Few men want to talk about their inability to get or maintain an erection, however, erectile dysfunction can have a profound impact on relationships and self-esteem. Fortunately, trouble in the bedroom doesn't necessarily mean you're dealing with erectile dysfunction. Most men will have problems with an erection at some point in their sexual history. But one bad day in the bedroom doesn't mean major sexual health problems. So how can you know if you're dealing with erectile dysfunction?
Researchers found that this compound, delivering 6mg of yohimbine HCL and 3.25g of L-arginine, significantly improved erectile function in those with mild-to-moderate ED. [15] L-arginine is an amino acid that acts as a precursor to and plays a critical role in nitric oxide production. Yohimbine paired with a compound encouraging nitric oxide production may be the perfect combination for significantly decreasing or eliminating symptoms of erectile dysfunction.
This scenario raises a key concern for us (and should for you as well) about what is recommended to treat erectile dysfunction. I performed a quick Google search on kegels as treatment for the pelvic floor, and found hundreds of websites instructing men to perform kegels to ameliorate erectile dysfunction, have longer and stronger erections – a quick and easy fix. I found a few sites instructing men to perform anywhere from 50-100 repetitions per day (insanity). I discovered a new book called Male Pelvic Fitness, a “user manual to your man parts
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.
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).
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.
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.
Stress is another main cause of impotence in men. Psychological stress lowers libido in general and may suppress a man’s ability to become aroused, causing impotence. This is usually temporary and is easier to reverse than cases of physiological impotence. Nonetheless it is extremely important to manage stress levels when working to reverse impotence. Whether a man is experiencing impotence due to physiological reasons or psychological reasons, stress plays a key role. Any man that is experiencing erectile dysfunction will experience higher levels of stress because of the condition itself. Stress management skills need to be in place when working to reverse impotence.
The RigiScan™ portable home monitor recorded nocturnal penile tumescence and rigidity testing. The monitor's quantitative analysis software quantitates various parameters of tumescence and rigidity, which includes the area under the curve over time slept, reported as tumescence activity units and rigidity activity units. The reproducibility and accuracy of this technique have been reported.28 Baseline normal values were used as previously reported,29 Rigidity had to be at least 60% at the base and 50% at the tip and maintained for at least 10 min. At least half of the episodes had to meet these criteria, with a minimum of three or four episodes per night. Tumescence had to achieve a height of 3 cm at the base and 2 cm at the tip.

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.
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.
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In the 18th century, Spain embraced the Age of Enlightenment, directing the beacons of thought to all endeavors. But while Spain was not as advanced as France, Britain, Germany, or America, its new political thinking led to the revocation of most of the historical rights and privileges of the sub-kingdoms that comprised the Spanish Crown. Those changes, in turn, allowed for the freedom of inquiry that was so needed for medical discovery, among others.
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).
Often when we start to look outside of mainstream medicine for alternative protocols to heal our health issues we replace one pill-taking protocol with another. The prescription drugs are replaced with a long list of supplements. Supplements alone, without any other lifestyle changes, will have some impact, but it will be nowhere near what they can achieve when working in a body supported with a healthy way of life.
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).
Research in the medical journal Experimental and Therapeutic Medicine found that supplementing with the mineral zinc, along with the vitamins folic acid and biotin, as well as the herb Rhodiola rosea improved ejaculatory control in males suffering from premature ejaculation. Premature ejaculation is a common type of sexual dysfunction that affects 20 to 30 percent of men between the ages of 18 and 55. The low incidence of any side-effects of these natural treatments may also make it preferable to drug treatments by many men.
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.
Research in the medical journal Experimental and Therapeutic Medicine found that supplementing with the mineral zinc, along with the vitamins folic acid and biotin, as well as the herb Rhodiola rosea improved ejaculatory control in males suffering from premature ejaculation. Premature ejaculation is a common type of sexual dysfunction that affects 20 to 30 percent of men between the ages of 18 and 55. The low incidence of any side-effects of these natural treatments may also make it preferable to drug treatments by many men.
From the overall analysis, the niacin group showed a significant increase in both IIEF-Q3 scores (0.53 ± 1.18, P < 0.001) and IIEF-Q4 scores (0.35 ± 1.17, P = 0.013) compared with baseline values. The placebo group also showed a significant increase in IIEF-Q3 scores (0.30 ± 1.16, P = 0.040) but not IIEF-Q4 scores (0.24 ± 1.13, P = 0.084). However, 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 ± 0.96 [P = 0.037] and 1.03 ± 1.20 [P < 0.001], respectively) and IIEF-Q4 scores (0.56 ± 1.03 [P = 0.048] and 0.84 ± 1.05 [P < 0.001], respectively] compared with baseline values, but not for the placebo group. The improvement in IIEF-EF domain score for severe and moderate ED patients in the niacin group were 5.28 ± 5.94 (P < 0.001) and 3.31 ± 4.54 (P = 0.014) and in the placebo group were 2.65 ± 5.63 (P < 0.041) and 2.74 ± 5.59 (P = 0.027), respectively. There was no significant improvement in erectile function for patients with mild and mild-to-moderate ED for both groups. For patients not receiving statins treatment, there was a significant improvement in IIEF-Q3 scores (0.47 ± 1.16 [P = 0.004]) for the niacin group, but not for the placebo group.

One of the best methods that you can do in order to locate your pelvic floor is to stop your urine in mid-stream several times. These muscles that you clench are the ones that you have to exercise on. In order to perform repetition on Kegel exercises, you can squeeze your pelvic muscles, holding the position for 5 seconds, and then relaxing. You may repeat this for about 10 to 20 times, two to three times in a day. You may also want to do this while in different positions such as standing, sitting, lying down, sitting in a chair, as well as standing.
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.
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