Maca root (Lepedium meyenii W): this native Peruvian root has been cultivated for thousands of years. Considered an integral part of the diet, the Incans found maca root so potent (14), it was restricted to royal use only. Known for its energy enhancing abilities, maca root enjoys a special place amongst herbalists and health seekers. Like ginseng, this plant is employed to increase strength, libido and sexual function (14). Clinically its effects have been proved with experimental animals (5,15).
From the conservation point of view, medicinal plants usage will continue to grow in popularity as people seek ways to support health naturally and gently31. So far, over 72% of these medicinal plants used in ED conditions were harvested from the wild. Yet, there is increasing trend in usage of traditional medicine in developed countries30. The dramatic increase in herbal remedies usage will continue to rise since WHO has taken on monitoring of all unconventional medicine according to the traditional medicine strategic plan of 2002 to 200533. Most medicinal plants have proved successful sources or have acted as leads of effective ingredients that today's drug companies often look first to traditional places such as the rain forests, forest animals and traditional healers for clues to guide their drug development efforts. Furthermore, the harvesting of medicinal plants from the wild places such as the forest reserves, national parks in QEBR is a point of concern whereby no viable mechanisms have been put in place to propagate them. The plant parts harvested especially those of wild medicines such as roots and stem, pose threat to the future survival of natural reservoirs if domestication strategies are not adopted in the near future.
Saw palmetto. Saw palmetto comes from the fruit of a small palm tree. It has been used to treat symptoms in men with an enlarged prostate gland, such as difficulty urinating, and it has been recommended to treat ED caused by an enlarged prostate. However, several recent clinical trials did not show that saw palmetto works any better on an enlarged prostate than a placebo does. "There is no evidence that saw palmetto should be used to treat erectile dysfunction," says Dr. Gilbert. Like ginkgo biloba, saw palmetto can interact with some prescription medications.
The basis of ED herbal therapies is that they are anti-inflammatory, antioxidant and immunomodulatory, and can stimulate testosterone production. On the other hand, the synthetic drugs act via NO. The principal mediator of the relaxation of corporal smooth muscle of the penis has been shown to be NO, which is released mainly from parasympathetic nerves and endothelium [13]. NO is believed to relax the corporal smooth muscle by activating soluble guanylate cyclase to increase cGMP content [14,15]. Penile rigidity depends on maximizing inflow of blood while minimizing outflow [6]. The increased blood flow in the cavernous sinuses puts pressure on the walls of the surrounding veins, causing the lumen of the veins narrow, temporarily interfering with the flow of blood but causing tumescence. Normally, the parasympathetic nerve produces Ach. Ach acts on muscarinic receptors and nicotinic cholinergic receptors. When the parasympathetic nerve is stimulated, preganglionic neurons release Ach at the ganglion, which acts on nicotinic receptors on postganglionic receptors. Postganglionic neurons then release Ach to stimulate muscarinic receptors of the target organs. The muscarinic receptor M3, present in the endothelial cells and smooth muscle, is activated, and the M2 receptor in the heart may also be activated. This may result in the production of Ach, which can cause endothelial cells to produce NO. Ach released from postganglionic parasympathetic nerves acting through G-protein-mediated muscarinic receptors and nicotinic cholinergic receptors helps to release NO. Normally, M1, M2 and M3 receptors are found in secretory glands, heart, smooth muscle and endothelial cells, respectively. M1, M2 and M3 receptors cause activation of phospholipase C and generate inositol trisphosphate and diacylglycerol, which increase calcium. Activation of M4 may inhibit adenylate cyclase, decreasing the messenger cyclic AMP. This mechanism may be involved in the relaxation and contraction of cavernosal smooth muscle cells.
In reality, on a few and proven key herbs that shown to cure and improve on erectile dysfunction. A simple stack of 3 key supplements has proven to treat and cure erectile dysfunction, namely improving and restoring your libido, blood circulation and erectile strength.  As a naturally supplement combo, this 3 herbal combination is proven to reverse or cure erectile dysfunction.
Usually patients will try less invasive alternatives to treat impotence before opting for surgery. These alternatives may include supplements, herbs, lifestyle changes and even medications. In cases where other treatments do not work to resolve ED, surgery might be a last-resort option. Surgery involves implanting a penile prosthesis. This is a saline-filled silicone device or a malleable device. Although the likelihood of serious side effects is considered to be low, certain risks are associated with surgery to correct erectile dysfunction. These side effects may include: anesthetic risk, device infection, and device malfunction or mechanical failure. Some studies have found that five years following surgery around 10–20 percent of men experience device malfunction and failure. Infection rates are low. Around one percent of men who opt for this type of surgery get an infection.
Physical and emotional stress — whether over-exercising, under-sleeping or just dealing with everyday stressors like work and a busy schedule — causes an increase in “stress hormones,” including cortisol and adrenaline. Stress can lower desire for sex. This is because stress can contribute to fatigue or preoccupation with other tasks. It can also significantly affect blood flow by increasing inflammation.
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.
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.

