Anxiety. There is mixed evidence about the effectiveness of yohimbine, the active ingredient in yohimbe, for treating anxiety related to phobias. Some research suggests that it does not improve anxiety when combined with exposure-based therapy used to reduce fear of flying. However, other research suggests that taking yohimbine along with exposure-based therapy helps treat claustrophobia better than exposure-based therapy alone. The effect of yohimbe bark on anxiety is not clear.
Participants in this study gradually increased their daily intake of niacin from 250 mg to 3,000 mg over 36 weeks. Nine of the 23 people who were taking immediate-release niacin withdrew from the study early because of facial flushing, fatigue, or skin discoloration. Eighteen of the 23 who were taking 3,000 mg daily of sustained-release niacin dropped out due to upset stomachs, fatigue, or abnormal liver function tests. All of these side effects disappeared once the participants stopped taking the vitamin. Additional cause for concern comes from other reports suggesting that high doses of sustained-release niacin can cause jaundice and liver failure.
In the United States, certain prescription drugs containing yohimbine have been approved since the 1980s. They are labeled Yohimbine hydrochloride (which go by the brand names Aphrodyne or Yocon). Yohimbine medications are prescribed most commonly to treat sexual dysfunction in both men and women caused by a number of factors like aging, hormonal imbalances or side effects of medications.
The Medline (Pubmed) electronic database was searched (from June 1972 to November 2010) for systematic reviews that evaluated the effects of therapeutic exercise on ED. The key words and search terms used to develop the search strategy for each of these databases included: exercise therapy, aerobic exercise, therapeutic exercise, rehabilitation exercise, impotence and erectile dysfunction. In addition, the electronic searches were supplemented by checking the reference lists of any relevant identified articles.
A study in the Journal of Sexual Medicine found that a large percentage of men with ED also have low levels of vitamin D. If you’re experiencing ED, you may want to have your level of vitamin D checked. Other symptoms of a low vitamin D level may be too subtle to notice. However, if you have serious vitamin D deficiency, you may have bone pain or muscle weakness. Vitamin D levels can be checked with a simple blood test and for most people corrected with a supplement.
In the present study zinc caused an elevation of T. This showed an increase from 2.39 to 8.21 ng/dl after two weeks of zinc treatment. This elevated T level may have contributed to the increase in number of penile thrusting (from 26.5 to 52.8) observed. Supplementation with 459 μmol/day of zinc for three months, in marginally zinc deficient healthy elderly men, has been shown to increase the levels of serum T from 8.3 to 16 ng/dl.[25] Laboratory experiments indicate that the nitric oxide erectile pathway is T dependent.[26] Many studies using animal models have confirmed that T is important in modulating the central and peripheral regulation of erectile dysfunction. T deprivation has a negative impact on the structure of penile tissues and erectile nerves.[27] Thus, elevated T levels subsequent to zinc supplementation may increase the sexual competence via rigid and sustained erection. This may promote greater tactile stimulation of the penis due to increased contact with vagina.[25]
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.
When it comes to boosting sexual performance, many men will walk all over God’s green earth looking for ways to maintain a good sex life. Luckily men, all you have to do is walk — not run — 2 miles a day. This, along with other healthier lifestyle interventions can help obese men reduce their risk of ED, or even “reverse” current impotence, according to a 2005 study. This comes of importance, since maintaining a trim waistline is a good defense for ED, as men with a 42-inch waist are 50 percent more likely to have ED than those with a 32-inch waist. Getting to a healthy weight and maintaining it is a good strategy for preventing and treating ED.
Poor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones. 
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
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.

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.
Besides, niacin’s beneficial effects became more evident when the Hong Kong study researchers excluded those already using statin therapy. If there is an overlapping effect of these two groups of lipid-lowering agents on endothelial function, this would make sense. Also, chronic statin use could lessen the effect of niacin on endothelial function and hence affect improvement in erectile function.
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.
Yohimbine significantly increased subjective measurements of sexual desire, sexual satisfaction, frequency of sexual contacts, and erection quality during sexual intercourse. Each subject also underwent a sleep study and researchers found that yohimbine also objectively increased the rigidity of erections while sleeping. [12] Yohimbine appears to alleviate both physical and psychological symptoms associated with ED.
Evidence from 5 randomized studies published in the years between 2004 and 2010, has demonstrated strong evidence that aerobic exercise can benefit people with arterogenic ED. These review results of this study build on and update the evidence from studies that concluded that concluded that exercise was beneficial for people with ED and cardiovascular disorders (25–27); on ED and obesity (18) and on normal subjects with ED (24). However, studies have shown common pathway for ED, cardiovascular (28 –30) and metabolic disorders (19, 31).

