Response to yohimbine was not dependent on patient age. Patients who showed a positive response had fewer medical risk factors overall, although the small number of patients was not large enough to provide statistical significance. The positive clinical response was verified subjectively both by the formal questionnaire and by the in-office clinical encounter. The positive response was verified objectively by measuring nocturnal penile tumescence and rigidity with the RigiScan™ home monitor. The trend of the baseline penile erectile response was better in the responders, suggesting that use of yohimbine might be more effective in patients who have less severe erectile dysfunction. Some authors have questioned the effect of yohimbine on penile activity, but either inadequate doses of yohimbine were used or only tumescence was measured,21,32 often in an office setting where anxiety and embarrassment might affect results.
Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject Impulse, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include papaverine, alprostadil and phentolamine. Often these combination medications are known as bimix (if two medications are included) or trimix (if three are included).
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.
The principal difference between the Hong Kong study. and others that proceeded it, is that the researchers used niacin alone, rather than in combination with PDE5 inhibitors. The results indicate that niacin can improve erectile function in those with moderate to severe ED but not in those with mild and mild-to-moderate ED. Statins also appear to be effective for improving erectile function in those with more severe ED.
Intermountain Healthcare is a Utah-based, not-for-profit system of 23 hospitals, a Medical Group with more than 1,600 physicians and advanced practice clinicians at about 180 clinics, a health plans division called SelectHealth, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and in efficient healthcare delivery.

Just because a product claims to be natural doesn't mean it's safe. Many herbal remedies and dietary supplements can cause side effects and dangerous interactions when taken with certain medications. Talk to your doctor before you try an alternative treatment for erectile dysfunction — especially if you're taking medications or you have a chronic health problem such as heart disease or diabetes.
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.
MEDLINE is the U.S. National Library of Medicine's (NLM) premier bibliographic database that contains over 18 million references to journal articles in life sciences with a concentration on biomedicine. A distinctive feature of MEDLINE is that the records are indexed with NLM Medical Subject Headings (MeSH).The great majority of journals are selected for MEDLINE based on the recommendation of the Literature Selection Technical Review Committee (LSTRC), a National Institute of Health (NIH)-chartered advisory committee of external experts analogous to the committees that review NIH grant applications. MEDLINE is the primary component of PubMed, part of the entry series of databases provided by the NLM National Center for Biotechnology Information (NCBI). MEDLINE may also be searched via the NLM Gateway (23).
Thank you for posting this. The exact same thing happened to me, My Dr. recommended Niacin to reduce LDL and increase HDL. Trouble is I noticed my sex life really dropped quickly. Very rare to get and maintain an erection. I couldn't quite tell but it seemed to me the problems started a couple of weeks after I began the Niacin. Out of desperation I quit Niacin to see what would happen and suddenly the full and regular erectiions came back. Everything I read says the effect should be the opposite. Now I have to decide do a die earlier of heart disease and have more sex or better cholesterol control with a diminished and almost non-existent sex life. Pretty sure I'm gonna favor the sex life!
If you’ve been to the health food store lately, you’ve seen shelves lined with vitamins and “organic” supplements, each claiming to boost immunity, revitalize organ function, or “promote health.” And it’s working. Supplements are currently a $30 billion industry in the US, with more than 90,000 products on the market, and vitamin use is on the rise. In fact, a recent survey in Journal of American Medicine Association showed that “52% of US adults reported use of at least 1 supplement product.”

Pelvic floor exercises are actually good as they can enhance the strength of the pelvic floor muscles. These exercises are commonly called Kegel exercises. These are the types of exercises that women usually perform in order to regain their muscle tone right after childbirth. They are also known to enhance urinary continence and overall male sexual health.
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.
This no.1 penis strengthening exercise is essential for helping to correct erectile dysfunction problems and can lead to mind-blowing orgasms. The download instructions (see link above) also contain important information regarding a common mistake that men make, especially when doing Kegel exercises. Kegel Exercises are not the best treatment for premature ejaculation! However, a slight modification to a common Kegel exercise can make it become more beneficial in overcoming PE and ED. See the above instructions for detailed explanation.
Yohimbe is an evergreen tree with large, leathery leaves. It is native to the tropical west coast of Africa, from Nigeria to Gabon. Natives in that region have used the inner bark of Yohimbe to treat angina, hypertension, fever, cough and leprosy. It was also smoked or snuffed to attain an altered state of consciousness. Its main use and rumored “power” was that it was an aphrodisiac. Today science recognizes it as a sensual stimulant, but Native Africans also recognized that drinking Yohimbe tea encouraged sexual arousal. It was traded with Europeans and the tales of Yohimbe’s “powers” spread, giving rise for its increased demand by Europeans.
Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor's OK. Medications for erectile dysfunction do not work in all men and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:
Yohimbe A number of clinical trials have shown that the primary component of this bark from an African tree can improve sexual dysfunction associated with selective-serotonin reuptake inhibitors (SSRIs) used to treat depression. This herb has been linked to a number of side effects, including increased blood pressure, fast or irregular heartbeat, and anxiety. Yohimbe shouldn't be used without a doctor's supervision.
Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He’s a practicing Gastroenterologist and Hepatologist with a focus on Men’s and Women’s Health, and a regular contributor to Women’s health, Shape and Prevention Magazine.
In addition to male sexual health, zinc is needed for burn and wound healing, proper digestion and utilization of carbohydrate foods, including: fruits, grains, sweets and vegetables as well as protein foods like beans, eggs, tofu or meat. Zinc is also necessary for the body to manufacture at least 200 different enzymes needed for various aspects of metabolism and life. Our blood, bones, brain, heart, liver and muscles require adequate amounts of this essential mineral to function properly.
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

