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.
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.
I am so grateful Jacqui, I am seeing my girlfriend tomorrow and feel like the problem is pretty much gone! I can't believe it I thought I was broken!!! I have searched on sooo many sites and got so much bad advice and feel like posting the link of your site on all of those others. As this is a horrible problem and your method will work for me - so guys need to know this! Many, many thanks for the help.
With an inflatable implant, fluid-filled cylinders are placed lengthwise in the penis. Tubing joins these cylinders to a pump placed inside the scrotum (between the testicles). When the pump is engaged, pressure in the cylinders inflate the penis and makes it stiff. Inflatable implants make a normal looking erection and are natural feeling for your partner. Your surgeon may suggest a lubricant for your partner. With the implant, men can control firmness and, sometimes, the size of the erection. Implants allows a couple to be spontaneously intimate. There is generally no change to a man's feeling or orgasm.
With an inflatable implant, fluid-filled cylinders are placed lengthwise in the penis. Tubing joins these cylinders to a pump placed inside the scrotum (between the testicles). When the pump is engaged, pressure in the cylinders inflate the penis and makes it stiff. Inflatable implants make a normal looking erection and are natural feeling for your partner. Your surgeon may suggest a lubricant for your partner. With the implant, men can control firmness and, sometimes, the size of the erection. Implants allows a couple to be spontaneously intimate. There is generally no change to a man's feeling or orgasm.
A study published in the journal Fertility and Sterility that analyzed the effect of various fruit and vegetables on sperm quality discovered carrots had the best all-around results on sperm count and motility—a term used to describe the ability of sperm to swim towards an egg. Men who ate the most carrots saw improved sperm performance by 6.5 to 8 percent. The Harvard researchers attribute the boost to carotenoids, powerful antioxidative compounds in carrots that help the body make vitamin A.

Several studies (15–17) have shown an inverse relationship between physical activity levels and biomarkers of inflammation in both the healthy individuals and subjects with cardiovascular condition. Studies (18–21) have also reported the role of exercise in the management of erectile dysfunction. The majority of these studies are subjective, retrospective case series and non randomized non controlled studies. However, randomized controlled trials (RCTs) are generally accepted as the most valid method for determining the efficacy of a therapeutic intervention, because the biases associated with other experimental designs can be avoided (22). Therefore, the purpose of the present Meta analysis study was to determine the role and effect of aerobic exercise in the management of erectile dysfunction in randomized controlled trials.
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.
The Enlightenment proved itself to be an intellectual movement in 18th Century Europe that mobilized the power of reason to advance knowledge and reform society. It promoted intellectual transaction and opposed intolerance and abuses by both Church and State. This constituted a challenge to and disparagement of the heavy-handedness of the State. Thus, society was lifted and enlightened.
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.
Scientists have found a consistent link between maintaining a healthy weight and avoiding erectile problems. In one Italian study, researchers followed 110 obese men experiencing ED over the course of two years. Of the participants that lost the most weight, 31% ceased to suffer from ED. In the group that lost the least weight, only 5% of the men saw an improvement.
This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
But in this case, zinc is much harder to absorb. This explains a decrease in testosterone levels in vegetarians. Slippery jack mushrooms, button mushrooms, beef liver, and fish are also rich in zinc. They are followed by breadstuffs, egg yolk, rabbit, chicken, beans, tea, and cocoa. In addition, zinc is found in onions, garlic, and rice. And a very small amount of zinc is available in fruits, vegetables, and milk.
Responders tended to have consistently higher scores compared with nonresponders. For nonresponders, none of the scores was significantly different when comparing baseline scores with either of the yohimbine doses. However, a trend toward an improved total questionnaire score was noted from baseline to the 5.4 mg tid dose (P=0.083). For responders, a significant increase in the Florida Sexual History Questionnaire total score was observed from baseline to the time the 5.4-mg tid dose was administered (P=0.021). A trend closely approaching statistical significance (P=0.055) was noted from baseline to the administration of the 10.8 mg tid dose of yohimbine. Inspection of changes in the individual items revealed that responders reported significantly greater frequency of vaginal penetration with both the 5.4- and 10.8-mg doses of yohimbine tid compared with baseline (P=0.010 and P=0.010, respectively). Participants also noted less difficulty obtaining an erection for sexual intercourse while taking 10.8 mg of the drug compared with baseline (P=0.011). Responders reported having significantly less difficulty maintaining an erection for sexual intercourse compared with baseline with both the 5.4-mg tid dose (P=0.049) and the 10.8-mg tid dose (P<0.001). Responders also reported significantly greater penile firmness and rigidity before intercourse or masturbation in both treatment conditions compared with baseline (P=0.02 for the 5.4-mg tid dose and P=0.013 for the 10.8-mg tid dose).
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!
ICI Alprostadil may be used as a mixture with two other drugs to treat ED. This combination therapy called "bimix or trimix" is stronger than alprostadil alone and has become standard treatment for ED. Only the Alprostadil ingredient is FDA approved for ED. The amount of each drug used can be changed based on the severity of your ED, by an experienced health professional. You will be trained by your health professional on how to inject, how much to inject and how to safely raise the drug's dosage if necessary.

