b) Men With Digestive Disorders.  There are many, many GI disorders that plague modern, urban dwellers:  atrophic gastritis, Crohn's, diverticulitis, enzyme deficiencies, IBS, ulcerative colities and on and on.  All of these can lower vitamin and mineral absoprtion.  Men struggling with these issues may very well benefit from increased amounts of niacin in the diet or possibly with supplementation.
Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He's a practicing Gastroenterologist and Hepatologist with a focus on Men's and Women's Health, and a regular contributor to Women's health, Shape and Prevention Magazine.

"The problem with alternative treatments for any medical problem, including erectile dysfunction, is that until you have about 20 well-controlled studies over several years, you really don't know what you are working with," cautions Richard Harris, MD, a urologist at Gottlieb Memorial Hospital, part of the Loyola University Health System in Chicago.


Yohimbe is an herbal remedy that comes from the bark of an African tree, Pausinystalia yohimbe. Before Viagra, drugs containing yohimbine hydrochloride, the active ingredient in yohimbe bark extract, were used to treat erectile dysfunction (ED). However, levels of yohimbine in yohimbe bark extract vary considerably and are often very low. Yohimbe bark extract, by itself, never has been shown to work as effectively as drugs containing yohimbine hydrochloride. What’s more, yohimbe can have serious side effects including paralysis, fatigue, stomach disorders, even death. I don’t recommend it, and harvesting of its bark is driving the yohimbe species to extinction.
*all photos are models and not actual patients.If you are interested in a prescription product, Hims will assist in setting up a visit for you with an independent physician who will evaluate whether or not you are an appropriate candidate for the prescription product and if appropriate, may write you a prescription for the product which you can fill at the pharmacy of your choice.
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:
Three of the randomized studies (25–27) that contributed to the present study data indicated the positive role of both interval and continuous aerobic training in the dual management of both ED and cardiovascular disorders (hypertension and ischemic heart disease ,respectively); this is not surprising because of the arterogenic interrelationship between ED and several cardiovascular disorders. The physiological basis for the therapeutic role of continuous exercise in the management of both ED and some cardiovascular disorders as reported in the present study, could be related to the biochemical, neural and hormonal changes in the blood vessel walls that induce an acute and long-term blood vessel relaxation. The blood vessels might relax after each exercise session because of body warming effects; local production of certain chemicals, such lactic acid and NO; decreases in nerve activity; and changes in certain hormones and their receptors (32, 33). Over time, as the exercise is repeated, there appears to be a growing evidence of a prolonged effect. Thus, chronic (regular, longterm) physical training might reduce basal concentrations of inflammatory markers.
The improvements in IIEF-erectile function domain (IIEF-EF) score for moderate and severe ED patients in the niacin group were 3.31 and 5.28 and in the placebo group were 2.74 and 2.65, respectively. In the lower range of mild and mild-to-moderate ED, there was no significant improvement in erectile function. Of the 160 patients in the study, 32 were using statins; 18 in the niacin group and 14 in the placebo group. For patients not receiving statin treatment, there was a significant improvement in IIEF-Q3 scores (0.47) for the niacin group, but not for the placebo group. To summarize, niacin alone can improve the erectile function in patients suffering from moderate to severe ED and dyslipidemia.
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.

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In the end, open and honest communication with your therapist will yield the best course of action. If you do decide to try pelvic floor PT, a comprehensive evaluation will determine what exactly is going on with your muscles. They may be tight and weak or they could have poor coordination. So my advice for those suffering from erectile dysfunction is this: before you try kegels, make an appointment with your pelvic floor therapist.
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.
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

The art of acupuncture has become the new treatment for everything from back pain, depression, and even ED. Impotence could be more of a state of mind, and acupuncture may help. Through this alternative therapy, fine needles are placed in various parts of the body to relieve pain or stress. Although there are many mixed studies for acupuncture and ED, many tend to confirm positive results. A 1999 study found acupuncture improved the quality of erection and even restored sexual activity in 39 percent of participants.
Most human studies completed thus-far examine the impact of oral yohimbine consumption on erectile dysfunction (ED) in males. A meta-analysis of seven randomized, placebo-controlled trials found that yohimbine is significantly more effective in treating ED compared to placebo. [11] These findings did not compare yohimbine to prescription medications like Viagra®, which are designed to treat ED.
While balancing your sexual focus is singularly the most important aspect of solving a sexual dysfunction challenge, it's important to also address the physical component. This is especially true if you are over 40, or suffer from erectile dysfunction. Exercise increases blood flow and helps your body eliminate toxins. As well as this, exercise also improves your strength, stamina and form.
Intermountain Healthcare is a Utah-based, not-for-profit system of 23 hospitals, a Medical Group with more than 1,600 physicians and advanced practice clinicians at about 180 clinics, a health plans division called SelectHealth, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and in efficient healthcare delivery.
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.
Carlo Adrian Cañon is a graduate of Bachelor of Secondary Education major in English from Southern Leyte State University-Tomas Oppus in the Philippines. He has written numerous articles on a variety of topics on men’s health, fitness, and product reviews. He is contributing to consumerhealthdigest.com for men sexual health category. You can follow him on: LinkedIn.
In addition, statins had a relatively fast effect on the problem of erectile dysfunction as compared to its role in the reduction of cholesterol, which suggest that Niacin drugs were reaching to deal with root inflammation of the mentioned problems significantly. According to the researcher Howard Hermann, Men consuming Niacin scored better on both self-reported tests associated with the function of erectile and the levels of lipids in blood.
Most human studies completed thus-far examine the impact of oral yohimbine consumption on erectile dysfunction (ED) in males. A meta-analysis of seven randomized, placebo-controlled trials found that yohimbine is significantly more effective in treating ED compared to placebo. [11] These findings did not compare yohimbine to prescription medications like Viagra®, which are designed to treat ED.
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.

