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.

The RigiScan™ portable home monitor recorded nocturnal penile tumescence and rigidity testing. The monitor's quantitative analysis software quantitates various parameters of tumescence and rigidity, which includes the area under the curve over time slept, reported as tumescence activity units and rigidity activity units. The reproducibility and accuracy of this technique have been reported.28 Baseline normal values were used as previously reported,29 Rigidity had to be at least 60% at the base and 50% at the tip and maintained for at least 10 min. At least half of the episodes had to meet these criteria, with a minimum of three or four episodes per night. Tumescence had to achieve a height of 3 cm at the base and 2 cm at the tip.

It is important that you exercise, not only to combat ED but also to maintain your general health. Any aerobic exercise such as running, cycling or swimming will be great for improving your overall health and fitness. These kinds of exercise improves your cardiovascular health, which is important to help you treat your ED. You may also find it helpful to review your general lifestyle and reduce factors which could be contributing to your ED, such as smoking, drinking alcohol and eating unhealthy foods.
Talk with your doctor about going to a counselor if psychological or emotional issues are affecting your ED. A counselor can teach you how to lower your anxiety or stress related to sex. Your counselor may suggest that you bring your partner to counseling sessions to learn how to support you. As you work on relieving your anxiety or stress, a doctor can focus on treating the physical causes of ED.
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.
You've probably heard of the old saying "use it or lose it". Your sex muscles are just like any other muscles. If you're not using them regularly (masturbation doesn't count) they will lose size and strength. This commonly happens as you age. Considering most people judge a healthy sex life to be 3-5 times per week, that's not a lot of use for these important muscle groups. Therefore, it's best to exercise the muscles which support a healthy sex life so you can enjoy sex well into your 80's.
Yes, niacin is good for erectile dysfunction. Vitamin B3 or Niacin acts as a powerful agent to improve the condition of erectile dysfunction and a research study conducted in a medical center of Hong Kong confirmed that Niacin supplementation has resulted in the increase of blood flow across the pelvic region in men. In addition, researchers have further confirmed that the Vitamin comes with the ability to unclog various harmful fats collected in the artery region.
Minor side effects associated with erectile dysfunction medications include indigestion, runny nose and skin flushes. Sildenafil may cause temporary changes in your vision, and vardenafil may cause muscle aches and back pain. More serious side effects include hearing loss and erections that last longer than four hours. If you have cardiovascular problems, including a history of heart attacks or strokes, high or low blood pressure or vision problems such as retinitis pigmentosa, it may prove unsafe for you to take sildenafil, vardenafil or tadalafil. These medications may also interact poorly with some antibiotics, blood thinners and medications to prevent seizures and heart rhythm disorders.

In a recent study, moderate-intensity exercise such as walking briskly and light cycling was shown to boost mood for up to 12 hours. Exercising every day might be best to lift your mood, but strive for at least 5 days a week. Another study showed exercise can improve your body image, regardless of body weight or shape. And feeling good about your body is a great start toward making the bedroom a happier place.
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."
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)
Handful of things can cause erectile dysfunction, but healthy vitamins supply for erection will make your sex life very soothing and romantic. Healthy blood vessels are necessary for good circulation, as blood is pumped around the body to carry nutrients to the cells. Vitamins can help the blood vessels to dilate or open so blood can fill the manhood. 

Clinically I have seen these results in doses of just 20 mg twice daily.   It is important to note that prolonged zinc supplementation can lead to lowered copper levels so it is not advisable to continue this therapy unless it is in a cyclical nature.  For those on long term zinc there are combination products with Zinc and Copper.   In cases where some prescriptions that lower zinc are given, like acid lowering meds, thiazide diuretics and ACE inhibitors, or in renal dialysis patients, this chronic monitoring of zinc may lead to longer term supplementation.


In a recent study, moderate-intensity exercise such as walking briskly and light cycling was shown to boost mood for up to 12 hours. Exercising every day might be best to lift your mood, but strive for at least 5 days a week. Another study showed exercise can improve your body image, regardless of body weight or shape. And feeling good about your body is a great start toward making the bedroom a happier place.
Saw palmetto. Saw palmetto comes from the fruit of a small palm tree. It has been used to treat symptoms in men with an enlarged prostate gland, such as difficulty urinating, and it has been recommended to treat ED caused by an enlarged prostate. However, several recent clinical trials did not show that saw palmetto works any better on an enlarged prostate than a placebo does. "There is no evidence that saw palmetto should be used to treat erectile dysfunction," says Dr. Gilbert. Like ginkgo biloba, saw palmetto can interact with some prescription medications.
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).