Aerobic exercises and pelvic floor exercises are two of the best methods to start with. As a matter of fact, you can see improvements on your condition without having to witness the side effects of other male enhancement products. For one, there are certain male enhancement products which should not be taken if you are suffering from other types of medical condition. For instance, if the product contains substances that may react to the male enhancement ingredients of a product, you may suffer from certain consequences.
You can find this compound as a standalone ingredient in capsule, tablet, or tea form as well as a component of popular pre-workouts and fat burners. Yohimbine is not for everyone - even with moderate dosages it can increase the frequency and severity of panic attacks in high-anxiety individuals, interfere with medications, as well as cause headaches, dizziness, and nausea.
For Men: Soy is terrible for the male sex drive as the phytoestrogens build up to unnatural levels much too quickly. In fact, an ex boyfriend and I experimented with this when he decided to become vegan. He ate and drank soy products for a month and by the end of that time he had zero libido. Within two weeks of stopping all soy, he was back to normal.
A study in the Journal of Sexual Medicine found that a large percentage of men with ED also have low levels of vitamin D. If you’re experiencing ED, you may want to have your level of vitamin D checked. Other symptoms of a low vitamin D level may be too subtle to notice. However, if you have serious vitamin D deficiency, you may have bone pain or muscle weakness. Vitamin D levels can be checked with a simple blood test and for most people corrected with a supplement.
Twenty-one men were screened. Two were rejected because they had normal results on nocturnal penile study, and one man was excluded from the study because of a protocol violation. Eighteen men completed the study. The mean age of the men was 60.2 y (range, 34–69 y). The mean duration of erectile dysfunction was 3.1 y (range, 1–10 y). All men were in stable heterosexual relationships. The listed medical risk factors for erectile dysfunction were hypertension in nine men, atherosclerotic cardiovascular disease in seven, single offending medication in seven (mostly beta-blockers), multiple medications in five, diabetes mellitus in four (one with neuropathy), venous leakage in two, and peripheral vascular insufficiency in one.
Research suggests that drinking alcohol may play a part in erectile problems. One study that considered the prevalence of ED among people diagnosed with alcohol dependence syndrome found that heavy drinkers were more likely to experience sexual dysfunction. Experts also believe that the depressant effect of alcohol can inhibit sexual response and even suppress libido in some people.
Important Caution: Before choosing Yohimbe be sure to let your doctor know you are interested in using this herb. Yohimbe should not be use in those people with low blood pressure or who are on blood pressure medications. Never exceed the dosage of this herb. Not to be taken at the same time you eat cheese, liver or red wine, all of which contain the amino acid tyramine. In addition, there have been many reports that French and American Yohimbine products did not actually contain any yohimbe, but caffeine instead. Before choosing to purchase any Yohimbe product, be sure that it is from a reputable, high-quality source. Never exceed suggested dosage of Yohimbe, as it may be toxic in high doses. Always follow the guidelines on the label of the product you have purchased.
A noticing fact is that each of these men had problems of lipid levels and high levels of cholesterol. According to the author Dr. Chi-Fai in Hong Kong, "Niacin or Vitamin B3 is one among the old erectile dysfunction drugs and medical experts have documented its safety in well manner. Because of this, we should consider it as a simple and an easy way to bring improvements in the men's erectile function."
Reiter, W. J., Pycha, A., Schatzl, G., Pokorny, A., Gruber, D. M., Huber, J. C., & Marberger, M. (1999, March). Dehydroepiandrostone in the treatment of erectile dysfunction: A prospective, double-blind, randomized, placebo-controlled study [Abstract]. Urology, 53(3), 590-594. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429598005718
The endothelium is vital to the maintenance of vascular health. It is a critical determinant of vascular tone and patency, reactivity, inflammation, vascular remodeling, and blood fluidity. (9, 10). Nitric oxide (NO) is the most potent vasodilator and is secreted by the endothelium. It is synthesized from Larginine by the endothelial enzyme NO synthase (eNOS). NO released in response to sexual stimulation relaxes penile vascular smooth muscle by increasing intracellular cyclic 3′, 5′-guanosine monophosphate (cGMP) concentration. Vasodilatation of erectile tissues allows the sinusoidal spaces to fill with blood resulting in the attainment and maintenance of an erection (5).
Taking high doses can also cause other severe problems, including difficulty breathing, paralysis, very low blood pressure, heart problems, and death. After taking a one-day dose of yohimbine, one person reported an allergic reaction involving fever; chills; listlessness; itchy, scaly skin; progressive kidney failure; and symptoms that looked like the auto-immune disease called lupus.
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.

