Intermountain Healthcare is a Utah-based, not-for-profit system of 23 hospitals, a Medical Group with more than 1,600 physicians and advanced practice clinicians at about 180 clinics, a health plans division called SelectHealth, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and in efficient healthcare delivery.
Most human studies completed thus-far examine the impact of oral yohimbine consumption on erectile dysfunction (ED) in males. A meta-analysis of seven randomized, placebo-controlled trials found that yohimbine is significantly more effective in treating ED compared to placebo. [11] These findings did not compare yohimbine to prescription medications like Viagra®, which are designed to treat ED.
Over the years, myriad treatments and gadgets have been invented to assist with issues related to erections. They run the gamut from vacuum pumps to constriction bands, surgical implants, male hormone therapy, herbal supplements (ginkgo biloba, saw palmetto,  L- arginine, and yohimbe), and even shock-wave therapy. Lifestyle changes include: increasing exercise, decrease smoking, losing weight, and eating healthier. More natural alternative treatments include acupuncture and watermelon juice. In her hilarious and informative book entitled Bonk, researcher Mary Roach explores coupling of science and sex, and dedicates a couple of chapters to in-depth analysis of erectile dysfunction treatments.
Parameters evaluated in this study are determinants of some important aspects of the male sexual competence. Libido index, intromission and mount latencies are indicators of libido, arousability and motivation. Copulatory efficiency and inter-copulatory intervals are indicators of sexual vigor, while penile thrusting is an indicator of penile erection.[8,11,14,15] Our results showed that the libido index was significantly reduced in the 10 mg/day zinc saulphate treated group. In the same group, majority of the animals (62%) failed to complete their sexual behavioral cycle within the observed period. Though these unsuccessful rats showed the initial steps of the cycle such as licking, physical contacts with the females and few mounts and intromissions, they were inactive at later stages. Therefore a significant reduction of the libido index, number of intromissions, mounts, and ejaculations were observed in the high dose of zinc treated group compared to controls.
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.
The prolongation of ejaculatory latency may be beneficial when present with unimpaired arousability, penile erection and sex vigor. The ejaculatory latency can also be prolonged due to some disorders in the neuroendocrine or reproductive system.[24] But the duration of zinc supplementation in our study was only two weeks which is not long enough to have an impact on the neuroendocrine or reproductive system.

Though higher doses of zinc reduce libido, supplementation with a medium dose (5 mg/day) has some beneficial effect on the sexual competence of adult male rats. The major significant effects of this dose of zinc are prolongation of ejaculatory latency without disturbing sexual arousability, motivation, penile erection and sex vigor. Also, the partner preference index of the 5 mg/day group was positive and comparable to the controls. A positive partner preference index is indicative of unchanged sexual interest of males.[16] These results confirmed that libido and sexual interest are not affected by zinc supplementation with a 5 mg/day dose. However, mild reduction in percentage of intromission was observed in this group and it is postulated that this may be situational rather than an effect of supplemented zinc. This is based on our observation where mild rejection by the females at the initial phase of the behavior led some males to refrain from sexual activity.


