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).
The response to yohimbine did not vary with patient age; the responders were 60.3 y of age vs 60.0 for the nonresponders (Table 4; P=0.106). The number of medical risk factors was slightly higher in the nonresponders (2.3 per person) compared with the responders (1.8 per person), but this difference was not significant (P=0.346). Documenting the quality of the men's erections in the office with a simple grading system showed a significant difference at the end of the study between responders and nonresponders. For the responders, the value was 3.0 compared with 1.9 for the nonresponders (P<0.001). This result correlated with the overall sexual satisfaction of patients who stated whether or not they were able to engage in regular sexual intercourse.
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]
Niacin, prescribed for more than 50 years, has been successful in treating all three types of lipids in your bloodstream. It can reduce levels of low-density lipoprotein -- LDL, or “bad,” cholesterol -- and triglycerides, as well as elevate your levels of protective high-density lipoprotein -- HDL, or “good,” cholesterol. But other medications, as well as diet and lifestyle changes, can restore your cholesterol to heart-healthy levels. If you currently take niacin and want to start taking medication to treat erectile dysfunction, ask your doctor about switching to a different type of cholesterol medication.
Erectile Dysfunction is an embarrassing and frustrating condition among many men. There are several reasons behind this. Most of the time, it is caused by certain medical conditions such as diabetes, heart disease, obesity, as well as low testosterone. Other reasons may also include problems in blood flow, psychological issues, nerve damage, as well as hormonal fluctuations.
Yohimbe has been shown to be an alpha-adrenoceptor blocker. This action reduces the effects of hormones that increase the constriction of blood vessels as a person ages. Yohimbe also increases production of norepinephrine, which plays a role in achieving erection during sexual arousal. Yohimbe increases the amount of adrenaline that reaches the nerve endings, enhancing sexual sensations and allowing for a more satisfying sexual experience. Yohimbe has been shown to support sexual longevity.
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)
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)
All hormone determinations were performed by radioimmunoassay using kits provided by commercial suppliers. All blood samples were drawn between 8 am and 1 pm, quickly spun down, frozen, and then stored. All determinations were performed at the same time after the end of the study. The serum LH kit was obtained from Nichols Institute (now Quest; Tarzana, CA, USA) (normal male range, 1.4–11.1 mIU/ml). The serum free testosterone kit was obtained from Diagnostic Products Corporation (DPC, Los Angeles, USA) (normal male range, 15–40 pg/ml). The serum cortisol kit was bought from DPC (normal morning range, 10–24 mcg/dl; normal afternoon range, 5–12 mcg/dl). The serum dehydroepiandrosterone sulfate kit was obtained from DPC (normal range, 150–350 mcg/dl from adolescence to the peak at age 50 y, with a progressive decrease with advancing years).
While the rationale behind why it would work is airtight, the research on arginine’s actual effect on erectile dysfunction is slim, points out Charles Walker, M.D., assistant professor of urology and cofounder of the Cardiovascular and Sexual Health clinic at Yale University. But given its solid safety profile, minimal side effects, and potential benefit on heart disease, it’s worth a try, he adds, especially when taken in conjunction with other herbs on this list, which studies have shown can be more effective.
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
According to the FDA (Food and Drug Administration), many of these products sold on the internet contain potentially harmful compounds. And they aren’t listed on the label. In an investigation, the FDA found that one-third of these online supplements were laced with undisclosed ingredients. This includes sildenafil—the active ingredient in Viagra. Doctors prescribe Viagra to some patients, but it’s not safe for everyone. The drug could interact with other medications and lower your blood pressure to dangerous levels. This makes ordering supplements online risky. You don’t know whether they contain sildenafil or other ingredients that could harm your health. 
The group treated with the lower concentration of zinc (1 mg/day) did not show an alteration in any of the observed parameters. However, supplementation with a dose of 5 mg/day per rat caused substantial prolonged ejaculatory latency and increased in number of penile thrusting. The other parameters studied remained unchanged indicating uninterrupted libido, sex vigor and performance. Majority of male rats (75 %) showed the prominent actions of sexual behaviour (mount, intromission and penile thrusting) and did not ejaculate within the 15-minute observation period.

The group treated with the lower concentration of zinc (1 mg/day) did not show an alteration in any of the observed parameters. However, supplementation with a dose of 5 mg/day per rat caused substantial prolonged ejaculatory latency and increased in number of penile thrusting. The other parameters studied remained unchanged indicating uninterrupted libido, sex vigor and performance. Majority of male rats (75 %) showed the prominent actions of sexual behaviour (mount, intromission and penile thrusting) and did not ejaculate within the 15-minute observation period.
Yohimbe supplements often list yohimbe bark extract or yohimbine as the active ingredient. However, some of these products might not provide accurate information about the amount of yohimbine in the supplement. Also, some yohimbe supplements list yohimbine hydrochloride as an active ingredient. Yohimbe products containing man-made yohimbine hydrochloride as an ingredient are not legal to sell as a dietary supplement in the US.
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.
Cai, T., Verze, P., Massenio, P., Tiscione, D., Malossini, G., Cormio, L. ... Mirone, V. (2016, August 12). Rhodiola rosea, folic acid, zinc and biotin (EndEP®) is able to improve ejaculatory control in patients affected by lifelong premature ejaculation: Results from a phase I II study. Experimental and Therapeutic Medicine, 12(4), 2083-2087. Retrieved from https://www.spandidos-publications.com/10.3892/etm.2016.3595
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