I was heartbroken because i had very small penis, not nice to satisfy a woman, i had so many relationship called off because of my situation, i have used so many product which i found online but none could offer me the help i searched for. i saw some few comments about this specialist called Dr James and decided to email him on [email protected]
From the overall analysis, the niacin group showed a significant increase in both IIEF-Q3 scores (0.53 ± 1.18, P < 0.001) and IIEF-Q4 scores (0.35 ± 1.17, P = 0.013) compared with baseline values. The placebo group also showed a significant increase in IIEF-Q3 scores (0.30 ± 1.16, P = 0.040) but not IIEF-Q4 scores (0.24 ± 1.13, P = 0.084). However, when patients were stratified according to the baseline severity of ED, the patients with moderate and severe ED who received niacin showed a significant improvement in IIEF-Q3 scores (0.56 ± 0.96 [P = 0.037] and 1.03 ± 1.20 [P < 0.001], respectively) and IIEF-Q4 scores (0.56 ± 1.03 [P = 0.048] and 0.84 ± 1.05 [P < 0.001], respectively] compared with baseline values, but not for the placebo group. The improvement in IIEF-EF domain score for severe and moderate ED patients in the niacin group were 5.28 ± 5.94 (P < 0.001) and 3.31 ± 4.54 (P = 0.014) and in the placebo group were 2.65 ± 5.63 (P < 0.041) and 2.74 ± 5.59 (P = 0.027), respectively. There was no significant improvement in erectile function for patients with mild and mild-to-moderate ED for both groups. For patients not receiving statins treatment, there was a significant improvement in IIEF-Q3 scores (0.47 ± 1.16 [P = 0.004]) for the niacin group, but not for the placebo group.
To evaluate the patients' response clinically in the office, a simple grading system was used.27 The patients were asked about the quality of their erections, which were graded as follows: grade 1, tumescence but no rigidity; grade 2, tumescence with minimal rigidity; grade 3, rigidity sufficient for sexual intercourse; and grade 4, fully rigid erection. At the end of the study, patients were graded as to whether they thought they had improved enough to have satisfactory regular intercourse, which is defined as success in 75% of attempts. The degree of subjective improvement in intercourse was used to classify patients as ‘responders’ vs ‘nonresponders’ in subsequent analyses. A log was kept by the couple of their sexual activity, and it was taken to the clinic for review by the clinical investigator.
The RigiScan™ portable home monitor recorded nocturnal penile tumescence and rigidity testing. The monitor's quantitative analysis software quantitates various parameters of tumescence and rigidity, which includes the area under the curve over time slept, reported as tumescence activity units and rigidity activity units. The reproducibility and accuracy of this technique have been reported.28 Baseline normal values were used as previously reported,29 Rigidity had to be at least 60% at the base and 50% at the tip and maintained for at least 10 min. At least half of the episodes had to meet these criteria, with a minimum of three or four episodes per night. Tumescence had to achieve a height of 3 cm at the base and 2 cm at the tip.
Yohimbine: The main component of an African tree bark, yohimbine is probably one of the most problematic of all natural remedies for ED. Some research suggests that yohimbine can improve a type of sexual dysfunction that is linked with a drug used to treat depression. However, studies have linked yohimbine to a number of side effects, which can include anxiety, increased blood pressure, and a fast, irregular heartbeat. Like all natural remedies, yohimbine should only be used after advice and under supervision from a doctor.
Green vegetables, legumes, seeds, nuts and brown rice are among the best sources of dietary magnesium. Most other foods don’t contain enough of the mineral to contribute to daily recommended levels, which is why many people choose to take a magnesium supplement or a daily multivitamin that contains magnesium. If you’re concerned about your overall magnesium level, particularly as it relates to erectile function, discuss supplement options and dietary changes with your doctor.
Many men experience E.D. According to UW Health, “Mild and moderate erectile dysfunction affects approximately 10 percent of men per decade of life (i.e., 50 percent of men in their 50s, 60 percent of men in their 60s).” And if you think erectile dysfunction is only a problem for older men, think again. As reported by The Greatist, a 2014 study found a quarter of patients newly diagnosed with E.D. were under 40. Of these men, almost half were experiencing severe E.D., meaning they were unable to get or maintain an erection during sex. If this is happening to you, before ordering Viagra online, check in with your primary care practitioner. It could be an early warning sign of atherosclerosis, so it’s worth getting a full evaluation before simply throwing medications at the problem.
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
DHEA. Dehydroepiandrosterone (DHEA) is a hormone produced in your body’s adrenal gland that aids in the production of testosterone and other hormones. Since testosterone is critical for healthy male sexuality, supplementing with DHEA may help with issues like sluggish libido and impotence. One double-blind, placebo-controlled study found subjects given 50 milligrams of DHEA every day for six months experienced improvement in symptoms of E.D.
Few men want to talk about their inability to get or maintain an erection, however, erectile dysfunction can have a profound impact on relationships and self-esteem. Fortunately, trouble in the bedroom doesn't necessarily mean you're dealing with erectile dysfunction. Most men will have problems with an erection at some point in their sexual history. But one bad day in the bedroom doesn't mean major sexual health problems. So how can you know if you're dealing with erectile dysfunction?
If you have symptoms of ED, it’s important to check with your doctor before trying any treatments on your own. This is because ED can be a sign of other health problems. For instance, heart disease or high cholesterol could cause ED symptoms. With a diagnosis, your doctor could recommend a number of steps that would likely improve both your heart health and your ED. These steps include lowering your cholesterol, reducing your weight, or taking medications to unclog your blood vessels.
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.

