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.
If you’ve been to the health food store lately, you’ve seen shelves lined with vitamins and “organic” supplements, each claiming to boost immunity, revitalize organ function, or “promote health.” And it’s working. Supplements are currently a $30 billion industry in the US, with more than 90,000 products on the market, and vitamin use is on the rise. In fact, a recent survey in Journal of American Medicine Association showed that “52% of US adults reported use of at least 1 supplement product.”
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.
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.
ED can be caused by a handful of things, but one thing’s for sure: You need a healthy supply of the neurotransmitter nitric oxide (NO) to get and maintain an erection. NO is produced in nerve tissue and helps jolt your Johnson by relaxing the smooth muscle so blood can fill the penis. After the initial release of NO, your body releases a cascade of chemicals—including more of the neurotransmitter—to help keep you hard and happy, according to a study in the Proceedings of the National Academy of Sciences.
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.
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.
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Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).
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.
The Science: There’s only been one double-blind placebo-controlled trial of the stuff: it found that men taking fenugreek extract reported that they felt more sexual arousal and experienced better orgasms. But testosterone levels in those same men didn’t change, and the study was also tiny–only 60 participants–so it’s not clear whether there’s actually a biochemical reason for the shift or whether it was all psychological. The experiment needs to be repeated with a larger group of people to find out whether those results can be reproduced.
"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.
The neurovascular mechanism of erection is complex and involves multiple factors including hormones, neurotransmitters, elements of the autonomic nervous system (sympathetic and parasympathetic) and vasodilators such as NO. The common causes of ED include psychogenic disturbance with failure to relax cavernous smooth muscle, arterial insufficiency as a result of atheromatous disease, damage to the parasympathetic nervous system, spinal cord injury, diabetes or following pelvic surgery such as radical prostatectomy, radical cystectomy or bowel resection [4]. It is important to note that cavernous nerves are unique in that although they belong to the autonomic nerves system they do not release either acetylcholine (Ach) or norepinephrine; however, they release NO in the penis. NO relaxes the smooth muscle of the corpora cavernosa via cyclic GMP (cGMP), allowing expansion of the cavernosal lacunar spaces, blood flow and erection. Thus, NO is not a direct dilator of the smooth muscle of cavernosal bodies, but it is an important mediator in this process. Erectile function may also be adversely affected by cigarette smoking, excess alcohol consumption, obesity and systemic diseases such as mononucleosis, hepatitis, HIV and cancer. Some men are prone to develop an erection that fails to subside after ejaculation (ie, priapism). The condition is associated with sickle-cell disease and leukemia, or may be a result of intracavernosal injection of drugs such as prostaglandin E1 [4]. Peyronie’s disease causes a physical bend in the erect penis and also contributes to ED.

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.
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.

Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).

There’s no bedroom bummer quite like having to fly at half mast, but your penis problems are likely more common than you think: As many as 30 million American men suffer from erectile dysfunction, and one in four who seek treatment for ED are actually under the age of 40, according to a study in The Journal of Sexual Medicine. We all know there’s a little blue pill that can fix the failure to launch—but you don’t necessarily have to fill a ‘script to save your stiffy.
Consider this:  penicillin, the first successful antibiotic, was derived from molds that inhibit bacterial growth.  Scientists had to figure out why the molds slowed bacteria, and refine the active ingredients.  Using herbal supplements is somewhat like putting mold on a wound.  It might help, a little, but it’s certainly not going to help as much as using penicillin.
Erectile dysfunction can occur as a side effect of medication taken for another health condition. Common culprits are high blood pressure meds, antidepressants, some diuretics, beta-blockers, heart medication, cholesterol meds, antipsychotic drugs, hormone drugs, corticosteroids, chemotherapy, and medication for male pattern baldness, among others.
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.

