We have presented objective evidence that yohimbine has a positive effect in men with organic erectile dysfunction. This is contrary to the blanket statement of the American Urological Association in their clinical guidelines for erectile dysfunction, which states: ‘Based on the data to date, yohimbine does not appear to be effective for erectile dysfunction and, thus, it should not be recommended as treatment for the standard patient.’17 Our data strongly suggest that yohimbine treatment should be revisited. Our study was observational with dose-escalation just to see if there was any rationale to expect any effect in men with organic erectile dysfunction, especially in men who do not have the risk factor of tobacco abuse. The next step would be a double-blind, placebo-controlled study using yohimbine in smokers vs non-smokers to verify the current observation. We believe that our data justify such a trial. Yohimbine will never be a first-line drug for erectile dysfunction, but may be useful in subsets of men with mild disease or few risk factors. Yohimbine might also be useful in combination therapy with other treatment modalities such as sildenafil and intraurethral alprostadil, when they do not produce adequate effects alone, as has already been shown with naloxone39 or trazedone.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.
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!
Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).
Testosterone levels did not differ statistically in the treatment groups and did not change during treatment with yohimbine. The levels of dehydroepiandrosterone and free testosterone tended to be higher in the responder group, but the levels in both groups were well into the age-adjusted normal ranges. Androgens play a part in peripheral erectile activity, but they are not necessary for the central arousal stimulation of yohimbine,36 in which norepinephrine release acts as an inhibitor antagonist.2 Peripheral sympathetic stimulation also occurs37 but less than its adrenergic antagonistic activity. These peripheral effects are prompting the search for new alpha-2 adrenergic antagonists38
Kegel exercises benefits a lot of men. In particular, they also help in strengthening the bulbocavernosus muscle. This very important muscle performs three types of roles. One it allows the penis to grow and be engorged with blood during erection. Second, it pumps while ejaculation, and third, it helps in emptying the urethra right after urination.
Take note that you may not be able to complete a series of about 10 kegel exercises on your first try. This is just fine. Just do what you can, and gradually work on more kegel exercises until you reach 10 to 20 kegels, up to three times in a day. When performing these exercises, avoid holding your breath, or pushing your stomach, thigh muscles, or buttocks in. It would be helpful if you relax after every count of five. You may also challenge yourself by alternating between long and short squeezes.
Psychosocial problems are important and may cause erectile dysfunction by themselves or together with other causes of erectile dysfunction, such as diabetes and heart disease. Relationships are complicated and many factors cause tensions, which can affect sexual relations. For some men, these problems can become ongoing and it can help to talk through the issue with a skilled counsellor. It is important to know that the longer erectile dysfunction is left untreated, the greater the effect on relationships. This is another reason why early treatment of erectile dysfunction is important.
In the New World, maize was traditionally treated with lime, an alkali now shown to make niacin nutritionally available and thereby reducing the chance of developing pellagra.1 However, when in the 18th century corn cultivation was adopted worldwide, treatment with lime was not accepted because the benefit was not understood. Thus in the New World, often heavily dependent on corn, cultivators rarely suffered from pellagra, which became common only when corn became a staple that was eaten without the traditional treatment. Of interest, if maize is not so processed, it is a poor source of tryptophan as well as niacin.
I was impressed with the questionnaire to make sure the meds I requested were right for me and the follow up email from the prescribing doctor to see if I needed any support. The meds came promptly, were well packaged and are comfortably in date - I thought they might be very near their sell by date but I was wrong to be suspicious. If I ever need this service again I wouldn't hesitate.
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.
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.
This is one B team you want to get on pronto: A recent report from Harvard University highlighted a study that has linked low levels of B12 to erectile dysfunction. A causal link hasn’t been nailed down, but the B vitamin is used by every system in the body, particularly in cell metabolism and the production of blood — two essential factors in getting and keeping a quality erection.
Antioxidants boost nitric oxide production and prevent NO breakdown. Ascorbic acid has direct effects on the bioactivity of NO, and augments NO production in a variety of body processes. The effects are actually synergistic with Vitamin E. Both vitamins are not usually measured, and a reasonable dose of Vitamin C is 500 to 1,000 mg daily. Vitamin E supplementation should be limited to <400 IU per day because of potential adverse long-term health effects of higher doses.
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.
Although you should steer clear of supplements advertised online, research shows certain vitamins and herbs can help ED. They may help improve the health of your blood vessels, increase blood flow to the penis, and boost erectile function. If other treatments have failed, you’re not a candidate for ED medications, or you’re looking for a more natural approach, ask your doctor whether these supplements could be right for you. Here are three to discuss with your doctor:
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.
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.
Aerobic exercise — which means "with oxygen" — consists of continuous, repetitive movements that increase your heart rate and get healthy oxygen into all your muscles by increasing blood flow that supports the heart and blood vessels (and in turn, prevents ED). In fact, research suggests that regular aerobic exercise can lower the risk for erectile dysfunction by about 40 percent.
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.
Niacin is another class of lipid-lowering agents, about which research dates back at least 55 years.2 Not only does niacin lower low-density lipoprotein (LDL-C, the “bad” cholesterol), total cholesterol, and triglycerides, it increases HDL-cholesterol (HDL-C, the “good” cholesterol) by inhibition of lipolysis in adipose tissue, which eventually leads to improvement in all lipid parameters. Furthermore, there are studies suggesting that niacin can improve the clinical outcome in cardiovascular disease, and that it may lead to the regression of atherosclerotic plaque. Dyslipidemia is closely related to erectile dysfunction (ED) and evidence has shown that statins can improve erectile function. However, the potential role of that other lipid-lowering agent, niacin, hasn’t been known until now.
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:
Nitric oxide is made internally from L-arginine, which is an amino acid found in red meat, poultry, fish, and dairy products. In other words, L-arginine is the building block for nitric oxide, which is essential for erections. A lack of one can lead to a lack of the other. However, there’s a problem when it comes to treating L-arginine deficiency with supplements.