There is no evidence that mild or even moderate alcohol consumption is bad for erectile function, says Ira Sharlip, MD, a urology professor at the University of California San Francisco School of Medicine. But chronic heavy drinking can cause liver damage, nerve damage, and other conditions -- such as interfering with the normal balance of male sex hormone levels -- that can lead to ED.

Over 18 million American men over 20 years old suffer from erectile dysfunction, a condition characterized by the inability to keep an erection. It’s a complex disorder brought on by a number of factors, but it’s almost always devastating for the man it affects — causing him to lose confidence in himself and different aspects of his life. The stress it causes can deteriorate relationships and lead to lost productivity at work. Health problems aren’t uncommon either. But there’s good news in all the bad; a new study finds exercise may be a simple way to get things going under the sheets again.
Often when we start to look outside of mainstream medicine for alternative protocols to heal our health issues we replace one pill-taking protocol with another. The prescription drugs are replaced with a long list of supplements. Supplements alone, without any other lifestyle changes, will have some impact, but it will be nowhere near what they can achieve when working in a body supported with a healthy way of life.
Motivated by philosophers that included John Locke (the most influential of Enlightenment thinkers), Voltaire, Newton, and Leibniz, ruling princes throughout Europe endorsed and fostered the intelligentsia of the Enlightenment. Some of these rulers even attempted to apply the ideas of the enlightenment to government. When grasped by “natural aristocrats,” the Enlightenment was particularly successful in America where it influenced Benjamin Franklin and Thomas Jefferson, among many others, and fueled the fires that led to the American Revolution, the Declaration of Independence, and the creation of the United States.
Adequate daily magnesium intake is slightly lower for younger men than for those in their 30s and older. The University of Maryland Medical Center recommends 400 mg daily for men between the ages of 19 and 30, and 420 mg per day for men 31 and older. While these levels are a good general guideline, you should check with your doctor to determine the proper dosage for a daily magnesium supplement, particularly if you’re using magnesium to help treat or prevent erectile problems.
It is now thought that ED is part of the cardiovascular disease complex related to metabolic syndrome (MS). Although endothelial dysfunction and atherosclerosis are believed to be part of the main mechanisms for ED in patients with MS, other mechanisms account for ED in MS include androgen deficiency, drugs, the veno-occlusive mechanism, etc. Because dyslipidemia is one of the key risk factors for the development of endothelial dysfunction and atherosclerosis in MS patients, there is a close relationship between ED and dyslipidemia.
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.
The more you try not to think about your sex problems, the more these problems consume your thoughts! While it appears that your problem is complicated, my Hard and in Control program provides the complete strategy so you can complete mutually satisfying sexual acts. This will enable you to eliminate performance anxiety and restore enjoyment for your partner.
While eating magnesium-rich foods or taking a magnesium supplement at the proper dosage is safe for most men, the mineral can interfere or interact with some medications. Discuss the benefits and risks of altering your daily magnesium intake with your doctor, particularly if you take blood pressure medications, diuretics, diabetes medications or antibiotics. Men diagnosed with erectile dysfunction often require changes in other minerals and vitamins or even prescription medication. Ensuring a proper daily intake of magnesium may help maintain healthy erectile function, but magnesium alone is unlikely to cause a significant reduction in ED symptoms. Magnesium levels can also be affected by excess weight, chronic stress and excessive amounts of alcohol. These factors may also be partially responsible for erectile problems.
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.
"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.
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.
Yohimbe is commonly taken to increase sexual excitement and to reduce sexual problems such as symptoms of erectile dysfunction (ED), also called impotence. Research shows that yohimbe may be capable of increasing blood flow to the penis or vagina. It also increases nerve impulses that play a role in orgasm. Due to how yohimbine affects blood vessels, it can cause relaxation of the penile tissue and engorgement of blood. This helps a man to maintain an erection. These effects are beneficial for both sexes when it comes to experiencing sexual satisfaction.
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.
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.
Where it comes from: Yohimbe is derived from the bark of a west African evergreen tree. Yohimbine is an active chemical (an alkaloid) found in said bark and is cultivated into supplement form. Yohimbine hydrochloride is a standardized form of yohimbine that is available as a prescription drug in the United States. These terms are all related but are interchangeable.

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.
DHEA. Dehydroepiandrosterone (DHEA) is a hormone produced in your body’s adrenal gland that aids in the production of testosterone and other hormones. Since testosterone is critical for healthy male sexuality, supplementing with DHEA may help with issues like sluggish libido and impotence. One double-blind, placebo-controlled study found subjects given 50 milligrams of DHEA every day for six months experienced improvement in symptoms of E.D.
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