One of the main actions of yohimbe bark is alpha-2 antagonism (this is why it’s also sometimes called an “alpha-2 blocker”). This means that it can impact sympathetic nervous system activity and increase the release of adrenaline (or noradrenaline). This is because it blocks alpha-2 receptors in the brain stem. (4) Other types of alpha-2 agonists medications work in a similar way. They affect the central nervous system by altering release of certain neurotransmitters and dilating blood vessels. This increases alertness, circulation and other physiological processes.
Vidal and her team looked at self-reported physical activity among 300 men, and then categorized them into categories: sedentary, mildly active, moderately active, and highly active. These men also reported their levels of sexual function, including their ability to have an erection and orgasm, as well as the quality and frequency of their erections and overall sexual function.
There are many different reasons a man’s ability to sustain or maintain an erection may be impaired. Impotence is the most common sexual disorder among men. It is thought that most men should be able to achieve and maintain an erection well into their 80s, but about 25 percent of all men over the age of 50 are thought to experience some form of impotence. By the age of 75, half of all men will be impotent. Impotence may come and go, depending on the state of their physical health as well as their stress levels. One of the number one causes of impotence is cardiovascular disease. Cardiovascular disease may restrict blood flow to the penile tissues, which greatly affects a man’s ability to achieve and maintain an erection during sexual arousal.

There are risks to prosthetic surgery and patients are counselled before the procedure. If there is a post-operative infection, the implant will likely be removed. The devices are reliable, but in the case of mechanical malfunction, the device or a part of the device will need to be replaced surgically. If a penile prosthesis is removed, other non-surgical treatments may no longer 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.
Dr. Traxler is a University-trained obstetrician/gynecologist, working with patients in Minnesota for over 20 years. She is a professional medical writer; having authored multiple books on pregnancy and childbirth; textbooks and coursework for medical students and other healthcare providers; and has written over 1000 articles on medical, health, and wellness topics.  Dr. Traxler attended the University of Minnesota College of Biological Sciences and University of Minnesota Medical School,  earning a degree in biochemistry with summa cum laude honors in 1981,  and receiving her Medical Doctorate degree (MD) in 1986.

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.
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.
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).
Where it comes from: Yohimbe is derived from the bark of a west African evergreen tree. Yohimbine is an active chemical (an alkaloid) found in said bark and is cultivated into supplement form. Yohimbine hydrochloride is a standardized form of yohimbine that is available as a prescription drug in the United States. These terms are all related but are interchangeable.

Although not every study has shown that yohimbe can have slimming effects, certain other studies have found positive results. One study found that yohimbine significantly increased mean weight loss in overweight female patients following a low-energy diet. (12) Possible mechanisms of action include: boosting lipolysis (the breakdown of fats and other lipids by releasing fatty acids into the blood) both during and following exercise, regulating insulin secretion, and reducing appetite. (13)
E.D. may just be that early warning sign. Erections depend on blood flow, and blood flow depends on nice, wide-open arteries. Atherosclerosis doesn’t just affect the arteries around your heart; if you have plaque build-up, you are likely to have it all around the arterial system — and the penile artery is one of the smallest arteries you have (no matter what you claim about your size). So if you have atherosclerosis, then the plaque there will be one of the first places where you would notice a decline in blood flow.
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:

Overall, studies have been inconclusive about the aphrodisiac benefits of taking yohimbine supplements. However, most have found it works better than placebos. (7) According to a report published in the Iranian Journal of Psychiatry, a recent analysis of seven trials concluded that between 34–75 percent of men involved in studies experienced favorable results when taking between 5–10 milligrams. (8)


