The concentration of yohimbine in commercial supplements may vary from one manufacturer to another. A chemical analysis conducted on 26 brands of yohimbe supplement shows that nine products contain no yohimbe extract at all, while eight products contain only small amounts of yohimbine — approximately 0.1 to 1 parts per million (ppm), which is significantly low compared to 7,089 ppm yohimbine in an authentic yohimbe bark.3
Many people experience occasional erectile dysfunction when they're stressed or preoccupied. This is because stress increases levels of the hormone adrenaline, which actually causes blood vessels to contract. As having a firm erection depends upon a strong supply of blood to and within the penis, feeling chronically stressed can lead to repeated bouts of ED.
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.
Parameters evaluated in this study are determinants of some important aspects of the male sexual competence. Libido index, intromission and mount latencies are indicators of libido, arousability and motivation. Copulatory efficiency and inter-copulatory intervals are indicators of sexual vigor, while penile thrusting is an indicator of penile erection.[8,11,14,15] Our results showed that the libido index was significantly reduced in the 10 mg/day zinc saulphate treated group. In the same group, majority of the animals (62%) failed to complete their sexual behavioral cycle within the observed period. Though these unsuccessful rats showed the initial steps of the cycle such as licking, physical contacts with the females and few mounts and intromissions, they were inactive at later stages. Therefore a significant reduction of the libido index, number of intromissions, mounts, and ejaculations were observed in the high dose of zinc treated group compared to controls.

In male rats, main olfactory epithelium (MOE) exerts an important role in regulating sexual behavior. Intranasal irrigation with zinc sulphate has been reported to destroy the MOE and completely abolish the sex behavior.[6] In this study supplementation of zinc was done using a feeding tube and precautions were taken to avoid contacting nasal area. Hence the possibility of reducing sexual performance due to MOE disturbance is ruled out. Some humans experience gastrointestinal irritation with supplementation of zinc.[23] If the same is applicable to animals it may be another possible explanation for the reduction of libido index with elevated doses of zinc. One drawback of our study is that we did not compare the weight of animals before and after treatment.
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.
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.
We studied the involvement of zinc in the sexual behavioral response of male rats. The study design employed a rat model to predict the human sexual response to elemental zinc supplementation. Rats were used because they are very social and copulate under a variety of circumstances, regardless of the presence of a human experimenter. They are practical (small and easy to handle) and certain tissues and neuroendocrine systems are strikingly similar to humans.[13]
Stress is another main cause of impotence in men. Psychological stress lowers libido in general and may suppress a man’s ability to become aroused, causing impotence. This is usually temporary and is easier to reverse than cases of physiological impotence. Nonetheless it is extremely important to manage stress levels when working to reverse impotence. Whether a man is experiencing impotence due to physiological reasons or psychological reasons, stress plays a key role. Any man that is experiencing erectile dysfunction will experience higher levels of stress because of the condition itself. Stress management skills need to be in place when working to reverse impotence.
When men are given supplemental testosterone it can have positive effects on erectile dysfunction as well as the “grumpy old men” syndrome of low energy, loss of drive, low libido, and loss of endurance as well as “man boobs”.  Zinc has a direct effect on the two main enzyme systems that act on testosterone: conversion of testosterone to estrogen via aromatase and the conversion of testosterone to DHT by 5 alpha reductase.   Zinc blocks the testosterone to estrogen pathway leading to more testosterone.  It turns out that only at really high zinc levels does zinc inhibit the 5 alpha reductase enzyme so when we give mild to moderate zinc supplements, DHT actually increases because there is more testosterone to feed into this pathway.   This actually benefits things because DHT has 2-3 times the times the androgen receptor affinity than testosterone.  In any case, we see an increase of testosterone and androgenic activity from DHT with zinc supplements and whether a guy has low or normal T to begin with, there is a positive change in erectile dysfunction and libido in some men due to the increased androgenic activity and less estrogen pulling in the opposite direction.  Conversely we see testosterone levels drop when a diet is low in Zinc as well as a drop in DHT.  It is important to note that this effect of increased testosterone with zinc supplementation, while well established, does not always lead to an improvement of ED and increased Libido.
There was a higher incidence of adverse events in those taking niacin. However, most patients could tolerate it at the maximum dosage (1,500 mg/day). With this in mind, niacin could be an alternative choice of treatment for patients with ED. Despite the success of phosphodiesterase type 5 inhibitors (PDE5 inhibitors), such as sildenafil, only around 60–70% of patients have a satisfactory response to this class of drugs. And there are adverse effects such as headache, flushing, dyspepsia, nasal congestion, and impaired vision, including photophobia and blurred vision. Hence, there is a need to develop other therapeutic agents for those patients who do not respond satisfactorily to PDE5 inhibitors or are contraindicated for those such as sildenafil.
The key to all of this is the endothelium, the inner lining of blood vessels that helps blood flow smoothly. Regular exercise has been shown to improve the way the endothelium works. The endothelium lines the blood vessels in the heart and the penis, explains Dr. Hellstrom, but the blood vessels in the penis are about one-third the size of those in the heart. So if you fail to have erections due to vascular problems, that indicates that you’re at risk for heart problems as well.
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.