Do it at home: Take a white onion, peel it off, crush and then fry in butter. This mixture can be taken daily with a spoon of honey, but make sure to consume this mixture when your stomach has been empty for at least two hours. This remedy helps to treat premature ejaculation, impotence and involuntary loss of semen during sleep or other times (known as spermatorrhea).
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L-arginine is used by the body to increase and precursor to the production of human growth hormone, prolactin and several amino acids It even increases our sensitivity to insulin, analogously to body when we exercise, by accepting more glucose to enter into our cells and improve better cellular energy therefore less fatigue with much more stamina. L-arginine’s function in supporting our metabolic health are also extremely important for building stronger muscle tissue and potentially to help fight inflammation.
The causes of ED are varies from one individual to another. For whatever cause, since an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. This sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa23. Thus, ED causes reported include, damage to nerves, arteries, smooth muscles, and fibrous tissues. These are often as a result of diseases, such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic diseases that account for about 70 percent of ED cases23. NIH23 reported that between 35 and 50 percent of men with diabetes experience ED. NIH23 further reported that the usage of many common medicines such as blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug) can produce ED as a side effect. Nevertheless, psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of ED cases. In addition, men with a physical cause for ED frequently experience the same sort of psychological reactions (stress, anxiety, guilt, depression)23. Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone23.
Feeling fatigued, very stressed, depressed or dealing with another mood-related issue that can lower libido. Sources of stress and diminished quality of life — such as “deteriorating economic position,” unhappiness with one’s job or other aspects that lower emotional health — are believed to be major causes for sexual dysfunction in both men and women
E longifolia is a medicinal plant (family Simaroubaceae) native to Indonesia, Malaysia, Thailand, Vietnam and Laos. The root extract has been found to be the most powerful herbal aphrodisiac [17]. Tongkat ali extracts contain many alkaloids, quassinoids, phenolic compounds, tannins, high-molecular-weight glycoproteins and mucopolysaccharides. The main bioactive compounds are eurycomaoside, eurycolactone, eurycomalactone, eurycomanone and pasakbumin-B. It is considered to be natural ‘Viagra’. It increases sexual desire, and enhances performance and general well-being [17- 19]. In addition to its aphrodisiac effect, other medicinal effects, such as antimalarial, antibacterial, antipyretic, antiulcer and antitumour effects, have been reported [20,21]. Root decoction has been used as a general tonic (18,22]. Laboratory animal studies show that root extract enhances sexual characteristics and performance in rodents [22-25]. In a study involving a boar model, it was found that E longifolia root extract-treated boars increased sperm counts and semen volume; the effect was attributed to increased level of plasma testosterone [26]. Reports also suggest that E longifolia extract reverses the inhibitory effects of estrogen on testosterone production and spermatogenesis in rats [27]. Oral administration of E longifolia extract to inexperienced castrated male rats produced dose-dependent increases in sexual performance [28]. Zakaria et al [29] found that eurycomanone, a potential bioactive compound in the root extract of E longifolia, induced apoptosis in hepatocarcinoma (Hep G2) cells. Furthermore, their work suggested that eurycomanone was cytotoxic to Hep G2 cells and less toxic to normal Chang’s liver and WLR-68 cells. Tambi and Imran [19] investigated the effects of water-soluble extract of the root of E longifolia Jack and found that the extract increased semen volume, sperm concentration, percent of normal sperm morphology and sperm motility in male partners of subfertile couples with idiopathic infertility. Supplementation with E longifolia elevated the testosterone levels and upregulated osteoprotegerin gene expression in male Sprague-Dawley rats [30].
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.

Pay attention to your vascular health. High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the heart (causing heart attack), in the brain (causing stroke), and leading to the penis (causing ED). An expanding waistline also contributes. Check with your doctor to find out whether your vascular system — and thus your heart, brain, and penis — is in good shape or needs a tune-up through lifestyle changes and, if necessary, medications.

