ICI therapy often produces a reliable erection, which comes down after 20-30 minutes or with climax. Since the ICI erection is not regulated by your penile nerves, you should not be surprised if the erection lasts after orgasm. The most common side effect of ICI therapy is a prolonged erection. Prolonged erections (>1 hour) can be reversed by a second injection (antidote) in the office.
Aerobic exercise — which means "with oxygen" — consists of continuous, repetitive movements that increase your heart rate and get healthy oxygen into all your muscles by increasing blood flow that supports the heart and blood vessels (and in turn, prevents ED). In fact, research suggests that regular aerobic exercise can lower the risk for erectile dysfunction by about 40 percent.
Ginkgo biloba. Ginkgo is an herb that is used in Chinese medicine that’s thought to improve blood flow. "Any ED treatment that improves blood flow may help," explains Dr. Harris. "An erection is just blood in and blood out." However, the evidence that ginkgo can improve blood flow in ED is limited, and most experts say the jury is still out. In addition, ginkgo can increase the risk for bleeding problems if combined with certain medications, such as warfarin (Coumadin).
Saw palmetto. Saw palmetto comes from the fruit of a small palm tree. It has been used to treat symptoms in men with an enlarged prostate gland, such as difficulty urinating, and it has been recommended to treat ED caused by an enlarged prostate. However, several recent clinical trials did not show that saw palmetto works any better on an enlarged prostate than a placebo does. "There is no evidence that saw palmetto should be used to treat erectile dysfunction," says Dr. Gilbert. Like ginkgo biloba, saw palmetto can interact with some prescription medications.
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]

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.
Erectile problems can sometimes be linked to cardiovascular issues. If your heart isn't in full health, your sex life maybe suffering as result. Men who suffer with moderate to severe erection problems have significantly lower levels of folic acid than guys without the issue. The B vitamin has been shown to work with nitric oxide which would explain why an absence of it would lead to problems in the manhood. This seems to help with erectile dysfunction more than some medications. Treatment with folic acid resulted in men having an increase in their erectile strength.
Can one of the B vitamins actually improve erectile dysfunction?  The research makes a strong case that Niacin, a.k.a. Vitamin B3, does indeed do just that for a big percentage of men. Of course, this is a inexpensive help to erectile issues, as high niacin foods and supplements are cheap and readily available.  Below I summarize the most prominent human evidence to date that shows which men will likely benefit and why:
An Anti-Inflammatory Diet PlanDiabetes Smart TipsLiving Well with Rheumatoid ArthritisLiving Well with Colitis or Crohn'sManage Your Child's ADHDMood, Stress and Mental HealthTalking to Your Doctor About Hepatitis CTalking to Your Doctor About PsoriasisTalking to Your Doctor About Rheumatoid ArthritisYour Guide to Diabetes ManagementYour Guide to Headache and Migraine PainYour Guide to Managing DepressionSee All
People who do not have any contra-indications (see below) generally tolerate it well. However, taking yohimbe can sometimes cause side effects including: high blood pressure, headaches, anxiety, restlessness/nervousness, dizziness or shakiness. These side effects seem to affect people with a history of mental illness or mood-related problems most often. But it’s possible for them to develop in anybody.
The substance that gives hot peppers their kick can also give you some kick in the pants: Studies have associated the natural chemical with increased testosterone levels. In animal studies, capsaicin has also shown to increase the size of sex organs, while simultaneously decreasing belly fat. A 2014 study from France also found that men who ate more spicy food had higher testosterone levels than those who ate less. You can consume capsaicin via peppers, chili powder or a cayenne supplement.
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.

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.