Despite the name, horny goat weed actually helps improve your erection, not libido.  Botanically known as epimedium, this herb has been used by the Chinese for centuries to treat, among other things, low libido and erectile dysfunction. “A growing body of research shows that isolated icariin—the extract of epimedium—inhibits the enzyme phosphodiesterase-5 (PDE-5) and significantly increases nitric oxide synthase, helping to improve erectile function,” says Fisch. In fact, this is the same mechanism that Viagra works through (but the herb comes with a way better name).

Geraerts, I., van Poppel, H., Devoogdt, N., de Groef, A., Fieuws, S., & van Kampen, M. (2016, January–February). Pelvic floor muscle training for erectile dysfunction and climacturia 1 year after nerve sparing radical prostatectomy: A randomized controlled trial [Abstract]. International Journal of Impotence Research, 28(1), 9–13. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26538105
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.
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)
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

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.


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.
"Erectile dysfunction can be a very serious issue because it's a marker of underlying cardiovascular disease, and it often occurs before heart conditions become apparent. Therefore, men should consider improving their weight and overall nutrition, exercise more, drink less alcohol and have a better night's sleep, as well as address risk factors such as diabetes, high blood pressure and cholesterol.
Erectile dysfunction supplements and other natural remedies have long been used in Chinese, African and other cultures. But unlike prescription medications for erectile dysfunction, such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis, Adcirca) and avanafil (Stendra), erectile dysfunction herbs and supplements haven't been well-studied or tested. Some can cause side effects or interact with other medications. And the amount of the active ingredient can vary greatly from product to product.
Penile erection is a hemodynamic process involving increased arterial inflow and restricted venous outflow, coordinated with corpus cavernosum and penile arterial smooth muscle relaxation. Any problem in this mechanism results in Erectile Dysfunction and its etiology is generally multifactorial. This study is aimed at determining the objective outcome of aerobic training in the management of Erectile Dysfunction of arterogenic origin using Meta analysis.

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).
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!

So, in establishing physiology, pharmacology, clinical results and safety, zinc is a good choice when you look at cost and side effect profile as well as ease of availability and interaction profile with other meds and other medical conditions.  Having said all of this, there is no bulletproof evidence out there guaranteeing that increasing your zinc consumption either in food or via a supplement will improve ED or increase libido.  Even if a patient experiences an increase in testosterone from such a supplementation, this is not a certain gateway to resolution of theses symptoms as there is more to it than just one hormone level.  However for those that are experiencing problems in these areas, it is certainly worth a try for them.  The patient should be mindful however that supplements should be treated like any other medication and trying to increase your testosterone shouldn’t be done without consultation with your doctor and pharmacist.  You should also check for any interactions with any meds or medical conditions before trying any supplement as well.

