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.
The truth is medication or psychosexual counselling are the first treatments a doctor will suggest because they’ve been proven to work. If a doctor has approved a medication for you then it’s safe. If you would still like to see if herbal supplements work for you, then there is a list below of supplements thought to work for erectile dysfunction. Just before you invest your money in them, remember they aren’t proven to work:
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 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.
Several studies have shown that erectile dysfunction is somehow linked to problems with cardiovascular health — which one comes first has been the question. It makes sense; the penis becomes erect through a complex system of blood vessels and spongy tissue called the corpora cavernosa — this is where the blood gets trapped, causing the erection. When problems arise through this system, whether they’re caused in the brain or through problems with the blood vessels, the penis can’t get erect.
Males consuming yohimbine HCL for its pro-erectile benefits should take 5.4mg to 6mg three times per day but don't expect for the results to be noticeable until after about two to weeks of consistent dosing. [4] Not all males will experience this benefit so if you do not notice a change after four weeks of consistent dosing then consider stopping supplementation altogether.
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
A study published in The American Journal of Cardiology confirmed that aerobic exercises will help you to cure your erectile dysfunction. Erectile dysfunction is most commonly caused by obesity, hypertension, and diabetes, which decrease the blood flow in the penis. Aerobic exercises can and will help you to improve your health in general, improve your blood flow, and ultimately treat your condition.

Three of the randomized studies (25–27) that contributed to the present study data indicated the positive role of both interval and continuous aerobic training in the dual management of both ED and cardiovascular disorders (hypertension and ischemic heart disease ,respectively); this is not surprising because of the arterogenic interrelationship between ED and several cardiovascular disorders. The physiological basis for the therapeutic role of continuous exercise in the management of both ED and some cardiovascular disorders as reported in the present study, could be related to the biochemical, neural and hormonal changes in the blood vessel walls that induce an acute and long-term blood vessel relaxation. The blood vessels might relax after each exercise session because of body warming effects; local production of certain chemicals, such lactic acid and NO; decreases in nerve activity; and changes in certain hormones and their receptors (32, 33). Over time, as the exercise is repeated, there appears to be a growing evidence of a prolonged effect. Thus, chronic (regular, longterm) physical training might reduce basal concentrations of inflammatory markers.


Studies of mixed organic causes for erectile dysfunction showed varied results;15,16 thus, certain guidelines recommended that it not be used to treat erectile dysfunction.17 Side effects occurred when a high dose was given.18 Patients with organic erectile dysfunction had mixed results, with positive effects in 26,19 33,20 3421 and 43%,22 respectively. The results were better when the dose was doubled.20,21 Several meta-analyses showed a slight positive effect of yohimbine compared with placebo.23,24
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.
Although there have been sufficient data on the relationship between ED and several wellrecognized risk factors which including aging, coronary artery disease, atherosclerosis, diabetes mellitus, dyslipidemia, high blood pressure, and pelvic surgeries, little attention has been paid by the urologists to the role of lifestyle factors in ED. However, accumulating data from basic science and clinical studies have determined a link between the occurrence of ED and a number of lifestyle factors, such as smoking, obesity, alcohol consumption, and lack of physical activity. The application of findings from animal and human studies to the clinical practice regarding the modification of lifestyle factors could help to improve ED as well as reducing the risks of developing cardiovascular diseases (14).
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).
Also to be considered, patients were not using PDE5 inhibitors during the study period. Therefore it wasn’t determined whether the combined use with niacin can enhance the response of PDE5 inhibitors. Another limitation on the study results was the exclusion of the partner’s assessments. This would help to provide a more comprehensive assessment of the efficacy of niacin.
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).

Over the years, myriad treatments and gadgets have been invented to assist with issues related to erections. They run the gamut from vacuum pumps to constriction bands, surgical implants, male hormone therapy, herbal supplements (ginkgo biloba, saw palmetto,  L- arginine, and yohimbe), and even shock-wave therapy. Lifestyle changes include: increasing exercise, decrease smoking, losing weight, and eating healthier. More natural alternative treatments include acupuncture and watermelon juice. In her hilarious and informative book entitled Bonk, researcher Mary Roach explores coupling of science and sex, and dedicates a couple of chapters to in-depth analysis of erectile dysfunction treatments.
People who do not have any contra-indications (see below) generally tolerate it well. However, taking yohimbe can sometimes cause side effects including: high blood pressure, headaches, anxiety, restlessness/nervousness, dizziness or shakiness. These side effects seem to affect people with a history of mental illness or mood-related problems most often. But it’s possible for them to develop in anybody.
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
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.
There have been only a few  well-controlled studies to test the effects of herbal yohimbe (as opposed to medications) on humans. There’s some evidence that yohimbine has potential to enhance the nitric oxide pathway, helping to bring blood flow to the corpus cavernosum tissue of the penis. It may also stimulate the pelvic nerve ganglia and boost adrenaline supply to nerve endings. It seems to have the most effects overall when combined with other treatments or herbal remedies. (6) One study that evaluated the effects of yohimbe on ED found that those taking the herbal remedy experienced slight benefits compared to a control group that was not taking the supplement.

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).
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.

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.


Also to be considered, patients were not using PDE5 inhibitors during the study period. Therefore it wasn’t determined whether the combined use with niacin can enhance the response of PDE5 inhibitors. Another limitation on the study results was the exclusion of the partner’s assessments. This would help to provide a more comprehensive assessment of the efficacy of niacin.
Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He's a practicing Gastroenterologist and Hepatologist with a focus on Men's and Women's Health, and a regular contributor to Women's health, Shape and Prevention Magazine.
×