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. 
When it comes to boosting sexual performance, many men will walk all over God’s green earth looking for ways to maintain a good sex life. Luckily men, all you have to do is walk — not run — 2 miles a day. This, along with other healthier lifestyle interventions can help obese men reduce their risk of ED, or even “reverse” current impotence, according to a 2005 study. This comes of importance, since maintaining a trim waistline is a good defense for ED, as men with a 42-inch waist are 50 percent more likely to have ED than those with a 32-inch waist. Getting to a healthy weight and maintaining it is a good strategy for preventing and treating ED.
ICI Alprostadil may be used as a mixture with two other drugs to treat ED. This combination therapy called "bimix or trimix" is stronger than alprostadil alone and has become standard treatment for ED. Only the Alprostadil ingredient is FDA approved for ED. The amount of each drug used can be changed based on the severity of your ED, by an experienced health professional. You will be trained by your health professional on how to inject, how much to inject and how to safely raise the drug's dosage if necessary.
The problem with this though is that there are a lot of websites that are claiming to have a specific exercise technique or perhaps very effective male enhancement products that can guarantee erectile dysfunction. Be careful not to fall for a male enhancement scam. Even though erectile dysfunction may be stressful or difficult to discuss about, there are proven and safe methods that can help you in dealing with it.
Pelvic floor exercises are actually good as they can enhance the strength of the pelvic floor muscles. These exercises are commonly called Kegel exercises. These are the types of exercises that women usually perform in order to regain their muscle tone right after childbirth. They are also known to enhance urinary continence and overall male sexual health.
A study from 1990 (eight years before Viagra was introduced) found that sedentary but otherwise healthy middle-aged men who started an intense aerobic exercise program reported higher levels of sexual intimacy, and more reliable sexual function. Men in the study who started a walking program also experienced improvements, though not as dramatic. But the bottom line is, improved physical fitness often improves sexual functioning and satisfaction. Here are 5 exercises that can help with erectile dysfunction.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
In the United States, certain prescription drugs containing yohimbine have been approved since the 1980s. They are labeled Yohimbine hydrochloride (which go by the brand names Aphrodyne or Yocon). Yohimbine medications are prescribed most commonly to treat sexual dysfunction in both men and women caused by a number of factors like aging, hormonal imbalances or side effects of medications.
There are two things that need to be looked at in recommending a supplement for a medical condition: what is the physiology of the medical condition and what is the pharmacology of the supplement you are using.  There then is a search for a link between the two that leads to a tie in with a therapeutic approach.  In some ways this is like a logic course that says A causes B, B causes C therefor A causes C.  We then must apply this to the scientific method and finally the ultimate test: clinical response and safety.  This is often made out to be the gold standard for our typical Rx meds that I dispense every day, but often ridiculed when it crosses the barbed wired “nutraceutical” boarder.  If it is a nutrient then we must be getting the right amount in our food after all right?  Regardless of 1)what the real amount is in the food we eat, not to mention 2)the depletion that may be taking place of that nutrient due to a prescription drug we are taking (an absolute science based cause and effect) – we blindly accept what our food has in it and the level our bodies maintain – this is an incorrect assumption.  In fact it is quite ironic that the anti-nutraceutical court is still hanging onto this assumption when both are established by science.

While the rationale behind why it would work is airtight, the research on arginine’s actual effect on erectile dysfunction is slim, points out Charles Walker, M.D., assistant professor of urology and cofounder of the Cardiovascular and Sexual Health clinic at Yale University. But given its solid safety profile, minimal side effects, and potential benefit on heart disease, it’s worth a try, he adds, especially when taken in conjunction with other herbs on this list, which studies have shown can be more effective.
While the rationale behind why it would work is airtight, the research on arginine’s actual effect on erectile dysfunction is slim, points out Charles Walker, M.D., assistant professor of urology and cofounder of the Cardiovascular and Sexual Health clinic at Yale University. But given its solid safety profile, minimal side effects, and potential benefit on heart disease, it’s worth a try, he adds, especially when taken in conjunction with other herbs on this list, which studies have shown can be more effective.
If other options sound boring, maybe you should consider a fun, revved-up option like salsa dancing. You and your partner can lose yourself in the music, and it’s an intense exercise that engages the senses, combining cardio, balance, and coordination. Plus salsa dancing is great for keeping weight under control because it burns a lot of calories. Furthermore, it’s an activity that can build self-confidence, and if you’re single, the classes can be terrific for meeting new people. Regular exercise doesn’t have to be drudgery, and there are many types of dance classes that can seriously improve fitness and help you address erectile dysfunction.
If you can't take one of these oral medications, your physician may have you try Caverject (alprostadil for injection), a hormone that you inject into your penis using a fine needle, or Muse (alprostadil urogenital), a tiny suppository that you insert into the tip of the penis. Both of these will bring on an erection within five to 15 minutes without sexual stimulation.
Males consuming yohimbine HCL for its pro-erectile benefits should take 5.4mg to 6mg three times per day but don't expect for the results to be noticeable until after about two to weeks of consistent dosing. [4] Not all males will experience this benefit so if you do not notice a change after four weeks of consistent dosing then consider stopping supplementation altogether.

