Even at the higher doses of yohimbine, no changes in blood pressure or pulse were noted. This agent would appear to be safe in men with medically controlled hypertension. There was an increase in the morning cortisol levels in all men; the value was higher but not significantly so in responders. Telöken et al18 reported a high percentage (80%) of adverse events, but these authors administered a large dose (100 mg) of yohimbine. A toxic overdose of 200 mg produced only tachycardia, elevated blood pressure and anxiety of brief duration.33 Even direct intravenous dosing of yohimbine raised the mean arterial blood pressure by 12%,34 Goldstein et al35 systematically administered yohimbine and noted large hemodynamic and norepinephrine responses in both normal and hypertensive men; only the men who had a history of anxiety, depression, or other psychopathologic factors had symptoms. Oral administration of yohimbine at standard doses or even four tablets (21.6 mg) at a time has had no effect on blood pressure.4 Elevated blood pressure and heart rate were recorded when eight tablets (43.2 mg) were given at one time.3

Using the protocol of a clinical randomized placebo-controlled parallel-group trial, the study also took place at the University of Hong Kong. One hundred sixty male patients with ED and dyslipidemia were randomized into two groups receiving either up to 1,500 mg of oral niacin daily or placebo for 12 weeks. Using questions from the International Index of Erectile Function (IIEF, particularly questions Q3 and Q4), the primary outcome was improvement in erectile function. Q3 ranked “frequency of penetration,” while Q4 ranked “frequency of maintained erections after penetration.” Other outcome measurements included the total IIEF score, IIEF-erectile function domain, and Sexual Health Inventory for Men (SHIM) score.
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.
Even at the higher doses of yohimbine, no changes in blood pressure or pulse were noted. This agent would appear to be safe in men with medically controlled hypertension. There was an increase in the morning cortisol levels in all men; the value was higher but not significantly so in responders. Telöken et al18 reported a high percentage (80%) of adverse events, but these authors administered a large dose (100 mg) of yohimbine. A toxic overdose of 200 mg produced only tachycardia, elevated blood pressure and anxiety of brief duration.33 Even direct intravenous dosing of yohimbine raised the mean arterial blood pressure by 12%,34 Goldstein et al35 systematically administered yohimbine and noted large hemodynamic and norepinephrine responses in both normal and hypertensive men; only the men who had a history of anxiety, depression, or other psychopathologic factors had symptoms. Oral administration of yohimbine at standard doses or even four tablets (21.6 mg) at a time has had no effect on blood pressure.4 Elevated blood pressure and heart rate were recorded when eight tablets (43.2 mg) were given at one time.3
Hypovitaminosis may occur due to adherence to a monotonous diet that implies refined grain products’ eating; excessive consumption of carbohydrates and proteins; chronic alcoholism; abuse of beer; sufficient and long-term consumption of raw fish (carp and herring); heavy physical work and nervous tension; exposure to heat or cold; chronic bowel disorders; diabetes; and thyrotoxicosis. The symptoms of vitamin B1 deficiency include decreased appetite, nausea, constipation, headaches, irritability, memory loss, peripheral polyneuritis, tachycardia, labored breathing, precordialgia, and muscle weakness.

To maximize efficacy, you should consume this stack in a fasted or semi-fasted state and at least 6 hours before bedtime. This stack is going to significantly increase your heart rate and blood pressure so be watch out for overexertion if you choose to take the ECY stack immediately before an intense weightlifting session. Some users also choose to alternate consuming EC and EY to obtain some of the positive effects without being overstimulated.

In a 2005 study, three months of twice-daily sets of kegel exercises combined with biofeedback and advice on lifestyle changes, such as quitting smoking, losing weight, and limiting alcohol, worked far better than just giving the participants advice. “Wearing tight pants will affect impotence along with some other medical conditions like diabetes and heart disease,” which can also affect a man’s degree of impotence, Dr. Jennifer Burns, specializing in family practice with an emphasis on gastrointestinal health at the BienEtre Center, told Medical Daily.

In addition to lowering low-density and total cholesterol along with triglycerides, increasing high-density lipoprotein cholesterol (HDL-C) has become one of the principal objectives for treating hyperlipidemia. Considerable evidence has shown that even a minor improvement in HDL-C levels may significantly reduce cardiovascular risk. For example, it has been found that an increase of 1 mg/dl in HDL-C levels results in a parallel reduction in coronary artery disease risk by 2% in men and 3% in women. Moreover, HDL-C helps to transport oxidized cholesterol from peripheral tissues where it instigates atherosclerosis to the liver for excretion. Furthermore, HDL-C has potential anti-inflammatory, anti-thrombotic and anti-oxidant effects.
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.