The main surgical treatment of ED involves insertion of a penile implant (also called penile prostheses). Because penile vascular surgery is not recommended for aging males who have failed oral PDE5 inhibitors, ICI or IU therapies, implants are the next step for these patients. Although placement of a penile implant is a surgery which carries risks, they have the highest rates of success and satisfaction among ED treatment options.
Consequently, this negatively affects sexual function. Finally, if you frequently suffer from stress, then Vitamin B2 deficiency surely takes place. And the symptoms of this deficiency include peeling lips, cracked lips, stomatitis, tongue inflammation, skin lesions resembling eczema, conjunctivitis, photophobia, lacrimation, and decrement in visual acuity.
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.)
If you can't take one of these oral medications, your physician may have you try Caverject (alprostadil for injection), a hormone that you inject into your penis using a fine needle, or Muse (alprostadil urogenital), a tiny suppository that you insert into the tip of the penis. Both of these will bring on an erection within five to 15 minutes without sexual stimulation.
In the end, the data from the Hong Kong study suggest that niacin alone can improve the erectile function of subjects with dyslipidemia suffering from ED. This is the first time this conclusion has appeared in the literature. Once again, the effect of niacin is clinically significant in those with moderate to severe ED. Further, because of the close relationship between ED and dyslipidemia, niacin could prove to be an important therapy for managing both conditions. Who knows? There may even be other benefits. Future studies will further refine the indications and benefits of niacin in patients with ED.

That’s no joke. Like every part of the body, the male repro system needs the right nutrients for optimal health, from function to fertility. Studies have isolated several nutrients that are particularly beneficial. You can get them through these best foods for your penis, or these best proteins for your penis, but we’ve broken them down here by nutrient in case you want to ensure you’re getting enough. (And if you do decide to go the supplement route, as always, talk to your doctor and never exceed recommended dosages.)
*all photos are models and not actual patients.If you are interested in a prescription product, Hims will assist in setting up a visit for you with an independent physician who will evaluate whether or not you are an appropriate candidate for the prescription product and if appropriate, may write you a prescription for the product which you can fill at the pharmacy of your choice.
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.
Suggested intake: “The problem with yohimbine is that you can’t regulate the amount in a dosage,” says Fratellone. “It all depends on what part of the tree it comes from, how it’s cultivated, how it’s exported, and so on. The amount of extract you get will vary.” FDA researchers analyzed a number of over-the-counter yohimbe bark products. They found that the supplements contained only seven percent or less of the amount of yohimbine that would be found in actual yohimbe bark, which suggests that they contained little or no yohimbe. However, the prescription form of yohimbine is strictly regulated by the FDA. It is approved only for the treatment of impotence, and is available in tablets and capsules. For erectile dysfunction, 5.4 to 10 milligrams three times daily has been studied and regarded as generally safe.
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.
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.
Poor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones. 
Many studies have been conducted on this topic; their results have been challenged by lack of controlled groups and non-randomization. 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.Non-randomized controlled trials, can detect associations between an intervention and an outcome. But they cannot rule out the possibility that the association was caused by a third factor linked to both intervention and outcome. Random allocation ensures no systematic differences between intervention groups in factors, known and unknown, that may affect outcome. Randomized controlled trials are the most rigorous way of determining whether a cause-effect relation exists between treatment and outcome and for assessing the cost effectiveness of a treatment (45, 22).
Research has shown that the same eating patterns that can cause heart attacks due to restricted blood flow in the coronary arteries can also impede blood flow to and within the penis. The blood flow is needed for the penis to become erect. Diets that include very few fruits and vegetables along with lots of fatty, fried, and processed foods can contribute to decreased blood circulation throughout the body.
If you suffer from premature ejaculation, erectile dysfunction or are unable to reach orgasm, it’s important that you reach a higher level of fitness than you currently have. This is also a requirement for you to become a healthier human being. These best exercises to improve sexual function are aimed at redeveloping your groups of muscles directly involved in the sexual act. Increasing the health of your sex muscles can naturally increase blood flow and can lead to improving your sexual performance.
Yohimbe is commonly taken to increase sexual excitement and to reduce sexual problems such as symptoms of erectile dysfunction (ED), also called impotence. Research shows that yohimbe may be capable of increasing blood flow to the penis or vagina. It also increases nerve impulses that play a role in orgasm. Due to how yohimbine affects blood vessels, it can cause relaxation of the penile tissue and engorgement of blood. This helps a man to maintain an erection. These effects are beneficial for both sexes when it comes to experiencing sexual satisfaction.
The key to all of this is the endothelium, the inner lining of blood vessels that helps blood flow smoothly. Regular exercise has been shown to improve the way the endothelium works. The endothelium lines the blood vessels in the heart and the penis, explains Dr. Hellstrom, but the blood vessels in the penis are about one-third the size of those in the heart. So if you fail to have erections due to vascular problems, that indicates that you’re at risk for heart problems as well.
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.
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).
For best results, men with ED take these pills about an hour or two before having sex. The drugs require normal nerve function to the penis. PDE5 inhibitors improve on normal erectile responses helping blood flow into the penis. Use these drugs as directed. About 7 out of 10 men do well and have better erections. Response rates are lower for Diabetics and cancer patients.