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.
Although not proven, it is likely that erectile dysfunction can be prevented by good general health, paying particular attention to body weight, exercise, and cigarette smoking. For example, heart disease and diabetes are problems that can cause erectile dysfunction, and both are preventable through lifestyle changes such as sensible eating and regular exercise. Furthermore, early diagnosis and treatment of associated conditions like diabetes, hypertension and high cholesterol may prevent or delay erectile dysfunction, or stop the erectile dysfunction from getting more serious.
A noticing fact is that each of these men had problems of lipid levels and high levels of cholesterol. According to the author Dr. Chi-Fai in Hong Kong, "Niacin or Vitamin B3 is one among the old erectile dysfunction drugs and medical experts have documented its safety in well manner. Because of this, we should consider it as a simple and an easy way to bring improvements in the men's erectile function."
Vitamin B6 deficiency leads to irritability, numbness in the extremities, muscle weakness, fatigue, drowsiness, impaired mental activity, peripheral neuritis, seborrheic dermatitis, stomatitis, conjunctivitis, and, of course, impairment of sexual potency. Lack of this vitamin can be a result of long-term use of anti-tuberculosis drugs and chronic diseases of the gastrointestinal tract.

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.

Some men say certain alternative medicines taken by mouth can help them get and maintain an erection. However, not all “natural” medicines or supplements are safe. Combinations of certain prescribed and alternative medicines could cause major health problems. To help ensure coordinated and safe care, discuss your use of alternative medicines, including use of vitamin and mineral supplements, with a health care professional. Also, never order a medicine online without talking with your doctor.

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.
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.
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).
Pay attention to your vascular health. High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the heart (causing heart attack), in the brain (causing stroke), and leading to the penis (causing ED). An expanding waistline also contributes. Check with your doctor to find out whether your vascular system — and thus your heart, brain, and penis — is in good shape or needs a tune-up through lifestyle changes and, if necessary, medications.
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.
Practicing natural health and herbalism for over 18 years, Dalene received her training and herbal certification under the guidance of Lynn Albers at Yarmony Mt. Herbal College in Colorado in 2000. She went on to become a Certified Birth Doula at Birthingway College of Midwifery in Portland, Oregon in 2007. As a Birth Doula, Dalene has helped to bring many new lives in to this world. Dalene has written 280+ fertility articles and with her vast array of herbal and holistic healing knowledge has helped 1000’s of women on their journey to Motherhood.
The principal difference between the Hong Kong study. and others that proceeded it, is that the researchers used niacin alone, rather than in combination with PDE5 inhibitors. The results indicate that niacin can improve erectile function in those with moderate to severe ED but not in those with mild and mild-to-moderate ED. Statins also appear to be effective for improving erectile function in those with more severe ED.
Athletes or dieters sometimes use products containing yohimbe to help promote easier weight loss, especially from body fat, and to increase energy expenditure. Some have speculated that it may help increase muscle mass and endurance while cutting fat. But there’s not much evidence from studies that this is necessarily true. Yohimbe does seem to have potential to increase energy expenditure by acting as a stimulant, increasing adrenaline levels in the body and potentially preventing fatigue during or following exercise.

