Esposito et al (18), in their randomized study investigated the effect of physical activities on 110 obese subjects. They reported significant effect of physical activities on both body mass index and EF. The physiological rationales underlying this hypothesis are that healthy lifestyle factors are associated with maintenance of good erectile function in men (19); obesity has been positively associated with endothelial dysfunction and increased serum concentrations of vascular inflammatory markers (34, 35); and both endothelial and erectile dysfunction may share some common metabolic and vascular pathways that may be influenced by behavioral-related pathways (19, 36). Obese men with erectile dysfunction had evidence of abnormal endothelial function, which was indicated by reduced blood pressure and platelet aggregation responses to L-arginine and elevated serum concentrations of markers of low-grade inflammation, such as IL-6, IL-8, and CRP. It has been shown that there are significant associations between IEEF score and proxy indicators of elevated body fat, the vascular response to L-arginine, and circulating IL-8 and CRP levels. The association we found between IEEF score and indices of endothelial dysfunction supports the presence of common vascular pathways underlying both conditions in obese men. A disturbance in nitric oxide activity linked to reduced nitric oxide availability could provide a unifying explanation for this association. In particular, in isolated corpus cavernosum strips from patients with erectile dysfunction both neurogenic and endothelium-dependent relaxation is impaired (37).
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.
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 fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.

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.

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!
Stimulant drugs speed up the nervous system. By speeding up the nervous system, stimulant medications can make you feel jittery and speed up your heartbeat. Yohimbe might also speed up the nervous system. Taking yohimbe along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with yohimbe.
None of the parameters showed a significant difference between controls and the group treated with 1 mg of zinc. The percentage of males who engaged in intromission (% intromitted), was significantly reduced in 10 mg/day zinc group; only three animals showed the particular behavior. Similarly percentage of rats which ended up with ejaculation significantly decreased with the high dose (two out of eight). Libido index of the highest zinc treated group was significantly low compared to controls; (38 % vs. 88 %, P < 0.05). Number of mounts and intromissions was also significantly decreased in the same group; Number of mounts: 1.58 (SEM 3.16) vs. 11.0 (SEM 1.59) and number of intromissions 2.13 (SEM 4.27) vs. 11.0 (SEM 1.59), P < 0.05).
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).

With the erectile dysfunction (ED) market expected to reach 3.4 billion dollars (USD) by 2019, this is a lucrative area to invest in, and not much grabs the attention of a guy watching a commercial during a Monday night football game than the promise to easily cure this problem with one pill as needed.  But is this the answer for everyone?  What causes ED?  For the guy with no apparent risk factors like depression or diabetes, hypothyroidism, injury or stress issues, erectile dysfunction or loss of libido (which don’t necessarily go hand in hand) can be confusing and frustrating for a guy as well as his partner.


Researchers at Johns Hopkins University last year looked at 3,400 healthy Americans and found that men who were vitamin D deficient were 32% more likely to have trouble getting it up than those with sufficient levels, even after adjusting for other ED risk factors. In fact, the connection is so common, Walker says D levels are something he always checks in ED patients. Why? The sunshine vitamin is crucial for keeping the endothelial cells that line blood vessels healthy. Without enough of the stuff, blood flow is inhibited, affecting everything from your heart to your hard-on.
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Adequate daily magnesium intake is slightly lower for younger men than for those in their 30s and older. The University of Maryland Medical Center recommends 400 mg daily for men between the ages of 19 and 30, and 420 mg per day for men 31 and older. While these levels are a good general guideline, you should check with your doctor to determine the proper dosage for a daily magnesium supplement, particularly if you’re using magnesium to help treat or prevent erectile problems.

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).
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.
Although not proven, it is likely that erectile dysfunction can be prevented by good general health, paying particular attention to body weight, exercise, and cigarette smoking. For example, heart disease and diabetes are problems that can cause erectile dysfunction, and both are preventable through lifestyle changes such as sensible eating and regular exercise. Furthermore, early diagnosis and treatment of associated conditions like diabetes, hypertension and high cholesterol may prevent or delay erectile dysfunction, or stop the erectile dysfunction from getting more serious.

Using the protocol of a clinical randomized placebo-controlled parallel-group trial, the study also took place at the University of Hong Kong. One hundred sixty male patients with ED and dyslipidemia were randomized into two groups receiving either up to 1,500 mg of oral niacin daily or placebo for 12 weeks. Using questions from the International Index of Erectile Function (IIEF, particularly questions Q3 and Q4), the primary outcome was improvement in erectile function. Q3 ranked “frequency of penetration,” while Q4 ranked “frequency of maintained erections after penetration.” Other outcome measurements included the total IIEF score, IIEF-erectile function domain, and Sexual Health Inventory for Men (SHIM) score.
It promotes the formation of red blood cells, enhances cellular metabolism, supports brain function, improves sexual function in men, and contributes to the healthy sperm production. This is because vitamin B12 is required for the formation and duplication of DNA which, in turn, is responsible for the healthy sperm production. And vitamin B12 deficiency affects genetic material the sperm carries.
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.

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.
Take note that you may not be able to complete a series of about 10 kegel exercises on your first try. This is just fine. Just do what you can, and gradually work on more kegel exercises until you reach 10 to 20 kegels, up to three times in a day. When performing these exercises, avoid holding your breath, or pushing your stomach, thigh muscles, or buttocks in. It would be helpful if you relax after every count of five. You may also challenge yourself by alternating between long and short squeezes.
Niacin -- with or without the addition of drugs to treat impotence -- poses serious health risks, including stomach ulcers and liver damage. If you have Type 2 diabetes, taking niacin could cause drastic elevations in your blood sugar levels. Less serious side effects include stomach upset and skin flushes -- your face and chest turn red and your skin itches, tingles or burns. You can purchase niacin without a prescription, but some over-the-counter formulas -- no-flush varieties that contain niacinamide -- will unlikely help lower your cholesterol.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
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.

Yohimbe goes by many names depending on how it’s sold. These include Yohimbehe, Yocon, Yohimex, Johime, Aphrodien and Corynine. Do any yohimbe supplements actually work to help treat sexual problems like impotence, or other conditions? Study results have been somewhat mixed. But there’s some evidence that they may help these conditions. It’s especially helpful when combined with other substances that promote better flow and higher energy levels, such as L-arginine. (3)
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.
The Institute of Medicine recommends cumulative daily vitamin D intake of 600 international units (IU) for adults between 18 and 70 years of age , and 800 IU for those over 80. A 3oz serving of salmon contains about 450IU, while an 8oz. glass of milk only has about 100IU. Low vitamin D levels may be an independent, potentially modifiable risk for ED, so it’s worth taking Vitamin D supplements for your “D.” However, keep your daily vitamin D supplement intake below 4,000IU, as too much vitamin D can be toxic.
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