Reduction of the libido index was the major disadvantage that we observed with zinc supplementation. Substances that affect libido usually act centrally and may reduce desire by causing sedation or hormonal disturbances.[17] The role of elevated levels of PRL in serum as an inhibitor of sexual drive and gonadal function is well established.[18] This reduction of sex drive may occur through the modification of activity of dopaminergic neurons in the CNS that are regarded as controlling sexual motivation and function.[19] Our study demonstrated a significant increase of serum PRL level (2.9 to 7.22 ng/dl) within two weeks of supplementation of zinc (5 mg/day). This is a possible explanation for the reduced libido with increasing doses of zinc observed in this study.
Dealing with erection problems can be a challenge. However, there are lots of treatments and lifestyle changes which can help. While medications such as Viagra improve symptoms in the short term, pelvic floor exercises can help you improve your sexual function in the long term. Find out why pelvic floor, also known as Kegel exercises, can be used to treat ED and how to perform the exercises correctly.
"Sexual relations are not only an important part of people's wellbeing. From a clinical point of view, the inability of some men to perform sexually can also be linked to a range of other health problems, many of which can be debilitating or potentially fatal," says Professor Gary Wittert, Head of the Discipline of Medicine at the University of Adelaide and Director of the University's Freemasons Foundation Centre for Men's Health.
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.
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.
When it comes to keeping your gut healthy and immunity strong, consuming fermented foods and probiotic supplements is essential. Probiotic foods and supplements fortify the ‘good’ bacteria that live in the gut – the all-important microbiome – which in turn protects the gut wall, regulates inflammation, and assists with hormone and neurotransmitter production. Also essential… View Article
Usually there will not be a specific treatment that will lead to the improvement of erectile dysfunction. However, there are treatments that will allow erections to happen and can be used to allow sexual activity to take place. There are three main types of treatments: non-invasive treatments such as tablet medicines and external devices (e.g. vacuum device); penile injections; or for men who have not had success with other treatments, surgery may be an option.
Even at the higher doses of yohimbine, no changes in blood pressure or pulse were noted. This agent would appear to be safe in men with medically controlled hypertension. There was an increase in the morning cortisol levels in all men; the value was higher but not significantly so in responders. Telöken et al18 reported a high percentage (80%) of adverse events, but these authors administered a large dose (100 mg) of yohimbine. A toxic overdose of 200 mg produced only tachycardia, elevated blood pressure and anxiety of brief duration.33 Even direct intravenous dosing of yohimbine raised the mean arterial blood pressure by 12%,34 Goldstein et al35 systematically administered yohimbine and noted large hemodynamic and norepinephrine responses in both normal and hypertensive men; only the men who had a history of anxiety, depression, or other psychopathologic factors had symptoms. Oral administration of yohimbine at standard doses or even four tablets (21.6 mg) at a time has had no effect on blood pressure.4 Elevated blood pressure and heart rate were recorded when eight tablets (43.2 mg) were given at one time.3
The key to all of this is the endothelium, the inner lining of blood vessels that helps blood flow smoothly. Regular exercise has been shown to improve the way the endothelium works. The endothelium lines the blood vessels in the heart and the penis, explains Dr. Hellstrom, but the blood vessels in the penis are about one-third the size of those in the heart. So if you fail to have erections due to vascular problems, that indicates that you’re at risk for heart problems as well.

When experiencing difficulty in achieving an erection, it’s important to figure out if you are able to achieve an erection at all or if this happens only when you are with your partner. If you are unable to achieve an erection on your own, this may be more related to a medical and/or physical condition. Examples of this could include heart conditions, neuromuscular disorders, or pelvic pain. To evaluate if this is the cause of your condition, you should follow-up with your physician to examine your cardiovascular, neurological, and musculoskeletal system. From here, they may recommend medications such as Viagra or Cialis, or sometimes a referral to a urologist.
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.
Ginseng, specifically “red ginseng,” is known as the “herbal Viagra” that helps puts to rest men’s bedroom woes. Red ginseng is when the root has been steamed and then dried. The ginseng root is the part of the plant that is mostly used as a natural remedy when in its supplement form. However, the plant must be grown for a minimum of five years before it can be used. In a 2008 review, seven studies on red ginseng and ED, ranging in dosages from 600 to 1,000 milligrams three times a day, were found to provide evidence for the effectiveness of the herb in ED treatment.
However, the case is entirely different for Niacin, as it is not only relatively more convenient, but also it allows men to enjoy sex any time when they want even when they take Niacin for only one time in a day for erectile dysfunction. Niacin formulates in the form of various slow-release pills designed primarily to seep in a slow way within the human bloodstream during the course of one day.

Yohimbine significantly increased subjective measurements of sexual desire, sexual satisfaction, frequency of sexual contacts, and erection quality during sexual intercourse. Each subject also underwent a sleep study and researchers found that yohimbine also objectively increased the rigidity of erections while sleeping. [12] Yohimbine appears to alleviate both physical and psychological symptoms associated with ED.

L-arginine. L-arginine is an important amino acid that the body needs to build proteins. Because L-arginine has been shown to improve blood flow, some alternative practitioners have recommended that the supplements be used to treat ED. The Natural Medicines Comprehensive Database, which is a reliable authority on alternative medicines, says L-arginine is possibly effective for treating erectile dysfunction. But Harris warns that "although this supplement could improve blood flow, side effects can be dangerous." L-arginine can cause an allergic reaction or worsen asthma in some people; it can also lower blood pressure.