• Eliminate your bad habits: Bad lifestyle habits may take a toll on your body, making it harder for you to maintain your athletic performance, regulate your weight or treat sexual dysfunction. To keep your body in its best condition, quit your bad habits immediately — eliminate smoking, avoid excessive alcohol intake and cut down your late-night meals.


It's also important to remember that your mental health plays as much a part of your sexual ability as your physical health. Stress and other mental health concerns can cause or make erectile dysfunction worse. Minor health problems may slow your sexual response, but the accompanying anxiety that comes with the slow sexual response can shut things down entirely.
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.
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

Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), dextromethorphan, donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.
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Yohimbine significantly increased subjective measurements of sexual desire, sexual satisfaction, frequency of sexual contacts, and erection quality during sexual intercourse. Each subject also underwent a sleep study and researchers found that yohimbine also objectively increased the rigidity of erections while sleeping. [12] Yohimbine appears to alleviate both physical and psychological symptoms associated with ED.


The sunshine vitamin will brighten things up in the bedroom. In a recent study published in the Journal of Sexual Medicine, Italian researchers found that of 143 men with erectile dysfunction, 80% had less-than-optimal levels of D, and the men with severe ED had, on average, a 24% lower level of D than with a milder condition. They theorize that low levels of D damage blood vessels and lead to a shortage of nitric oxide.

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.

Erectile dysfunction (ED) is commonly called impotence. It’s a condition in which a man can’t achieve or maintain an erection during sexual performance. Symptoms may also include reduced sexual desire or libido. Your doctor is likely to diagnose you with ED if the condition lasts for more than a few weeks or months. ED affects as many as 30 million men in the United States.

Zinc affects different aspects of mammalian reproduction. Testicular disruption, impaired spermatogenesis and subsequent poor semen parameters are found in males with zinc deficiency. Testicular concentration of zinc was lower in male sheep fed with zinc deficient diets. The same animals showed smaller seminiferous tubules and less lumen development than the controls.[1] Similarly variable degrees of maturation arrest in different stages of spermatogenesis with reduced diameter of seminiferous tubules were noted when rats were fed with zinc deficient diets.[2] Zinc deficiency causes a reduction in the structural parameters of seminiferous tubules influences serum levels of testosterone (T) and prolactin (PRL) in rats.[3,4]
According to a study conducted by the University of the West of England, Bristol, pelvic floor exercises may be very effective in treating erectile problems. Many participants of the study, all of whom were men who had been experiencing erectile dysfunction for at least six months, reported a significant improvement of their condition within three months of training their pelvic floor. 
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.
A study published in May 2014 in The Journal of Sexual Medicine found that some men can reverse erectile dysfunction with healthy lifestyle changes, such as exercise, weight loss, a varied diet, and good sleep. The Australian researchers also showed that even if erectile dysfunction medication is required, it's likely to be more effective if you implement these healthy lifestyle changes.
So what causes erectile dysfunction?  Sometimes it is a circulation problem.  Sometimes it is a low testosterone issue.  Sometimes it is not.  Testosterone (T) supplementation can help ED and low libido in cases of low T and even if there is a normal T level at baseline, ED can be helped.  In cases where thyroid under or overactivity is causing T levels to be less than optimal.  Aging is also a problem as T levels drop after mid 20’s and as adipose tissue increases and aromatase enzyme conversion of T to Estrogen correspondingly increases.  This causes an unfavorable E:T ratio which equates to low T.

This African tree bark extract sends blood flow to the genitals, said herbalist Ed Smith, a founding member of the American Herbalists Guild, who adds a warning that Yohimbe can cause nervousness and raise already-existing high blood pressure (so avoid taking it if you have heart or kidney disease), and can also negatively interact with antidepressants.


Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), dextromethorphan, donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.
Certain drugs can also deplete zinc levels, including: ACE inhibitors, thiazide diuretics and acid-reducing drugs like Prliosec and Pepcid. Eating a high grain diet in which the grains have not been pre-soaked or sprouted, can also inhibit the uptake of zinc in the body, due to the phytic acid content. Soaking or sprouting grains and rinsing off the soak-water prior to cooking significantly reduces the phytic acid content in grains.
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