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.
Allow me to explain. We know that cardiovascular disease is the number-one killer of men in the United States. Well, the “vascular” part of cardiovascular disease means that the cause is really blockage of the arteries around the heart, a process called atherosclerosis. It’s proven that over half of heart attacks occur in men with normal cholesterol. And many times, heart disease develops without warnings, causing sudden cardiac arrest.  So any early warning sign can be a life saver — and might compel you to get checked out before the big one hits.
3. Men With Bad Lipid Readings.  One study examined men with both erectile dysfunction and "dyslipidemia."  Dyslipidemia is medical speak for bad HDL, LDL, triglyceride or some combination of the three.  They gave these men 1.5 grams of niacin, which is a megadosed amount, and is a favorite of Dr. Davis.  (See my  Review of Track Your Plaque for Dr. Davis' approach to plaque regression.) Besides the above listed benefits, niacin will also a) lower triglycerides, b) boost HDL, c) increase particle size and d) decrease LDL particle counts.  All of these are very anti-atherosclerosis and great for your arteries. 
Three subsets (eight in each subset) of sexually experienced adult male rats were supplemented with three different oral doses of zinc sulphate (a daily dose of 1 mg, 5 mg and 10 mg respectively) for two weeks. A subset of eight animals without zinc supplementation was used as the control group Sexual behavior was observed by placing them individually in cages with receptive females.
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.
According to a study conducted by the University of the West of England, Bristol, pelvic floor exercises may be very effective in treating erectile problems. Many participants of the study, all of whom were men who had been experiencing erectile dysfunction for at least six months, reported a significant improvement of their condition within three months of training their pelvic floor. 
One study that evaluated the effects of yohimbine supplementation on body composition (muscle mass, body mass, etc.) and exercise performance in professional soccer players found that body fat percentage/fat mass significantly decreased in the yohimbine group compared to the placebo group. However, supplementation with yohimbine did not significantly alter overall body mass, muscle mass, or performance indicators. (10) Other studies, however, have found that people do tend to experience increases in energy and alertness when taking yohimbe, sometimes even so much that it causes symptoms of anxiety or restlessness (much like caffeine does).
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Lastly, it should be remembered that many individuals without dyslipidemia take niacin as a preventative measure. If you plan to take more than about 800 mg of niacin a day, it is a good idea to have your liver tested periodically just to make sure that your liver has no problem with high-dose niacin. These liver tests are the same used to check for liver toxicity in people taking statins, from which there is a higher likelihood of liver toxicity compared to taking niacin. The principal problem from taking statins is muscle damage which is serious enough to be life-threatening. This problem does not occur with those who take niacin. Not to be forgotten, niacin has been found to prolong orgasm.
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.
In addition, when research has shown a nutrient such as zinc or niacin to improve sexual function, it's usually in people who are deficient in it. So, before you stock up on over-the-counter nutritional supplements for ED, speak with your doctor. He can test you for deficiencies and steer you toward the most effective and safest way to treat your erectile dysfunction. 
Erectile dysfunction can occur as a side effect of medication taken for another health condition. Common culprits are high blood pressure meds, antidepressants, some diuretics, beta-blockers, heart medication, cholesterol meds, antipsychotic drugs, hormone drugs, corticosteroids, chemotherapy, and medication for male pattern baldness, among others.
Over 18 million American men over 20 years old suffer from erectile dysfunction, a condition characterized by the inability to keep an erection. It’s a complex disorder brought on by a number of factors, but it’s almost always devastating for the man it affects — causing him to lose confidence in himself and different aspects of his life. The stress it causes can deteriorate relationships and lead to lost productivity at work. Health problems aren’t uncommon either. But there’s good news in all the bad; a new study finds exercise may be a simple way to get things going under the sheets again.
ICI therapy often produces a reliable erection, which comes down after 20-30 minutes or with climax. Since the ICI erection is not regulated by your penile nerves, you should not be surprised if the erection lasts after orgasm. The most common side effect of ICI therapy is a prolonged erection. Prolonged erections (>1 hour) can be reversed by a second injection (antidote) in the office.

ICI therapy often produces a reliable erection, which comes down after 20-30 minutes or with climax. Since the ICI erection is not regulated by your penile nerves, you should not be surprised if the erection lasts after orgasm. The most common side effect of ICI therapy is a prolonged erection. Prolonged erections (>1 hour) can be reversed by a second injection (antidote) in the office.
When given orally, yohimbine reaches peak levels in 10–15 min, and the half-life is 0.6 h. The efficacy of yohimbine in sexual function has been questioned, perhaps because of early questionable multidrug preparations.10,11 Yohimbine has been shown to have some effect on psychologic erectile dysfunction12,13 and in reversing fluoxetine-induced sexual dysfunction.14
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]
Between 2001–2006, one-third of the US population had insufficient amounts of vitamin D, according to the Institute of Medicine. Risk factors for vitamin D deficiency include obesity and high BMI, not enough sun exposure or outdoor activity, having darker skin and suffering from certain from inflammatory conditions like Crohn’s disease. You can get a blood test to find out if you’re vitamin D deficient.
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