There have been some studies to suggest that a placebo effect that improves ED may work for some men. One study found that men taking an oral placebo pill showed as much improvement in ED symptoms as men who took actual medication to improve ED. Conversely, men who were given therapeutic suggestions to improve ED did not see signs of symptom improvement.
A list of 33 medicinal plants both cultivated and wild-harvested generated show that herbal remedies are greatly utilized by men for managing sexual impotence and erectile dysfunction in western Uganda. Erectile dysfunction and sexual impotence are old problem and traditionally the indigenous knowledge had ways of treating or managing these conditions associated with male reproductive system. These plants in the tables we are discussing have been in use for centuries in treating or managing conditions in male reproductive organs.
The study was conducted between April 2000 and March 2003 in western Uganda. To collect this data indirect asking of questions and investigations that do not refer or offend anyone were used since nobody especially men can say openly that they have this problem. These methods are explained in the textbook of ethnobotany and others have been used in the field for this kind of studies in Uganda and elsewhere in the world10,12,13,14,21. These methods included visiting the traditional healers to document the indigenous knowledge (IK), regarding medicinal plants used, gender and socio-cultural aspects and where the plants are harvested. Informal and formal conversations, discussions and interviews, market surveys and field visits were conducted.
Do herbs work to rectify ED in the Aging Male? We will take some of these and discuss their properties. These herbals can be found throughout Asia and range from Eurycoma longifolia (Tongkat Ali), Ginseng and Tribulus etc. Those that act as Testosterone releasers have some value especially if the male has andropause and those containing some-pick-me-ups and energizers like Ginseng helps the tired and fatigued male and possibly those with asthenia. Deer horn contains growth factors and taking these do help improve nocturnal erections in the male with somatopause. Popular in historic Singapore was Penis soup and Snake meat (Figure 2), whilst Surabaya was known for Cobra meat and Cobra blood (Figure 3) which had claims of improving erectogenic prowess-the myths and realities concerning these and other Village doctor remedies are what they are—myths!
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.
Cavallini, G., Modenini, F., Vitali, G., & Koverech, A. (2005, November). Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology, 66(5), 1080-5. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429505006515
The proved herbal remedies with therapeutic values such as Prunus africana used in the treatment of hypertrophy in male genitalia is indicative that some herbals may be potent though not yet studied comprehensively5,13. However, most of the herbal remedies used in male ailments are not well documented and researched. The dangers of loosing valuable indigenous knowledge (IK) on sexual impotence and ED are likely to occur because westernization in the present generation. This indigenous knowledge in medicine ought to be documented for future use and sustainable utilisation19. According to the convention on biological diversity (CBD)6, specific reference is made to the need to protect the world's indigenous cultures and traditions (Art. 8 of CBD). This article points out that national legislation need to respect, preserve and maintain knowledge, innovations and practices of indigenous and local communities encompassing traditional life styles relevant for the conservation and sustainable use of biodiversity. UNEP argues nations to have an urgent action to safeguard indigenous cultures and their knowledge.
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.
Yohimbine. This chemical is found in the bark of an African tree called yohimbe. It has been used as a male aphrodisiac in Africa, and under medical supervision it has been used as a prescription drug to treat ED. Supplements made from yohimbe bark are also available without a prescription, but they can be life-threatening if used at high doses, according to the Natural Medicines Comprehensive Database. The supplement can interact in a harmful way with certain drugs, such as blood pressure medications, and should be avoided by anyone with liver, kidney, heart, or diabetes problems or problems with anxiety or depression. Like DHEA, yohimbine should not be taken without a doctor's supervision.

The medicinal plants used such as Citropsis articulata, Cannabis sativa, Cleome gynandra and Cola acuminata are frequently utilized. Some of these plants (Citropsis articulata, Cola acuminate) are already under sale for treating these conditions. Their propagation is on-going in western Uganda in places like Rukararwe Partnership Workshop for Rural Development Centre in Bushenyi District36 and researchers personal experience at Rukararwe. Rukararwe is a non-governmental organisation that is processing herbs, running a famous herbal clinic and with a medicinal plants arboretum and medicinal plants agro-forestry.


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.
Gutiérrez-González, Enrique; Castelló, Adela; Fernández-Navarro, Pablo; Castaño-Vinyals, Gemma; Llorca, Javier; Salas-Trejo, Dolores; Salcedo-Bellido, Inmaculada; Aragonés, Nuria; Fernández-Tardón, Guillermo; Alguacil, Juan; Gracia-Lavedan, Esther; García-Esquinas, Esther; Gómez-Acebo, Inés; Amiano, Pilar; Romaguera, Dora; Kogevinas, Manolis; Pollán, Marina; Pérez-Gómez, Beatriz. “Dietary Zinc and Risk of Prostate Cancer in Spain: MCC-Spain Study.” Nutrients. Jan 2019, 11(1).

