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.
Yohimbine has had questionable effects in men with organic erectile dysfunction. We conducted this study to better define the population of men responsive to yohimbine, because tobacco was thought to affect a regimen of yohimbine more than other risk factors. We measured nocturnal penile tumescence with the RigiScan™ monitor, hormone profiles, answers to the Florida Sexual Health Questionnaire, and clinical responses at baseline and after two different doses of yohimbine in 18 nonsmoking men with erectile dysfunction. Of the 18 men, nine (50%) were successful in completing intercourse in more than 75% of attempts. The yohimbine responders were men with less severe erectile dysfunction as manifested by improved increased rigidity on RigiScan™ testing, higher Florida Sexual Health Questionnaire scores, and slightly higher levels of serum testosterone. Yohimbine is an effective therapy to treat organic erectile dysfunction in some men with erectile dysfunction.

In the 18th century, Spain embraced the Age of Enlightenment, directing the beacons of thought to all endeavors. But while Spain was not as advanced as France, Britain, Germany, or America, its new political thinking led to the revocation of most of the historical rights and privileges of the sub-kingdoms that comprised the Spanish Crown. Those changes, in turn, allowed for the freedom of inquiry that was so needed for medical discovery, among others.
The problem with this though is that there are a lot of websites that are claiming to have a specific exercise technique or perhaps very effective male enhancement products that can guarantee erectile dysfunction. Be careful not to fall for a male enhancement scam. Even though erectile dysfunction may be stressful or difficult to discuss about, there are proven and safe methods that can help you in dealing with it.
A study from 1990 (eight years before Viagra was introduced) found that sedentary but otherwise healthy middle-aged men who started an intense aerobic exercise program reported higher levels of sexual intimacy, and more reliable sexual function. Men in the study who started a walking program also experienced improvements, though not as dramatic. But the bottom line is, improved physical fitness often improves sexual functioning and satisfaction. Here are 5 exercises that can help with erectile dysfunction.
A study from the University of the West in the United Kingdom found that pelvic exercises helped 40 percent of men with ED regain normal erectile function. They also helped an additional 33.5 percent significantly improve erectile function. Additional research suggests pelvic muscle training may be helpful for treating ED as well as other pelvic health issues.
The appropriate dose of yohimbe depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for yohimbe. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
The researchers reasoned from other studies that when the degree of endothelial dysfunction and atherosclerosis are more severe, the effects of niacin and statins as lipid-lowering agents are also more apparent. Their current study seemed to bear this out. Also, in another study assessing the effect of a PDE5 inhibitor in patients using a statin, patients with higher baseline serum LDL-C had better improvement in erectile function after the use of a PDE5 inhibitor. This supports the researchers’ hypothesis that patients with potentially more serious endothelial dysfunction, such as those with higher LDL-C levels, may have better response to the combination usage of a PDE5 inhibitor and niacin.

The main surgical treatment of ED involves insertion of a penile implant (also called penile prostheses). Because penile vascular surgery is not recommended for aging males who have failed oral PDE5 inhibitors, ICI or IU therapies, implants are the next step for these patients. Although placement of a penile implant is a surgery which carries risks, they have the highest rates of success and satisfaction among ED treatment options.


There have been only a few  well-controlled studies to test the effects of herbal yohimbe (as opposed to medications) on humans. There’s some evidence that yohimbine has potential to enhance the nitric oxide pathway, helping to bring blood flow to the corpus cavernosum tissue of the penis. It may also stimulate the pelvic nerve ganglia and boost adrenaline supply to nerve endings. It seems to have the most effects overall when combined with other treatments or herbal remedies. (6) One study that evaluated the effects of yohimbe on ED found that those taking the herbal remedy experienced slight benefits compared to a control group that was not taking the supplement.

