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.


Alprostadil is injected into the side of penis with a very fine needle. It's of great value to have the first shot in the doctor's office before doing this on your own. Self-injection lessons should be given in your doctor's office by an experienced professional. The success rate for getting an erection firm enough to have sex is as high as 85% with this treatment. Many men who do not respond to oral PDE5 inhibitors can be ‘rescued' with ICI.
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

Several studies (15–17) have shown an inverse relationship between physical activity levels and biomarkers of inflammation in both the healthy individuals and subjects with cardiovascular condition. Studies (18–21) have also reported the role of exercise in the management of erectile dysfunction. The majority of these studies are subjective, retrospective case series and non randomized non controlled studies. However, 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 (22). Therefore, the purpose of the present Meta analysis study was to determine the role and effect of aerobic exercise in the management of erectile dysfunction in randomized controlled trials.


Yohimbine also helps to increase levels of the coenzyme NAD (or nicotinamide adenine dinucleotide). This affects metabolism, cognitive processes, and detoxification of drugs in the body. NAD is not currently used to treat cognitive or mood-related disorders on its own, but has been shown in some studies to potentially have uses for preventing neurodegenerative diseases including Parkinson’s disease or Alzheimer’s. However on the other hand, studies have found that because it can increase anxiety in some patients, yohimbine may actually worsen mental illness in some patients, including those with Parkinson’s. (15) For this reason, it’s important for anyone taking mood-altering medications, or who has a history of any cognitive or mood disorder, to work with a professional while taking or starting any new herbal treatments.
Some studies suggest that alpha 2-antagonists may help improve patients’ response to antidepressant medications. (5) Yohimbe has a chemical structure that is similar to several medications, and even recreational drugs, that are used to manage conditions like like mood-related disorders such as depression or schizophrenia, low libido, dizziness due to low blood pressure, and others. One such medication is called Reserpine, a type of indole alkaloid that is prescribed as an antipsychotic and antihypertensive drug. Another is lysergic acid (also known as LSD), which has much stronger psychological/psychedelic effects. While yohimbine doesn’t actually have psychedelic effects, according to research findings, it impacts neurotransmitters including dopamine, adrenaline and serotonin. It also seems to help some people suffering from symptoms due to mental illness.

It's also important to remember that your mental health plays as much a part of your sexual ability as your physical health. Stress and other mental health concerns can cause or make erectile dysfunction worse. Minor health problems may slow your sexual response, but the accompanying anxiety that comes with the slow sexual response can shut things down entirely.


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.
Data from the Florida Sexual History Questionnaire collected at each time period (baseline, 5.4 mg tid and 10.8 mg tid) are presented in Table 6. Three patients (two responders and one nonresponder) did not complete the entire questionnaire for each study period and were excluded from the analyses. Thus, data in the table and statistical analyses are based on the responses of seven responders and eight nonresponders.
It’s hard to concentrate on what’s happening in the bedroom when you’re thinking about problems at work. For many men, it’s psychological issues like anxiety rather than physical ones that contribute to E.D. Chronic stress has also been linked to heart disease, high blood pressure, depression, and more. Find a way of blowing off steam that works for you (I like exercise and meditation) and stick to it.
"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.
Lastly, it should be remembered that many individuals without dyslipidemia take niacin as a preventative measure. If you plan to take more than about 800 mg of niacin a day, it is a good idea to have your liver tested periodically just to make sure that your liver has no problem with high-dose niacin. These liver tests are the same used to check for liver toxicity in people taking statins, from which there is a higher likelihood of liver toxicity compared to taking niacin. The principal problem from taking statins is muscle damage which is serious enough to be life-threatening. This problem does not occur with those who take niacin. Not to be forgotten, niacin has been found to prolong orgasm.
In a 2005 study, three months of twice-daily sets of kegel exercises combined with biofeedback and advice on lifestyle changes, such as quitting smoking, losing weight, and limiting alcohol, worked far better than just giving the participants advice. “Wearing tight pants will affect impotence along with some other medical conditions like diabetes and heart disease,” which can also affect a man’s degree of impotence, Dr. Jennifer Burns, specializing in family practice with an emphasis on gastrointestinal health at the BienEtre Center, told Medical Daily.
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.
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)
Yohimbine also helps to increase levels of the coenzyme NAD (or nicotinamide adenine dinucleotide). This affects metabolism, cognitive processes, and detoxification of drugs in the body. NAD is not currently used to treat cognitive or mood-related disorders on its own, but has been shown in some studies to potentially have uses for preventing neurodegenerative diseases including Parkinson’s disease or Alzheimer’s. However on the other hand, studies have found that because it can increase anxiety in some patients, yohimbine may actually worsen mental illness in some patients, including those with Parkinson’s. (15) For this reason, it’s important for anyone taking mood-altering medications, or who has a history of any cognitive or mood disorder, to work with a professional while taking or starting any new herbal treatments.
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.
Geraerts, I., van Poppel, H., Devoogdt, N., de Groef, A., Fieuws, S., & van Kampen, M. (2016, January–February). Pelvic floor muscle training for erectile dysfunction and climacturia 1 year after nerve sparing radical prostatectomy: A randomized controlled trial [Abstract]. International Journal of Impotence Research, 28(1), 9–13. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26538105

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, 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.
Response to yohimbine was not dependent on patient age. Patients who showed a positive response had fewer medical risk factors overall, although the small number of patients was not large enough to provide statistical significance. The positive clinical response was verified subjectively both by the formal questionnaire and by the in-office clinical encounter. The positive response was verified objectively by measuring nocturnal penile tumescence and rigidity with the RigiScan™ home monitor. The trend of the baseline penile erectile response was better in the responders, suggesting that use of yohimbine might be more effective in patients who have less severe erectile dysfunction. Some authors have questioned the effect of yohimbine on penile activity, but either inadequate doses of yohimbine were used or only tumescence was measured,21,32 often in an office setting where anxiety and embarrassment might affect results.
A 2011 study of 160 men with moderate or severe erectile dysfunction divided the group in two—80 men were given niacin supplements, and 80 a placebo. The group given niacin reported improved ability to “maintain an erection versus the control group.” It’s not exhaustive research, but still promising. The best part about niacin is that it’s naturally found in foods like turkey, avocado, and peanuts (yum). If you’re not a turkey sandwich fan, you can supplement with a vitamin B complex.
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