Vitamin C has been associated with higher sperm counts. You can get it naturally from strawberries, raspberries and blueberries, which are anthocyanins, colorful plant chemicals which help keep your arteries unclogged, boosting circulation and erection quality. In supplement stores, you’ll find all manner of megadoses — steer clear of those; they might do more harm than good.
"The good news is, our study also found that a large proportion of men were naturally overcoming erectile dysfunction issues. The remission rate of those with erectile dysfunction was 29%, which is very high. This shows that many of these factors affecting men are modifiable, offering them an opportunity to do something about their condition," Professor Wittert says.
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.
Data from the Florida Sexual History Questionnaire collected at each time period (baseline, 5.4 mg tid and 10.8 mg tid) are presented in Table 6. Three patients (two responders and one nonresponder) did not complete the entire questionnaire for each study period and were excluded from the analyses. Thus, data in the table and statistical analyses are based on the responses of seven responders and eight nonresponders.
Data from the Florida Sexual History Questionnaire collected at each time period (baseline, 5.4 mg tid and 10.8 mg tid) are presented in Table 6. Three patients (two responders and one nonresponder) did not complete the entire questionnaire for each study period and were excluded from the analyses. Thus, data in the table and statistical analyses are based on the responses of seven responders and eight nonresponders.
a) Some Vegetarians and Vegans.  It should be pointed out that certain animal-based foods are known for being the highest providers of niacin. So does this mean that animal-emphasized diets will result in increased blood flow over vegetarians?  My experience on the Peak Testosterone Forum has been the opposite and this is the subject of my book The Peak Erectile Strength Diet. Basically, a great many plant foods directly stimulate nitric oxide and will increase blood flow while lowering blood pressure. In fact, some plant foods can lower blood pressure as much as modern hypertension medications. See my page on Flaxseed and Blood Pressure for an example of that. High nitrate foods, such as spinach, arugula and beets, are yet another example.
Andrew McCullough, MD, associate professor of clinical urology and director, male sexual health program, New York University Langone Medical Center. Lecturer: Auxillium. Research grant: Pfizer. Data safety monitoring board: Pfizer. Consultant: Slate Pharmaceuticals. Clinical trials: Warner Chilcott, Vivus, Lilly, Bayer-GSK, ICOS, Timm, Schering Plough, Aeterna.
Move a muscle, but we're not talking about your biceps. A strong pelvic floor enhances rigidity during erections and helps keep blood from leaving the penis by pressing on a key vein. In a British trial, three months of twice-daily sets of Kegel exercises (which strengthen these muscles), combined with biofeedback and advice on lifestyle changes — quitting smoking, losing weight, limiting alcohol — worked far better than just advice on lifestyle changes.

When it comes to boosting sexual performance, many men will walk all over God’s green earth looking for ways to maintain a good sex life. Luckily men, all you have to do is walk — not run — 2 miles a day. This, along with other healthier lifestyle interventions can help obese men reduce their risk of ED, or even “reverse” current impotence, according to a 2005 study. This comes of importance, since maintaining a trim waistline is a good defense for ED, as men with a 42-inch waist are 50 percent more likely to have ED than those with a 32-inch waist. Getting to a healthy weight and maintaining it is a good strategy for preventing and treating ED.
There’s much evidence to suggest that Yohimbine does have a positive effect in men who have erectile dysfunction. Initially, it was considered a failure as a treatment because it doesn’t increase levels of testosterone in the body, the hormone needed for erections. However, recent trials have shown that it works well to increase arousal, help blood flow to the penis, and as a general stimulant.
Practicing natural health and herbalism for over 18 years, Dalene received her training and herbal certification under the guidance of Lynn Albers at Yarmony Mt. Herbal College in Colorado in 2000. She went on to become a Certified Birth Doula at Birthingway College of Midwifery in Portland, Oregon in 2007. As a Birth Doula, Dalene has helped to bring many new lives in to this world. Dalene has written 280+ fertility articles and with her vast array of herbal and holistic healing knowledge has helped 1000’s of women on their journey to Motherhood.
As an alpha-2 antagonist, yohimbine promotes sympathetic activity. According to a number of studies, yohimbe can increase blood pressure. This is why it’s useful for things like erectile dysfunction or diabetic nerve problems. Yohimbine is sometimes used to treat low blood pressure and symptoms like dizziness when standing up. It works by dilating blood vessels and acting on the sympathetic nervous system. However, it’s important to point out that increased blood pressure can also be a problem for some people, especially those with existing cardiovascular problems, people taking blood pressure medications, or those who already have high blood pressure.
It’s hard to concentrate on what’s happening in the bedroom when you’re thinking about problems at work. For many men, it’s psychological issues like anxiety rather than physical ones that contribute to E.D. Chronic stress has also been linked to heart disease, high blood pressure, depression, and more. Find a way of blowing off steam that works for you (I like exercise and meditation) and stick to it.
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