Another important natural source of non-essential amino acid, L-Arginine is well studied to support many bodily functions even though its usually present in low quantities, especially as we started to age it is one of the most . One of the biggest benefits to our body is L-arginine or L Citruline (Our body converts L-citrulline to L-arginine, another type of amino acid) is converted into nitric oxide (proven), which causes blood vessels to open wider is its capability to improve blood flow and better circulation for Erectile Dysfunction.
About 70 – 80% of the Ugandan population still rely on traditional healers for day-to-day health care. In some rural areas the percentage is around ninety compared to 80% reported world-wide10,13,14. WHO32 had earlier estimates that the usage of traditional medicine in developing countries is 80 %. This is an indication that herbal medicine is important in primary health care provision in Uganda. There are several reproductive ailments that local communities have been handling and treating for ages such as sexual impotence and erectile dysfunction (ED). The concept of reproductive health care has been focusing mainly on women disregarding men and yet men are part.
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.
3. Testosterone replacement. Before oral medications like Viagra, testosterone was routinely used to treat erectile dysfunction as it is central in the male sexual response, including the desire for sex and the process of getting an erection. Testosterone can be administered in a number of ways, for example orally, by means of an injection, skin patch, or subcutaneous (under the skin) pellet. 

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.
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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.
Some studies carried in and outside Uganda show that some of these plants listed in the management of sexual impotence and ED may be potent. Some of these medicinal plants are regarded as traditionally aphrodisiacs, implying that they have ability to increase sexual desires. For instance, Cola acuminata fruits are widely used herbal remedies in ED and are harvested from the forests of Democratic Republic of Congo. The Cola acuminata fruits contain about 2% catechine-coffeine (Colanine)7. The roasted seeds in Europe are used as strong stimulant, in addition to the treatment of migraine, neuralgia, diarrhoea and stimulant or cardiotonic, loss of appetite, antidepressant and melancholy (severe form of depression)7. Coffee is drunk for certain migraine, nausea, resuscitation and diuretic7. Coffee is a famous stimulant used world over as a beverage. However, the wild coffee species are more popular in treating ED and are believed to contain more alkaloids (caffeine). Coffee is further reported to be a nervous system stimulant (Pampalona-Roger, 2000). Cannabis sativa (Marijuana) is smoked by mentally sick and impoverished men7. C. sativa is like morphine, it is an opioid analgesics. Allium sativum (garlic) is used in treatment of diabetes, high blood pressure, prevention of arteriosclerosis (hardening of the arteries and is one of the causes of ED)7. Garlic reduces blood sugar levels and blood cholesterol levels which are the direct causes of ED if not checked. The Zingiber officinalis (ginger) volatile oils from the rhizome are used for stimulating the nerves and making then sensitive7. Capsicum frutescens in many African cultures is a known powerful stimulant and carminative24. Capsicum frutescens (chilli) contains enzyme capsaicine that helps in blood clotting (fibrinolytic) and people who consume C. frutescens seldom suffer from heart attack. In addition, the pharmacological tests showed that the capsaicin chemical compound from Capsicum frutescens acted like powerful stimulant of the receptors participating in circulatory and respiratory reflexes24.
Phytolacca dodecandra leaves and roots are pounded and smeared on ripe banana and then the ripe banana roasted before being eaten for treating erectile dysfunction. However, care has to be taken Phytolacca dodecandra is poisonous. Cola acuminata fruits are mixed with other plants in Benin to treat primary and secondary sterility24. Cola acuminata is also said to be diuretic and laxative when administered orally24. Some Acacia species are regarded as aphrodisiacs in Niger2. Cassia species have high repute as drugs and poisons. For instance, Cassia sieberiana is used urinary problems, impotence and kidney diseases in Mali24. In Burkina Faso, Cassia occidentalis is used as a stimulant24. Flueggea virosa is famous medicine in African cultures. Flueggea virosa used in sterility, aphrodisiacs, stimulant, rheumatism, arthritis, spermatorrhoea, kidney and liver problems among many other diseases treated17,24.
The Plant: It’s true, the name’s hilarious. But as it turns out, it’s not just one plant: supplement manufacturers might put any one of 15 different species from this genus of shade-loving perennials inside that pill. That’s important to keep in mind, because the types and amounts of biologically active molecules the plant contains can differ from species to species.
Ginseng. Korean red ginseng has long been used to stimulate male sexual function, but few studies have tried systematically to confirm its benefits. In one 2002 study involving 45 men with significant ED, the herb helped alleviate symptoms of erectile dysfunction and brought "enhanced penile tip rigidity." Experts aren't sure how ginseng might work, though it's thought to promote nitric oxide synthesis. "I would recommend ginseng [for men with ED]," says Espinosa. Discuss with your doctor before taking it since ginseng can interact with drugs you may already be taking and cause allergic reactions.
The field visits and excursions were arranged with the healers for places far from their homesteads or took place concurrently with the interviews and discussions. When going to the forests, game reserves or other areas where herbalists collect plant specimens, prior arrangements were made with the community leaders and park staff. This was done with individuals or groups depending on where the herbs are collected. In the shared areas such as the fishing villages, or the multiple use areas, group and individual excursions were conducted. Some of the medicinal plants that are harvested from distant places such as the Democratic Republic of Congo, other districts and unsafe areas within the reserve were not collected but their local names were recorded. The data collected were to supplement the information on plant names, plant parts used, collection of the herbarium voucher specimens and conservation status of these medicinal plants. The medicinal plants collected were given the voucher numbers and then later identified in Botany Department herbarium of Makerere University.
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.
Epimedium extract (Horny Goat Weed) (11), (Figure 9): the Chinese refer to this herb as ‘yin yang huo’, which has been loosely translated as ‘licentious goat plant’; hence, its common name is well known as ‘horny goat weed’ by many Western cultures. Scientifically, studies have shown that Epimedium may restore low levels of both testosterone and thyroid hormone, bringing low levels back to their normal levels (5), which may account for some of its benefits in improving sexual libido. Other benefits to Epimedium involve increased muscle mass. Used for fatigue and aging, And vasodilatation effect; thus, most frequently used in treatment of sexual dysfunction in Traditional Chinese Medicine (12). The active substance from horny goat weed was reported by Xin Zhong Cheng at Beijing Medical University as Icarin—acts by increasing sexual activities and ICP levels in castrated rats after long term oral administration. It has no effects on serum testosterone level in castrated rats after long term oral administration. Instead Icariin increases nNOS and iNOS mRNA and protein expression in the corpus cavernosum after long term oral administration and hence may have long term efficacy on erectile dysfunction after oral administration.

