It’s important to note that high levels of zinc can reduce available copper in the body and affect iron levels. High levels of zinc can also interfere with different kinds of medications. Though it is estimated that 40 milligrams of zinc supplement are safe for men to take daily, there is no long-term research into the effects that this practice could yield.
Men, aged 40–80 y, were recruited from new consultations seen for erectile dysfunction at the Lahey Clinic Center for Sexual Function. Patients were screened by history and physical examination and by evaluation of nocturnal penile tumescence and rigidity with the RigiScan™ (Timm Medical Technologies, Inc., Minneapolis, USA). Candidates completed a sexual questionnaire and had morning blood tests for luteinizing hormone (LH), free testosterone, cortisol, dehydroepiandrosterone sulfate and androstenedione. Inclusion criteria included normal initial serum testosterone and prolactin levels and the presence of an organic cause of erectile dysfunction manifested by abnormal nocturnal tumescence and rigidity testing with the RigiScan™ monitor. Active smokers and men with concurrent major psychiatric problems were excluded. No other treatment for erectile dysfunction was permitted during the study. Yohimbine hydrochloride (supplied by Palisades Pharmaceuticals, Palisades, NJ, USA) was started at a dose of 5.4 mg three times a day (tid) for 4 weeks, after which the sex questionnaire was administered again and blood tests, nocturnal penile tumescence and rigidity testing were repeated. The dose of yohimbine then was increased to 10.8 mg tid for 4 additional weeks followed by a third administration of the sex questionnaire and final measurements of hormone levels and nocturnal penile tumescence and rigidity monitoring.
There is no evidence that mild or even moderate alcohol consumption is bad for erectile function, says Ira Sharlip, MD, a urology professor at the University of California San Francisco School of Medicine. But chronic heavy drinking can cause liver damage, nerve damage, and other conditions -- such as interfering with the normal balance of male sex hormone levels -- that can lead to ED.
The problem with this though is that there are a lot of websites that are claiming to have a specific exercise technique or perhaps very effective male enhancement products that can guarantee erectile dysfunction. Be careful not to fall for a male enhancement scam. Even though erectile dysfunction may be stressful or difficult to discuss about, there are proven and safe methods that can help you in dealing with it.
When stimulated by the nerves, the spongy tissue arranges itself in such a way that more blood can be stored in the penis. The veins running through the outer sheath of the penis then compress which stops the blood from leaving the penis. As the blood is stopped from flowing out, the penis fills with blood and stretches within the outer casing, giving an erection.

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.
In fact, dyslipidemia is commonly found in ED patients, and studies show that statins can help to improve the response of PDE5 inhibitors in those suffering from ED precisely because they improve atherosclerosis. Consequently, statins can be used as a treatment in patients with an unsatisfactory response to PDE5 inhibitors, yet there are problems with statins too, among them raised liver enzymes and muscle problems, some of which can be quite serious and even deadly (rhabdomylosis).
Our bodies are designed to be active and in motion. By keeping active and engaging in regular aerobic exercise, you increase the blood flow to your muscles, and your penis along the way. One of the most interesting things about increasing your blood flow is that it becomes a signal to your blood vessels to grow and get wider. It benefits your brain, your heart, and your erection. The principle of "use it or lose it" is the best advise one can follow. In fact, if you don't engage in sexual activity at least once or twice a week, it would be beneficial to masturbate. This not only helps with prostate health, but encourages the blood vessels that contribute to your erection to maintain their patency and flow. 
Vitamin B6 deficiency leads to irritability, numbness in the extremities, muscle weakness, fatigue, drowsiness, impaired mental activity, peripheral neuritis, seborrheic dermatitis, stomatitis, conjunctivitis, and, of course, impairment of sexual potency. Lack of this vitamin can be a result of long-term use of anti-tuberculosis drugs and chronic diseases of the gastrointestinal tract.
Over 18 million American men over 20 years old suffer from erectile dysfunction, a condition characterized by the inability to keep an erection. It’s a complex disorder brought on by a number of factors, but it’s almost always devastating for the man it affects — causing him to lose confidence in himself and different aspects of his life. The stress it causes can deteriorate relationships and lead to lost productivity at work. Health problems aren’t uncommon either. But there’s good news in all the bad; a new study finds exercise may be a simple way to get things going under the sheets again.