A recent study tested whether ginseng extract would influence exercise-induced muscle damage and inflammation responses. Male college students took either ginseng or a placebo, and then performed a high-intensity uphill treadmill running task. In those taking ginseng, inflammation markers were significantly decreased during recovery, suggesting that ginseng could reduce exercise-induced muscle damage.


We present herein a new herbal combination called Etana that is composed of five herbal extracts including Panax quinquelotius (Ginseng), Eurycoma longifolia (Tongkat Ali), Epimedium grandiflorum (Horny goat weed), Centella asiatica (Gotu Kola) and flower pollen extracts. Most of the above-mentioned extracts have a long historical and traditional use for erectile dysfunction (ED). On the basis of the mechanism of action of each of the above, a combination is introduced to overcome several physiological or induced factors of ED. This study was conducted to show an enhancement of erectile function in male rats. The animals were observed for 3 h after each administration for penile erection, genital grooming and copulation mounting, and the penile erection index (PEI) was calculated. The maximum response was observed at the concentration of 7.5 mg kg(-1) of Etana. At a 7.5 mg kg(-1) single dose, the percentage of responding rats was 53+/-7 with a PEI of 337+/-72 compared with 17+/-6 with a PEI of 30+/-10 for control animals. This PEI was significantly (P<0.001) higher than each single component and than the sum of any two herbal components of Etana. When compared with sildenafil citrate, Etana induced more pronounced PEI than 0.36 mg kg(-1), but similar to 0.71 mg kg(-1) of sildenafil. Furthermore, full acute and sub-acute toxicity studies showed no toxic effects of Etana. In conclusion, this study describes a new and safe combination of herbal components that enhance erectile function in male rats. Clinical studies are warranted for evaluating Etana's significance in ED.
Most importantly, herbal supplements are not well regulated in the United States.  Studies have shown that 40-50% of herbal supplements do not even contain the supposed main ingredient, and many contain substances that are not listed which may have dangerous side effects2.  Another study found that over two thirds of the products tested had substituted other plant species for the plants listed on the label, and a third of products also contained other fillers or contaminants3.  A study by the New York State Attorney General of herbal products sold at GNC, Target, Walgreens, and Walmart found that four out of every five products didn’t contain the ingredient they claimed!  Fourteen US states and territories have petitioned Congress to regulate the herbal supplements industry.

If impotence affects you or someone you love, don’t lose hope. You may be suffering from a medical or emotional issue that is causing low libido or impotence — possibly interfering with both your confidence and relationship — but the good news is there are effective natural remedies for impotence that can help reverse this problem in most men. Around 70 percent of ED cases are resolved with natural impotence remedies that can help restore your sexual health.