The medical ethnobotanical indigenous knowledge were collected by visiting traditional healers and documenting the medicinal plants used and other socio-cultural aspects allied with sexual impotence and erectile dysfunction. The methods used to collect the relevant information regarding the medicinal plants used included informal and formal discussions, field visits and focused semi-structured interviews.
DHEA. Testosterone is essential for a healthy libido and normal sexual function, and erectile dysfunction sufferers known to have low testosterone improve when placed on prescription testosterone replacement therapy. Similarly, studies have shown that taking over-the-counter supplements containing DHEA, a hormone that the body converts to testosterone and estrogen, can help alleviate some cases of ED. But DHEA can cause problems, including suppression of pituitary function, acne, hair loss and its long-term safety is unknown, says McCullough. For this reason, many experts discourage use of the supplements.
Historically, it has been shown that herbal medicines may cure or prevent certain ailments. However, there are very little recorded data available to support the dose, efficacy, side effects and interactions. Because the safety and efficacy of herbal remedies have not been assessed, unlike synthetic drugs, well-controlled and randomized studies are warranted to establish the therapeutic efficy and safety of such products. Determination of side effects and interactions with prescription medicines are also needed. The amount of active ingredients in herbals may vary among preparations; thus, standardization of herbal medicines is required.

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.
Ginseng is generally indicated for daily, consistent use in moderate doses. Do not use ginseng as a short-term stimulant. Ginseng and other adaptogens work best after long-term (one–three months) use by regulating hormone levels and other biological functions to protect us against the damaging effects of chronic stress,” says herbalist Christopher Hobbs, author of The Ginsengs. A typical dose is 4,000–6,000 mg per day.

This study was carried out in areas in and around Queen Elizabeth Biosphere Reserve (QEBR) and some other sub counties such as Katerera, Kichwamba and Kitagata in Bushenyi and Munkunyu, Kayonza and Kitsinga in Kasese districts in Western Uganda. The sampling sites were located in the parishes around the biosphere reserve, and in the selected fishing villages within the biosphere reserve. These included, Katwe, Mweya, Katunguru, Hamukungu, Kahendero and Kayanja Fishing Villages and many other villages.


