Aids in fat loss: Yohimbe and other alkaloids in the bark extract are said to block specific receptors that actually inhibit fat loss. A three-week study in 1991 observed 20 obese females on 1,000-calorie diets. They were given 20 mg of yohimbe each day and lost three pounds more than the group receiving placebos. Not a drastic weight loss, but enough to give experts hope that yohimbe can help with weight loss. Other studies have found that yohimbe increases the amount of non-esterified fatty acids, a result of fat breaking down. More research is needed. Most other studies in the field are done using the drug yohimbine. Extracted chemicals are not the same as yohimbe bark. Studies with yohimbine are expected to give different results than studies that used the raw plant.
Ashwagandha, an Ayurvedic herbal remedy reputed to act as a mild aphrodisiac, or Asian ginseng (Panax ginseng), a good stimulant and sexual energizer. For either, follow the dosage on the package, and give it six or eight weeks to have an effect. Both ashwagandha and Asian ginseng are generally safe (but Asian ginseng can raise blood pressure and cause irritability and insomnia in some people).
If other options sound boring, maybe you should consider a fun, revved-up option like salsa dancing. You and your partner can lose yourself in the music, and it’s an intense exercise that engages the senses, combining cardio, balance, and coordination. Plus salsa dancing is great for keeping weight under control because it burns a lot of calories. Furthermore, it’s an activity that can build self-confidence, and if you’re single, the classes can be terrific for meeting new people. Regular exercise doesn’t have to be drudgery, and there are many types of dance classes that can seriously improve fitness and help you address erectile dysfunction.
You may find that using a vacuum device requires some practice or adjustment. Using the device may make your penis feel cold or numb and have a purple color. You also may have bruising on your penis. However, the bruises are most often painless and disappear in a few days. Vacuum devices may weaken ejaculation but, in most cases, the devices do not affect the pleasure of climax, or orgasm.
Moreover, it has a positive effect on the nervous system, liver, skin, and mucous membranes, as well as keeps skin, nails, and hair healthy. And of course, what is important for men, erectile dysfunction treatment with vitamin B2 relieves symptoms of the most hateful male disease. Moreover, this vitamin is well-known as a supplier of sexual energy and vitality.
Yohimbe supplements haven't been tested for safety and keep in mind that the safety of supplements in pregnant women, nursing mothers, children, and those with medical conditions or who are taking medications has not been established. You can get tips on using supplements here, but if you're considering the use of Yohimbe, it is essential that you talk with your physician first. 
These results are remarkable, because it appears that not only can niacin improve short term erectile function in many men, but also can likely help to reverse arterial plaque if a comprehensive program is undertaken.  Of course, neither I nor anyone else knows how safe megadosed niacin is long term, but many experts consider it safe when used under the care of a knowledgeable physician.  You'll have to do your own due diligence.
Several studies (15–17) have shown an inverse relationship between physical activity levels and biomarkers of inflammation in both the healthy individuals and subjects with cardiovascular condition. Studies (18–21) have also reported the role of exercise in the management of erectile dysfunction. The majority of these studies are subjective, retrospective case series and non randomized non controlled studies. However, 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 (22). Therefore, the purpose of the present Meta analysis study was to determine the role and effect of aerobic exercise in the management of erectile dysfunction in randomized controlled trials.
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.)
"The problem with alternative treatments for any medical problem, including erectile dysfunction, is that until you have about 20 well-controlled studies over several years, you really don't know what you are working with," cautions Richard Harris, MD, a urologist at Gottlieb Memorial Hospital, part of the Loyola University Health System in Chicago.

Oysters are also a great source of zinc, with just 3 ounces providing 493% of your recommended daily intake. In fact, oysters are so rich in zinc that eating too much can cause an accidental zinc overdose, so just be wary of this. Bear in mind as well that oysters are a common source of food poisoning, and they are also very high in cholesterol – might be best to stick to your nuts and seeds!
Move a muscle, but we're not talking about your biceps. A strong pelvic floor enhances rigidity during erections and helps keep blood from leaving the penis by pressing on a key vein. In a British trial, three months of twice-daily sets of Kegel exercises (which strengthen these muscles), combined with biofeedback and advice on lifestyle changes — quitting smoking, losing weight, limiting alcohol — worked far better than just advice on lifestyle changes.
A study of 23 individuals found that a dose of 0.4mg/kg of yohimbine not only increased norepinephrine in the blood, blood pressure, and heart rate, but it also increases impulsive response rates. These response rates are measured by the number of impulsive errors, response biases, and reaction times on an immediate memory task. [10] While yohimbine may improve your reaction time it may also encourage you to act irrationally.
Physical exercises are only one part of overcoming sexual dysfunctions. If you're serious about restoring full control sexually then you need to understand which of your current thoughts and actions are causing your failure. After you understand how your problem works, THEN you can apply the correct thought and action sequence to stay in control sexually!