We studied the involvement of zinc in the sexual behavioral response of male rats. The study design employed a rat model to predict the human sexual response to elemental zinc supplementation. Rats were used because they are very social and copulate under a variety of circumstances, regardless of the presence of a human experimenter. They are practical (small and easy to handle) and certain tissues and neuroendocrine systems are strikingly similar to humans.[13]
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
Using the protocol of a clinical randomized placebo-controlled parallel-group trial, the study also took place at the University of Hong Kong. One hundred sixty male patients with ED and dyslipidemia were randomized into two groups receiving either up to 1,500 mg of oral niacin daily or placebo for 12 weeks. Using questions from the International Index of Erectile Function (IIEF, particularly questions Q3 and Q4), the primary outcome was improvement in erectile function. Q3 ranked “frequency of penetration,” while Q4 ranked “frequency of maintained erections after penetration.” Other outcome measurements included the total IIEF score, IIEF-erectile function domain, and Sexual Health Inventory for Men (SHIM) score.

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
Ashwagandha, an Ayurvedic herbal remedy reputed to act as a mild aphrodisiac, or Asian ginseng (Panax ginseng), a good stimulant and sexual energizer. For either, follow the dosage on the package, and give it six or eight weeks to have an effect. Both ashwagandha and Asian ginseng are generally safe (but Asian ginseng can raise blood pressure and cause irritability and insomnia in some people).
Esposito et al (18), in their randomized study investigated the effect of physical activities on 110 obese subjects. They reported significant effect of physical activities on both body mass index and EF. The physiological rationales underlying this hypothesis are that healthy lifestyle factors are associated with maintenance of good erectile function in men (19); obesity has been positively associated with endothelial dysfunction and increased serum concentrations of vascular inflammatory markers (34, 35); and both endothelial and erectile dysfunction may share some common metabolic and vascular pathways that may be influenced by behavioral-related pathways (19, 36). Obese men with erectile dysfunction had evidence of abnormal endothelial function, which was indicated by reduced blood pressure and platelet aggregation responses to L-arginine and elevated serum concentrations of markers of low-grade inflammation, such as IL-6, IL-8, and CRP. It has been shown that there are significant associations between IEEF score and proxy indicators of elevated body fat, the vascular response to L-arginine, and circulating IL-8 and CRP levels. The association we found between IEEF score and indices of endothelial dysfunction supports the presence of common vascular pathways underlying both conditions in obese men. A disturbance in nitric oxide activity linked to reduced nitric oxide availability could provide a unifying explanation for this association. In particular, in isolated corpus cavernosum strips from patients with erectile dysfunction both neurogenic and endothelium-dependent relaxation is impaired (37).
Guay and Spark observed independently (unpublished data) that yohimbine was associated with a very poor response in cigarette smokers. This is believed to be relevant, because studies several decades ago may have included a large percentage of smokers, which only recently has been recognized as a risk factor for erectile dysfunction. We tested this hypothesis by studying nonsmoking men with documented organic impotence and by judging whether any possible effect might be related to adrenal or testicular hormones, which, to our knowledge, has not been studied.

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.


Three subsets (eight in each subset) of sexually experienced adult male rats were supplemented with three different oral doses of zinc sulphate (a daily dose of 1 mg, 5 mg and 10 mg respectively) for two weeks. A subset of eight animals without zinc supplementation was used as the control group Sexual behavior was observed by placing them individually in cages with receptive females.
These results are remarkable, because it appears that not only can niacin improve short term erectile function in many men, but also can likely help to reverse arterial plaque if a comprehensive program is undertaken.  Of course, neither I nor anyone else knows how safe megadosed niacin is long term, but many experts consider it safe when used under the care of a knowledgeable physician.  You'll have to do your own due diligence.
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)

