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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.
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.
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.
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However, you might actually be better off going one step back in the chain reaction and taking an L-citrulline supplement. While your body converts L-arginine to nitric oxide, it also metabolizes it too fast when the amino acid is taken in an oral supplement, according to a 2011 study from the University of Foggia in Italy. L-citrulline, which the body converts to L-arginine, is actually a better option to follow the same metabolic pathway and serve as a treatment for ED, the same study found.
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.
I got married to my wife about 1 month after we met on a photo studio, we lived happily for the first 3 months of our marriage until i and my wife started having quarrels at home because i couldn't satisfy her on bed with my little penis. Actually my penis was very small, it measured about 3 inch long on erection and i am 39 years old. my wife said it was forbidden by the women of this world. my wife started to fight with me . Sometimes i will return from 

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.
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.
Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).
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.
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.
Twenty-one men were screened. Two were rejected because they had normal results on nocturnal penile study, and one man was excluded from the study because of a protocol violation. Eighteen men completed the study. The mean age of the men was 60.2 y (range, 34–69 y). The mean duration of erectile dysfunction was 3.1 y (range, 1–10 y). All men were in stable heterosexual relationships. The listed medical risk factors for erectile dysfunction were hypertension in nine men, atherosclerotic cardiovascular disease in seven, single offending medication in seven (mostly beta-blockers), multiple medications in five, diabetes mellitus in four (one with neuropathy), venous leakage in two, and peripheral vascular insufficiency in one.
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.
One of the keys to addressing erectile dysfunction is improving the functioning of the endothelium, which is the inner lining of blood vessels. Wayne Hellstrom, MD, urology professor at Tulane University School of Medicine says keeping endothelium healthy can help you improve erectile functioning. Cardio training helps with this, as does resistance training. Adding weight training to cardio training increases muscle mass and bone strength helps your balance and stability (which can help prevent injuries) and can help lower blood pressure as well. Improved muscle definition can also be great for self-esteem, and that can’t hurt.
Vitamin B5 (Pantothenic acid) is irreplaceable if you wish to increase life expectancy. Vitamin B5 has a positive impact on the nervous system and intestinal motility. Calcium pantothenate is a form of vitamin B5 that has a powerful anabolic effect, enhances the synthesis of steroid hormones, and takes part in the synthesis of coenzyme A. In addition, calcium pantothenate helps release energy from foods. So, to a large extent, it improves your body’s endurance and stamina, as well as increases human tolerance to different loads.
Over the years, myriad treatments and gadgets have been invented to assist with issues related to erections. They run the gamut from vacuum pumps to constriction bands, surgical implants, male hormone therapy, herbal supplements (ginkgo biloba, saw palmetto,  L- arginine, and yohimbe), and even shock-wave therapy. Lifestyle changes include: increasing exercise, decrease smoking, losing weight, and eating healthier. More natural alternative treatments include acupuncture and watermelon juice. In her hilarious and informative book entitled Bonk, researcher Mary Roach explores coupling of science and sex, and dedicates a couple of chapters to in-depth analysis of erectile dysfunction treatments.
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

Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He’s a practicing Gastroenterologist and Hepatologist with a focus on Men’s and Women’s Health, and a regular contributor to Women’s health, Shape and Prevention Magazine.
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