Size matters, so get slim and stay slim. A trim waistline is one good defense — a man with a 42-inch waist is 50% more likely to have ED than one with a 32-inch waist. Losing weight can help fight erectile dysfunction, so getting to a healthy weight and staying there is another good strategy for avoiding or fixing ED. Obesity raises risks for vascular disease and diabetes, two major causes of ED. And excess fat interferes with several hormones that may be part of the problem as well.
The sunshine vitamin will brighten things up in the bedroom. In a recent study published in the Journal of Sexual Medicine, Italian researchers found that of 143 men with erectile dysfunction, 80% had less-than-optimal levels of D, and the men with severe ED had, on average, a 24% lower level of D than with a milder condition. They theorize that low levels of D damage blood vessels and lead to a shortage of nitric oxide.
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.
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.
Niacin is another class of lipid-lowering agents, about which research dates back at least 55 years.2 Not only does niacin lower low-density lipoprotein (LDL-C, the “bad” cholesterol), total cholesterol, and triglycerides, it increases HDL-cholesterol (HDL-C, the “good” cholesterol) by inhibition of lipolysis in adipose tissue, which eventually leads to improvement in all lipid parameters. Furthermore, there are studies suggesting that niacin can improve the clinical outcome in cardiovascular disease, and that it may lead to the regression of atherosclerotic plaque. Dyslipidemia is closely related to erectile dysfunction (ED) and evidence has shown that statins can improve erectile function. However, the potential role of that other lipid-lowering agent, niacin, hasn’t been known until now.
When given orally, yohimbine reaches peak levels in 10–15 min, and the half-life is 0.6 h. The efficacy of yohimbine in sexual function has been questioned, perhaps because of early questionable multidrug preparations.10,11 Yohimbine has been shown to have some effect on psychologic erectile dysfunction12,13 and in reversing fluoxetine-induced sexual dysfunction.14
Some men say certain alternative medicines taken by mouth can help them get and maintain an erection. However, not all “natural” medicines or supplements are safe. Combinations of certain prescribed and alternative medicines could cause major health problems. To help ensure coordinated and safe care, discuss your use of alternative medicines, including use of vitamin and mineral supplements, with a health care professional. Also, never order a medicine online without talking with your doctor.

Prostate problems are most common in older men, but it’s never too early to start looking after your prostate! Problems such as BPH (enlarged prostate) and prostatitis can cause unpleasant symptoms such as frequent urination, weak urine stream, difficulty urinating and sudden urges to urinate, which can really get in the way of daily life and interrupt sleep.
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Exercise lowers blood pressure – a consistently high blood pressure (hypertension) can damage your arteries and cause them to harden, limiting the flow of blood to the penis and leading to cardiovascular problems. Exercise works to reduce the force required to pump blood around your body, protecting your artery linings as a result. You should aim to have a blood pressure less than 140/90mm Hg.

Erection is a complex physiological process in which vascular factors play a pre-eminent role. Therapeutic options for men with arteriogenic erectile dysfunction (ED) are mainly administration of phosphodiesterase type 5 inhibitors, intracavernous injections of vasoactive agents (for example, prostaglandin El, papaverine/phentolamine, or triple drug), intraurethral administration of prostaglandin El, and administration of centrally acting drugs (11, 12). However, all of these methods circumvent the patient's problem temporarily, and patients are not cured of impotence, they will remain dependent on these treatments for the remainder of their sexually active lives. An effective treatment that cures the problem permanently is needed where penile revascularization and exercise remain treatment options for such patients. However, due to the complexity of penile revascularization such as cost ineffectiveness, unavailability of experts, side effects of surgery and high failure rates among the elderly (13) have left people with ED at the mercy of exercise.

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).
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.
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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