Could the bark of a tree actually increase libido and improve impotence? Well yes it can… Yohimbe bark (Pausinystalia yohimbe), one of the most popular herbal remedies for male sexual dysfunction, has been shown in studies to increase blood flow to the genitals of both men and women, proving to be helpful for those with low libido. Though Yohimbe can be used by women, its actions have been shown to be extremely supportive for men experiencing erectile dysfunction due to stress or as a side effect of physiological health issues.
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
Some medications are changed and broken down by the liver. Yohimbe might decrease how quickly the liver breaks down some medications. Taking yohimbe along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking yohimbe talk to your healthcare provider if you take any medications that are changed by the liver.
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.
There’s much evidence to suggest that Yohimbine does have a positive effect in men who have erectile dysfunction. Initially, it was considered a failure as a treatment because it doesn’t increase levels of testosterone in the body, the hormone needed for erections. However, recent trials have shown that it works well to increase arousal, help blood flow to the penis, and as a general stimulant.
The truth is medication or psychosexual counselling are the first treatments a doctor will suggest because they’ve been proven to work. If a doctor has approved a medication for you then it’s safe. If you would still like to see if herbal supplements work for you, then there is a list below of supplements thought to work for erectile dysfunction. Just before you invest your money in them, remember they aren’t proven to work:
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.
Being as of a common condition as it is, there is no reason why you should be ashamed of asking for help to treat erectile dysfunction. It seems as men are still unaware of how common but how easily treatable this condition is. You can choose from the variety of natural remedies, such as changing your diet, routine, habits, exercising or you can choose from the variety of products available on the market to treat this condition. The point of this article is to raise awareness on the topic of erectile dysfunction and the importance and beneficial effects of exercising as a way to treat erectile dysfunction. We understand how overwhelmed you could feel from hearing all those people’s opinions on the topic and sharing their stories. That is why we choose some of the best exercises you can perform in order to improve your health. Do not hesitate to ask for help. A few changes in your diet and routine is all that is separating you from an improving your health in general.
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
A cold slice of watermelon can do more than just satisfy thirst and hunger during the warm summer months; it can help with bedroom satisfaction. Citrulline, the amino acid found in high concentrations of watermelon, is found to improve blood flow to the penis. A 2011 study revealed men who suffered from mild to moderate ED and took L-citrulline supplementation showed an improvement with their erectile function and were very satisfied. Natural watermelon juice, or “nature’s Viagra,” can also be easier on the stomach, since taking pills like Viagra can cause nausea and diarrhea.

One study found that sticking to a Mediterranean diet rich in virgin olive oil, vegetables, fruits, whole grains, nuts, and fish was associated with a lower risk of ED development and improvement in people who already suffered from ED. There is also some evidence that vegetarian and vegan diets may lower the risk of some types of heart disease, which in turn decreases the likelihood of developing ED.

Our bodies are designed to be active and in motion. By keeping active and engaging in regular aerobic exercise, you increase the blood flow to your muscles, and your penis along the way. One of the most interesting things about increasing your blood flow is that it becomes a signal to your blood vessels to grow and get wider. It benefits your brain, your heart, and your erection. The principle of "use it or lose it" is the best advise one can follow. In fact, if you don't engage in sexual activity at least once or twice a week, it would be beneficial to masturbate. This not only helps with prostate health, but encourages the blood vessels that contribute to your erection to maintain their patency and flow. 
Just because a product claims to be natural doesn't mean it's safe. Many herbal remedies and dietary supplements can cause side effects and dangerous interactions when taken with certain medications. Talk to your doctor before you try an alternative treatment for erectile dysfunction — especially if you're taking medications or you have a chronic health problem such as heart disease or diabetes.
Three subsets (eight in each subset) of sexually experienced adult male rats were supplemented with three different oral doses of zinc sulphate (a daily dose of 1 mg, 5 mg and 10 mg respectively) for two weeks. A subset of eight animals without zinc supplementation was used as the control group Sexual behavior was observed by placing them individually in cages with receptive females.
A complete sexual behavioral cycle of males involved pre sexual performances, copulation and ultimate ejaculation. Pre sexual behavior comprises physical contact with the female, sniffing and licking of female genital area, licking of their own penis, and few mounts without intromissions. Although all induced females were screened for receptivity, some females showed a mild rejection in the beginning. However, there were no rejections when they were coupled with very active males. All animals which completed the behavioral cycle showed a normal pattern of behavior (not an aberrant sexual behaviour) during the observation period.
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.
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.
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.
In addition, when research has shown a nutrient such as zinc or niacin to improve sexual function, it's usually in people who are deficient in it. So, before you stock up on over-the-counter nutritional supplements for ED, speak with your doctor. He can test you for deficiencies and steer you toward the most effective and safest way to treat your erectile dysfunction. 
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).
a) Some Vegetarians and Vegans.  It should be pointed out that certain animal-based foods are known for being the highest providers of niacin. So does this mean that animal-emphasized diets will result in increased blood flow over vegetarians?  My experience on the Peak Testosterone Forum has been the opposite and this is the subject of my book The Peak Erectile Strength Diet. Basically, a great many plant foods directly stimulate nitric oxide and will increase blood flow while lowering blood pressure. In fact, some plant foods can lower blood pressure as much as modern hypertension medications. See my page on Flaxseed and Blood Pressure for an example of that. High nitrate foods, such as spinach, arugula and beets, are yet another example.
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.