When given orally, yohimbine reaches peak levels in 10–15 min, and the half-life is 0.6 h. The efficacy of yohimbine in sexual function has been questioned, perhaps because of early questionable multidrug preparations.10,11 Yohimbine has been shown to have some effect on psychologic erectile dysfunction12,13 and in reversing fluoxetine-induced sexual dysfunction.14


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.

Exercise lowers blood pressure – a consistently high blood pressure (hypertension) can damage your arteries and cause them to harden, limiting the flow of blood to the penis and leading to cardiovascular problems. Exercise works to reduce the force required to pump blood around your body, protecting your artery linings as a result. You should aim to have a blood pressure less than 140/90mm Hg.
The art of acupuncture has become the new treatment for everything from back pain, depression, and even ED. Impotence could be more of a state of mind, and acupuncture may help. Through this alternative therapy, fine needles are placed in various parts of the body to relieve pain or stress. Although there are many mixed studies for acupuncture and ED, many tend to confirm positive results. A 1999 study found acupuncture improved the quality of erection and even restored sexual activity in 39 percent of participants.
These medications don’t work for everyone but they are easy to use and work for around 60% of people who try them. They work by making it easier to get an erection by reducing the effect of (inhibiting) the chemical PDE-5. This chemical is used in the body to make sure there isn’t too much blood in the penis during an erection, but if you have erectile dysfunction then this chemical ends up over-compensating.

"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.
For Men: Soy is terrible for the male sex drive as the phytoestrogens build up to unnatural levels much too quickly. In fact, an ex boyfriend and I experimented with this when he decided to become vegan. He ate and drank soy products for a month and by the end of that time he had zero libido. Within two weeks of stopping all soy, he was back to normal.
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.
Eggs a supplement? Yup. Testosterone is derived from cholesterol, and eggs are the healthiest way to ensure you’re getting enough of the good kind (LDL cholesterol). Plus, eggs are rich in choline, a powerful natural chemical that not only burns fat but can help set your pants afire. Choline triggers the production of nitric oxide (NO), which relaxes arteries in the penis and enables blood flow to do its thing. Choline is a precursor to acetylcholine, a neurotransmitter which controls sexual behavior through its activity in the brain; having a higher level of AcH has been associated with more frequent sex and more intense, longer orgasms. And that’s not all: Check out these things that happen to your body when you eat eggs!
Researchers in London set out to find out if the claims about Yohimbe were true. Could the bark of a tree actually increase libido and improve impotence? They performed a double-blind trial using yohimbine for the treatment of erection inadequacy. Men, aged 18-70 years, seeking help for the secondary erection inadequacy for 6 months or longer, took part in the trial. None of the participants had any serious psychiatric disease, hypertension or liver insufficiency. Half of the men were given 5.4mg of yohimbine, the other half a placebo, for 8 weeks. Patients were assessed in 4-week intervals. After 8 weeks of treatment, 37 percent said they had good erections, as compared to only 13% in the placebo group. After the 8-week treatment, the placebo group was given the yohimbine as well, results for improved stimulated erection after the second 8-week trial increased to a total of 42 percent overall.
There are risks to prosthetic surgery and patients are counselled before the procedure. If there is a post-operative infection, the implant will likely be removed. The devices are reliable, but in the case of mechanical malfunction, the device or a part of the device will need to be replaced surgically. If a penile prosthesis is removed, other non-surgical treatments may no longer work.