I'll explain the best exercises for sex below. Know that if you suffer from PE or ED you also need to change the way you are thinking about sex to gain full control of yourself. Not just during sex, but in the lead up to sex as well, so you can reprogram your brain to achieve hard and in control. I explain this in the following video which is taken directly from my Sex Mastery program:
Handful of things can cause erectile dysfunction, but healthy vitamins supply for erection will make your sex life very soothing and romantic. Healthy blood vessels are necessary for good circulation, as blood is pumped around the body to carry nutrients to the cells. Vitamins can help the blood vessels to dilate or open so blood can fill the manhood. 
If you have symptoms of ED, it’s important to check with your doctor before trying any treatments on your own. This is because ED can be a sign of other health problems. For instance, heart disease or high cholesterol could cause ED symptoms. With a diagnosis, your doctor could recommend a number of steps that would likely improve both your heart health and your ED. These steps include lowering your cholesterol, reducing your weight, or taking medications to unclog your blood vessels.
Though higher doses of zinc reduce libido, supplementation with a medium dose (5 mg/day) has some beneficial effect on the sexual competence of adult male rats. The major significant effects of this dose of zinc are prolongation of ejaculatory latency without disturbing sexual arousability, motivation, penile erection and sex vigor. Also, the partner preference index of the 5 mg/day group was positive and comparable to the controls. A positive partner preference index is indicative of unchanged sexual interest of males.[16] These results confirmed that libido and sexual interest are not affected by zinc supplementation with a 5 mg/day dose. However, mild reduction in percentage of intromission was observed in this group and it is postulated that this may be situational rather than an effect of supplemented zinc. This is based on our observation where mild rejection by the females at the initial phase of the behavior led some males to refrain from sexual activity.
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.
I recently treated a young twenty-something man with a primary complaint of erectile dysfunction. When he started to notice this issue, he attempted to treat it by performing lots of kegels. (If you haven’t heard of kegel exercises, they’re done by repeatedly contracting and relaxing the muscles that form part of the pelvic floor, as if you were trying to stop peeing mid-stream.) I found this man’s story interesting because, as we discovered, in his case the kegels actually did more harm than good. We found that once he stopped kegeling and allowed his pelvic muscles to relax, his erections became stronger and he was able to ejaculate without any issues.
In addition, when research has shown a nutrient such as zinc or niacin to improve sexual function, it's usually in people who are deficient in it. So, before you stock up on over-the-counter nutritional supplements for ED, speak with your doctor. He can test you for deficiencies and steer you toward the most effective and safest way to treat your erectile dysfunction. 
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.
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
I recently treated a young twenty-something man with a primary complaint of erectile dysfunction. When he started to notice this issue, he attempted to treat it by performing lots of kegels. (If you haven’t heard of kegel exercises, they’re done by repeatedly contracting and relaxing the muscles that form part of the pelvic floor, as if you were trying to stop peeing mid-stream.) I found this man’s story interesting because, as we discovered, in his case the kegels actually did more harm than good. We found that once he stopped kegeling and allowed his pelvic muscles to relax, his erections became stronger and he was able to ejaculate without any issues.

But, first for those of you who do not know anything on this topic, let’s define erectile dysfunction. Erectile dysfunction is a condition which characterizes itself with the inability to maintain an erection during sexual intercourse. Luckily, although erectile dysfunction is a common condition, this condition seems to be easily treated. You can choose from the variety of natural remedies, including supplements, which claim to increase your stamina, sexual ability, and muscle mass. This article is dedicated to the importance of exercise as a way to treat erectile dysfunction and highlight the best exercises you could use as a part of the treatment. 
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.
Lifestyle changes like getting more exercise and adjusting your diet can help. In a study of obese men with E.D. who restricted calories for two years and were advised to be more active, participants not only lost weight but also experienced decreased severity of their E.D. Research also shows aerobic exercise can significantly lower your risk of erectile dysfunction thanks to its ability to boost blood flow and circulation. Eating certain foods can also reduce incidence of E.D.
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