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Because cholesterol is a building block for testosterone, drugs that interfere with cholesterol production can lower levels of this hormone (Journal of Sexual Medicine, April, 2010). French and Dutch researchers have reported that decreased libido and erectile dysfunction may be associated with statin-type drugs (British Journal of Clinical Pharmacology, Sept. 2004; Drug Safety, July, 2009).
A number of nonprescription products claim to be herbal forms of Viagra. Some of these products contain unknown amounts of ingredients similar to those in prescription medications, which can cause dangerous side effects. Some actually contain the real drug, which should be given by prescription only. Although the Food and Drug Administration has banned many of these products, some potentially dangerous erectile dysfunction remedies remain on the market.

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.

Various hormone levels were monitored during therapy, and it did not appear that there were major changes in the group as a whole (Table 2). Cortisol levels rose significantly from baseline to the first dose of yohimbine. When the hormone levels were evaluated in responders vs nonresponders (Table 3), slight differences were noted. Free testosterone levels were higher at baseline in the responders but did not increase significantly with the higher doses of yohimbine. Dehydroepiandrosterone sulfate levels were not significantly higher at baseline in the responders, and they did not change with the higher dose of yohimbine. Cortisol levels appeared to increase in both groups with increased doses of yohimbine, significantly more so in responders than in nonresponders (P=0.03).

How it works: Magnesium makes it harder for your testosterone to bind onto proteins and allows for more of it to remain “free” in your bloodstream – which is exactly how you want it to be for a higher sex drive. Higher levels of free testosterone makes for more desire. Magnesium also combats anxiety and prevents depressive feelings, helping you enjoy yourself more.
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.
So, in establishing physiology, pharmacology, clinical results and safety, zinc is a good choice when you look at cost and side effect profile as well as ease of availability and interaction profile with other meds and other medical conditions.  Having said all of this, there is no bulletproof evidence out there guaranteeing that increasing your zinc consumption either in food or via a supplement will improve ED or increase libido.  Even if a patient experiences an increase in testosterone from such a supplementation, this is not a certain gateway to resolution of theses symptoms as there is more to it than just one hormone level.  However for those that are experiencing problems in these areas, it is certainly worth a try for them.  The patient should be mindful however that supplements should be treated like any other medication and trying to increase your testosterone shouldn’t be done without consultation with your doctor and pharmacist.  You should also check for any interactions with any meds or medical conditions before trying any supplement as well.
Yohimbine. This chemical is found in the bark of an African tree called yohimbe. It has been used as a male aphrodisiac in Africa, and under medical supervision it has been used as a prescription drug to treat ED. Supplements made from yohimbe bark are also available without a prescription, but they can be life-threatening if used at high doses, according to the Natural Medicines Comprehensive Database. The supplement can interact in a harmful way with certain drugs, such as blood pressure medications, and should be avoided by anyone with liver, kidney, heart, or diabetes problems or problems with anxiety or depression. Like DHEA, yohimbine should not be taken without a doctor's supervision.
The phrase “penis exercise” actually refers to exercises known as pelvic floor or Kegel exercises, in which a man focuses on strengthening the muscles that control the flow of urine and ejaculation. These exercises are often recommended to men who are recovering from prostate cancer treatment, have problems with ejaculation, or have a hard time holding their urine, but they do not appear to help erectile dysfunction.
How it works: Rhodiola works in supporting our adrenal glands by preventing the breakdown of too much dopamine and serotonin during stressful times, leaving enough for us to remain buoyant and energized. What’s extra fun about Rhodiola is that it works fast – in 30 minutes – to change your energy levels and focus – so pop one before you think you want to get frisky.

In fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.


One of the main actions of yohimbe bark is alpha-2 antagonism (this is why it’s also sometimes called an “alpha-2 blocker”). This means that it can impact sympathetic nervous system activity and increase the release of adrenaline (or noradrenaline). This is because it blocks alpha-2 receptors in the brain stem. (4) Other types of alpha-2 agonists medications work in a similar way. They affect the central nervous system by altering release of certain neurotransmitters and dilating blood vessels. This increases alertness, circulation and other physiological processes.