The search criteria identified 210 studies from 1972 to 2010; on inserting randomized controlled trials only 26 studies were identified out of which only 5 met the inclusion criteria and 21 studies did not meet the inclusion criteria, hence, were excluded. Five (18, 24–27) randomized controlled trials (RCTs) met the inclusion criteria; studies involved the use of aerobic exercise in the management of ED, the IIEF was the assessment tool for ED and also involved control groups. A total of 385 subjects were involved: Lamina et al (25), n=43; Lamina et al (26), n=43; Esposito et al (18), n= 110; Kalka et al (27), n= 129; Maio, Saraed and Marchiori (24), n= 60.
What are the alternatives to viagra? Erectile dysfunction, when a man cannot achieve or maintain an erection, is a common condition that causes much distress. Viagra is just one of several drug treatments that can help relieve the problem. Other methods and treatments can help, too, including alternative herbal remedies that people may wish to try. Read now
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.
The following parameters were computed using the observed behavioral measures. Copulatory efficiency (proportion of mounts resulting in vaginal penetration relative to the total number of mounts), intromission ratio (number of intromissions/number of intromissions + number of mounts) and intercopulatory intervals (average time between intromissions).[8]

Physical exercises are only one part of overcoming sexual dysfunctions. If you're serious about restoring full control sexually then you need to understand which of your current thoughts and actions are causing your failure. After you understand how your problem works, THEN you can apply the correct thought and action sequence to stay in control sexually!
If ED continues to be a problem even after making certain lifestyle changes, talk with your doctor. ED is an uncomfortable subject for many men to discuss, but it’s treatable in most cases, so there’s no reason to avoid getting help. Doctors see patients every day about ED, so you’re simply one of millions of men dealing with this common condition.
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.
Information on this website is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information on this website for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. Any third party offering or advertising on this website does not constitute an endorsement by Andrew Weil, M.D. or Healthy Lifestyle Brands.
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Clinically I have seen these results in doses of just 20 mg twice daily.   It is important to note that prolonged zinc supplementation can lead to lowered copper levels so it is not advisable to continue this therapy unless it is in a cyclical nature.  For those on long term zinc there are combination products with Zinc and Copper.   In cases where some prescriptions that lower zinc are given, like acid lowering meds, thiazide diuretics and ACE inhibitors, or in renal dialysis patients, this chronic monitoring of zinc may lead to longer term supplementation.
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 following parameters were computed using the observed behavioral measures. Copulatory efficiency (proportion of mounts resulting in vaginal penetration relative to the total number of mounts), intromission ratio (number of intromissions/number of intromissions + number of mounts) and intercopulatory intervals (average time between intromissions).[8]
Unfortunately, many of the same factors that brought the Italian Renaissance to an end—among them corruption, wars, and a widespread backlash over secularism and indulgence (leading to the “Bonfire of the Vanities”)—also terminated the “rebirth” in Spain. Chasing heresies became a sport that led to the resurrection of the Inquisition, which unlike its prior appearances operated completely under royal authority, rather than the aegis of the church.
It is common for a healthy older man to still want sex and be able to have sex within appropriate limitations. Understanding what is normal in older age is important to avoid frustration and concern. Older men and their partners often value being able to continue sexual activity and there is no age where the man is ‘too old’ to think about getting help with his erection or other sexual problems.
Yohimbe has been found to increase circulation to the erectile tissues; aiding in the resolution of physiological and psychogenic (mental/emotional) impotence. Impotence, the inability to sustain erection, is the most common sexual disorder among men. Yohimbine is the active component found in yohimbe bark. Yohimbine has been shown to dilate the blood vessels and lower blood pressure, which enlarges the vessels in the sexual organs and increases reflex excitability in the lower spinal cord. In many cases, yohimbe has shown to make erections firmer. It is thought to help sustain an erection by causing compression and preventing blood to flow back out of the penis while sexually aroused.
Talk with your doctor about going to a counselor if psychological or emotional issues are affecting your ED. A counselor can teach you how to lower your anxiety or stress related to sex. Your counselor may suggest that you bring your partner to counseling sessions to learn how to support you. As you work on relieving your anxiety or stress, a doctor can focus on treating the physical causes of ED.
When it comes to maintaining your libido, the B vitamins, found in beef, liver, and fish, are all your wingmen, but niacin (a.k.a. Vitamin B3) is especially helpful. In a study published in the Journal of Sexual Medicine, men suffering from impotence who took a niacin supplement reported a significant improvement in their bedroom performance than men who took a placebo. Stock up on these best foods to eat for niacin!

