In rare cases, the drug Viagra ® can cause blue-green shading to vision that lasts for a short time. In rare cases, the drug Cialis® can cause or increase back pain or aching muscles in the back. In most cases, the side effects are linked to PDE5 inhibitor effects on other tissues in the body, meaning they are working to increase blood flow to your penis and at the same time impacting other vascular tissues in your body. These are not ‘allergic reactions'.
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.
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.
This scenario raises a key concern for us (and should for you as well) about what is recommended to treat erectile dysfunction. I performed a quick Google search on kegels as treatment for the pelvic floor, and found hundreds of websites instructing men to perform kegels to ameliorate erectile dysfunction, have longer and stronger erections – a quick and easy fix. I found a few sites instructing men to perform anywhere from 50-100 repetitions per day (insanity). I discovered a new book called Male Pelvic Fitness, a “user manual to your man parts
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.
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.
Does diabetes cause erectile dysfunction? Diabetes can lead to lower levels of testosterone, and this can result in erectile dysfunction. Controlling blood sugar levels, maintaining a healthy weight, getting exercise, and reducing stress are all ways of reducing this problem. Hormone therapy, Viagra, and counseling are some ways that medicine can help. Read now

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.


Talk with your doctor about going to a counselor if psychological or emotional issues are affecting your ED. A counselor can teach you how to lower your anxiety or stress related to sex. Your counselor may suggest that you bring your partner to counseling sessions to learn how to support you. As you work on relieving your anxiety or stress, a doctor can focus on treating the physical causes of ED.
That said, I think that guys like myself who eat a ton of plant foods have to be consider the fact that they may not always be getting all the niacin they could.  Men with lower niacin status can probably give their erectile strength and cardiovascular health a nice boost by consuming more niacin-rich plant foods.  There are many plant foods, such as broccoli and mushrooms that are quite high in niacin.  I actually consume nutritional yeast and BPA-free sardines daily and get a nice amount of niacin this way on top of my regular diet.  Therefore, I feel that I am likely maximizing my erectile strength by combining the best of both worlds, i.e. some NO-boosting plant foods and high niacin foods as well.  (Both  sardines and nutritional yeast also have a decent amount of protein as well, which is important to me since I enjoy lifting weights.)
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.
Antioxidants  boost nitric oxide production and prevent NO breakdown. Ascorbic acid has direct effects on the bioactivity of NO, and augments NO production in a variety of body processes. The effects are actually synergistic with Vitamin E. Both vitamins are not usually measured, and a reasonable dose of Vitamin C is 500 to 1,000 mg daily. Vitamin E supplementation should be limited to <400 IU per day because of potential adverse long-term health effects of higher doses.
However, a recent study that involves yohimbe supplementation to athletes ended with an unsatisfactory result. According to this study, yohimbe did not have any significant effects on body mass, muscle mass and exercise performance even after it was taken for 21 days. Even though it helped burn body fat, it may not be a useful supplement for boosting endurance.9

Much higher doses have been used in certain studies, sometimes up to 100 milligrams daily. However, this is considered a very high dose that is potentially dangerous and likely to cause some side effects. Overall, it’s best to start with small doses while monitoring your reaction. Speak to a doctor or herbal practitioner before increasing your dosage to high levels.


In the analysis of the study, the niacin group showed a significant increase in both IIEF-Q3 scores and IIEF-Q4 scores compared to the initial baseline values. While the placebo group also showed a significant increase in IIEF-Q3 scores (high hopes, no doubt), it did not for IIEF-Q4 scores. In other words, the “placebo effect” did not extend to maintaining erections. Also, when patients were stratified according to the baseline severity of ED, the patients with moderate and severe ED who received niacin showed a significant improvement in IIEF-Q3 scores (0.56 and 1.03, respectively) and IIEF-Q4 scores (0.56 and 0.84, respectively) compared with baseline values. These results were not significantly increased for the placebo group.
This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
This is one B team you want to get on pronto: A recent report from Harvard University highlighted a study that has linked low levels of B12 to erectile dysfunction. A causal link hasn’t been nailed down, but the B vitamin is used by every system in the body, particularly in cell metabolism and the production of blood — two essential factors in getting and keeping a quality erection.
On the other hand, high zinc levels have negative effects on sperm quality. Excessive zinc intake in mice have indicated a negative effect of increasing doses of zinc on sperm count and motility.[5] Although there have been studies focusing on various aspects of zinc related reproductive functions, studies on zinc related sexual behavioral aspects have received scant attention. In one study, intranasal irrigation with zinc sulphate has been reported to completely abolish the sexual behavior of male rats.[6]
The response to yohimbine did not vary with patient age; the responders were 60.3 y of age vs 60.0 for the nonresponders (Table 4; P=0.106). The number of medical risk factors was slightly higher in the nonresponders (2.3 per person) compared with the responders (1.8 per person), but this difference was not significant (P=0.346). Documenting the quality of the men's erections in the office with a simple grading system showed a significant difference at the end of the study between responders and nonresponders. For the responders, the value was 3.0 compared with 1.9 for the nonresponders (P<0.001). This result correlated with the overall sexual satisfaction of patients who stated whether or not they were able to engage in regular sexual intercourse.
Call this the Marvin Gaye of amino acids: L-arginine converts to nitric oxide (NO), a naturally occuring gas that causes blood vessels to relax and facilitate blood flow, helping you get and stay hard. You can find plenty of the nutrient in oysters, but in supplement form, the Mayo Clinic says that 400-6,000 milligrams is the maximum dose. And these are the best foods for arginine!
Have you heard about the famous Kegel exercises women often turn to for help? Well, these exercises are not for women only. You can perform them also and get the same beneficial effects as women. Kegel exercises for men are often recommended by many doctors to be used in the treatment of erectile dysfunction. Kegel exercises will strengthen your pelvic floor muscles. In order to perform these exercises, you will need to locate your pelvic floor muscles (to do that you will need to stop the process of urinating a couple of times) and squeeze them a couple of times. Start performing these exercises a couple of times a day and see the results for yourself.
Acupuncture. Acupuncture has been used for centuries to treat ED and impotence in China. A recent review of studies on acupuncture for erectile dysfunction was published in the British Journal of Urology International. After reviewing four studies, the authors concluded that there was not sufficient evidence to say that acupuncture worked. However, some experts believe it's worth trying. "Acupuncture can work," says Gilbert. "It probably works best to treat the psychological component of ED. There is very little downside to trying it."
DHEA. DHEA, or dehydroepiandrosterone, is a natural hormone that the body uses to make the male hormone testosterone. DHEA and testosterone decrease with age, just as ED increases with age, so it seems that taking DHEA might protect against ED. But Harris says that "it is unlikely that taking DHEA would raise your testosterone enough to make much difference." DHEA should not be used by people with liver problems; it also has many side effects.
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).
Yohimbe is taken by mouth to arouse sexual excitement, for erectile dysfunction (ED), sexual problems caused by medications for depression called selective-serotonin reuptake inhibitors (SSRIs), and general sexual problems in both men and women. It is also used for athletic performance, weight loss, exhaustion, chest pain, high blood pressure, low blood pressure that occurs when standing up, diabetic nerve pain, and for depression along with certain other medications.
The vitamin-deficiency disease pellagra was first identified in 1735 by Spanish physician Gaspar Casal. Considered to be Spain’s first epidemiologist, Casal is famous for his clarity and independence of thought, along with his conceptual change in the approach to medicine. Instead of mere observation and reporting, Casal moved to a fact-based induction methodology, presaging the work of John Stuart Mill, the political philosopher, economist, and logician, one hundred years earlier.
Uses and risks of viagra Viagra treats erectile dysfunction and pulmonary arterial hypertension. For sexual purposes, it helps someone with erectile dysfunction achieve and maintain an erection. However, Viagra can have unpleasant side effects, and an overdose can be serious. We cover everything you need to know about Viagra in this article. Read now
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.
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.

