Your doctor will ask you questions about your symptoms and health history. They may do tests to determine if your symptoms are caused by an underlying condition. You should expect a physical exam where your doctor will listen to your heart and lungs, check your blood pressure, and examine your testicles and penis. They may also recommend a rectal exam to check your prostate. Additionally, you may need blood or urine tests to rule out other conditions.
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.
Past research has suggested that living a healthier life full of exercise and a good diet can bring men back to sexual health. But according to researchers at Cedars-Sinai Medical Center in Los Angeles, most of these studies underrepresented African-American men. “This study is the first to link the benefits of exercise in relation to improved erectile and sexual function in a racially diverse group of patients,” said senior author of the study Dr. Adriana Vidal, of Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute and Department of Surgery, in a press release.
Niacin or Vitamin B3 has proved to be helpful in improving both lipid levels and cholesterol among patients suffering from the problem of atherosclerosis i.e. accumulation of waste fats across the walls of the human blood vessel. Because of this, Niacin is helpful in the treatment of erectile dysfunction, as ED and atherosclerosis have more or less similar causes.
As mentioned above, the extract of yohimbe bark has been used as an aphrodisiac for centuries. Recently, yohimbe supplement also became popular for its bodybuilding and fat-burning properties, despite the lack of data to support it as a dieting agent. In addition, supplement manufacturers claim that yohimbe can be used for the following applications:6,7
If other options sound boring, maybe you should consider a fun, revved-up option like salsa dancing. You and your partner can lose yourself in the music, and it’s an intense exercise that engages the senses, combining cardio, balance, and coordination. Plus salsa dancing is great for keeping weight under control because it burns a lot of calories. Furthermore, it’s an activity that can build self-confidence, and if you’re single, the classes can be terrific for meeting new people. Regular exercise doesn’t have to be drudgery, and there are many types of dance classes that can seriously improve fitness and help you address erectile dysfunction.
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.
However, a recent study that involves yohimbe supplementation to athletes ended with an unsatisfactory result. According to this study, yohimbe did not have any significant effects on body mass, muscle mass and exercise performance even after it was taken for 21 days. Even though it helped burn body fat, it may not be a useful supplement for boosting endurance.9
Some men say certain alternative medicines taken by mouth can help them get and maintain an erection. However, not all “natural” medicines or supplements are safe. Combinations of certain prescribed and alternative medicines could cause major health problems. To help ensure coordinated and safe care, discuss your use of alternative medicines, including use of vitamin and mineral supplements, with a health care professional. Also, never order a medicine online without talking with your doctor.
A yohimbine HCL dosage of 0.2 milligrams per kilogram of bodyweight taken on an empty stomach immediately upon waking or in-between meals ramps up fat oxidation without causing undesirable side effects like high blood pressure or racing heart.  The table below provides a guideline on how many 2.5mg capsules of yohimbine HCL you should take based on your weight and the recommended dosage:
Stimulant drugs speed up the nervous system. By speeding up the nervous system, stimulant medications can make you feel jittery and speed up your heartbeat. Yohimbe might also speed up the nervous system. Taking yohimbe along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with yohimbe.
Overall, studies have been inconclusive about the aphrodisiac benefits of taking yohimbine supplements. However, most have found it works better than placebos. (7) According to a report published in the Iranian Journal of Psychiatry, a recent analysis of seven trials concluded that between 34–75 percent of men involved in studies experienced favorable results when taking between 5–10 milligrams. (8)
"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.
It’s easy to see how erectile dysfunction subsides with exercise. Not only does it help reduce cardiovascular risk factors, but it’s also been shown to reduce stress, another cause of the condition. The best part is that it doesn’t take much effort to get started on an exercise routine. “When it comes to exercise, there is no one-size-fits-all approach,” co-author Dr. Stephen Freedland said in the release. “However, we are confident that even some degree of exercise, even if it’s less intense, is better than no exercise at all.”
Could the bark of a tree actually increase libido and improve impotence? Well yes it can… Yohimbe bark (Pausinystalia yohimbe), one of the most popular herbal remedies for male sexual dysfunction, has been shown in studies to increase blood flow to the genitals of both men and women, proving to be helpful for those with low libido. Though Yohimbe can be used by women, its actions have been shown to be extremely supportive for men experiencing erectile dysfunction due to stress or as a side effect of physiological health issues.
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
A 2011 study of 160 men with moderate or severe erectile dysfunction divided the group in two—80 men were given niacin supplements, and 80 a placebo. The group given niacin reported improved ability to “maintain an erection versus the control group.” It’s not exhaustive research, but still promising. The best part about niacin is that it’s naturally found in foods like turkey, avocado, and peanuts (yum). If you’re not a turkey sandwich fan, you can supplement with a vitamin B complex.