Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing some men to function normally. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections.
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.)
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.
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.
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
Yohimbine's powerful effects on blood flow explain why it's been used in traditional African medicine to increase sexual desire in both genders as well as improve the strength of erections in males. [1] Yohimbine's powerful stimulant properties may also benefit athletic performance on and off the field. The body absorbs and expels yohimbine rapidly.
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.

Overall, studies have been inconclusive about the aphrodisiac benefits of taking yohimbine supplements. However, most have found it works better than placebos. (7) According to a report published in the Iranian Journal of Psychiatry, a recent analysis of seven trials concluded that between 34–75 percent of men involved in studies experienced favorable results when taking between 5–10 milligrams. (8)
Weak erection is one of the most embarrassing problems in this world because i was always shy to meet new partners due to the fact that i already know that i cannot perform at all and even when i did i was so weak. I could only last 45 seconds and this this made me to ask myself many a times if i am a man, four of my girlfriends left me due to this problem. In my search for a cure and a solution i told an old friend all i have been facing and he told me about Dr. MACK how he helped him save his marriage using his very effective ED medicine which restored back his erection. I contacted him and he sent me the medicine and that is one of the best decision i have ever made in my entire life. I think this will help someone out there if you have any ED related problem do not hesitate to contact [email protected] com i know he can help you.
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.
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.
Yohimbe supplements often list yohimbe bark extract or yohimbine as the active ingredient. However, some of these products might not provide accurate information about the amount of yohimbine in the supplement. Also, some yohimbe supplements list yohimbine hydrochloride as an active ingredient. Yohimbe products containing man-made yohimbine hydrochloride as an ingredient are not legal to sell as a dietary supplement in the US.
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.
A vacuum erection device is a plastic tube that slips over the penis, making a seal with the skin of the body. A pump at the other end of the tube makes a low-pressure vacuum around the erectile tissue, which results in an erection. An elastic ring is then slipped onto the base of the penis. This holds the blood in the penis (and keeps it hard) for up to 30 minutes. With proper training, 75 out of 100 men can get a working erection using a vacuum erection device.
A study from the University of the West in the United Kingdom found that pelvic exercises helped 40 percent of men with ED regain normal erectile function. They also helped an additional 33.5 percent significantly improve erectile function. Additional research suggests pelvic muscle training may be helpful for treating ED as well as other pelvic health issues.

Although not every study has shown that yohimbe can have slimming effects, certain other studies have found positive results. One study found that yohimbine significantly increased mean weight loss in overweight female patients following a low-energy diet. (12) Possible mechanisms of action include: boosting lipolysis (the breakdown of fats and other lipids by releasing fatty acids into the blood) both during and following exercise, regulating insulin secretion, and reducing appetite. (13)
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.
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).

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.
On the other hand, high zinc levels have negative effects on sperm quality. Excessive zinc intake in mice have indicated a negative effect of increasing doses of zinc on sperm count and motility.[5] Although there have been studies focusing on various aspects of zinc related reproductive functions, studies on zinc related sexual behavioral aspects have received scant attention. In one study, intranasal irrigation with zinc sulphate has been reported to completely abolish the sexual behavior of male rats.[6]

However, for most men who experience erectile dysfunction, their overall experience can be improved even further through regular exercise. There are many reasons why exercise improves sexual satisfaction. For one thing, regular, sustained exercise can lead to the release of chemicals called endorphins that are responsible for the so-called runner’s high, and which stimulate the release of sex hormones. Exercise also generally improves mood and imparts a sense of calm afterward, with lower heart rate, lower blood pressure, better digestion, and lower levels of stress hormones.


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.
Controlling stress, having a healthy diet, and getting enough sleep to create a good foundation for sexual satisfaction. But sometimes the basics aren’t quite enough. Millions of men experience erectile dysfunction (ED), but ED can usually be successfully treated with prescription medications like Viagra, Levitra, Staxyn, and Cialis. These drugs have helped men understand that ED isn’t all in their mind, have opened up the topic to a more honest discussion, and have transformed many men’s sex lives.
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
ED can also occur among younger men. A 2013 study found that one in four men seeking their first treatment for ED were under the age of 40. The researchers found a stronger correlation between smoking and illicit drug use and ED in men under 40 than among older men. That suggests that lifestyle choices may be a main contributing factor for ED in younger men.
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).
Pelvic floor exercises are actually good as they can enhance the strength of the pelvic floor muscles. These exercises are commonly called Kegel exercises. These are the types of exercises that women usually perform in order to regain their muscle tone right after childbirth. They are also known to enhance urinary continence and overall male sexual health.
This study was designed to test the hypothesis that hydrochlorothiazide a diuretic used to treat hypertension depletes body zinc and thereby cause sexual dysfunction. Serum zinc and sexual dysfunction were measured in 39 middle aged hypertensive men who had been taking hydrochlorothiazide in average daily doses of between 25 and 50 mg daily for at least six months, and a control group of 27 unmedicated middle aged normotensive men. The medicated group had a higher incidence of sexual dysfunction (56 pc) as compared to 11 pc in the control group. The use of hydrochlorothiazide did affect serum zinc levels significantly in 20 patients. Sexual dysfunction occurred more often in older and overweight patients (p < 0.004). Three of the normotensive men experienced sexual dysfunction probably related to old age. Twenty two of the 39 on hydrochlorothiazide and experiencing sexual dysfunction were divided into two groups of 11 patients. Bloods were taken from the 27 normotensive and 22 hypertensive men receiving hydrochlorothiazide for the analyses of zinc. Subsequently one group of the patients were supplemented with zinc 500 mg daily for 30 days while the other group was supplemented with magnesium chloride 1 g daily for 30 days. The normotensive men were not treated. After 30 days, bloods were again taken from the three groups of analyses for zinc and magnesium. Serum zinc was significantly decreased (p < 0.05) by hydrochlorothiazide and a non significant decrease in serum magnesium (p = ns) was observed. After supplementation with zinc, the serum zinc levels returned to normal only in eight patients. There was improvement in the symptoms of sexual dysfunction in five patients. Two patients gained weight. Hydrochlorothiazide decreased serum zinc levels (p < 0.05) and was unchanged with magnesium supplementation but the serum magnesium returned to normal values. Improvement of symptoms of sexual dysfunction was positive in one patient. This study shows that low serum zinc levels may be associated with sexual dysfunction but the definitive role of zinc in the pathogenesis of sexual dysfunction will remain controversial.

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.
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.
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.
The number of animals ejaculating within 15 minutes was significantly reduced in 5 mg zinc treated group (one out of eight). However, all intromitted rats ejaculated between 20-30 minutes when observation was continued. Ejaculatory latency was significantly high in this group compared to controls; 711.60 Sec (SEM 85.47) vs. 489.50 Sec (SEM 67.66), P < 0.05. Similarly, they showed a significantly higher frequency of penile thrusting compared to controls; 26.50 (SEM 6.17) vs. 52.80 (SEM 11.28), P < 0.05 [Table 1].
Health benefits and risks of copper Copper is an essential trace mineral that occurs in all body tissues. It is vital for a range of body functions including the production of red blood cells and energy, and the maintenance of nerve cells and the immune system. A copper deficiency can be harmful, but too much can be toxic. Learn more about copper here. Read now
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