Past research has suggested that living a healthier life full of exercise and a good diet can bring men back to sexual health. But according to researchers at Cedars-Sinai Medical Center in Los Angeles, most of these studies underrepresented African-American men. “This study is the first to link the benefits of exercise in relation to improved erectile and sexual function in a racially diverse group of patients,” said senior author of the study Dr. Adriana Vidal, of Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute and Department of Surgery, in a press release.

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Derived from the bark of a West African evergreen tree, yohimbe was the go-to ‘script for a wonky willy prior to the advent of wonder drugs like Viagra, Walker says. “Yohimbe enhances sexual performance both by blocking certain neurotransmitters in the brain and by increasing the release of nitric oxide in the cavernosal nerves of the penis,” he explains. And it pairs well with other erection-friendly tablets: A 2010 study in the Iranian Journal of Psychiatry found that a combination of yohimbe and L-arginine successfully helps guys get it up. However, yohimbe also has a handful of side effects, including elevated blood pressure and anxiety, so definitely talk to your doctor before you start on the supp.
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.
The Medline (Pubmed) electronic database was searched (from June 1972 to November 2010) for systematic reviews that evaluated the effects of therapeutic exercise on ED. The key words and search terms used to develop the search strategy for each of these databases included: exercise therapy, aerobic exercise, therapeutic exercise, rehabilitation exercise, impotence and erectile dysfunction. In addition, the electronic searches were supplemented by checking the reference lists of any relevant identified articles.
Disclaimer: The entire contents of this website are based upon the opinions of Dr. Mercola, unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Mercola and his community. Dr. Mercola encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. If you are pregnant, nursing, taking medication, or have a medical condition, consult your health care professional before using products based on this content.
Counselling or sex therapy (58% of people find this works for them) –mind-related causes of erectile dysfunction can affect anyone. They are more likely if you experience erectile dysfunction at a younger age. Talking to a counsellor or therapist can help some people overcome erectile dysfunction related to these problems, possibly for good. They can also help you if your erectile dysfunction is causing you stress, as this can make matters worse.
You may know horny goat weed from its omnipresence behind the counter at your local convenience store, but this traditional Chinese formula is less sketchy than it sounds. Used for centuries to treat low libido and erectile dysfunction, the herb’s potential efficacy was show in a 2010 study published in the Journal of Sexual Medicine. Researchers who fed the supplement to rats found they had improved erectile function; another study showed that the supplement can block a natural chemical that wilts erections. (Just be warned: Viagra was found to be 80 times more powerful.)
Yohimbe supplements often list yohimbe bark extract or yohimbine as the active ingredient. However, some of these products might not provide accurate information about the amount of yohimbine in the supplement. Also, some yohimbe supplements list yohimbine hydrochloride as an active ingredient. Yohimbe products containing man-made yohimbine hydrochloride as an ingredient are not legal to sell as a dietary supplement in the US.

L-arginine, an amino acid that is naturally present in the body and helps make nitric oxide, supports a successful erection. Nitric oxide is responsible for making the blood vessels relax, which helps sustain an erection for men. A 1999 study, observed the effects of six weeks of high-dose (5 grams/day) orally administered nitric oxide (NO) donor L-arginine on men with organic ED. Thirty-one percent of those who took 5 grams/day of L-arginine experienced significant improvements in sexual function. Burns told Medical Daily, “l-arginine and deer antler velvet” have been the most popular go-to natural treatments for men.
The researchers reasoned from other studies that when the degree of endothelial dysfunction and atherosclerosis are more severe, the effects of niacin and statins as lipid-lowering agents are also more apparent. Their current study seemed to bear this out. Also, in another study assessing the effect of a PDE5 inhibitor in patients using a statin, patients with higher baseline serum LDL-C had better improvement in erectile function after the use of a PDE5 inhibitor. This supports the researchers’ hypothesis that patients with potentially more serious endothelial dysfunction, such as those with higher LDL-C levels, may have better response to the combination usage of a PDE5 inhibitor and niacin.

The appropriate dose of yohimbe depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for yohimbe. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
The Florida Sexual History Questionnaire, a 20-item questionnaire that assesses interest and desire for sexual activity, sexual development, current sexual behaviors, and satisfaction with current sexual activity, was used to assess male sexual dysfunction. Individuals responded to each question by choosing one of six ordinally scaled response categories, with higher scores representing better functioning. Scores on the Florida Sexual History Questionnaire have been shown to significantly discriminate between men with and without impotence25 and between men with primary organic and primary psychogenic erectile dysfunction.26 According to Geisser et al,25 the Florida Sexual History Questionnaire has high internal consistency as well as split-half reliability. Chronbach's alpha has been reported to be as high as 0.90, and Spearman Brown's coefficient is reported to be 0.86.
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.
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.
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.'”
Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), dextromethorphan, donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.
As an alpha-2 antagonist, yohimbine promotes sympathetic activity. According to a number of studies, yohimbe can increase blood pressure. This is why it’s useful for things like erectile dysfunction or diabetic nerve problems. Yohimbine is sometimes used to treat low blood pressure and symptoms like dizziness when standing up. It works by dilating blood vessels and acting on the sympathetic nervous system. However, it’s important to point out that increased blood pressure can also be a problem for some people, especially those with existing cardiovascular problems, people taking blood pressure medications, or those who already have high blood pressure.
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.
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.

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.

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).

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
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)

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.
That’s no joke. Like every part of the body, the male repro system needs the right nutrients for optimal health, from function to fertility. Studies have isolated several nutrients that are particularly beneficial. You can get them through these best foods for your penis, or these best proteins for your penis, but we’ve broken them down here by nutrient in case you want to ensure you’re getting enough. (And if you do decide to go the supplement route, as always, talk to your doctor and never exceed recommended dosages.)

The human body only contains 2 or 3 grams of zinc at any given time. Zinc is distributed throughout the body in organs, blood, and bones. It can be difficult to diagnose zinc deficiency. While a low blood zinc level does indicate a deficiency, a normal blood level does not necessarily indicate the absence of a deficiency. And examination of the hair for zinc or a zinc taste test (ZTT) may also be used for supportive evidence in the diagnosis of zinc deficiency.
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