Minor side effects associated with erectile dysfunction medications include indigestion, runny nose and skin flushes. Sildenafil may cause temporary changes in your vision, and vardenafil may cause muscle aches and back pain. More serious side effects include hearing loss and erections that last longer than four hours. If you have cardiovascular problems, including a history of heart attacks or strokes, high or low blood pressure or vision problems such as retinitis pigmentosa, it may prove unsafe for you to take sildenafil, vardenafil or tadalafil. These medications may also interact poorly with some antibiotics, blood thinners and medications to prevent seizures and heart rhythm disorders.


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.
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).
Clinically I have seen these results in doses of just 20 mg twice daily.   It is important to note that prolonged zinc supplementation can lead to lowered copper levels so it is not advisable to continue this therapy unless it is in a cyclical nature.  For those on long term zinc there are combination products with Zinc and Copper.   In cases where some prescriptions that lower zinc are given, like acid lowering meds, thiazide diuretics and ACE inhibitors, or in renal dialysis patients, this chronic monitoring of zinc may lead to longer term supplementation.
A study published in May 2014 in The Journal of Sexual Medicine found that some men can reverse erectile dysfunction with healthy lifestyle changes, such as exercise, weight loss, a varied diet, and good sleep. The Australian researchers also showed that even if erectile dysfunction medication is required, it's likely to be more effective if you implement these healthy lifestyle changes.
Long considered an aphrodisiac by the Chinese, ginseng may do more than just rev your engine. A 2013 South Korean study found that taking the herb for just a few weeks improved guys’ performance in the bedroom, including helping them last longer before finishing. Meanwhile, a study in Spermatogenesis found that ginseng can also help make for harder, longer-lasting erections and improve testosterone levels, which in turn boosts libido. “Ginseng is a promising herbal therapy for ED because it helps promote relaxation of smooth muscle in the penis, increase dopamine levels in the brain, and increase pressure in the cavernosal nerves of the penis which helps nitric oxide synthesis,” Walker explains.
A study published in May 2014 in The Journal of Sexual Medicine found that some men can reverse erectile dysfunction with healthy lifestyle changes, such as exercise, weight loss, a varied diet, and good sleep. The Australian researchers also showed that even if erectile dysfunction medication is required, it's likely to be more effective if you implement these healthy lifestyle changes.
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.

Yohimbine hydrochloride is the principal alkaloid of the bark of the African yohimbe tree. It is primarily selective for the presynaptic alpha-2 receptor that enhances the central release of norepinephrine1,2 or even epinephrine,3 although the latter is controversial.4 This central action increases sexual arousal2,5 and appears similar to the central alpha-2 adrenergic mechanism that initiates hot flashes.6 Peripherally, yohimbine may partially antagonize norepinephrine-induced contraction of corporeal cavernosal smooth muscle.7,8 The action is that of an antagonist to postjunctional alpha-2 adrenergic receptors, but a direct effect on vascular smooth muscle is also possible.9


Another study discovered that nicotine significantly reduced participants' physical arousal in response to erotic films; the erections achieved by study participants who had ingested nicotine were 23% smaller than those who hadn't. This is in spite of the fact that participants didn't report feeling any less psychologically aroused by the erotic films.
Acupuncture. Acupuncture has been used for centuries to treat ED and impotence in China. A recent review of studies on acupuncture for erectile dysfunction was published in the British Journal of Urology International. After reviewing four studies, the authors concluded that there was not sufficient evidence to say that acupuncture worked. However, some experts believe it's worth trying. "Acupuncture can work," says Gilbert. "It probably works best to treat the psychological component of ED. There is very little downside to trying it."
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.
This is one B team you want to get on pronto: A recent report from Harvard University highlighted a study that has linked low levels of B12 to erectile dysfunction. A causal link hasn’t been nailed down, but the B vitamin is used by every system in the body, particularly in cell metabolism and the production of blood — two essential factors in getting and keeping a quality erection.

There’s no bedroom bummer quite like having to fly at half mast, but your penis problems are likely more common than you think: As many as 30 million American men suffer from erectile dysfunction, and one in four who seek treatment for ED are actually under the age of 40, according to a study in The Journal of Sexual Medicine. We all know there’s a little blue pill that can fix the failure to launch—but you don’t necessarily have to fill a ‘script to save your stiffy.
Sildenafil, vardenafil and tadalafil increase the amount of nitric oxide in your body. Your body contains nitric oxide naturally, which is a gas that relaxes blood vessels. Medications to treat erectile dysfunction relax blood vessels in a man’s penis to help obtain and maintain an erection. Some medications that treat high blood pressure, high cholesterol and heart disease also relax your blood vessels. If you take niacin while you also take medications to treat erectile dysfunction, your blood pressure could drop drastically. You could faint or develop other health problems.

