In a study with human subjects, Kruger et al. have reported that acute changes in the normal physiological levels of PRL led to a significantly prolonged ejaculatory latency, but minor reductions of sexual drive and function.[19] Although zinc induced elevation of PRL was not an acute effect, findings similar to the human study (prolongation of ejaculation and mild reduction of libido index with medium dose of zinc) were observed in this study. However, the prolongation of ejaculatory latency may not be merely due to effects of elevated PRL because elevated PRL levels are known to be associated with the negative aspects of sexual activities (decreased sexual desire and frequency of sexual intercourse).[20]
MEDLINE is the U.S. National Library of Medicine's (NLM) premier bibliographic database that contains over 18 million references to journal articles in life sciences with a concentration on biomedicine. A distinctive feature of MEDLINE is that the records are indexed with NLM Medical Subject Headings (MeSH).The great majority of journals are selected for MEDLINE based on the recommendation of the Literature Selection Technical Review Committee (LSTRC), a National Institute of Health (NIH)-chartered advisory committee of external experts analogous to the committees that review NIH grant applications. MEDLINE is the primary component of PubMed, part of the entry series of databases provided by the NLM National Center for Biotechnology Information (NCBI). MEDLINE may also be searched via the NLM Gateway (23).

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. 
Dr. Traxler is a University-trained obstetrician/gynecologist, working with patients in Minnesota for over 20 years. She is a professional medical writer; having authored multiple books on pregnancy and childbirth; textbooks and coursework for medical students and other healthcare providers; and has written over 1000 articles on medical, health, and wellness topics.  Dr. Traxler attended the University of Minnesota College of Biological Sciences and University of Minnesota Medical School,  earning a degree in biochemistry with summa cum laude honors in 1981,  and receiving her Medical Doctorate degree (MD) in 1986.
The herb is particularly effective for those whose willy woes are based on other medications: An older study from the University of California found ginkgo biloba is 76% effective in treating sexual dysfunction caused by antidepressants. “Gingko helps counteract sexual dysfunction caused by certain antidepressants called SSRIs by blocking serotonin activity in the erectile centers of the brain, ultimately leading to better synthesis and bioavailability of nitric oxide,” Walker explains.

If you can't take one of these oral medications, your physician may have you try Caverject (alprostadil for injection), a hormone that you inject into your penis using a fine needle, or Muse (alprostadil urogenital), a tiny suppository that you insert into the tip of the penis. Both of these will bring on an erection within five to 15 minutes without sexual stimulation.


We studied the involvement of zinc in the sexual behavioral response of male rats. The study design employed a rat model to predict the human sexual response to elemental zinc supplementation. Rats were used because they are very social and copulate under a variety of circumstances, regardless of the presence of a human experimenter. They are practical (small and easy to handle) and certain tissues and neuroendocrine systems are strikingly similar to humans.[13]
Most studies related to male infertility show a clear concise relationship between zinc and ed. During a study some young men were given a diet which included very little amounts of zinc and thus they developed a zinc deficiency. When testosterone levels were measured after 20 weeks of low-zinc diet it was found that the level of the hormone had drastically reduced. The study also found that in elderly men, with an increase in the uptake of zinc, testosterone levels nearly doubled.
E.D. may just be that early warning sign. Erections depend on blood flow, and blood flow depends on nice, wide-open arteries. Atherosclerosis doesn’t just affect the arteries around your heart; if you have plaque build-up, you are likely to have it all around the arterial system — and the penile artery is one of the smallest arteries you have (no matter what you claim about your size). So if you have atherosclerosis, then the plaque there will be one of the first places where you would notice a decline in blood flow.
Penile implants - are generally used if physical damage (like an accident) makes the anatomical parts needed for an erection not work. These are inserted by surgery and can provide a permanent treatment choice if others fail to work. The implants can be semi-rigid or inflatable. They can be pretty expensive and are not usually available on the NHS.

Instead of injecting a medicine, some men insert a suppository of alprostadil into the urethra. A suppository is a solid piece of medicine that you insert into your body where it dissolves. A health care professional will prescribe a prefilled applicator for you to insert the pellet about an inch into your urethra. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes.
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.
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.
The group treated with the lower concentration of zinc (1 mg/day) did not show an alteration in any of the observed parameters. However, supplementation with a dose of 5 mg/day per rat caused substantial prolonged ejaculatory latency and increased in number of penile thrusting. The other parameters studied remained unchanged indicating uninterrupted libido, sex vigor and performance. Majority of male rats (75 %) showed the prominent actions of sexual behaviour (mount, intromission and penile thrusting) and did not ejaculate within the 15-minute observation period.
Suggested intake: “The problem with yohimbine is that you can’t regulate the amount in a dosage,” says Fratellone. “It all depends on what part of the tree it comes from, how it’s cultivated, how it’s exported, and so on. The amount of extract you get will vary.” FDA researchers analyzed a number of over-the-counter yohimbe bark products. They found that the supplements contained only seven percent or less of the amount of yohimbine that would be found in actual yohimbe bark, which suggests that they contained little or no yohimbe. However, the prescription form of yohimbine is strictly regulated by the FDA. It is approved only for the treatment of impotence, and is available in tablets and capsules. For erectile dysfunction, 5.4 to 10 milligrams three times daily has been studied and regarded as generally safe.
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

