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.
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).

This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
Yohimbe bark is an herbal supplement. Its species name is Pausinystalia yohimbe. Yohimbe comes from the bark of the evergreen Corynanthe yohimbe tree, which is in the plant family called Rubiaceae. The active ingredient in yohimbe, called yohimbine, is also used to make certain medications. Civilizations in Western Africa have used it for centuries. Today it’s studied for its ability to help treat conditions including erectile dysfunction/impotence, diabetes, depression, hypotension, and overuse of certain medications.

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.
Energy-boosting goji berries have been used for thousands of years in Chinese medicine to help increase energy and enhance the release of hormones.”Goji is also beneficial for increasing blood flow, which helps to oxygenate all of the cells and tissues of the body, including the sex organs,” says celebrity nutritionist Dr. Lindsey Duncan. “Which increases libido—that’s why they call goji the ‘Viagra of China.'”
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.
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.
Ginkgo biloba. Ginkgo is an herb that is used in Chinese medicine that’s thought to improve blood flow. "Any ED treatment that improves blood flow may help," explains Dr. Harris. "An erection is just blood in and blood out." However, the evidence that ginkgo can improve blood flow in ED is limited, and most experts say the jury is still out. In addition, ginkgo can increase the risk for bleeding problems if combined with certain medications, such as warfarin (Coumadin).
Pay attention to your vascular health. High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the heart (causing heart attack), in the brain (causing stroke), and leading to the penis (causing ED). An expanding waistline also contributes. Check with your doctor to find out whether your vascular system — and thus your heart, brain, and penis — is in good shape or needs a tune-up through lifestyle changes and, if necessary, medications.
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!
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).
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.
Having your current medication checked – if you are taking medication already, it could be that your erection problems are a side effect. Have a doctor check whether this is the cause of your problems and if it is, you might be able to switch medications and then find that your erectile dysfunction goes away completely – or at least improves. Medications that can cause erection problems include:
A daily dose of niacin improves erectile function, particularly in men with high cholesterol, according to a 2011 study in The Journal of Sexual Medicine. The vitamin helps increase blood flow and reduce inflammation—one of the underlying causes of both high cholesterol and erectile dysfunction. “Vitamin B3 is also used to make sex hormones and other important chemical-signal molecules,” says Fisch. Like many of the others on our list, this tablet is most powerful when taken in conjunction with others: A cocktail of propionyl, L-carnitine, L-arginine, and niacin taken for three months improved 40% of erections in a study from researchers at Sapienza University of Rome in Italy.
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)
Eggs a supplement? Yup. Testosterone is derived from cholesterol, and eggs are the healthiest way to ensure you’re getting enough of the good kind (LDL cholesterol). Plus, eggs are rich in choline, a powerful natural chemical that not only burns fat but can help set your pants afire. Choline triggers the production of nitric oxide (NO), which relaxes arteries in the penis and enables blood flow to do its thing. Choline is a precursor to acetylcholine, a neurotransmitter which controls sexual behavior through its activity in the brain; having a higher level of AcH has been associated with more frequent sex and more intense, longer orgasms. And that’s not all: Check out these things that happen to your body when you eat eggs!
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.
Yohimbe is an evergreen tree with large, leathery leaves. It is native to the tropical west coast of Africa, from Nigeria to Gabon. Natives in that region have used the inner bark of Yohimbe to treat angina, hypertension, fever, cough and leprosy. It was also smoked or snuffed to attain an altered state of consciousness. Its main use and rumored “power” was that it was an aphrodisiac. Today science recognizes it as a sensual stimulant, but Native Africans also recognized that drinking Yohimbe tea encouraged sexual arousal. It was traded with Europeans and the tales of Yohimbe’s “powers” spread, giving rise for its increased demand by Europeans.
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.
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)

ICI Alprostadil may be used as a mixture with two other drugs to treat ED. This combination therapy called "bimix or trimix" is stronger than alprostadil alone and has become standard treatment for ED. Only the Alprostadil ingredient is FDA approved for ED. The amount of each drug used can be changed based on the severity of your ED, by an experienced health professional. You will be trained by your health professional on how to inject, how much to inject and how to safely raise the drug's dosage if necessary.
Yohimbine also helps to increase levels of the coenzyme NAD (or nicotinamide adenine dinucleotide). This affects metabolism, cognitive processes, and detoxification of drugs in the body. NAD is not currently used to treat cognitive or mood-related disorders on its own, but has been shown in some studies to potentially have uses for preventing neurodegenerative diseases including Parkinson’s disease or Alzheimer’s. However on the other hand, studies have found that because it can increase anxiety in some patients, yohimbine may actually worsen mental illness in some patients, including those with Parkinson’s. (15) For this reason, it’s important for anyone taking mood-altering medications, or who has a history of any cognitive or mood disorder, to work with a professional while taking or starting any new herbal treatments.

