In the Hong Kong study, the researchers postulated that niacin might be as beneficial as statins on erectile function, and have other related benefits too. Niacin is known to produce a flushing effect (see “Toleration Despite Adversity,” above), which is related to prostaglandin D2 (PGD2) release in the skin. This can lead to vasodilation and concomitant flushing. The production of PGD2 can also occur in macrophages, a type of protective white blood cell. Consequently, when PGD2 production is induced by niacin, it may affect all body tissue, including the cavernosal tissue in the penis. Indeed, PGD2 is one of the potential agents causing the vasodilation and engorgement of cavernosal tissue, thereby leading to erection. Thus, niacin improves erectile function by stimulating the production of PGD2.
In the end, the data from the Hong Kong study suggest that niacin alone can improve the erectile function of subjects with dyslipidemia suffering from ED. This is the first time this conclusion has appeared in the literature. Once again, the effect of niacin is clinically significant in those with moderate to severe ED. Further, because of the close relationship between ED and dyslipidemia, niacin could prove to be an important therapy for managing both conditions. Who knows? There may even be other benefits. Future studies will further refine the indications and benefits of niacin in patients with ED.
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).
Testosterone levels generally decrease as an individual ages. This is normal and natural, but it can lead to erectile problems for some people because androgenic hormones such as testosterone play an important part in regulating the function of tissues in the penis and testicles. One study found that supplementing with testosterone gel improved both the libido and erectile function of participants with low testosterone between the ages of 32 and 84.
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.

Yohimbine significantly increased subjective measurements of sexual desire, sexual satisfaction, frequency of sexual contacts, and erection quality during sexual intercourse. Each subject also underwent a sleep study and researchers found that yohimbine also objectively increased the rigidity of erections while sleeping. [12] Yohimbine appears to alleviate both physical and psychological symptoms associated with ED.
When given orally, yohimbine reaches peak levels in 10–15 min, and the half-life is 0.6 h. The efficacy of yohimbine in sexual function has been questioned, perhaps because of early questionable multidrug preparations.10,11 Yohimbine has been shown to have some effect on psychologic erectile dysfunction12,13 and in reversing fluoxetine-induced sexual dysfunction.14
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).
The more you try not to think about your sex problems, the more these problems consume your thoughts! While it appears that your problem is complicated, my Hard and in Control program provides the complete strategy so you can complete mutually satisfying sexual acts. This will enable you to eliminate performance anxiety and restore enjoyment for your partner.
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.

Erectile dysfunction can occur as a side effect of medication taken for another health condition. Common culprits are high blood pressure meds, antidepressants, some diuretics, beta-blockers, heart medication, cholesterol meds, antipsychotic drugs, hormone drugs, corticosteroids, chemotherapy, and medication for male pattern baldness, among others.
The concentration of yohimbine in commercial supplements may vary from one manufacturer to another. A chemical analysis conducted on 26 brands of yohimbe supplement shows that nine products contain no yohimbe extract at all, while eight products contain only small amounts of yohimbine — approximately 0.1 to 1 parts per million (ppm), which is significantly low compared to 7,089 ppm yohimbine in an authentic yohimbe bark.3
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).

Unfortunately, many of the same factors that brought the Italian Renaissance to an end—among them corruption, wars, and a widespread backlash over secularism and indulgence (leading to the “Bonfire of the Vanities”)—also terminated the “rebirth” in Spain. Chasing heresies became a sport that led to the resurrection of the Inquisition, which unlike its prior appearances operated completely under royal authority, rather than the aegis of the church.
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:
Some medications are changed and broken down by the liver. Yohimbe might decrease how quickly the liver breaks down some medications. Taking yohimbe along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking yohimbe talk to your healthcare provider if you take any medications that are changed by the liver.
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