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:


In the statistical analysis, the difference between the pre-test and post-test values (changed score) for IIEF score was computed. Student t-test was used to compare the mean changed score values of IIEF. All statistical analysis was performed on an IBM compatible micro computer using SPSS for window version 15.0, (Chicago IL, USA). The probability level for all the above tests was set at 0.05 to indicate significance.
So what causes erectile dysfunction?  Sometimes it is a circulation problem.  Sometimes it is a low testosterone issue.  Sometimes it is not.  Testosterone (T) supplementation can help ED and low libido in cases of low T and even if there is a normal T level at baseline, ED can be helped.  In cases where thyroid under or overactivity is causing T levels to be less than optimal.  Aging is also a problem as T levels drop after mid 20’s and as adipose tissue increases and aromatase enzyme conversion of T to Estrogen correspondingly increases.  This causes an unfavorable E:T ratio which equates to low T.
Once you get checked out for artery blockage and low T, there are things you can do to help treat ED besides taking medications. Yes, Viagra is now available generically (it’s called sildenafil), but it is still expensive, and many men experience side effects, like heart palpitations or blue-ish vision. Here are a few proven natural ways to help improve E.D.
As we mentioned before, there are a lot of treatment options that you could use to treat a condition as erectile dysfunction. A lot of the men diagnosed with erectile dysfunction decide to try some of the natural remedies before they refer to some of the top men enhancement pills. Exercise is one of the most commonly recommended ways as a natural remedy for erectile dysfunction. We all know that exercising has a lot of different beneficial effects on our bodies so why not use it as a part of the treatment for this condition? 

Although not direct proof of cause and effect, the positive results that we report in half of the men in the current study may reinforce our clinical observation with objective RigiScan™ data that use of yohimbine might be associated with better effects in nonsmokers. We30 reported that cessation of smoking may rapidly improve nocturnal erectile activity and found that nicotine was not the noxious agent in our study. We postulated that carbon monoxide might create a hypoxic environment in the penis. This effect probably was mediated through restoration of nitric oxide activity.31

We studied the involvement of zinc in the sexual behavioral response of male rats. The study design employed a rat model to predict the human sexual response to elemental zinc supplementation. Rats were used because they are very social and copulate under a variety of circumstances, regardless of the presence of a human experimenter. They are practical (small and easy to handle) and certain tissues and neuroendocrine systems are strikingly similar to humans.[13]

Many prostate problems, including cancer, are linked to zinc deficiency, and when the Chicago Center for the Study of Prostatic Diseases gave 50 to 100mg of zinc daily to patients suffering from infection of the prostate, 70 per cent of cases showed improvement. Zinc levels decline with age and men over fifty can fight impotency and prostate enlargement by taking zinc supplements.

Yohimbe is taken by mouth to arouse sexual excitement, for erectile dysfunction (ED), sexual problems caused by medications for depression called selective-serotonin reuptake inhibitors (SSRIs), and general sexual problems in both men and women. It is also used for athletic performance, weight loss, exhaustion, chest pain, high blood pressure, low blood pressure that occurs when standing up, diabetic nerve pain, and for depression along with certain other medications.


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!
Yohimbine has had questionable effects in men with organic erectile dysfunction. We conducted this study to better define the population of men responsive to yohimbine, because tobacco was thought to affect a regimen of yohimbine more than other risk factors. We measured nocturnal penile tumescence with the RigiScan™ monitor, hormone profiles, answers to the Florida Sexual Health Questionnaire, and clinical responses at baseline and after two different doses of yohimbine in 18 nonsmoking men with erectile dysfunction. Of the 18 men, nine (50%) were successful in completing intercourse in more than 75% of attempts. The yohimbine responders were men with less severe erectile dysfunction as manifested by improved increased rigidity on RigiScan™ testing, higher Florida Sexual Health Questionnaire scores, and slightly higher levels of serum testosterone. Yohimbine is an effective therapy to treat organic erectile dysfunction in some men with erectile dysfunction.
Saw palmetto. Saw palmetto comes from the fruit of a small palm tree. It has been used to treat symptoms in men with an enlarged prostate gland, such as difficulty urinating, and it has been recommended to treat ED caused by an enlarged prostate. However, several recent clinical trials did not show that saw palmetto works any better on an enlarged prostate than a placebo does. "There is no evidence that saw palmetto should be used to treat erectile dysfunction," says Dr. Gilbert. Like ginkgo biloba, saw palmetto can interact with some prescription medications.

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
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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