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.
Psychosocial problems are important and may cause erectile dysfunction by themselves or together with other causes of erectile dysfunction, such as diabetes and heart disease. Relationships are complicated and many factors cause tensions, which can affect sexual relations. For some men, these problems can become ongoing and it can help to talk through the issue with a skilled counsellor. It is important to know that the longer erectile dysfunction is left untreated, the greater the effect on relationships. This is another reason why early treatment of erectile dysfunction is important.
There’s no bedroom bummer quite like having to fly at half mast, but your penis problems are likely more common than you think: As many as 30 million American men suffer from erectile dysfunction, and one in four who seek treatment for ED are actually under the age of 40, according to a study in The Journal of Sexual Medicine. We all know there’s a little blue pill that can fix the failure to launch—but you don’t necessarily have to fill a ‘script to save your stiffy.
When experiencing difficulty in achieving an erection, it’s important to figure out if you are able to achieve an erection at all or if this happens only when you are with your partner. If you are unable to achieve an erection on your own, this may be more related to a medical and/or physical condition. Examples of this could include heart conditions, neuromuscular disorders, or pelvic pain. To evaluate if this is the cause of your condition, you should follow-up with your physician to examine your cardiovascular, neurological, and musculoskeletal system. From here, they may recommend medications such as Viagra or Cialis, or sometimes a referral to a urologist.
An Anti-Inflammatory Diet PlanDiabetes Smart TipsLiving Well with Rheumatoid ArthritisLiving Well with Colitis or Crohn'sManage Your Child's ADHDMood, Stress and Mental HealthTalking to Your Doctor About Hepatitis CTalking to Your Doctor About PsoriasisTalking to Your Doctor About Rheumatoid ArthritisYour Guide to Diabetes ManagementYour Guide to Headache and Migraine PainYour Guide to Managing DepressionSee All
This African tree bark extract sends blood flow to the genitals, said herbalist Ed Smith, a founding member of the American Herbalists Guild, who adds a warning that Yohimbe can cause nervousness and raise already-existing high blood pressure (so avoid taking it if you have heart or kidney disease), and can also negatively interact with antidepressants.
If you’re experiencing psychological ED, you may benefit from talk therapy. Therapy can help you manage your mental health. You’ll likely work with your therapist over several sessions, and your therapist will address things like major stress or anxiety factors, feelings around sex, or subconscious conflicts that could be affecting your sexual well-being.
There’s no bedroom bummer quite like having to fly at half mast, but your penis problems are likely more common than you think: As many as 30 million American men suffer from erectile dysfunction, and one in four who seek treatment for ED are actually under the age of 40, according to a study in The Journal of Sexual Medicine. We all know there’s a little blue pill that can fix the failure to launch—but you don’t necessarily have to fill a ‘script to save your stiffy.
Not only will regular exercise burn calories and lower stress, it may lower your risk of ED. Before you start working out, check with your doctor about the best program for you. Think of exercises you're likely to enjoy and will want to continue on a daily basis, whether it's 30 minutes in the morning on a stationary bike while watching the news, a kick-boxing class, or a brisk after-dinner walk around the neighborhood with a friend.
Three types of medications to treat erectile dysfunction -- sildenafil, vardenafil and tadalafil -- may cause low blood pressure. Niacin, used to treat conditions such as high cholesterol and hardening of the arteries, can also lower your blood pressure. If you take medications to treat male impotence, ask your doctor before combining it with niacin.
Three types of medications to treat erectile dysfunction -- sildenafil, vardenafil and tadalafil -- may cause low blood pressure. Niacin, used to treat conditions such as high cholesterol and hardening of the arteries, can also lower your blood pressure. If you take medications to treat male impotence, ask your doctor before combining it with niacin.

Alprostadil is injected into the side of penis with a very fine needle. It's of great value to have the first shot in the doctor's office before doing this on your own. Self-injection lessons should be given in your doctor's office by an experienced professional. The success rate for getting an erection firm enough to have sex is as high as 85% with this treatment. Many men who do not respond to oral PDE5 inhibitors can be ‘rescued' with ICI.
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.
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
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.

Low levels of zinc can be the cause for a variety of health-related problems. Zinc is a key mineral that cells use to metabolize nutrients. Immune function, DNA and protein production, and cell division are all related to zinc levels in the body. Zinc also enables the male body to produce testosterone. Because of this, your levels of zinc may affect erectile dysfunction.
×