In diabetes, vasoconstrictors and vasoactive factors are increased in addition to structural changes and attenuation of relaxation responses in the corpus cavernosum. A shifting of the balance of vasoactive factors occurs such that relaxation factors (eg, nitric oxide [NO]) are inhibited and contractile factors are induced in microvascular disease. With epidemiological predictions suggesting that the incidence of diabetes mellitus will increase to 300 million by 2025, management of diabetes-induced ED is increasingly important.

Experts feel that treating erectile dysfunction on your own, without consulting a doctor, is unsafe. "If you have ED, the first thing you need is a diagnosis," says impotence expert Steven Lamm, MD, a New York City internist and the author of The Hardness Factor (Harper Collins) and other books on male sexual health. He says men with severe erectile dysfunction probably need one of the prescription ED drugs, which include Levitra (vardenafil) and Cialis (tadalafil) as well as Viagra. But, he says, mild ED -- including the feeling that "you're not as hard as you could be" -- often responds to natural remedies.


Your doctor may also choose to lower your dose of certain medications. Or your provider may switch the type of drug you’re taking if it’s interfering with your sex life. Some medicines used for managing blood pressure, insomnia, anxiety, depression, seizures and prostate problems increase the risk for erectile dysfunction. Beta-blockers (for high blood pressure), SSRIs (often used to treat depression) and the class of drugs called benzodiazepines (like Ativan, Xanax, Librium and Valium) are commonly tied to ED. You may want to speak to your doctor about this.
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 informal conversations were held with the specialist resource users and other knowledgeable people on particular ailments. The meeting places were the gardens, women group meetings, at their homes, and any other places convenient to them. Through conversations, the sources of knowledge of the healers on medicinal plants, the medicinal plants used and changes in the availability of medicinal plants were established. Those who were more knowledgeable were later followed and interviewed further especially the TBAs, and some knowledgeable men healers. Focused discussions were held with them later for formal recording. In some instances, young mothers were visited too. This was done to verify the information gathered and the spread of the indigenous knowledge (IK) in reproductive health care among the different reproductive groups particularly on ED management.
For many men, stopping smoking is an erectile dysfunction remedy, particularly when ED is the result of vascular disease, which occurs when blood supply to the penis becomes restricted because of blockage or narrowing of the arteries. Smoking and even smokeless tobacco can also cause the narrowing of important blood vessels and have the same negative impact. 
There is no single cause for erectile dysfunction. Achieving an erection involves a complex series of physiological events; in order for an erection to occur, the body is required to coordinate nervous system responses with tactile sensations, emotional triggers, and signals from certain hormones. If any of these events are disrupted, impotence is likely to occur.
3. Testosterone replacement. Before oral medications like Viagra, testosterone was routinely used to treat erectile dysfunction as it is central in the male sexual response, including the desire for sex and the process of getting an erection. Testosterone can be administered in a number of ways, for example orally, by means of an injection, skin patch, or subcutaneous (under the skin) pellet. 
Yohimbine is the principal alkaloid of the bark of the West African evergreen P johimbe (formerly known as C johimbe), family Rubiaceae. The main active chemical present in P johimbe bark is yohimbine hydrochloride (an indole alkaloid), which has stimulant and aphrodisiac effects. However, the levels of yohimbine that are present in P johimbe bark extract are variable and often very low. Therefore, although P johimbe bark has traditionally been used to treat ED [38], there is insufficient scientific evidence to form a definitive conclusion in this area. It is an antagonist of α2-receptors and has no direct relation to erection. It acts as a sex motivation stimulant. Yohimbine has been used as both an over-the-counter dietary supplement in the form of an herbal extract, and as a prescription medicine in purified form for the treatment of sexual dysfunction. Yohimbine 20 mg or adjusted dose has been found to be effective in the treatment of orgasmic dysfunction. Yohimbine was recently associated as a treatment for type 2 diabetes mellitus in animal and human models carrying polymorphisms of the alpha-2A adrenergic receptor gene [39]. The National Institutes of Health states that yohimbine hydrochloride is the standardized form of yohimbine that is available as a prescription medicine in the United States, and has been shown in human studies to be effective in the treatment of male impotence. Yohimbine hydrochloride USP has been used to treat ED. Controlled studies suggest that it is not always an effective treatment for impotence, and evidence of increased sex drive (libido) is anecdotal only. It cannot be excluded that orally administered yohimbine can have a beneficial effect in some patients with ED. The conflicting results available may be attributed to differences in drug design, patient selection and definition of positive response. Yohimbine has been shown to be effective in the reversal of sexual satiety and exhaustion in male rats, and has also been shown to increase the volume of ejaculated semen in dogs, with the effect lasting at least 5 h after administration. Yohimbine has also been shown to be effective in the treatment of orgasmic dysfunction in men, and has also been used for the treatment of sexual side effects caused by some antidepressants, and female hyposexual disorder. Yohimbine has significant side effects, such as anxiety reactions. Higher doses of oral yohimbine may create numerous side effects, such as rapid heart rate, high blood pressure, overstimulation, insomnia and/or sleeplessness. More serious adverse effects may include seizures and renal failure. Yohimbine should not be consumed by individuals with liver, kidney or heart disease, or psychological disorders. The therapeutic index of yohimbine is low; the range between an effective dose and a dangerous dose is very narrow. Side effects include gastrointestinal upset, increased blood pressure, headache, agitation, rash, tachycardia and frequent urination [40].
Your doctor may also choose to lower your dose of certain medications. Or your provider may switch the type of drug you’re taking if it’s interfering with your sex life. Some medicines used for managing blood pressure, insomnia, anxiety, depression, seizures and prostate problems increase the risk for erectile dysfunction. Beta-blockers (for high blood pressure), SSRIs (often used to treat depression) and the class of drugs called benzodiazepines (like Ativan, Xanax, Librium and Valium) are commonly tied to ED. You may want to speak to your doctor about this.
Ginseng is generally indicated for daily, consistent use in moderate doses. Do not use ginseng as a short-term stimulant. Ginseng and other adaptogens work best after long-term (one–three months) use by regulating hormone levels and other biological functions to protect us against the damaging effects of chronic stress,” says herbalist Christopher Hobbs, author of The Ginsengs. A typical dose is 4,000–6,000 mg per day.
Animal testicles: derived from bulls and wild boars, the orchic substance has been used as a way to possibly increase testosterone levels and sperm counts. In Singapore, testis soap was once very popular (Figure 2). It is still sold in parts of China and Japan. The dried Dog testis and penis (canis familiaris) is believed to tonify the kidneys and strengthen the yang II. Kidney deficiency is believed to be the cause of impotency in Chinese literature.
DHEA. Testosterone is essential for a healthy libido and normal sexual function, and erectile dysfunction sufferers known to have low testosterone improve when placed on prescription testosterone replacement therapy. Similarly, studies have shown that taking over-the-counter supplements containing DHEA, a hormone that the body converts to testosterone and estrogen, can help alleviate some cases of ED. But DHEA can cause problems, including suppression of pituitary function, acne, hair loss and its long-term safety is unknown, says McCullough. For this reason, many experts discourage use of the supplements.