They found that men who exercised the most were also the most likely to have higher scores in sexual function. Specifically, those who expended 18 METS, or metabolic equivalents, per week were most likely to enjoy sex. METS is a physiological measurement that denotes the amount of energy a person spends on a specific activity, as well as the intensity of it. According to the researchers, 18 METS was equal to about two hours of strenuous exercise like running or swimming, 3.5 hours of moderate-intensity exercise, or six hours of light exercise.   
The lack of strong scientific proof that vitamin supplementation can improve erectile function doesn’t stop companies from selling vitamins, herbal supplements, and other products with the promise that they will do the job. ED is often treatable with prescription medications or medical procedures, so be careful not to get taken by a manufacturer’s empty promises.
"Sexual relations are not only an important part of people's wellbeing. From a clinical point of view, the inability of some men to perform sexually can also be linked to a range of other health problems, many of which can be debilitating or potentially fatal," says Professor Gary Wittert, Head of the Discipline of Medicine at the University of Adelaide and Director of the University's Freemasons Foundation Centre for Men's Health.
The phrase “penis exercise” actually refers to exercises known as pelvic floor or Kegel exercises, in which a man focuses on strengthening the muscles that control the flow of urine and ejaculation. These exercises are often recommended to men who are recovering from prostate cancer treatment, have problems with ejaculation, or have a hard time holding their urine, but they do not appear to help erectile dysfunction.

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.


Zinc therapy (5 mg/day) improves sexual competence by increasing penile thrusting and prolonging ejaculatory latency without disturbing arousability and motivation of male rats. Increase in the T levels observed with zinc supplementation is beneficial in this regard. However, increase in PRL is responsible for the reduced libido index. Further studies on pigs and monkeys are needed to evaluate the possible therapeutic use of zinc in sexual dysfunction.
Clinical trials were included if they met all of the following inclusion criteria: study population defined; Men with arteriogenic ED were considered; the present review was concerned with studies that used aerobic exercise on ED; only randomized controlled trials on this topic were selected for review; The main outcome measure was satisfactory intercourse without additional therapy using the International Index of Erectile Dysfunction (IIED) scores. The present review utilized studies that had successfully undergone rigorous peer review (i.e., published peerreviewed journals), were included.

The positive response in our patients was enhanced with the higher dose of yohimbine, a phenomenon noted previously.20,21 We agree that several weeks of therapy are needed before clinical effects are seen,21,22 and that some responders may be able to take yohimbine only on demand before sexual activity.39 Yohimbine is effective in a subset of men with organic erectile dysfunction, especially nonsmokers, and it deserves a place in our therapeutic armamentarium. When yohimbine is ineffective alone, it may be useful in combination with other treatment modalities, as has been shown with naloxone39 or trazodone.40


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If you can achieve erection on your own, but you then are unable to keep it while with your partner, it could be related to anxiety, stress, or any sort of relationship issue. There has been extensive research conducted into all potential contributors to erectile dysfunction, including increased use of Internet pornography, assuming that excessive use of internet pornography can change the way the brain perceives arousal, therefore changing the desired response. Dan Savage also explores this topic on his love and sex advice podcast, the Savage Lovecast. If your dysfunction is related to anxiety, stress, or relationship issues, it may be time to explore therapy with a sex-positive provider, or even meditation.
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.
Besides, niacin’s beneficial effects became more evident when the Hong Kong study researchers excluded those already using statin therapy. If there is an overlapping effect of these two groups of lipid-lowering agents on endothelial function, this would make sense. Also, chronic statin use could lessen the effect of niacin on endothelial function and hence affect improvement in erectile function.

Scientists have found a consistent link between maintaining a healthy weight and avoiding erectile problems. In one Italian study, researchers followed 110 obese men experiencing ED over the course of two years. Of the participants that lost the most weight, 31% ceased to suffer from ED. In the group that lost the least weight, only 5% of the men saw an improvement.


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.)
Various hormone levels were monitored during therapy, and it did not appear that there were major changes in the group as a whole (Table 2). Cortisol levels rose significantly from baseline to the first dose of yohimbine. When the hormone levels were evaluated in responders vs nonresponders (Table 3), slight differences were noted. Free testosterone levels were higher at baseline in the responders but did not increase significantly with the higher doses of yohimbine. Dehydroepiandrosterone sulfate levels were not significantly higher at baseline in the responders, and they did not change with the higher dose of yohimbine. Cortisol levels appeared to increase in both groups with increased doses of yohimbine, significantly more so in responders than in nonresponders (P=0.03).
Yohimbine: The main component of an African tree bark, yohimbine is probably one of the most problematic of all natural remedies for ED. Some research suggests that yohimbine can improve a type of sexual dysfunction that is linked with a drug used to treat depression. However, studies have linked yohimbine to a number of side effects, which can include anxiety, increased blood pressure, and a fast, irregular heartbeat. Like all natural remedies, yohimbine should only be used after advice and under supervision from a doctor.
Does drinking water improve erectile dysfunction? Erectile dysfunction or ED is a common concern for men. Everyday factors, such as hydration levels, may affect a person's ability to get or maintain an erection. Drinking water may, therefore, help some men with ED. In this article, learn about the link between hydration and ED, and other factors that can cause ED. Read now
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.

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).

The concentration of yohimbine in commercial supplements may vary from one manufacturer to another. A chemical analysis conducted on 26 brands of yohimbe supplement shows that nine products contain no yohimbe extract at all, while eight products contain only small amounts of yohimbine — approximately 0.1 to 1 parts per million (ppm), which is significantly low compared to 7,089 ppm yohimbine in an authentic yohimbe bark.3
In addition to getting helpful nutrients from your diet, you can also consider supplementing. Many of these are also on my list of top five supplements to increase sex drive, so they’re helpful for overall sexual health. It’s a good idea to check in with a practitioner, particularly one with knowledge of your individual health issues and medications, before taking anything. Here are some I recommend:
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