive role of both interval and continuous aerobic training in the dual management of both ED and cardiovascular disorders (hypertension and ischemic heart disease ,respectively); this is not surprising because of the arterogenic interrelationship between ED and several cardiovascular disorders. The physiological basis for the therapeutic role of continuous exercise in the management of both ED and some cardiovascular disorders as reported in the present study, could be related to the biochemical, neural and hormonal changes in the blood vessel walls that induce an acute and long-term blood vessel relaxation. The blood vessels might relax after each exercise session because of body warming effects; local production of certain chemicals, such lactic acid and NO; decreases in nerve activity; and changes in certain hormones and their receptors (32, 33). Over time, as the exercise is repeated, there appears to be a growing evidence of a prolonged effect. Thus, chronic (regular, longterm) physical training might reduce basal concentrations of inflammatory markers.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.
Hypercholesterolemia (high cholesterol) is one of the main risk factors in the development of atherosclerosis, a condition that with the development of statins over the last 20 years has become more treatable, but not without consequences. Statins have been shown to reduce the incidence of cardiovascular events by 25–40%, yet this reduction is no big deal, especially considering that many patients need additional therapy to reach more optimal lipid levels and prevent cardiovascular events.
Does drinking water improve erectile dysfunction? Erectile dysfunction or ED is a common concern for men. Everyday factors, such as hydration levels, may affect a person's ability to get or maintain an erection. Drinking water may, therefore, help some men with ED. In this article, learn about the link between hydration and ED, and other factors that can cause ED. Read now
Controlling stress, having a healthy diet, and getting enough sleep to create a good foundation for sexual satisfaction. But sometimes the basics aren’t quite enough. Millions of men experience erectile dysfunction (ED), but ED can usually be successfully treated with prescription medications like Viagra, Levitra, Staxyn, and Cialis. These drugs have helped men understand that ED isn’t all in their mind, have opened up the topic to a more honest discussion, and have transformed many men’s sex lives.
Andrew McCullough, MD, associate professor of clinical urology and director, male sexual health program, New York University Langone Medical Center. Lecturer: Auxillium. Research grant: Pfizer. Data safety monitoring board: Pfizer. Consultant: Slate Pharmaceuticals. Clinical trials: Warner Chilcott, Vivus, Lilly, Bayer-GSK, ICOS, Timm, Schering Plough, Aeterna.

Many studies have been conducted on this topic; their results have been challenged by lack of controlled groups and non-randomization. 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.Non-randomized controlled trials, can detect associations between an intervention and an outcome. But they cannot rule out the possibility that the association was caused by a third factor linked to both intervention and outcome. Random allocation ensures no systematic differences between intervention groups in factors, known and unknown, that may affect outcome. Randomized controlled trials are the most rigorous way of determining whether a cause-effect relation exists between treatment and outcome and for assessing the cost effectiveness of a treatment (45, 22).


There are many different reasons a man’s ability to sustain or maintain an erection may be impaired. Impotence is the most common sexual disorder among men. It is thought that most men should be able to achieve and maintain an erection well into their 80s, but about 25 percent of all men over the age of 50 are thought to experience some form of impotence. By the age of 75, half of all men will be impotent. Impotence may come and go, depending on the state of their physical health as well as their stress levels. One of the number one causes of impotence is cardiovascular disease. Cardiovascular disease may restrict blood flow to the penile tissues, which greatly affects a man’s ability to achieve and maintain an erection during sexual arousal.
Can one of the B vitamins actually improve erectile dysfunction?  The research makes a strong case that Niacin, a.k.a. Vitamin B3, does indeed do just that for a big percentage of men. Of course, this is a inexpensive help to erectile issues, as high niacin foods and supplements are cheap and readily available.  Below I summarize the most prominent human evidence to date that shows which men will likely benefit and why:
While balancing your sexual focus is singularly the most important aspect of solving a sexual dysfunction challenge, it's important to also address the physical component. This is especially true if you are over 40, or suffer from erectile dysfunction. Exercise increases blood flow and helps your body eliminate toxins. As well as this, exercise also improves your strength, stamina and form.
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.
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]

Having your current medication checked – if you are taking medication already, it could be that your erection problems are a side effect. Have a doctor check whether this is the cause of your problems and if it is, you might be able to switch medications and then find that your erectile dysfunction goes away completely – or at least improves. Medications that can cause erection problems include:

There was a higher incidence of adverse events in those taking niacin. However, most patients could tolerate it at the maximum dosage (1,500 mg/day). With this in mind, niacin could be an alternative choice of treatment for patients with ED. Despite the success of phosphodiesterase type 5 inhibitors (PDE5 inhibitors), such as sildenafil, only around 60–70% of patients have a satisfactory response to this class of drugs. And there are adverse effects such as headache, flushing, dyspepsia, nasal congestion, and impaired vision, including photophobia and blurred vision. Hence, there is a need to develop other therapeutic agents for those patients who do not respond satisfactorily to PDE5 inhibitors or are contraindicated for those such as sildenafil.

Yohimbine: The main component of an African tree bark, yohimbine is probably one of the most problematic of all natural remedies for ED. Some research suggests that yohimbine can improve a type of sexual dysfunction that is linked with a drug used to treat depression. However, studies have linked yohimbine to a number of side effects, which can include anxiety, increased blood pressure, and a fast, irregular heartbeat. Like all natural remedies, yohimbine should only be used after advice and under supervision from a doctor.

All of these medicines work by relaxing smooth muscles and increasing blood flow in the penis during sexual stimulation. You should not take any of these medicines to treat ED if you are taking nitrates to treat a heart condition. Nitrates widen and relax your blood vessels. The combination can lead to a sudden drop in blood pressure, which may cause you to become faint or dizzy, or fall, leading to possible injuries.
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The RigiScan™ portable home monitor recorded nocturnal penile tumescence and rigidity testing. The monitor's quantitative analysis software quantitates various parameters of tumescence and rigidity, which includes the area under the curve over time slept, reported as tumescence activity units and rigidity activity units. The reproducibility and accuracy of this technique have been reported.28 Baseline normal values were used as previously reported,29 Rigidity had to be at least 60% at the base and 50% at the tip and maintained for at least 10 min. At least half of the episodes had to meet these criteria, with a minimum of three or four episodes per night. Tumescence had to achieve a height of 3 cm at the base and 2 cm at the tip.
Medicines like I-Arginine and viagra, can fix your problems for hours but vitamins and amino acids will cure erection problems for long term. Remember, not to take vitamins and medications (I-Arginine) at the same time as it can react in your body. Discuss your doctor before adding any vitamin to your routine. Apart for I-Arginine and other pills, here we have given some vitamins to quick fix your problem and have a better sex life.
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