Kegel exercises are very effective, simple and affordable methods in enhancing the strength of your muscles. These muscles are the ones that are involved in your sexual function. If you are unsure of the information that you read online, the best option is to talk with your doctor about your condition in order to avail of the best treatment methods for you.

3. Testosterone replacement. Before oral medications like Viagra, testosterone was routinely used to treat erectile dysfunction as it is central in the male sexual response, including the desire for sex and the process of getting an erection. Testosterone can be administered in a number of ways, for example orally, by means of an injection, skin patch, or subcutaneous (under the skin) pellet. 
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.
Aids in fat loss: Yohimbe and other alkaloids in the bark extract are said to block specific receptors that actually inhibit fat loss. A three-week study in 1991 observed 20 obese females on 1,000-calorie diets. They were given 20 mg of yohimbe each day and lost three pounds more than the group receiving placebos. Not a drastic weight loss, but enough to give experts hope that yohimbe can help with weight loss. Other studies have found that yohimbe increases the amount of non-esterified fatty acids, a result of fat breaking down. More research is needed. Most other studies in the field are done using the drug yohimbine. Extracted chemicals are not the same as yohimbe bark. Studies with yohimbine are expected to give different results than studies that used the raw plant.
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In conclusion, aerobic training can successfully treat ED in selected patients with arterogenic ED. However, there are very few high-quality randomized trials regarding aerobic training and ED. Practitioners should bear in mind that aerobic training and other risk factors modification is associated with higher rates of ED management success.Since these results are based on small studies, the evidence would be stronger if confirmed by large trials. Effectiveness data were limited; however, the effectiveness of ED is largely determined by the patient health status and associated condition. In addition, work is needed in the standardization of follow-up protocols, evaluation of ED management success and failure, patient selection, and statistical analysis. More randomized studies that compare various exercise techniques are warranted. These studies should evaluate efficacy, complications, quality of life, cost implications, and long-term outcomes of ED management compare to other therapeutic modalities available. Also more database search is also warranted to further broaden the data search on the topic.
The positive response in our patients was enhanced with the higher dose of yohimbine, a phenomenon noted previously.20,21 We agree that several weeks of therapy are needed before clinical effects are seen,21,22 and that some responders may be able to take yohimbine only on demand before sexual activity.39 Yohimbine is effective in a subset of men with organic erectile dysfunction, especially nonsmokers, and it deserves a place in our therapeutic armamentarium. When yohimbine is ineffective alone, it may be useful in combination with other treatment modalities, as has been shown with naloxone39 or trazodone.40
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.
The phrase “use it before you lose it” can be applied when it comes to helping men with ED regain normal erectile function. Pelvic exercises, more commonly known as kegel exercises, are used to promote urinary continence and sexual health. They help to strengthen the bulbocavernosus muscle, which does three things: allows the penis to engorge with blood during erection, it pumps during ejaculation, and it helps empty the urethra after urination, according to Healthline.
Three of the randomized studies (25–27) that contributed to the present study data indicated the positive role of both interval and continuous aerobic training in the dual management of both ED and cardiovascular disorders (hypertension and ischemic heart disease ,respectively); this is not surprising because of the arterogenic interrelationship between ED and several cardiovascular disorders. The physiological basis for the therapeutic role of continuous exercise in the management of both ED and some cardiovascular disorders as reported in the present study, could be related to the biochemical, neural and hormonal changes in the blood vessel walls that induce an acute and long-term blood vessel relaxation. The blood vessels might relax after each exercise session because of body warming effects; local production of certain chemicals, such lactic acid and NO; decreases in nerve activity; and changes in certain hormones and their receptors (32, 33). Over time, as the exercise is repeated, there appears to be a growing evidence of a prolonged effect. Thus, chronic (regular, longterm) physical training might reduce basal concentrations of inflammatory markers.
Acupuncture. Acupuncture has been used for centuries to treat ED and impotence in China. A recent review of studies on acupuncture for erectile dysfunction was published in the British Journal of Urology International. After reviewing four studies, the authors concluded that there was not sufficient evidence to say that acupuncture worked. However, some experts believe it's worth trying. "Acupuncture can work," says Gilbert. "It probably works best to treat the psychological component of ED. There is very little downside to trying it."
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)
In fact, dyslipidemia is commonly found in ED patients, and studies show that statins can help to improve the response of PDE5 inhibitors in those suffering from ED precisely because they improve atherosclerosis. Consequently, statins can be used as a treatment in patients with an unsatisfactory response to PDE5 inhibitors, yet there are problems with statins too, among them raised liver enzymes and muscle problems, some of which can be quite serious and even deadly (rhabdomylosis).