There was a higher incidence of adverse events in those taking niacin. However, most patients could tolerate it at the maximum dosage (1,500 mg/day). With this in mind, niacin could be an alternative choice of treatment for patients with ED. Despite the success of phosphodiesterase type 5 inhibitors (PDE5 inhibitors), such as sildenafil, only around 60–70% of patients have a satisfactory response to this class of drugs. And there are adverse effects such as headache, flushing, dyspepsia, nasal congestion, and impaired vision, including photophobia and blurred vision. Hence, there is a need to develop other therapeutic agents for those patients who do not respond satisfactorily to PDE5 inhibitors or are contraindicated for those such as sildenafil.
Shindel, A. W., Xin, Z.-C., Lin, G., Fandel, T. M., Huang, Y.-C., Banie, L., … Lue, T. F. (2010, February 5). Erectogenic and neurotrophic effects of icariin, a purified extract of horny goat weed (Epimedium spp.) in vitro and in vivo. The Journal of Sexual Medicine, 7(4), 1518-1528. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2009.01699.x/full
A study of 23 individuals found that a dose of 0.4mg/kg of yohimbine not only increased norepinephrine in the blood, blood pressure, and heart rate, but it also increases impulsive response rates. These response rates are measured by the number of impulsive errors, response biases, and reaction times on an immediate memory task. [10] While yohimbine may improve your reaction time it may also encourage you to act irrationally.

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.

ED can also occur among younger men. A 2013 study found that one in four men seeking their first treatment for ED were under the age of 40. The researchers found a stronger correlation between smoking and illicit drug use and ED in men under 40 than among older men. That suggests that lifestyle choices may be a main contributing factor for ED in younger men.
Responders tended to have consistently higher scores compared with nonresponders. For nonresponders, none of the scores was significantly different when comparing baseline scores with either of the yohimbine doses. However, a trend toward an improved total questionnaire score was noted from baseline to the 5.4 mg tid dose (P=0.083). For responders, a significant increase in the Florida Sexual History Questionnaire total score was observed from baseline to the time the 5.4-mg tid dose was administered (P=0.021). A trend closely approaching statistical significance (P=0.055) was noted from baseline to the administration of the 10.8 mg tid dose of yohimbine. Inspection of changes in the individual items revealed that responders reported significantly greater frequency of vaginal penetration with both the 5.4- and 10.8-mg doses of yohimbine tid compared with baseline (P=0.010 and P=0.010, respectively). Participants also noted less difficulty obtaining an erection for sexual intercourse while taking 10.8 mg of the drug compared with baseline (P=0.011). Responders reported having significantly less difficulty maintaining an erection for sexual intercourse compared with baseline with both the 5.4-mg tid dose (P=0.049) and the 10.8-mg tid dose (P<0.001). Responders also reported significantly greater penile firmness and rigidity before intercourse or masturbation in both treatment conditions compared with baseline (P=0.02 for the 5.4-mg tid dose and P=0.013 for the 10.8-mg tid dose).
Yohimbe supplements haven't been tested for safety and keep in mind that the safety of supplements in pregnant women, nursing mothers, children, and those with medical conditions or who are taking medications has not been established. You can get tips on using supplements here, but if you're considering the use of Yohimbe, it is essential that you talk with your physician first. 
Some men say certain alternative medicines taken by mouth can help them get and maintain an erection. However, not all “natural” medicines or supplements are safe. Combinations of certain prescribed and alternative medicines could cause major health problems. To help ensure coordinated and safe care, discuss your use of alternative medicines, including use of vitamin and mineral supplements, with a health care professional. Also, never order a medicine online without talking with your doctor.
But in this case, zinc is much harder to absorb. This explains a decrease in testosterone levels in vegetarians. Slippery jack mushrooms, button mushrooms, beef liver, and fish are also rich in zinc. They are followed by breadstuffs, egg yolk, rabbit, chicken, beans, tea, and cocoa. In addition, zinc is found in onions, garlic, and rice. And a very small amount of zinc is available in fruits, vegetables, and milk.
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.