The Florida Sexual History Questionnaire, a 20-item questionnaire that assesses interest and desire for sexual activity, sexual development, current sexual behaviors, and satisfaction with current sexual activity, was used to assess male sexual dysfunction. Individuals responded to each question by choosing one of six ordinally scaled response categories, with higher scores representing better functioning. Scores on the Florida Sexual History Questionnaire have been shown to significantly discriminate between men with and without impotence25 and between men with primary organic and primary psychogenic erectile dysfunction.26 According to Geisser et al,25 the Florida Sexual History Questionnaire has high internal consistency as well as split-half reliability. Chronbach's alpha has been reported to be as high as 0.90, and Spearman Brown's coefficient is reported to be 0.86.


You may know horny goat weed from its omnipresence behind the counter at your local convenience store, but this traditional Chinese formula is less sketchy than it sounds. Used for centuries to treat low libido and erectile dysfunction, the herb’s potential efficacy was show in a 2010 study published in the Journal of Sexual Medicine. Researchers who fed the supplement to rats found they had improved erectile function; another study showed that the supplement can block a natural chemical that wilts erections. (Just be warned: Viagra was found to be 80 times more powerful.)
Men can judge themselves pretty harshly when it comes to their performance in between the sheets. The unsettling fear of not being able to rise to the occasion becomes a reccurring nightmare for men that is often equated with failure, loss of dignity, and masculinity. If you suffer from erectile dysfunction (ED), don’t be so hard on yourself, since impotence can almost always be improved with treatment, without having to rely on Viagra or other medications. Whether you suffer from ED, or hope to prevent the condition, here are six tips to overcome impotence without the side effects of the little blue pill.
A variety of personal habits and lifestyle choices have been linked to ED. In some ways, this is a good thing, since habits can be broken and choices reconsidered. What's more, many of the lifestyle factors that contribute to sexual problems are ones that affect overall health and well-being, both physical and mental. Addressing these factors, therefore, can have benefits beyond improving erectile dysfunction.
When a man becomes sexually excited, muscles in their penis relax. This relaxation allows for increased blood flow through the penile arteries. This blood fills two chambers inside the penis called the corpora cavernosa. As the chambers fill with blood, the penis grows rigid. Erection ends when the muscles contract and the accumulated blood can flow out through the penile veins.
The final study we will be examining in this article took a novel approach to by dosing 16 healthy male subjects with 7.7 milligrams of yohimbine tartrate and 6 grams of L-arginine glutamate and comparing it to a placebo. Depending on their group each subject was randomly assigned to consume the placebo one week and the novel compound the other week.

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.
In the 1700s, pellagra was an endemic disease in northern Italy—which had not been known until maize (corn) was introduced from America. Italy gave the disease the name, “pelle agra” (pelle means skin; agra means rough). Casal had observed that patients with pellagra were all poor, subsisted mainly on maize, and rarely ate fresh meat. Because pellagra outbreaks occurred in regions of Europe where maize was a dominant food crop, the belief was that maize either carried a toxic substance or was a carrier of disease. When it was later noted that there were few pellagra outbreaks in Mesoamerica, where maize is a major food crop (and is processed), it was considered that the causes of pellagra may be due to factors other than toxins.
Long prescribed for women who want to restore muscle tone after childbirth, pelvic floor exercises, also known as Kegel exercises, can benefit men significantly too. A study by researchers at the University of West of England in Bristol showed that pelvic floor exercises can help men with erectile dysfunction and premature ejaculation. Furthermore, experts think these exercises can make orgasms stronger. Once learned, pelvic floor exercises can be done any time, even while doing other things.
Obesity is a state of chronic oxidative stress and inflammation (38). The increased oxidative stress associated with obesity may increase free radical formation, which could quench and deactivate nitric oxide, reducing its availability for target cells. Weight loss programs with dietary modifications and increased physical activity may lead to reduced oxidative stress associated with improved nitric oxide availability (39). As impaired nitric oxide activity appears to play an important role in the pathogenesis of erectile dysfunction (40), improved nitric oxide availability associated with weight loss may be implicated in the amelioration of erectile function in our series of obese men. A reduced CRP level due to sustained lifestyle changes may have contributed to amelioration of erectile function after treatment. Levels of CRP correlate significantly with reduced nitric oxide availability (41) and increasing severity of penile vascular disease as measured by penile Doppler (42). Moreover, consistent findings support a predictive role of CRP and IL-6 for cardiovascular events in different populations (43), while IL-8 is a potent chemoattractant (44).