A plant like Cleome gynandra is a popular vegetable used all over Uganda and is on sale in most markets. Other medicinal plants that are food stuff include Allium cepa (onions), Allium sativum (garlic), Rhus vulgaris, Capsicum frutescens(red pepper) and Zingiber officinale (Ginger) are also on sale in most markets of Uganda and internationally. In addition, the roots of Mondia whiteii are used as an aphrodisiac for males and for improving female sexuality (women's Viagra) in most areas of Uganda11 particularly in urban centres and the Kampala City. To date, Mondia whiteii has been an old traded medicinal plant in most in Kampala. Recently the patented ‘Mulondo Wine’ a drink flavoured by the roots of Mondia whiteii has hit the national and international markets35. The Mulondo Wine is also believed to be an aphrodisiac for both men and women.
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.
Poor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones. 
Yohimbe. Before Viagra and the other prescription erectile dysfunction drugs became available, doctors sometimes prescribed a derivative of the herb yohimbe (yohimbine hydrochloride) to their patients suffering from ED. But experts say the medication is not particularly effective, and it can cause jitteriness and other problems. "It's not a great drug," says McCullough. "And I suspect the herb is not as potent as the pharmaceutical version." What's more, evidence shows that yohimbe is associated with high blood pressure, anxiety, headache, and other health problems. Experts discourage its use.