Yohimbe can interact with several drugs and medications, so it’s not safe for everybody to use. Don’t take yohimbe bark if you’re currently taking any ACE inhibitor drug, beta blocker, SSRI drug, MAOI, stimulants or caffeine-containing drugs, or tricyclic antidepressant drugs. Those who have any of the conditions listed below should not take herbal treatments like yohimbe without speaking with a doctor first. This is because it may affect things like blood pressure, heart health, kidney function and neurotransmitter functions:
The Medline (Pubmed) electronic database was searched (from June 1972 to November 2010) for systematic reviews that evaluated the effects of therapeutic exercise on ED. The key words and search terms used to develop the search strategy for each of these databases included: exercise therapy, aerobic exercise, therapeutic exercise, rehabilitation exercise, impotence and erectile dysfunction. In addition, the electronic searches were supplemented by checking the reference lists of any relevant identified articles.
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.
Diet and lifestyle changes should come first when treating male sexual dysfunction. Any man experiencing erectile dysfunction should see a doctor right away to determine the cause and to diagnose any underlying health condition that may be contributing to this issue. Herbs can be a great way to support a man experiencing any type of sexual dysfunction. In the case of impotence, Yohimbe may be a great help support to the body when working to support a man through this very difficult reproductive issue.
Few men want to talk about their inability to get or maintain an erection, however, erectile dysfunction can have a profound impact on relationships and self-esteem. Fortunately, trouble in the bedroom doesn't necessarily mean you're dealing with erectile dysfunction. Most men will have problems with an erection at some point in their sexual history. But one bad day in the bedroom doesn't mean major sexual health problems. So how can you know if you're dealing with erectile dysfunction?

Men, aged 40–80 y, were recruited from new consultations seen for erectile dysfunction at the Lahey Clinic Center for Sexual Function. Patients were screened by history and physical examination and by evaluation of nocturnal penile tumescence and rigidity with the RigiScan™ (Timm Medical Technologies, Inc., Minneapolis, USA). Candidates completed a sexual questionnaire and had morning blood tests for luteinizing hormone (LH), free testosterone, cortisol, dehydroepiandrosterone sulfate and androstenedione. Inclusion criteria included normal initial serum testosterone and prolactin levels and the presence of an organic cause of erectile dysfunction manifested by abnormal nocturnal tumescence and rigidity testing with the RigiScan™ monitor. Active smokers and men with concurrent major psychiatric problems were excluded. No other treatment for erectile dysfunction was permitted during the study. Yohimbine hydrochloride (supplied by Palisades Pharmaceuticals, Palisades, NJ, USA) was started at a dose of 5.4 mg three times a day (tid) for 4 weeks, after which the sex questionnaire was administered again and blood tests, nocturnal penile tumescence and rigidity testing were repeated. The dose of yohimbine then was increased to 10.8 mg tid for 4 additional weeks followed by a third administration of the sex questionnaire and final measurements of hormone levels and nocturnal penile tumescence and rigidity monitoring.

Allow me to explain. We know that cardiovascular disease is the number-one killer of men in the United States. Well, the “vascular” part of cardiovascular disease means that the cause is really blockage of the arteries around the heart, a process called atherosclerosis. It’s proven that over half of heart attacks occur in men with normal cholesterol. And many times, heart disease develops without warnings, causing sudden cardiac arrest.  So any early warning sign can be a life saver — and might compel you to get checked out before the big one hits.
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