Penile erection is a hemodynamic process involving increased arterial inflow and restricted venous outflow, coordinated with corpus cavernosum and penile arterial smooth muscle relaxation. Any problem in this mechanism results in Erectile Dysfunction and its etiology is generally multifactorial. This study is aimed at determining the objective outcome of aerobic training in the management of Erectile Dysfunction of arterogenic origin using Meta analysis.
Regardless of diet or exercise - to control a sexual act, it's imperative to balance your sexual focus during foreplay, penetration, and intercourse. When you feel safe throughout foreplay it's easy to penetrate and if you're not worried at penetration time then intercourse is easier. A happy and satisfying sex life is knowing when and where to put your attention. How to do this is explained step-by-step in my Sex Mastery Hard AND in Control program for men.
Vitamin C has been associated with higher sperm counts. You can get it naturally from strawberries, raspberries and blueberries, which are anthocyanins, colorful plant chemicals which help keep your arteries unclogged, boosting circulation and erection quality. In supplement stores, you’ll find all manner of megadoses — steer clear of those; they might do more harm than good.
Take note that you may not be able to complete a series of about 10 kegel exercises on your first try. This is just fine. Just do what you can, and gradually work on more kegel exercises until you reach 10 to 20 kegels, up to three times in a day. When performing these exercises, avoid holding your breath, or pushing your stomach, thigh muscles, or buttocks in. It would be helpful if you relax after every count of five. You may also challenge yourself by alternating between long and short squeezes.
Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor's OK. Medications for erectile dysfunction do not work in all men and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:
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!
Niacin or Vitamin B3 has proved to be helpful in improving both lipid levels and cholesterol among patients suffering from the problem of atherosclerosis i.e. accumulation of waste fats across the walls of the human blood vessel. Because of this, Niacin is helpful in the treatment of erectile dysfunction, as ED and atherosclerosis have more or less similar causes.
All hormone determinations were performed by radioimmunoassay using kits provided by commercial suppliers. All blood samples were drawn between 8 am and 1 pm, quickly spun down, frozen, and then stored. All determinations were performed at the same time after the end of the study. The serum LH kit was obtained from Nichols Institute (now Quest; Tarzana, CA, USA) (normal male range, 1.4–11.1 mIU/ml). The serum free testosterone kit was obtained from Diagnostic Products Corporation (DPC, Los Angeles, USA) (normal male range, 15–40 pg/ml). The serum cortisol kit was bought from DPC (normal morning range, 10–24 mcg/dl; normal afternoon range, 5–12 mcg/dl). The serum dehydroepiandrosterone sulfate kit was obtained from DPC (normal range, 150–350 mcg/dl from adolescence to the peak at age 50 y, with a progressive decrease with advancing years).
Call this the Marvin Gaye of amino acids: L-arginine converts to nitric oxide (NO), a naturally occuring gas that causes blood vessels to relax and facilitate blood flow, helping you get and stay hard. You can find plenty of the nutrient in oysters, but in supplement form, the Mayo Clinic says that 400-6,000 milligrams is the maximum dose. And these are the best foods for arginine!

DHEA. DHEA, or dehydroepiandrosterone, is a natural hormone that the body uses to make the male hormone testosterone. DHEA and testosterone decrease with age, just as ED increases with age, so it seems that taking DHEA might protect against ED. But Harris says that "it is unlikely that taking DHEA would raise your testosterone enough to make much difference." DHEA should not be used by people with liver problems; it also has many side effects.
The paired t-test was used to assess differences in responses using various doses of yohimbine in responders and nonresponders. Responder and nonresponder changes in tumescence, rigidity, and other physiologic responses over the entire study period were compared using independent t-tests (assuming equal variances). Independent t-tests were repeated to determine whether significant differences existed in the mean numbers of risk factors, age, or side effects among groups. Matched pairs t-tests were used to compare Florida Sexual History Questionnaire responses at each dose. Finally, χ2 analysis (or Fisher's exact test when appropriate) was used to compare the two groups on dichotomous sexual satisfaction ratings at the end of the trial; 95% confidence intervals were consistently examined to determine the magnitudes of differences detected. Two-tailed P-levels were used in reporting all results. SPSS 9.0 statistical software (SPSS Inc, Chicago, IL, USA) was used for analysis.
The development of successful sexual behavior involves not only important neuroendocrine and local genital changes that begin at puberty, but also psychological and social influences that occur both before and after puberty.[7,8] Sexual behavior in males is regulated mainly by internal patterns of hormones; i.e. T, progesterone and PRL. These hormones are modulated by the male interactions with the social environment.[9]
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.
A physical exam checks your total health. Examination focusing on your genitals (penis and testicles) is often done to check for ED. Based on your age and risk factors, the exam may also focus on your heart and blood system: heart, peripheral pulses and blood pressure. Based on your age and family history your doctor may do a rectal exam to check the prostate. These tests are not painful. Most patients do not need a lot of testing before starting treatment.
Shindel, A. W., Xin, Z.-C., Lin, G., Fandel, T. M., Huang, Y.-C., Banie, L., … Lue, T. F. (2010, February 5). Erectogenic and neurotrophic effects of icariin, a purified extract of horny goat weed (Epimedium spp.) in vitro and in vivo. The Journal of Sexual Medicine, 7(4), 1518-1528. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2009.01699.x/full

L-arginine, or arginine, is an amino acid found in red meat, poultry, fish, and dairy products that helps expand blood vessels and increase blood flow. “The body uses this semi-essential amino acid as the primary building block for nitric oxide,” explains Harry Fisch, M.D., clinical professor of urology and reproductive medicine at Weill Cornell Medical College/New York Presbyterian Hospital.

Allow me to explain. We know that cardiovascular disease is the number-one killer of men in the United States. Well, the “vascular” part of cardiovascular disease means that the cause is really blockage of the arteries around the heart, a process called atherosclerosis. It’s proven that over half of heart attacks occur in men with normal cholesterol. And many times, heart disease develops without warnings, causing sudden cardiac arrest.  So any early warning sign can be a life saver — and might compel you to get checked out before the big one hits.
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