Long considered an aphrodisiac by the Chinese, ginseng may do more than just rev your engine. A 2013 South Korean study found that taking the herb for just a few weeks improved guys’ performance in the bedroom, including helping them last longer before finishing. Meanwhile, a study in Spermatogenesis found that ginseng can also help make for harder, longer-lasting erections and improve testosterone levels, which in turn boosts libido. “Ginseng is a promising herbal therapy for ED because it helps promote relaxation of smooth muscle in the penis, increase dopamine levels in the brain, and increase pressure in the cavernosal nerves of the penis which helps nitric oxide synthesis,” Walker explains.
However, you might actually be better off going one step back in the chain reaction and taking an L-citrulline supplement. While your body converts L-arginine to nitric oxide, it also metabolizes it too fast when the amino acid is taken in an oral supplement, according to a 2011 study from the University of Foggia in Italy. L-citrulline, which the body converts to L-arginine, is actually a better option to follow the same metabolic pathway and serve as a treatment for ED, the same study found.
These medications don’t work for everyone but they are easy to use and work for around 60% of people who try them. They work by making it easier to get an erection by reducing the effect of (inhibiting) the chemical PDE-5. This chemical is used in the body to make sure there isn’t too much blood in the penis during an erection, but if you have erectile dysfunction then this chemical ends up over-compensating.
In the New World, maize was traditionally treated with lime, an alkali now shown to make niacin nutritionally available and thereby reducing the chance of developing pellagra.1 However, when in the 18th century corn cultivation was adopted worldwide, treatment with lime was not accepted because the benefit was not understood. Thus in the New World, often heavily dependent on corn, cultivators rarely suffered from pellagra, which became common only when corn became a staple that was eaten without the traditional treatment. Of interest, if maize is not so processed, it is a poor source of tryptophan as well as niacin.
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. 
Latest research studies highlighted that a daily dose of Vitamin B3 or Niacin brings a drastic improvement in the erectile function of men dealing with the problem of high cholesterol. This result reveals that about 80 men, who consumed Niacin and started the study with either moderate or severe level of erectile dysfunction highlighted a significant improvement in the ability of maintaining an erection.
The herb is particularly effective for those whose willy woes are based on other medications: An older study from the University of California found ginkgo biloba is 76% effective in treating sexual dysfunction caused by antidepressants. “Gingko helps counteract sexual dysfunction caused by certain antidepressants called SSRIs by blocking serotonin activity in the erectile centers of the brain, ultimately leading to better synthesis and bioavailability of nitric oxide,” Walker explains.

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In fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.
Zinc is vital for the organism and it’s even more important for men because it inhibit the transformation of testosterone into dihydrotestosterone, it has an important role in the prostate health. The urologist recommended my dad to take a supplement that has zinc and after a good research I found him a supplement on amazon named alpharise, it has zinc, vitamin B9, pumpkin seeds (also a good source of zinc). There has been a huge difference between the after and before alpharise in my dad’s health (prostate)
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.
However, for most men who experience erectile dysfunction, their overall experience can be improved even further through regular exercise. There are many reasons why exercise improves sexual satisfaction. For one thing, regular, sustained exercise can lead to the release of chemicals called endorphins that are responsible for the so-called runner’s high, and which stimulate the release of sex hormones. Exercise also generally improves mood and imparts a sense of calm afterward, with lower heart rate, lower blood pressure, better digestion, and lower levels of stress hormones.
Some studies suggest that alpha 2-antagonists may help improve patients’ response to antidepressant medications. (5) Yohimbe has a chemical structure that is similar to several medications, and even recreational drugs, that are used to manage conditions like like mood-related disorders such as depression or schizophrenia, low libido, dizziness due to low blood pressure, and others. One such medication is called Reserpine, a type of indole alkaloid that is prescribed as an antipsychotic and antihypertensive drug. Another is lysergic acid (also known as LSD), which has much stronger psychological/psychedelic effects. While yohimbine doesn’t actually have psychedelic effects, according to research findings, it impacts neurotransmitters including dopamine, adrenaline and serotonin. It also seems to help some people suffering from symptoms due to mental illness.
The improvements in IIEF-erectile function domain (IIEF-EF) score for moderate and severe ED patients in the niacin group were 3.31 and 5.28 and in the placebo group were 2.74 and 2.65, respectively. In the lower range of mild and mild-to-moderate ED, there was no significant improvement in erectile function. Of the 160 patients in the study, 32 were using statins; 18 in the niacin group and 14 in the placebo group. For patients not receiving statin treatment, there was a significant improvement in IIEF-Q3 scores (0.47) for the niacin group, but not for the placebo group. To summarize, niacin alone can improve the erectile function in patients suffering from moderate to severe ED and dyslipidemia.
Zinc affects different aspects of mammalian reproduction. Testicular disruption, impaired spermatogenesis and subsequent poor semen parameters are found in males with zinc deficiency. Testicular concentration of zinc was lower in male sheep fed with zinc deficient diets. The same animals showed smaller seminiferous tubules and less lumen development than the controls.[1] Similarly variable degrees of maturation arrest in different stages of spermatogenesis with reduced diameter of seminiferous tubules were noted when rats were fed with zinc deficient diets.[2] Zinc deficiency causes a reduction in the structural parameters of seminiferous tubules influences serum levels of testosterone (T) and prolactin (PRL) in rats.[3,4]
A conflicting study of 22 subjects found that a 100mg daily dose of yohimbine for 30 days did not significantly improve penile rigidity. Three subjects experienced a notable increase in penile rigidity and twelve subject experience a partial increase in rigidity. [13] These findings do not completely discount the use of yohimbine to treat erectile dysfunction, but do suggest the compound's effects, even at very high dosages, will cause varying responses across a similar population.
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.

Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He's a practicing Gastroenterologist and Hepatologist with a focus on Men's and Women's Health, and a regular contributor to Women's health, Shape and Prevention Magazine.
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