Penile implants - are generally used if physical damage (like an accident) makes the anatomical parts needed for an erection not work. These are inserted by surgery and can provide a permanent treatment choice if others fail to work. The implants can be semi-rigid or inflatable. They can be pretty expensive and are not usually available on the NHS.
Exercise lowers blood pressure – a consistently high blood pressure (hypertension) can damage your arteries and cause them to harden, limiting the flow of blood to the penis and leading to cardiovascular problems. Exercise works to reduce the force required to pump blood around your body, protecting your artery linings as a result. You should aim to have a blood pressure less than 140/90mm Hg.
A study published in the journal Fertility and Sterility that analyzed the effect of various fruit and vegetables on sperm quality discovered carrots had the best all-around results on sperm count and motility—a term used to describe the ability of sperm to swim towards an egg. Men who ate the most carrots saw improved sperm performance by 6.5 to 8 percent. The Harvard researchers attribute the boost to carotenoids, powerful antioxidative compounds in carrots that help the body make vitamin A.

One study found that sticking to a Mediterranean diet rich in virgin olive oil, vegetables, fruits, whole grains, nuts, and fish was associated with a lower risk of ED development and improvement in people who already suffered from ED. There is also some evidence that vegetarian and vegan diets may lower the risk of some types of heart disease, which in turn decreases the likelihood of developing ED.


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.
Testosterone levels did not differ statistically in the treatment groups and did not change during treatment with yohimbine. The levels of dehydroepiandrosterone and free testosterone tended to be higher in the responder group, but the levels in both groups were well into the age-adjusted normal ranges. Androgens play a part in peripheral erectile activity, but they are not necessary for the central arousal stimulation of yohimbine,36 in which norepinephrine release acts as an inhibitor antagonist.2 Peripheral sympathetic stimulation also occurs37 but less than its adrenergic antagonistic activity. These peripheral effects are prompting the search for new alpha-2 adrenergic antagonists38
I'll explain the best exercises for sex below. Know that if you suffer from PE or ED you also need to change the way you are thinking about sex to gain full control of yourself. Not just during sex, but in the lead up to sex as well, so you can reprogram your brain to achieve hard and in control. I explain this in the following video which is taken directly from my Sex Mastery program:

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).
A complete sexual behavioral cycle of males involved pre sexual performances, copulation and ultimate ejaculation. Pre sexual behavior comprises physical contact with the female, sniffing and licking of female genital area, licking of their own penis, and few mounts without intromissions. Although all induced females were screened for receptivity, some females showed a mild rejection in the beginning. However, there were no rejections when they were coupled with very active males. All animals which completed the behavioral cycle showed a normal pattern of behavior (not an aberrant sexual behaviour) during the observation period.
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 fact, dyslipidemia is commonly found in ED patients, and studies show that statins can help to improve the response of PDE5 inhibitors in those suffering from ED precisely because they improve atherosclerosis. Consequently, statins can be used as a treatment in patients with an unsatisfactory response to PDE5 inhibitors, yet there are problems with statins too, among them raised liver enzymes and muscle problems, some of which can be quite serious and even deadly (rhabdomylosis).
Derived from the bark of a West African evergreen tree, yohimbe was the go-to ‘script for a wonky willy prior to the advent of wonder drugs like Viagra, Walker says. “Yohimbe enhances sexual performance both by blocking certain neurotransmitters in the brain and by increasing the release of nitric oxide in the cavernosal nerves of the penis,” he explains. And it pairs well with other erection-friendly tablets: A 2010 study in the Iranian Journal of Psychiatry found that a combination of yohimbe and L-arginine successfully helps guys get it up. However, yohimbe also has a handful of side effects, including elevated blood pressure and anxiety, so definitely talk to your doctor before you start on the supp.
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.
Consequently, this negatively affects sexual function. Finally, if you frequently suffer from stress, then Vitamin B2 deficiency surely takes place. And the symptoms of this deficiency include peeling lips, cracked lips, stomatitis, tongue inflammation, skin lesions resembling eczema, conjunctivitis, photophobia, lacrimation, and decrement in visual acuity.
Most studies related to male infertility show a clear concise relationship between zinc and ed. During a study some young men were given a diet which included very little amounts of zinc and thus they developed a zinc deficiency. When testosterone levels were measured after 20 weeks of low-zinc diet it was found that the level of the hormone had drastically reduced. The study also found that in elderly men, with an increase in the uptake of zinc, testosterone levels nearly doubled.

In the statistical analysis, the difference between the pre-test and post-test values (changed score) for IIEF score was computed. Student t-test was used to compare the mean changed score values of IIEF. All statistical analysis was performed on an IBM compatible micro computer using SPSS for window version 15.0, (Chicago IL, USA). The probability level for all the above tests was set at 0.05 to indicate significance.
Erectile dysfunction (ED) is one of the most common sexual problems that men deal with. There are a host of different causes of ED that range from nutrient deficiencies to clinical depression. It’s important to talk to a medical professional about ED, in order to determine the cause of the issue before exploring treatment options. That said, erectile dysfunction has been found in recent years to be a symptom of zinc deficiency.
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