The medicinal plants used in male-related conditions will be very significant in the present and future generations. From the researchers point of view, the usage of herbal remedies in managing sexual impotence and erectile dysfunction is useful because of long history of utilisation of some herbs that are perceived as effective. Thus, the establishment of rapport between modern health workers through collaborative ventures with traditional healers, relevant NGOs like Rukararwe in Bushenyi by having close supervision and monitoring of herbal treatments in such conditions is noble. Ministry of Health through its research wing in traditional medicine the Natural Chemotherapeutics Research Laboratory in Wandegeya has role to play in advocacy of traditional medicine. In addition, Public-Private Partnership in Health Care Delivery Desk Office in Ministry of Health and distinguished researchers in herbal medicine need to network, collaborate and have policy in place for herbal medicine as an alternative form of health care in Uganda. The traditional herbal medicines, relevant to the needs of ailing Ugandans can be tried out after being licensed by the National Drug Authority. In our view, sexual impotence and erectile dysfunction are real silent conditions affecting Ugandan men. Additionally, further investigations into the safety and efficacy of these traditional herbal remedies used in the treatment of erectile dysfunction and other male-related conditions are recommended in Uganda.
Size matters, so get slim and stay slim. A trim waistline is one good defense — a man with a 42-inch waist is 50% more likely to have ED than one with a 32-inch waist. Losing weight can help fight erectile dysfunction, so getting to a healthy weight and staying there is another good strategy for avoiding or fixing ED. Obesity raises risks for vascular disease and diabetes, two major causes of ED. And excess fat interferes with several hormones that may be part of the problem as well.
Information on this website is provided for informational purposes only and is not intended as a substitute for the advice provided by your physician or other healthcare professional. You should not use the information on this website for diagnosing or treating a health problem or disease, or prescribing any medication or other treatment. Any third party offering or advertising on this website does not constitute an endorsement by Andrew Weil, M.D. or Healthy Lifestyle Brands.
Ginseng (Figures 4,​,55): this is an adaptogenic herb touted to have boosted the potency of Ottoman sultans. It increases the body’s ability to handle environmental stresses and combat biochemical imbalances. It energizes when one is fatigue and calms when overanxious. It also increases sex related hormones like testosterone and enhances sexual responses in men and women. It thus acts as a tonic, stimulant and aphrodisiac (4,5).
"Just because there is evidence doesn't mean it's good evidence," says Andrew McCullough, MD, associate professor of clinical urology at New York University Langone Medical Center in New York City, and one of the original clinical investigators for the ED drug Viagra (sildenafil). "And before men with ED start down the naturopathic route, it's smart to make sure that there isn't some underlying medical condition that needs to be corrected." Moreover, it is estimated that 30 million American men have erectile dysfunction, and 70% of cases are a result of a potentially deadly condition like atherosclerosis, kidney disease, vascular disease, neurological disease, or diabetes. Additionally, ED can also be caused by certain medications, surgical injury, and psychological problems.
Having your current medication checked – if you are taking medication already, it could be that your erection problems are a side effect. Have a doctor check whether this is the cause of your problems and if it is, you might be able to switch medications and then find that your erectile dysfunction goes away completely – or at least improves. Medications that can cause erection problems include:
Classically the neuro-physiology of ejaculation traces the 3 Phases in which ejaculation is a complex event involving the (I) the propulsion of sperm and seminal plasma into the prostatic urethra which is accompanied by (II) bladder neck closure and (III) coordinated contractions of the bulbocavernosus and ischiocavernosus muscles, striated muscles of the pelvic floor, lower limbs and trunk. In the Asian Society of the Aging Male Study [2004] 63% have reduced erection, 68% reduced or absent ejaculation and 19% pain or discomfort at ejaculation. Disorders of ejaculation can be due to: (I) disorders of production of sperm or seminal plasma/prostatic secretions (II) disorders of propulsion. In the case of anejaculation (absence of ejaculatory) which is the ultimate disorder of ejaculation, the causes can be best classified as (I) primary or secondary. After covering psychogenic causes of ejaculation failure, the organic causes due to non-dynamic and obstructive etiologies in the prepubertal and post pubertal male will be highlighted. More details will be given on retarded ejaculation, premature ejaculation, aspermia, painful and weak (poor propulsive force) ejaculation. The evaluation of the patient must include a detailed history taken from the patient and often his partner. Aside from haematologic tests, various forms of radiological and ultrasonic imaging, neurophysiologic studies may be required. For the general practitioner the commonest scenario will be in the ED Clinic with abundant men with performance anxiety presenting with premature ejaculation. In the male aging clinic lack of arousal is the commonest cause of retarded orgasm and ejaculation but this group is plagued by decreased touch sensitivity, the need for more direct stimulation, reduced drive to orgasm, a less intense orgasm, ejaculation being weaker and of reduced quantity and disturbing complaints of a longer recovery period and less number of attainable orgasms per day or week. Thus it is not mere rumor that “by the time a man reaches 55, the refractory period to ‘do it again for a man’ increases to 12 hours or even up to a week”. In the STD clinic, painful or bloody ejaculation is frequently seen. The Condom may cause condom retarded orgasm/ejaculation.
Wild oats: a study in 1986 by the Institute for Advanced Study of Sexuality in San Francisco reported effects like heightened sexual awareness, increased sexual thoughts, more orgasms (36% in men and 29% in women) and some male subjects showed increased levels of testosterone attributed to unbinding of testosterone from TBG. Oats supply steroidal saponins which modulate hormonal balance (5).
The herbal medicines used in the management of sexual impotence and erectile dysfunction are mainly prepared by pounding, chewing and boiling and are mainly orally administered. The traditional healers treat sexual impotence and ED by prescribing some of these herbs in tea or using local beers, fermented milk and porridge. Some herbs are herbs are roasted or smoked such as coffee before administration. The dispensing of herbal medicines used in sexual impotence and ED using local beers, fermented milk and porridge possibly the alcoholic content improves on the kind of active chemicals extracted than water alone12.
Impotence, or erectile dysfunction (ED), is the inability for a man to sustain an erection long enough for normal, satisfying sexual intercourse.  To understand the underlying causes of impotence, it helps to know the basics about how an erection develops, along with potential problems that get in the way. Erections begin in the brain with a thought related to sexual desire. Then a chemical message travels from the brain to the penis. Blood flow to the penis increases as blood vessels leading to the reproductive system relax and allow for increased circulation.
Gingko biloba: this is an example of a tonic herb that equilibrates our body systems. When tired it energizes and when stressed it relaxes the individual. It increases blood circulation which better prepares the male for the heart-racing excitement of sex. Early reference to its medicinal use was in 2900 BC Chinese Materia medica which believed it increased sexual energy. Gingko’s circulation enhancer called terpene lactone increases cerebral as well as genital blood flow and its significantly increased production of dopamine, adrenaline and other neurotransmitters in the brain improves pleasure arousal and alertness (5).
Penile implants - are generally used if physical damage (like an accident) makes the anatomical parts needed for an erection not work. These are inserted by surgery and can provide a permanent treatment choice if others fail to work. The implants can be semi-rigid or inflatable. They can be pretty expensive and are not usually available on the NHS.
Gingko biloba: this is an example of a tonic herb that equilibrates our body systems. When tired it energizes and when stressed it relaxes the individual. It increases blood circulation which better prepares the male for the heart-racing excitement of sex. Early reference to its medicinal use was in 2900 BC Chinese Materia medica which believed it increased sexual energy. Gingko’s circulation enhancer called terpene lactone increases cerebral as well as genital blood flow and its significantly increased production of dopamine, adrenaline and other neurotransmitters in the brain improves pleasure arousal and alertness (5).
Gecko (Gejie): this toad-headed lizard (Gekko gecko L.) is caught in summer. The internal organs are removed, and the eyes are cut and drained. Pieces of bamboo are used to fix the body, and then the gecko is baked and put in a dry place. It is used to treat Impotence due to kidney efficiency. Gecko (Gejie) is used with Ginseng (Renshen), Pilose antler (Lurong) and Epimedium (Yinyanghuo). It can be used alone for this treatment.