3. Men With Bad Lipid Readings.  One study examined men with both erectile dysfunction and "dyslipidemia."  Dyslipidemia is medical speak for bad HDL, LDL, triglyceride or some combination of the three.  They gave these men 1.5 grams of niacin, which is a megadosed amount, and is a favorite of Dr. Davis.  (See my  Review of Track Your Plaque for Dr. Davis' approach to plaque regression.) Besides the above listed benefits, niacin will also a) lower triglycerides, b) boost HDL, c) increase particle size and d) decrease LDL particle counts.  All of these are very anti-atherosclerosis and great for your arteries. 
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.
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Vitamin B12 can be found only in the products of animal origin. That is, the greatest amount of this vitamin is available in by-products (liver, kidneys, and heart). The other vitamin B12 rich foods include cheese, seafood (crabs, salmon fish, and sardines), meat, and poultry. Vitamin B12 deficiency declares itself by diarrhea, decreased appetite, tingling tongue, burning tongue, low stomach acid, altered skin sensation, and impairment of sensation in the extremity muscles.
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.
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.
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.
A study of 23 individuals found that a dose of 0.4mg/kg of yohimbine not only increased norepinephrine in the blood, blood pressure, and heart rate, but it also increases impulsive response rates. These response rates are measured by the number of impulsive errors, response biases, and reaction times on an immediate memory task. [10] While yohimbine may improve your reaction time it may also encourage you to act irrationally.

The prolongation of ejaculatory latency may be beneficial when present with unimpaired arousability, penile erection and sex vigor. The ejaculatory latency can also be prolonged due to some disorders in the neuroendocrine or reproductive system.[24] But the duration of zinc supplementation in our study was only two weeks which is not long enough to have an impact on the neuroendocrine or reproductive system.
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.
Nocturnal penile tumescence and rigidity monitoring using tumescence and rigidity activity units measure the area under the curve of activity divided by the time slept so that varying sleep times may be compared. All four parameters of base and tip tumescence and rigidity rose more in responders than in nonresponders (Table 5). Most changes showed either a trend toward significance or achieved statistical significance. Baseline tip rigidity activity units and tip tumescence activity unit scores differed significantly between groups (P=0.038 and P=0.026, respectively). In fact, nearly all of the baseline values were higher in the responders compared with the nonresponders. Responder tip tumescence activity unit scores increased steadily, whereas nonresponder scores dropped negligibly with the 10.8 mg tid dose. Responders had a significantly higher final score while taking the 10.8-mg dose (P=0.010). Responder tip rigidity activity unit scores also increased steadily, whereas nonresponder scores increased at the second dose, then fell again at the final dose. The mean tip rigidity activity unit score of the responders was significantly higher than that of the nonresponders with the 5.4-mg tid dose (P=0.011). The final scores of the responders were almost twice those of the nonresponders as well (significant where P=0.041). Base rigidity activity unit scores did not differ significantly between the two groups, although the increased responder scores with the initial dose of yohimbine was greater than that of the nonresponders (trend where P=0.065). Finally, base tumescence activity unit scores of the responders who were taking high doses of yohimbine were significantly higher (P=0.009).

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