Extracts from medicinal plants have been used for considerable period of time in many parts of the world, particularly in Southwest Asia, to treat ED [16]. The current review focuses on four botanical medicinal plants, the roots of which are used in enhancing sexual performance and in the treatment of ED: Eurycoma longifolia Jack (tongkat ali); Chlorophytum borivilianum (safed musli); Withania somnifera (ashwagandha); and Pausinystalia johimbe (yohimbine, formerly known as Corynanthe johimbe).
In fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.
W somnifera (ashwagandha), also referred to as winter cherry (family Solanaceae), grows in Africa, the Mediterranean, India, Pakistan, Bangladesh, Afghanistan, South Africa, Egypt, Morocco, Congo and Jordan [36]. The roots of the plant contain steroid alkaloids and steroidal lactone, which are the main constituents of ashwagandha; these compounds are referred to as withanolides. Among the various alkaloids, withnine is the main constituent. The other alkaloids are somniferin, somnine, somniferine, withananine, pseudowithanine, tropine, pseudotropine, cuscohygrine, anferine and anhydrine. Two acyl steryl glucosides (sitoindoside VII and sitoindoside VIII) have been isolated from the root. The withanolides contain a C28 steroidal nucleus with a C9 side chain and six-membered lactone rings. Ashwagandha root also contains flavonoids and many ingredients of the withanolide class. It has several medicinal applications (aphrodisiac, liver tonic, anti-inflammatory agent, astringent), and is used to treat bronchitis, asthma, ulcers, insomnia, senility and dementia. Clinical trials and studies involving animal models support the use of ashwagandha for anxiety, cognitive and neurological disorders, inflammation and Parkinson’s disease. It also provides cryoprotective benefits to patients undergoing radiation and chemotherapy, and shows beneficial effects for nervous exhaustion. W somnifera is used as an aphrodisiac, sedative and rejuvenative, and is also used to treat chronic fatigue, dehydration, bone weakness, muscle weakness, loose teeth, impotency, premature ejaculation, debility, constipation, senility, rheumatism, nervous exhaustion, memory loss, drug withdrawal symptoms, anxiety and arthritis pain in the knee. Extracts from W somnifera inhibit transcription factor nuclear factor kappa B (NF-κB); thus, it acts as an anti-inflammatory agent. This has been attributed to its ability to interact with IKKB, a kinase that is responsible for the nuclear translocation of NF-κB and activation of inflammatory signalling pathways [37].
The semi-structured interviews and discussions were held with the specialist resource users and other knowledgeable people on particular ailments by use of interview schedules for each respondent. Interviewed people were mainly the herbalists (both men and women) and TBAs. In this selection to some extent, ethnic groups were recorded where possible because different people use the same plants differently. The time and place of interviews were arranged according to the schedules of the respondent. Depending on where the interviews and discussions were held, recording was done immediately or afterwards or appointments were made for more details in a more convenient place arranged with the respondent. Key informants were identified and later interviewed separately and even followed for further details. Some of the key questions asked included, name of the respondents, the village or parish or sub-county he or she was coming from, diseases treated, plant local names used, parts harvested, methods of preparation and administration. In addition, ingredients and incantations with which the plants are used for preparation and where the herbal medicines were harvested were documented.
Six herbs for treating erectile dysfunction Erectile dysfunction can be an embarrassing condition that can leave men unable to achieve an erection or a full orgasm. This MNT Knowledge Center article talks about six different herbal supplements that could help people with erectile dysfunction, including ginkgo biloba, horny goat weed, and red ginseng. Read now
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.
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 study published in May 2014 in The Journal of Sexual Medicine found that some men can reverse erectile dysfunction with healthy lifestyle changes, such as exercise, weight loss, a varied diet, and good sleep. The Australian researchers also showed that even if erectile dysfunction medication is required, it's likely to be more effective if you implement these healthy lifestyle changes.
Ashwagandha (Withania somnifera), used widely in Ayurvedic medicine, holds a similar role to that of ginseng in Chinese medicine. Though unrelated to ginseng, it appears to share similar properties and actions. Ayurveda considers this herb to be a rasayana, or particularly powerful rejuvenative. The name ashwagandha means “like a horse,” connoting that it is regarded as a premier sexual tonic.
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.
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).
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:
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.
The truth is medication or psychosexual counselling are the first treatments a doctor will suggest because they’ve been proven to work. If a doctor has approved a medication for you then it’s safe. If you would still like to see if herbal supplements work for you, then there is a list below of supplements thought to work for erectile dysfunction. Just before you invest your money in them, remember they aren’t proven to work:
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

Reiter, W. J., Pycha, A., Schatzl, G., Pokorny, A., Gruber, D. M., Huber, J. C., & Marberger, M. (1999, March). Dehydroepiandrostone in the treatment of erectile dysfunction: A prospective, double-blind, randomized, placebo-controlled study [Abstract]. Urology, 53(3), 590-594. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429598005718
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