Research has shown that the same eating patterns that can cause heart attacks due to restricted blood flow in the coronary arteries can also impede blood flow to and within the penis. The blood flow is needed for the penis to become erect. Diets that include very few fruits and vegetables along with lots of fatty, fried, and processed foods can contribute to decreased blood circulation throughout the body.
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.
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 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
Researchers in London set out to find out if the claims about Yohimbe were true. Could the bark of a tree actually increase libido and improve impotence? They performed a double-blind trial using yohimbine for the treatment of erection inadequacy. Men, aged 18-70 years, seeking help for the secondary erection inadequacy for 6 months or longer, took part in the trial. None of the participants had any serious psychiatric disease, hypertension or liver insufficiency. Half of the men were given 5.4mg of yohimbine, the other half a placebo, for 8 weeks. Patients were assessed in 4-week intervals. After 8 weeks of treatment, 37 percent said they had good erections, as compared to only 13% in the placebo group. After the 8-week treatment, the placebo group was given the yohimbine as well, results for improved stimulated erection after the second 8-week trial increased to a total of 42 percent overall.
Because cholesterol is a building block for testosterone, drugs that interfere with cholesterol production can lower levels of this hormone (Journal of Sexual Medicine, April, 2010). French and Dutch researchers have reported that decreased libido and erectile dysfunction may be associated with statin-type drugs (British Journal of Clinical Pharmacology, Sept. 2004; Drug Safety, July, 2009).
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.
Good information. However, be sure you are using yohimbine and not yohimbe. Reasons is that I had not realized this difference in the various products I was purchasing and I found out the hard way . Yohimbine can be sold at up to 2% at health food stores legally or you may ask your doctor and it can or is I believe prescribed at 8% yohimbine. I personally love yohimbine for helping me with depression and yes social anxiety. The form yohimbe is much cheaper but the alcoloids can include other stimulate ingredients and the active ingredient the yohimbine is not standardized leaving the user at risk of an uncertain but generally unpleasant overstimulation similar to to much coffee only worse and can last a rather long time up to 10 or more hours. So please just use Yohimbine 2percent and you should be safe . As always consult your medical doctor before taking any new supplements.

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.   


Regular cardiovascular exercise can not only improve erectile function, it can boost energy levels, lower blood pressure, and improve muscle tone. Furthermore, by reducing body fat and stress, regular cardio can improve a person’s self-image, improve sleep, and result in a more rested overall feeling. For maximum benefit, 20 to 30 minutes of cardiovascular exercise four or five times a week is ideal, and it may take time to work up to this. It’s smart to discuss this with your doctor if you have been living a sedentary lifestyle or haven’t had a physical in a while. The key to sticking with cardio is choosing an activity you enjoy so it won’t feel like a chore. Great choices in the cardiovascular exercise include:
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.

Erection is a complex physiological process in which vascular factors play a pre-eminent role. Therapeutic options for men with arteriogenic erectile dysfunction (ED) are mainly administration of phosphodiesterase type 5 inhibitors, intracavernous injections of vasoactive agents (for example, prostaglandin El, papaverine/phentolamine, or triple drug), intraurethral administration of prostaglandin El, and administration of centrally acting drugs (11, 12). However, all of these methods circumvent the patient's problem temporarily, and patients are not cured of impotence, they will remain dependent on these treatments for the remainder of their sexually active lives. An effective treatment that cures the problem permanently is needed where penile revascularization and exercise remain treatment options for such patients. However, due to the complexity of penile revascularization such as cost ineffectiveness, unavailability of experts, side effects of surgery and high failure rates among the elderly (13) have left people with ED at the mercy of exercise.
A study in the Journal of Sexual Medicine found that a large percentage of men with ED also have low levels of vitamin D. If you’re experiencing ED, you may want to have your level of vitamin D checked. Other symptoms of a low vitamin D level may be too subtle to notice. However, if you have serious vitamin D deficiency, you may have bone pain or muscle weakness. Vitamin D levels can be checked with a simple blood test and for most people corrected with a supplement.
Once you get checked out for artery blockage and low T, there are things you can do to help treat ED besides taking medications. Yes, Viagra is now available generically (it’s called sildenafil), but it is still expensive, and many men experience side effects, like heart palpitations or blue-ish vision. Here are a few proven natural ways to help improve E.D.
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