The number of intromissions in the 5 mg/day group was comparable with controls. On the other hand number of penile thrusting was significantly increased with the same dose. These are indications of unimpaired erectile function due to supplemented zinc. Our observations also confirmed the lack of aberrant sexual behavior which is indicative of uninhibited penile tactile sensations.[15] Sexual behavior may also be changed with motor weaknesses and incoordination.[12] Supplementation with zinc did not impair muscle strength or coordination when tested with bar and bridge tests, indicating that prolongation of ejaculation was not mediated through these mechanisms.


"The good news is, our study also found that a large proportion of men were naturally overcoming erectile dysfunction issues. The remission rate of those with erectile dysfunction was 29%, which is very high. This shows that many of these factors affecting men are modifiable, offering them an opportunity to do something about their condition," Professor Wittert says.
According to a study conducted by the University of the West of England, Bristol, pelvic floor exercises may be very effective in treating erectile problems. Many participants of the study, all of whom were men who had been experiencing erectile dysfunction for at least six months, reported a significant improvement of their condition within three months of training their pelvic floor. 
To evaluate the patients' response clinically in the office, a simple grading system was used.27 The patients were asked about the quality of their erections, which were graded as follows: grade 1, tumescence but no rigidity; grade 2, tumescence with minimal rigidity; grade 3, rigidity sufficient for sexual intercourse; and grade 4, fully rigid erection. At the end of the study, patients were graded as to whether they thought they had improved enough to have satisfactory regular intercourse, which is defined as success in 75% of attempts. The degree of subjective improvement in intercourse was used to classify patients as ‘responders’ vs ‘nonresponders’ in subsequent analyses. A log was kept by the couple of their sexual activity, and it was taken to the clinic for review by the clinical investigator.
Yohimbe is an herbal remedy that comes from the bark of an African tree, Pausinystalia yohimbe. Before Viagra, drugs containing yohimbine hydrochloride, the active ingredient in yohimbe bark extract, were used to treat erectile dysfunction (ED). However, levels of yohimbine in yohimbe bark extract vary considerably and are often very low. Yohimbe bark extract, by itself, never has been shown to work as effectively as drugs containing yohimbine hydrochloride. What’s more, yohimbe can have serious side effects including paralysis, fatigue, stomach disorders, even death. I don’t recommend it, and harvesting of its bark is driving the yohimbe species to extinction.
A cold slice of watermelon can do more than just satisfy thirst and hunger during the warm summer months; it can help with bedroom satisfaction. Citrulline, the amino acid found in high concentrations of watermelon, is found to improve blood flow to the penis. A 2011 study revealed men who suffered from mild to moderate ED and took L-citrulline supplementation showed an improvement with their erectile function and were very satisfied. Natural watermelon juice, or “nature’s Viagra,” can also be easier on the stomach, since taking pills like Viagra can cause nausea and diarrhea.
Acupuncture may help treat psychological ED, though studies are limited and inconclusive. You’ll likely need several appointments before you begin to notice any improvements. When choosing an acupuncturist, look for a certified practitioner who uses disposable needles and follows U.S. Food and Drug Administration guidelines for needle disposal and sterilization.

A yohimbine HCL dosage of 0.2 milligrams per kilogram of bodyweight taken on an empty stomach immediately upon waking or in-between meals ramps up fat oxidation without causing undesirable side effects like high blood pressure or racing heart. [3] The table below provides a guideline on how many 2.5mg capsules of yohimbine HCL you should take based on your weight and the recommended dosage:
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.
Green vegetables, legumes, seeds, nuts and brown rice are among the best sources of dietary magnesium. Most other foods don’t contain enough of the mineral to contribute to daily recommended levels, which is why many people choose to take a magnesium supplement or a daily multivitamin that contains magnesium. If you’re concerned about your overall magnesium level, particularly as it relates to erectile function, discuss supplement options and dietary changes with your doctor.
Testosterone levels did not differ statistically in the treatment groups and did not change during treatment with yohimbine. The levels of dehydroepiandrosterone and free testosterone tended to be higher in the responder group, but the levels in both groups were well into the age-adjusted normal ranges. Androgens play a part in peripheral erectile activity, but they are not necessary for the central arousal stimulation of yohimbine,36 in which norepinephrine release acts as an inhibitor antagonist.2 Peripheral sympathetic stimulation also occurs37 but less than its adrenergic antagonistic activity. These peripheral effects are prompting the search for new alpha-2 adrenergic antagonists38
Men typically have higher zinc needs than women, which can make them more vulnerable to zinc deficiencies. In men, zinc is also needed to support healthy prostate and penile function. Keep in mind that excessive amounts of zinc can be harmful so it is best to follow package directions on the supplement you choose, should you decide to supplement with the mineral.
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