Aside from pelvic floor exercises, it has been found out that aerobic exercises also work in treating erectile dysfunction. This condition is often caused by problems related to blood flow to the penis. Diabetes, obesity, vascular disease as well as high cholesterol may affect blood flow. This results to erectile dysfunction. By adding some aerobic exercises to your routine, you can significantly enhance your overall male sexual health and may even remove the problem totally in the long run.
Some medications are changed and broken down by the liver. Yohimbe might decrease how quickly the liver breaks down some medications. Taking yohimbe along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking yohimbe talk to your healthcare provider if you take any medications that are changed by the liver.
There have been some studies to suggest that a placebo effect that improves ED may work for some men. One study found that men taking an oral placebo pill showed as much improvement in ED symptoms as men who took actual medication to improve ED. Conversely, men who were given therapeutic suggestions to improve ED did not see signs of symptom improvement.
Some medical self-help books make niacin sound like a panacea for health-conscious people with rising cholesterol levels and shrinking budgets. Because this B vitamin is cheap and sold over-the-counter at drug and health food stores, people see no reason to check with the doctor before tossing back a handful of pills. What they may not know is that the high doses (1,500-3,000 mg) needed to lower cholesterol levels can cause serious complications. (As a dietary supplement, 10-20 mg is usually recommended). To add to the confusion, niacin comes in two forms: immediate- and sustained-release preparations.
Anxiety. There is mixed evidence about the effectiveness of yohimbine, the active ingredient in yohimbe, for treating anxiety related to phobias. Some research suggests that it does not improve anxiety when combined with exposure-based therapy used to reduce fear of flying. However, other research suggests that taking yohimbine along with exposure-based therapy helps treat claustrophobia better than exposure-based therapy alone. The effect of yohimbe bark on anxiety is not clear.
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.
Whether you’re looking to bulk up, or are just concerned about having enough protein to keep your body strong and healthy, zinc is an absolute must have! When we eat protein, it gets broken down by the body into amino acids, and then resynthesized into the different proteins needed by the body, and zinc is a vital part of this process. So even if you are eating lots of protein, without zinc you won’t be able to use it properly!
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.
Pelvic floor PT is a proven and effective treatment for erectile dysfunction. A study in 2006 involved 146 men with mean age of 42 with pelvic pain; 92% of these men had sexual dysfunction.  Treatment consisted of trigger point release and relaxation training, which led to improvement in symptoms by 77-87% – it’s notable that kegels were not part of this study.
"The problem with alternative treatments for any medical problem, including erectile dysfunction, is that until you have about 20 well-controlled studies over several years, you really don't know what you are working with," cautions Richard Harris, MD, a urologist at Gottlieb Memorial Hospital, part of the Loyola University Health System in Chicago.

In the analysis of the study, the niacin group showed a significant increase in both IIEF-Q3 scores and IIEF-Q4 scores compared to the initial baseline values. While the placebo group also showed a significant increase in IIEF-Q3 scores (high hopes, no doubt), it did not for IIEF-Q4 scores. In other words, the “placebo effect” did not extend to maintaining erections. Also, when patients were stratified according to the baseline severity of ED, the patients with moderate and severe ED who received niacin showed a significant improvement in IIEF-Q3 scores (0.56 and 1.03, respectively) and IIEF-Q4 scores (0.56 and 0.84, respectively) compared with baseline values. These results were not significantly increased for the placebo group.
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.
Two years ago I took regular Niacine for about a year to lower LDL and increase HDL. I did not want to take Statins because of its side effects. I was being monitored by my Dr. because of the effect on liver enzymes. I took 1.5 gr together with Phytosterols. The treatment was effective and the only side effect were the flushes which I found could be eliminated by having 500 mg at the end of each of the 3 main meals. I stopped treatment for a year or so, but now the Dr. suggested I start taking Niacine. or Statins. I chose Niacine (Nicotine Acid) and started with 500 mgs for 3 days; increased it to 1000 mgs. for 4 more days, until I increased it to 500 mgs x 3 for a total of 1.5 grms/day taking 500 mgms/meal. I started noticing my gradual decrease in libido this time almost inmediately. I do not take any other medicines as such I'm definitely inclined to blame Niacine because I have taken Phytosterols for 3 years and my libido was fine. I'm a senior. Hope this will help!

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.

Associated risks/scrutiny: “A dose of yohimbine that’s too big could drop your blood pressure, cause dizziness, facial flushing and nausea,” warns Fratellone. Yohimbine and yohimbe bark may also increase heart rate and raise blood pressure. “No one should experiment with herbs without talking to their doctor,” reminds Fratellone. “If you’re taking Flomax and you start taking yohimbe, you’re going to dilate your penal vessels and you’ll pee more.” Other potential interactions between yohimbe and other drugs and herbs should be considered. Some of these combinations may be dangerous.
It is now thought that ED is part of the cardiovascular disease complex related to metabolic syndrome (MS). Although endothelial dysfunction and atherosclerosis are believed to be part of the main mechanisms for ED in patients with MS, other mechanisms account for ED in MS include androgen deficiency, drugs, the veno-occlusive mechanism, etc. Because dyslipidemia is one of the key risk factors for the development of endothelial dysfunction and atherosclerosis in MS patients, there is a close relationship between ED and dyslipidemia.
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.

Evidence from 5 randomized studies published in the years between 2004 and 2010, has demonstrated strong evidence that aerobic exercise can benefit people with arterogenic ED. These review results of this study build on and update the evidence from studies that concluded that concluded that exercise was beneficial for people with ED and cardiovascular disorders (25–27); on ED and obesity (18) and on normal subjects with ED (24). However, studies have shown common pathway for ED, cardiovascular (28 –30) and metabolic disorders (19, 31).
Due to its ability to inhibit actions of the sympathetic nervous system, yohimbe can help to bring blood pressure levels back to balance. This is is why it’s used to sometimes increase blood flow, such as to tissues of the reproductive organs.  Or, also why it’s used to treat hypotension (abnormally low blood pressure). It may also be helpful for stimulating nerves and treating fatigue or symptoms of depression.
Vidal and her team looked at self-reported physical activity among 300 men, and then categorized them into categories: sedentary, mildly active, moderately active, and highly active. These men also reported their levels of sexual function, including their ability to have an erection and orgasm, as well as the quality and frequency of their erections and overall sexual function.
medicines called alpha-blockers such as Hytrin (terazosin
HCl), Flomax (tamsulosin HCl), Cardura (doxazosin
mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl),
 Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin).
Alpha-blockers are sometimes prescribed for prostate
problems or high blood pressure. In some patients, the use
of Sildenafil with alpha-blockers can lead to a drop in blood pressure or to fainting
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