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Knowing about your history of ED will help your health provider learn if your problems are because of your desire for sex, erection function, ejaculation, or orgasm (climax). Some of these questions may seem private or even embarrassing. However, be assured that your doctor is a professional and your honest answers will help find the cause and best treatment for you.
L-arginine, an amino acid that is naturally present in the body and helps make nitric oxide, supports a successful erection. Nitric oxide is responsible for making the blood vessels relax, which helps sustain an erection for men. A 1999 study, observed the effects of six weeks of high-dose (5 grams/day) orally administered nitric oxide (NO) donor L-arginine on men with organic ED. Thirty-one percent of those who took 5 grams/day of L-arginine experienced significant improvements in sexual function. Burns told Medical Daily, “l-arginine and deer antler velvet” have been the most popular go-to natural treatments for men.
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.
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The researchers noted that "when patients were stratified according to the baseline severity of ED, the patients with moderate and severe ED who received niacin showed a significant improvement in IIEF-Q3 scores (0.56 0.96 [P = 0.037] and 1.03 1.20 [P < 0.001], respectively) and IIEF-Q4 scores (0.56 1.03 [P = 0.048] and 0.84 1.05 [P < 0.001], respectively] compared with baseline values, but not for the placebo group...For patients not receiving statins treatment, there was a significant improvement in IIEF-Q3 scores (0.47 1.16 [P = 0.004]) for the niacin group, but not for the placebo group. Niacin alone can improve the erectile function in patients suffering from moderate to severe ED and dyslipidemia." 
In the end, open and honest communication with your therapist will yield the best course of action. If you do decide to try pelvic floor PT, a comprehensive evaluation will determine what exactly is going on with your muscles. They may be tight and weak or they could have poor coordination. So my advice for those suffering from erectile dysfunction is this: before you try kegels, make an appointment with your pelvic floor therapist.
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.
Males consuming yohimbine HCL for its pro-erectile benefits should take 5.4mg to 6mg three times per day but don't expect for the results to be noticeable until after about two to weeks of consistent dosing.  Not all males will experience this benefit so if you do not notice a change after four weeks of consistent dosing then consider stopping supplementation altogether.
In rare cases, the drug Viagra ® can cause blue-green shading to vision that lasts for a short time. In rare cases, the drug Cialis® can cause or increase back pain or aching muscles in the back. In most cases, the side effects are linked to PDE5 inhibitor effects on other tissues in the body, meaning they are working to increase blood flow to your penis and at the same time impacting other vascular tissues in your body. These are not ‘allergic reactions'.
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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.
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:
Low levels of zinc can be the cause for a variety of health-related problems. Zinc is a key mineral that cells use to metabolize nutrients. Immune function, DNA and protein production, and cell division are all related to zinc levels in the body. Zinc also enables the male body to produce testosterone. Because of this, your levels of zinc may affect erectile dysfunction.