Research suggests that drinking alcohol may play a part in erectile problems. One study that considered the prevalence of ED among people diagnosed with alcohol dependence syndrome found that heavy drinkers were more likely to experience sexual dysfunction. Experts also believe that the depressant effect of alcohol can inhibit sexual response and even suppress libido in some people.
Wistar rats (From Medical Research Institute, Colombo) were obtained and kept in a well ventilated animal house under natural dark light cycle (temperature 28-30°C, humidity; 50-55%). Animals were housed in groups (four per group) until they reached sexual maturity (150-200 g). They were provided with pelleted food and water. Male rats were permitted access to receptive females on three separate occasions and then screened for sexual proficiency. Male rats who displayed consistently vigorous sexual activity were selected for the study.

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. 
Reduction of the libido index was the major disadvantage that we observed with zinc supplementation. Substances that affect libido usually act centrally and may reduce desire by causing sedation or hormonal disturbances.[17] The role of elevated levels of PRL in serum as an inhibitor of sexual drive and gonadal function is well established.[18] This reduction of sex drive may occur through the modification of activity of dopaminergic neurons in the CNS that are regarded as controlling sexual motivation and function.[19] Our study demonstrated a significant increase of serum PRL level (2.9 to 7.22 ng/dl) within two weeks of supplementation of zinc (5 mg/day). This is a possible explanation for the reduced libido with increasing doses of zinc observed in this study.
Could the bark of a tree actually increase libido and improve impotence? Well yes it can… Yohimbe bark (Pausinystalia yohimbe), one of the most popular herbal remedies for male sexual dysfunction, has been shown in studies to increase blood flow to the genitals of both men and women, proving to be helpful for those with low libido. Though Yohimbe can be used by women, its actions have been shown to be extremely supportive for men experiencing erectile dysfunction due to stress or as a side effect of physiological health issues.
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.
One study that evaluated the effects of yohimbine supplementation on body composition (muscle mass, body mass, etc.) and exercise performance in professional soccer players found that body fat percentage/fat mass significantly decreased in the yohimbine group compared to the placebo group. However, supplementation with yohimbine did not significantly alter overall body mass, muscle mass, or performance indicators. (10) Other studies, however, have found that people do tend to experience increases in energy and alertness when taking yohimbe, sometimes even so much that it causes symptoms of anxiety or restlessness (much like caffeine does).
Exercise lowers blood pressure – a consistently high blood pressure (hypertension) can damage your arteries and cause them to harden, limiting the flow of blood to the penis and leading to cardiovascular problems. Exercise works to reduce the force required to pump blood around your body, protecting your artery linings as a result. You should aim to have a blood pressure less than 140/90mm Hg.

The RigiScan™ portable home monitor recorded nocturnal penile tumescence and rigidity testing. The monitor's quantitative analysis software quantitates various parameters of tumescence and rigidity, which includes the area under the curve over time slept, reported as tumescence activity units and rigidity activity units. The reproducibility and accuracy of this technique have been reported.28 Baseline normal values were used as previously reported,29 Rigidity had to be at least 60% at the base and 50% at the tip and maintained for at least 10 min. At least half of the episodes had to meet these criteria, with a minimum of three or four episodes per night. Tumescence had to achieve a height of 3 cm at the base and 2 cm at the tip.


Aerobic exercises and pelvic floor exercises are two of the best methods to start with. As a matter of fact, you can see improvements on your condition without having to witness the side effects of other male enhancement products. For one, there are certain male enhancement products which should not be taken if you are suffering from other types of medical condition. For instance, if the product contains substances that may react to the male enhancement ingredients of a product, you may suffer from certain consequences.
Disclaimer: The information on Natural Fertility Info.com is provided for educational purposes only and is not intended to treat, diagnose or prevent any disease. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Hethir Rodriguez and her community. We encourage you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.
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.
It’s best to take yohimbe when fasting, first thing in the morning, or between meals. Because it has stimulating effects, don’t combine yohimbe with other stimulants like caffeine or weight loss pills. These may cause reactions like faster heart rate, anxiety, high blood pressure or even cardiovascular complications. If you are planning on having caffeine along wth yohimbe (such as coffee or tea in the morning),  start with a half-dose in order to test your reaction.
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.

