Also to be considered, patients were not using PDE5 inhibitors during the study period. Therefore it wasn’t determined whether the combined use with niacin can enhance the response of PDE5 inhibitors. Another limitation on the study results was the exclusion of the partner’s assessments. This would help to provide a more comprehensive assessment of the efficacy of niacin.
"Sexual relations are not only an important part of people's wellbeing. From a clinical point of view, the inability of some men to perform sexually can also be linked to a range of other health problems, many of which can be debilitating or potentially fatal," says Professor Gary Wittert, Head of the Discipline of Medicine at the University of Adelaide and Director of the University's Freemasons Foundation Centre for Men's Health.
Ginseng, specifically “red ginseng,” is known as the “herbal Viagra” that helps puts to rest men’s bedroom woes. Red ginseng is when the root has been steamed and then dried. The ginseng root is the part of the plant that is mostly used as a natural remedy when in its supplement form. However, the plant must be grown for a minimum of five years before it can be used. In a 2008 review, seven studies on red ginseng and ED, ranging in dosages from 600 to 1,000 milligrams three times a day, were found to provide evidence for the effectiveness of the herb in ED treatment.
Yohimbine also helps to increase levels of the coenzyme NAD (or nicotinamide adenine dinucleotide). This affects metabolism, cognitive processes, and detoxification of drugs in the body. NAD is not currently used to treat cognitive or mood-related disorders on its own, but has been shown in some studies to potentially have uses for preventing neurodegenerative diseases including Parkinson’s disease or Alzheimer’s. However on the other hand, studies have found that because it can increase anxiety in some patients, yohimbine may actually worsen mental illness in some patients, including those with Parkinson’s. (15) For this reason, it’s important for anyone taking mood-altering medications, or who has a history of any cognitive or mood disorder, to work with a professional while taking or starting any new herbal treatments.

Lastly, it should be remembered that many individuals without dyslipidemia take niacin as a preventative measure. If you plan to take more than about 800 mg of niacin a day, it is a good idea to have your liver tested periodically just to make sure that your liver has no problem with high-dose niacin. These liver tests are the same used to check for liver toxicity in people taking statins, from which there is a higher likelihood of liver toxicity compared to taking niacin. The principal problem from taking statins is muscle damage which is serious enough to be life-threatening. This problem does not occur with those who take niacin. Not to be forgotten, niacin has been found to prolong orgasm.
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.
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.
Supplements are popular and often cheaper than prescription drugs for ED. However, supplements have not been tested to see how well they work or if they are a safe treatment for ED. Patients should know that many over-the-counter drugs have been found on drug testing to have ‘bootlegged' PDE 5 Inhibitors as their main ingredient. The amounts of Viagra, Cialis, Levitra or Stendra that may be in these supplements is not under quality control and may differ from pill to pill. The FDA has issued consumer warnings and alerts.
Niacin -- with or without the addition of drugs to treat impotence -- poses serious health risks, including stomach ulcers and liver damage. If you have Type 2 diabetes, taking niacin could cause drastic elevations in your blood sugar levels. Less serious side effects include stomach upset and skin flushes -- your face and chest turn red and your skin itches, tingles or burns. You can purchase niacin without a prescription, but some over-the-counter formulas -- no-flush varieties that contain niacinamide -- will unlikely help lower your cholesterol.
Regardless of diet or exercise - to control a sexual act, it's imperative to balance your sexual focus during foreplay, penetration, and intercourse. When you feel safe throughout foreplay it's easy to penetrate and if you're not worried at penetration time then intercourse is easier. A happy and satisfying sex life is knowing when and where to put your attention. How to do this is explained step-by-step in my Sex Mastery Hard AND in Control program for men.
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).