Tongkat Ali (Eurycoma longiflora) (Figure 7): this native plant found through SE Asia is used as an Aphrodisiac since 1996 (5). It has to be used regularly and works by enhancing the testosterone and cGMP production. Benefits are felt gradually over a period of time, mainly because it enhances the natural biological synthesis of testosterone. When the level is increased, health and vitality are restored. In studies on Mice, Tongkat Ali increases the number of times and duration of sexual performance of the animals under study (8) with testosterone levels increasing up to 440% in some animals. In a recent study on humans, 62% of subjects showed an increase of the free testosterone index indicating it’s biostimulatory effect on steroidogenesis. It has also been shown to increase sperm concentration and motility and increases energy in the individual by enhancing ATP production by 60% thru oxidative phosphorylation.
The Claim: If you squint and have an excellent imagination, mature ginseng roots vaguely resemble a human body. That ties into folk ideas for finding medicines–in this case, the idea that a plant that looks like a person must contain materials that help sick people. Ginseng was traditionally used as a tonic to treat erectile dysfunction and low sexual drive in men (as well as many other complaints).
Tribulus terrestris (6): this plant has long been used as a folk medicine in Eastern Europe and Bulgaria for sexual deficiency (5). The properties of this powerful ingredient have been associated with an increase in sperm production, sexual endurance, and testosterone levels. Also known as puncture vine, this herb has gained popularity over the past few years. Since testosterone plays a huge role for men, the addition of this herb can prove to be very beneficial. It is not a hormone as some believe. It is said that Tribulus terrestris can also help build muscle and strength, which enhances performance (5,7).
A variety of personal habits and lifestyle choices have been linked to ED. In some ways, this is a good thing, since habits can be broken and choices reconsidered. What's more, many of the lifestyle factors that contribute to sexual problems are ones that affect overall health and well-being, both physical and mental. Addressing these factors, therefore, can have benefits beyond improving erectile dysfunction.

Cordyceps (Dongchongxiacao): this Chinese caterpillar fungus and the carcass of the larvae of various insects are collected in the period of the Summer Solstice (tenth solar term). They are cleaned and dried in the sun or baked and used for treating deficient kidneys manifested as impotence, seminal emissions and soreness and pain in the lower back and knees (17). Cordyceps (Dongchongxiacao) is used with Dogwood fruit (Shanzhuyu), Dioscorea (Shanyao) and Dadder seed (Tusizi). The herb can also be used alone.


Does drinking water improve erectile dysfunction? Erectile dysfunction or ED is a common concern for men. Everyday factors, such as hydration levels, may affect a person's ability to get or maintain an erection. Drinking water may, therefore, help some men with ED. In this article, learn about the link between hydration and ED, and other factors that can cause ED. Read now
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.
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