Long considered an aphrodisiac by the Chinese, ginseng may do more than just rev your engine. A 2013 South Korean study found that taking the herb for just a few weeks improved guys’ performance in the bedroom, including helping them last longer before finishing. Meanwhile, a study in Spermatogenesis found that ginseng can also help make for harder, longer-lasting erections and improve testosterone levels, which in turn boosts libido. “Ginseng is a promising herbal therapy for ED because it helps promote relaxation of smooth muscle in the penis, increase dopamine levels in the brain, and increase pressure in the cavernosal nerves of the penis which helps nitric oxide synthesis,” Walker explains.
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.

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.
You may know horny goat weed from its omnipresence behind the counter at your local convenience store, but this traditional Chinese formula is less sketchy than it sounds. Used for centuries to treat low libido and erectile dysfunction, the herb’s potential efficacy was show in a 2010 study published in the Journal of Sexual Medicine. Researchers who fed the supplement to rats found they had improved erectile function; another study showed that the supplement can block a natural chemical that wilts erections. (Just be warned: Viagra was found to be 80 times more powerful.)
Males consuming yohimbine HCL for its pro-erectile benefits should take 5.4mg to 6mg three times per day but don't expect for the results to be noticeable until after about two to weeks of consistent dosing. [4] Not all males will experience this benefit so if you do not notice a change after four weeks of consistent dosing then consider stopping supplementation altogether.

Stimulant drugs speed up the nervous system. By speeding up the nervous system, stimulant medications can make you feel jittery and speed up your heartbeat. Yohimbe might also speed up the nervous system. Taking yohimbe along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure. Avoid taking stimulant drugs along with yohimbe.

Acupuncture may help treat psychological ED, though studies are limited and inconclusive. You’ll likely need several appointments before you begin to notice any improvements. When choosing an acupuncturist, look for a certified practitioner who uses disposable needles and follows U.S. Food and Drug Administration guidelines for needle disposal and sterilization.
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.
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.
Aerobic exercises and pelvic floor exercises are two of the best methods to start with. As a matter of fact, you can see improvements on your condition without having to witness the side effects of other male enhancement products. For one, there are certain male enhancement products which should not be taken if you are suffering from other types of medical condition. For instance, if the product contains substances that may react to the male enhancement ingredients of a product, you may suffer from certain consequences.
I use magnesium and zinc. I don’t find any difference with zinc but about 10 minutes after I pop a magnesium I’m all ready to go! But diet comes first! I went vegan about 10 weeks ago (and I’ll never look back) but I also quit my hormonal birth control about 3 weeks ago so my sex drive is at a big fat ZERO. But like I said, when I take a magnesium it still manages to come back. Mine you, I have a boyfriend who I’ve been with for 4 and a half years and I have so much love for him! But I wanna feel sexy everyday! I am losing weight so that will help and I’ve heard amazing things about Pine Pollen (tinture for men and powder for women) check it out! 🙂
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
The appropriate dose of yohimbe depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for yohimbe. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
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.
Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor's OK. Medications for erectile dysfunction do not work in all men and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:
These medications don’t work for everyone but they are easy to use and work for around 60% of people who try them. They work by making it easier to get an erection by reducing the effect of (inhibiting) the chemical PDE-5. This chemical is used in the body to make sure there isn’t too much blood in the penis during an erection, but if you have erectile dysfunction then this chemical ends up over-compensating.
Parameters evaluated in this study are determinants of some important aspects of the male sexual competence. Libido index, intromission and mount latencies are indicators of libido, arousability and motivation. Copulatory efficiency and inter-copulatory intervals are indicators of sexual vigor, while penile thrusting is an indicator of penile erection.[8,11,14,15] Our results showed that the libido index was significantly reduced in the 10 mg/day zinc saulphate treated group. In the same group, majority of the animals (62%) failed to complete their sexual behavioral cycle within the observed period. Though these unsuccessful rats showed the initial steps of the cycle such as licking, physical contacts with the females and few mounts and intromissions, they were inactive at later stages. Therefore a significant reduction of the libido index, number of intromissions, mounts, and ejaculations were observed in the high dose of zinc treated group compared to controls.
To maximize efficacy, you should consume this stack in a fasted or semi-fasted state and at least 6 hours before bedtime. This stack is going to significantly increase your heart rate and blood pressure so be watch out for overexertion if you choose to take the ECY stack immediately before an intense weightlifting session. Some users also choose to alternate consuming EC and EY to obtain some of the positive effects without being overstimulated.
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.
×