Shindel, A. W., Xin, Z.-C., Lin, G., Fandel, T. M., Huang, Y.-C., Banie, L., … Lue, T. F. (2010, February 5). Erectogenic and neurotrophic effects of icariin, a purified extract of horny goat weed (Epimedium spp.) in vitro and in vivo. The Journal of Sexual Medicine, 7(4), 1518-1528. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2009.01699.x/full
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.
Various hormone levels were monitored during therapy, and it did not appear that there were major changes in the group as a whole (Table 2). Cortisol levels rose significantly from baseline to the first dose of yohimbine. When the hormone levels were evaluated in responders vs nonresponders (Table 3), slight differences were noted. Free testosterone levels were higher at baseline in the responders but did not increase significantly with the higher doses of yohimbine. Dehydroepiandrosterone sulfate levels were not significantly higher at baseline in the responders, and they did not change with the higher dose of yohimbine. Cortisol levels appeared to increase in both groups with increased doses of yohimbine, significantly more so in responders than in nonresponders (P=0.03).
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)
What are the alternatives to viagra? Erectile dysfunction, when a man cannot achieve or maintain an erection, is a common condition that causes much distress. Viagra is just one of several drug treatments that can help relieve the problem. Other methods and treatments can help, too, including alternative herbal remedies that people may wish to try. Read now
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 conceiving the potential solutions to issues around erectile dysfunction, it’s really helpful to understand clearly how an erection is achieved and completed. To achieve an erection, there needs to be some form of stimulation, either from touch or some sort of audiovisual stimuli.  Once the stimulation occurs, chemical messengers are released and blood starts to fill into the penis. In terms of the musculature, the bulbospongiosus and ischiocavernosus muscles need to be relaxed so blood can fill the area completely. Then the bulbospongiosus needs to contract to keep the blood in the penis. The erection ‘completes’ with the rhythmic contraction of the bulbospongiosus muscle.
Another study discovered that nicotine significantly reduced participants' physical arousal in response to erotic films; the erections achieved by study participants who had ingested nicotine were 23% smaller than those who hadn't. This is in spite of the fact that participants didn't report feeling any less psychologically aroused by the erotic films.
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.
A cold slice of watermelon can do more than just satisfy thirst and hunger during the warm summer months; it can help with bedroom satisfaction. Citrulline, the amino acid found in high concentrations of watermelon, is found to improve blood flow to the penis. A 2011 study revealed men who suffered from mild to moderate ED and took L-citrulline supplementation showed an improvement with their erectile function and were very satisfied. Natural watermelon juice, or “nature’s Viagra,” can also be easier on the stomach, since taking pills like Viagra can cause nausea and diarrhea.
Depending on dosage, yohimbine can either increase or decrease blood pressure Small doses can increase blood pressure. Higher doses can lead to a potentially dangerous drop in blood pressure. Higher doses of oral yohimbine may have numerous side effects, such as rapid heart rate, overstimulation, unusual blood pressure, cold sweating, and insomnia.

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.
Talk with your doctor about going to a counselor if psychological or emotional issues are affecting your ED. A counselor can teach you how to lower your anxiety or stress related to sex. Your counselor may suggest that you bring your partner to counseling sessions to learn how to support you. As you work on relieving your anxiety or stress, a doctor can focus on treating the physical causes of ED.
In conceiving the potential solutions to issues around erectile dysfunction, it’s really helpful to understand clearly how an erection is achieved and completed. To achieve an erection, there needs to be some form of stimulation, either from touch or some sort of audiovisual stimuli.  Once the stimulation occurs, chemical messengers are released and blood starts to fill into the penis. In terms of the musculature, the bulbospongiosus and ischiocavernosus muscles need to be relaxed so blood can fill the area completely. Then the bulbospongiosus needs to contract to keep the blood in the penis. The erection ‘completes’ with the rhythmic contraction of the bulbospongiosus muscle.
Vidal and her team looked at self-reported physical activity among 300 men, and then categorized them into categories: sedentary, mildly active, moderately active, and highly active. These men also reported their levels of sexual function, including their ability to have an erection and orgasm, as well as the quality and frequency of their erections and overall sexual function.
This mineral is needed for a healthy sex life and a deficiency is linked to low testosterone levels which contributes to weaker erections. Zinc supplements can significantly improve matters in the bedroom. Food items loaded with Zinc can include oysters, shellfish, nuts and seeds. Erectile dysfunction and loss of interest in sex life can be caused by many physical and psychological reasons. Keep yourself healthy by consuming these vitamins and a healthy diet that is high in fibre and nutrients. Try to ignore OTC medicines like I-Arginine and other pills, and start including these fresh vegetables, apples, oats and whole grains in your daily life. 
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