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.
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.

There are so many potential reasons a man might develop erectile dysfunction (ED), it's nearly impossible to generalize the best ways to treat it. What works for one man may not work for another simply because they are having problems for different reasons. That said, it may encouraging to hear that there are a variety of options that may be considered, from psychological counseling to lifestyle changes, medications to treatments and devices.

Could the bark of a tree actually increase libido and improve impotence? Well yes it can… Yohimbe bark (Pausinystalia yohimbe), one of the most popular herbal remedies for male sexual dysfunction, has been shown in studies to increase blood flow to the genitals of both men and women, proving to be helpful for those with low libido. Though Yohimbe can be used by women, its actions have been shown to be extremely supportive for men experiencing erectile dysfunction due to stress or as a side effect of physiological health issues.


Selenium, found in Brazil nuts, liver and oysters, is a trace mineral that plays an important role in hormone health. You only need a tiny bit for healthy sperm, but a tiny deficiency can be catastrophic for reproductive health. In one study, men who had lower testosterone and were infertile also had significantly lower selenium levels than the fertile group. Supplementing with the mineral improved chances of successful conception by 56 percent. And a second British Journal of Urology study that included 69 infertile men with low levels of the mineral, found selenium supplementation could significantly improve sub-par sperm motility associated with testosterone deficiency. Check out these 7 Testosterone-Boosting Foods!
Andrew McCullough, MD, associate professor of clinical urology and director, male sexual health program, New York University Langone Medical Center. Lecturer: Auxillium. Research grant: Pfizer. Data safety monitoring board: Pfizer. Consultant: Slate Pharmaceuticals. Clinical trials: Warner Chilcott, Vivus, Lilly, Bayer-GSK, ICOS, Timm, Schering Plough, Aeterna.

Besides, niacin’s beneficial effects became more evident when the Hong Kong study researchers excluded those already using statin therapy. If there is an overlapping effect of these two groups of lipid-lowering agents on endothelial function, this would make sense. Also, chronic statin use could lessen the effect of niacin on endothelial function and hence affect improvement in erectile function.
That said, I think that guys like myself who eat a ton of plant foods have to be consider the fact that they may not always be getting all the niacin they could.  Men with lower niacin status can probably give their erectile strength and cardiovascular health a nice boost by consuming more niacin-rich plant foods.  There are many plant foods, such as broccoli and mushrooms that are quite high in niacin.  I actually consume nutritional yeast and BPA-free sardines daily and get a nice amount of niacin this way on top of my regular diet.  Therefore, I feel that I am likely maximizing my erectile strength by combining the best of both worlds, i.e. some NO-boosting plant foods and high niacin foods as well.  (Both  sardines and nutritional yeast also have a decent amount of protein as well, which is important to me since I enjoy lifting weights.)
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Have you heard about the famous Kegel exercises women often turn to for help? Well, these exercises are not for women only. You can perform them also and get the same beneficial effects as women. Kegel exercises for men are often recommended by many doctors to be used in the treatment of erectile dysfunction. Kegel exercises will strengthen your pelvic floor muscles. In order to perform these exercises, you will need to locate your pelvic floor muscles (to do that you will need to stop the process of urinating a couple of times) and squeeze them a couple of times. Start performing these exercises a couple of times a day and see the results for yourself.

Most human studies completed thus-far examine the impact of oral yohimbine consumption on erectile dysfunction (ED) in males. A meta-analysis of seven randomized, placebo-controlled trials found that yohimbine is significantly more effective in treating ED compared to placebo. [11] These findings did not compare yohimbine to prescription medications like Viagra®, which are designed to treat ED.
These are not currently approved by the FDA for ED management, but they may be offered through research studies (clinical trials). Patients who are interested should discuss the risks and benefits (informed consent) of each, as well as costs before starting any clinical trials. Most therapies not approved by the FDA are not covered by government or private insurance benefits.
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.

The Institute of Medicine recommends cumulative daily vitamin D intake of 600 international units (IU) for adults between 18 and 70 years of age , and 800 IU for those over 80. A 3oz serving of salmon contains about 450IU, while an 8oz. glass of milk only has about 100IU. Low vitamin D levels may be an independent, potentially modifiable risk for ED, so it’s worth taking Vitamin D supplements for your “D.” However, keep your daily vitamin D supplement intake below 4,000IU, as too much vitamin D can be toxic.
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