Low-intensity extracorporeal shock wave therapy has been proposed as a new non-invasive treatment for erectile dysfunction caused by problems with blood vessels. Shock wave therapy machines are now available in some medical practices in Australia. Although there is some evidence that it may help a proportion of men with erectile dysfunction, more research is needed before clear recommendations on its use can be made.
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
Much of the evidence shows high rates of vitamin D deficiency in patients with erectile dysfunction. In fact, one study of 3,400 participants found that men with vitamin D deficiency were 32% more likely to have trouble with erections when all other risk factors were controlled for. It’s a little on the nose that you need vitamin D for your “D,” but hey—science can be funny too.
Prostate problems are most common in older men, but it’s never too early to start looking after your prostate! Problems such as BPH (enlarged prostate) and prostatitis can cause unpleasant symptoms such as frequent urination, weak urine stream, difficulty urinating and sudden urges to urinate, which can really get in the way of daily life and interrupt sleep.
Relevant publications were searched up to November 2010 in the MEDLINE (PubMed) database. The citation lists of randomized controlled trials on the effect of aerobic training and Erectile Dysfunction management using the International Index of Erectile Function (IIEF) as treatment outcome measure. Studies on different operative techniques on the effects of aerobic training for men with Erectile Dysfunction due to arterogenic Erecile Dysfunction were selected. Data on participants' characteristics, study quality, population, intervention, treatment outcome were collected and analyzed.
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In the human body, folic acid interacts with vitamin B12, pantothenic acid, and vitamin B7 (also called vitamin H or biotin). The signs of biotin deficiency can be hair loss, skin inflammation, skin pallor, mucous membrane inflammation, depression, drowsiness, anemia, blood sugar disorders, muscle pain, poor appetite, nausea, and insomnia. Besides, a person feels tired, irritable and depressed. Consequently, male libido and sexual activity reduce. In turn, this negatively affects sexual performance.
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.
I recently treated a young twenty-something man with a primary complaint of erectile dysfunction. When he started to notice this issue, he attempted to treat it by performing lots of kegels. (If you haven’t heard of kegel exercises, they’re done by repeatedly contracting and relaxing the muscles that form part of the pelvic floor, as if you were trying to stop peeing mid-stream.) I found this man’s story interesting because, as we discovered, in his case the kegels actually did more harm than good. We found that once he stopped kegeling and allowed his pelvic muscles to relax, his erections became stronger and he was able to ejaculate without any issues.
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.
Sildenafil, vardenafil and tadalafil increase the amount of nitric oxide in your body. Your body contains nitric oxide naturally, which is a gas that relaxes blood vessels. Medications to treat erectile dysfunction relax blood vessels in a man’s penis to help obtain and maintain an erection. Some medications that treat high blood pressure, high cholesterol and heart disease also relax your blood vessels. If you take niacin while you also take medications to treat erectile dysfunction, your blood pressure could drop drastically. You could faint or develop other health problems.
Also to be considered, patients were not using PDE5 inhibitors during the study period. Therefore it wasn’t determined whether the combined use with niacin can enhance the response of PDE5 inhibitors. Another limitation on the study results was the exclusion of the partner’s assessments. This would help to provide a more comprehensive assessment of the efficacy of niacin.
In addition to getting helpful nutrients from your diet, you can also consider supplementing. Many of these are also on my list of top five supplements to increase sex drive, so they’re helpful for overall sexual health. It’s a good idea to check in with a practitioner, particularly one with knowledge of your individual health issues and medications, before taking anything. Here are some I recommend:
I never thought i could smile and be in a happy marriage again if not for the help of Dr salato. I got dr salato on his website https://drsalatosolutionte.wixsite.com/drsalato on the internet and i emailed him, and he got back to me with some encouraging words, he got me some herbs which i took for just 5 days and i began to feel the enlargement of my penis, and without surgery. This went on for a little period of about 14 days and to my surprise my wife keeps screaming that she love my big dick
Hypercholesterolemia (high cholesterol) is one of the main risk factors in the development of atherosclerosis, a condition that with the development of statins over the last 20 years has become more treatable, but not without consequences. Statins have been shown to reduce the incidence of cardiovascular events by 25–40%, yet this reduction is no big deal, especially considering that many patients need additional therapy to reach more optimal lipid levels and prevent cardiovascular events.
In the present study zinc caused an elevation of T. This showed an increase from 2.39 to 8.21 ng/dl after two weeks of zinc treatment. This elevated T level may have contributed to the increase in number of penile thrusting (from 26.5 to 52.8) observed. Supplementation with 459 μmol/day of zinc for three months, in marginally zinc deficient healthy elderly men, has been shown to increase the levels of serum T from 8.3 to 16 ng/dl.[25] Laboratory experiments indicate that the nitric oxide erectile pathway is T dependent.[26] Many studies using animal models have confirmed that T is important in modulating the central and peripheral regulation of erectile dysfunction. T deprivation has a negative impact on the structure of penile tissues and erectile nerves.[27] Thus, elevated T levels subsequent to zinc supplementation may increase the sexual competence via rigid and sustained erection. This may promote greater tactile stimulation of the penis due to increased contact with vagina.[25]
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:

If you can achieve erection on your own, but you then are unable to keep it while with your partner, it could be related to anxiety, stress, or any sort of relationship issue. There has been extensive research conducted into all potential contributors to erectile dysfunction, including increased use of Internet pornography, assuming that excessive use of internet pornography can change the way the brain perceives arousal, therefore changing the desired response. Dan Savage also explores this topic on his love and sex advice podcast, the Savage Lovecast. If your dysfunction is related to anxiety, stress, or relationship issues, it may be time to explore therapy with a sex-positive provider, or even meditation.
ICI therapy often produces a reliable erection, which comes down after 20-30 minutes or with climax. Since the ICI erection is not regulated by your penile nerves, you should not be surprised if the erection lasts after orgasm. The most common side effect of ICI therapy is a prolonged erection. Prolonged erections (>1 hour) can be reversed by a second injection (antidote) in the office.
Long considered an aphrodisiac by the Chinese, ginseng may do more than just rev your engine. A 2013 South Korean study found that taking the herb for just a few weeks improved guys’ performance in the bedroom, including helping them last longer before finishing. Meanwhile, a study in Spermatogenesis found that ginseng can also help make for harder, longer-lasting erections and improve testosterone levels, which in turn boosts libido. “Ginseng is a promising herbal therapy for ED because it helps promote relaxation of smooth muscle in the penis, increase dopamine levels in the brain, and increase pressure in the cavernosal nerves of the penis which helps nitric oxide synthesis,” Walker explains.
Many prostate problems, including cancer, are linked to zinc deficiency, and when the Chicago Center for the Study of Prostatic Diseases gave 50 to 100mg of zinc daily to patients suffering from infection of the prostate, 70 per cent of cases showed improvement. Zinc levels decline with age and men over fifty can fight impotency and prostate enlargement by taking zinc supplements.

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.

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.

Many prostate problems, including cancer, are linked to zinc deficiency, and when the Chicago Center for the Study of Prostatic Diseases gave 50 to 100mg of zinc daily to patients suffering from infection of the prostate, 70 per cent of cases showed improvement. Zinc levels decline with age and men over fifty can fight impotency and prostate enlargement by taking zinc supplements.
There’s some concern that supplements labeled as yohimbe contain different amounts of the active ingredient than the amount that’s listed. The FDA strictly regulates prescriptions containing yohimbine but not supplements. It can be difficult to determine exactly how much active yohimbine is in supplements due to how different growing and distributing variables affect the concentration. These variables can include: the exact type of yohimbe tree bark that is used, what part of the tree the bark is taken from, the maturity of the tree, how fresh the bark is, the processing techniques used to create supplements, and how the supplements are shipped/exported and stored. (16)
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.
An Italian study in 1994 on 63 patients with psychogenic impotence showed that yohimbine, the active ingredient in the inner bark of the Yohimbe tree, improves libido and sexual stimulation. Half of the patients were given 15mg orally of yohimbine and the antidepressant trazodone 50mg orally per day, the other half a placebo, over an 8-week period. Of the half that received the yohimbine, 71 percent had an increase in sexual desire, erectile function, and ejaculation, as compared with only 22 percent in the placebo group. Patients receiving the placebo then were given the yohimbine tablets over a new 8-week course and of that group, 74 percent showed improvement. After a 3- and 6-month follow-up, positive results were maintained in 58 percent of the patients. To me this is very notable, as the antidepressant trazodone is known to cause sexual dysfunction as a side effect.

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.
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.

Although there have been sufficient data on the relationship between ED and several wellrecognized risk factors which including aging, coronary artery disease, atherosclerosis, diabetes mellitus, dyslipidemia, high blood pressure, and pelvic surgeries, little attention has been paid by the urologists to the role of lifestyle factors in ED. However, accumulating data from basic science and clinical studies have determined a link between the occurrence of ED and a number of lifestyle factors, such as smoking, obesity, alcohol consumption, and lack of physical activity. The application of findings from animal and human studies to the clinical practice regarding the modification of lifestyle factors could help to improve ED as well as reducing the risks of developing cardiovascular diseases (14).

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]
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!
ED can be caused by a handful of things, but one thing’s for sure: You need a healthy supply of the neurotransmitter nitric oxide (NO) to get and maintain an erection. NO is produced in nerve tissue and helps jolt your Johnson by relaxing the smooth muscle so blood can fill the penis. After the initial release of NO, your body releases a cascade of chemicals—including more of the neurotransmitter—to help keep you hard and happy, according to a study in the Proceedings of the National Academy of Sciences.

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.
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