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!
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.
Generally, erectile dysfunction (ED) is a neurovascular condition directly involving the endothelium of the corpora cavernosal arterial blood vessels in the penis, and is indirectly linked to cardiovascular diseases. The underlying mechanisms of ED are, however, complex and involve psychogenic, neurogenic, hormonal and vascular factors. ED occurs in aging men, with a prevalence of 52% in men 40 to 70 years of age [1-3]. Conditions that may cause ED include hypertension, diabetes, diseases of the prostate and heart, and obesity. ED may also be caused by the effects of certain medications as well as physical injury or anatomical deformity of the penis [4], or may result from endocrine disorders such as low testosterone, hypogonadism, adrenal insufficiency and hypothyroidism. Changes in blood flow to the male reproductive organs as a result of hardening of the arteries or atherosclerosis, hypertension and hypercholesterolemia may result in ED. It is generally accepted that there are vascular and neuropathic components to the pathophysiology of the disease, and ED has been recognized as a potential indicator of underlying cardiovascular disease. Chronic infections and/or inflammation of the prostate and irritation of the bladder may contribute to the pathogenesis of ED.

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.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Yohimbine: The main component of an African tree bark, yohimbine is probably one of the most problematic of all natural remedies for ED. Some research suggests that yohimbine can improve a type of sexual dysfunction that is linked with a drug used to treat depression. However, studies have linked yohimbine to a number of side effects, which can include anxiety, increased blood pressure, and a fast, irregular heartbeat. Like all natural remedies, yohimbine should only be used after advice and under supervision from a doctor.
C borivilianum (family Liliaceae) is native to India. Analysis of C borivilianum root revealed a composition of 12% to 17% saponins, 1.9% to 3.5% stigmasterol, 0.79% arabinose, 3.8% galactose, 0.73% glucose and 0.78% rhamnose [31]. For dried root powder, the recommended dose is 5 g and the extract dose is 500 mg. It is used as an aphrodisiac and to cure ED, improve semen quality and volume. It eliminates premature ejaculation, improves general well-being and vitality, and increases stamina and libido. Visavadiya and Narasimhacharya [31] have demonstrated that administration of C borivilianum (0.75 g and 1.5 g root powder per rat per day for four weeks) to hypercholesteremic rats significantly increased highdensity lipoprotein cholesterol levels and decreased plasma and hepatic lipid profiles. Furthermore, the treatments also resulted in increased excretion of fecal cholesterol, sterols and bile and increased superoxide dismutase levels. Kenjale et al [32] evaluated the aphrodisiac and spermatogenic potential of the aqueous extract of dried roots of C borivilianum in rats. C borivilianum was given orally at doses of 125 mg/kg/day and 250 mg/kg/day. Viagra 4 mg/kg/day (sildenafil citrate) was administered as a control. Sexual behaviour was monitored 3 h later using a receptive female. Their sexual behaviour was monitored on days 1, 7, 14, 21 and 28 of treatment by pairing with proestrous female rats. For sperm count, the treatment was continued further in all groups except for the Viagra group for 60 days. At 125 mg/kg, C borivilianum had marked aphrodisiac action, as demonstrated by increased libido, sexual vigour and sexual arousal in the rats. Similarly, at the higher dose (250 mg/kg), all the parameters of sexual behaviour were enhanced, but showed saturation effect after 14 days. On day 60, the sperm count increased significantly in both the C borivilianum-treated groups (125 mg/kg/day and 250 mg/kg/day) in a dose-dependent manner. The administration of C borivilianum extract has been found to be useful for the treatment of premature ejaculation and oligospermia [32]. Supplementation with C borivilianum root 250 mg/kg/day and 500 mg/kg/day to streptozoticin-induced diabetic male rats for 28 consecutive days improved sperm morphology, and reduced oxidative stress and formation of free radicals [33]. In case of streptozotocin- and alloxan-induced hyperglycemia, the aqueus extracts from C borivilianum resulted in improved sexual performance compared with diabetic control [34,35].
The phrase “use it before you lose it” can be applied when it comes to helping men with ED regain normal erectile function. Pelvic exercises, more commonly known as kegel exercises, are used to promote urinary continence and sexual health. They help to strengthen the bulbocavernosus muscle, which does three things: allows the penis to engorge with blood during erection, it pumps during ejaculation, and it helps empty the urethra after urination, according to Healthline.

"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.
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.
A daily dose of niacin improves erectile function, particularly in men with high cholesterol, according to a 2011 study in The Journal of Sexual Medicine. The vitamin helps increase blood flow and reduce inflammation—one of the underlying causes of both high cholesterol and erectile dysfunction. “Vitamin B3 is also used to make sex hormones and other important chemical-signal molecules,” says Fisch. Like many of the others on our list, this tablet is most powerful when taken in conjunction with others: A cocktail of propionyl, L-carnitine, L-arginine, and niacin taken for three months improved 40% of erections in a study from researchers at Sapienza University of Rome in Italy.
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