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.
Older age. A man’s risk increases past the age of 40, as age is the variable most strongly associated with impotence. This is due to changing hormones, higher risk for heart problems and those affecting circulation, and decreased sexual desire that often occurs with increasing age. For example, based on findings from the National Health and Social Life Survey, it’s been found that “men between 50–60 years old are more than 3 times as likely to experience erection problems and to report low sexual desire compared to men aged 18 to 29 years.” (3)
In this day and age, there is a wide spectrum of innovative drug and other methods of treatment including psychosexual therapy and counseling, topical and systemic drug therapy, device-assisted therapy, electromagnetic stimulation to improve nerve and vascular function of the pelvis and perineal muscles. Electro-ejaculation and the less often done surgical techniques are currently available. The simpler electrovibration can help create or maintain erection or stimulate ejaculation. Although we give so much emphasis on ejaculation, in the Chinese traditional medical teaching, there is reference to improving health by ejaculatory control and abstaining from ejaculating during sexual activity—hence the popular belief that EJACULATING TOO MUCH will lead to WEAKNESS and ILL HEALTH!

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).
Maca root (Lepedium meyenii W): this native Peruvian root has been cultivated for thousands of years. Considered an integral part of the diet, the Incans found maca root so potent (14), it was restricted to royal use only. Known for its energy enhancing abilities, maca root enjoys a special place amongst herbalists and health seekers. Like ginseng, this plant is employed to increase strength, libido and sexual function (14). Clinically its effects have been proved with experimental animals (5,15).
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.

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.
Thirty-three medicinal plants both cultivated (Table 1) and wild harvested (Table 2) were documented and identified in the area of study. In the description below these results of these two table are combined as presented below. All the identified medicinal plants in both tables belong to 25 families and 30 genera. The family Rubiaceae (4) is the most represented followed by Alliaceae, Euphorbiaceae, Mimosaceae, Papilionaceae and Caesalpinaceae families which have two species each and the rest with one species. The composition is that 42.4% are shrubs, 39.4% herbs and herb climbers and 18.2% trees. Leaves (57.6%) are the commonest plant parts followed by roots (42.1%), barks (27.3%) and the rest of the plant parts harvested have less than 10% of the parts harvested. From Allium cepa, Allium sativum, Rhus vulgaris, Warburgia ugandensis, Cleome gynandra and Tarenna graveolens, three different plant parts, are harvested for use in sexual impotence and erectile dysfunction. In the case of Impetiens species and Urtica massaica, the whole plants are harvested while the rest of the species one or two different plant parts are used. The conservation status of these documented plants is that 27.3% are cultivated while 72.7% are collected from wild places. The common methods of plant medicine preparation included boiling, chewing, pounding, cooking, roasting and smoking. The commonest method of herbal administration was by oral means as food, herbal teas or by mixing in several drinks including locally made beer.

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.
Saw palmetto. Saw palmetto comes from the fruit of a small palm tree. It has been used to treat symptoms in men with an enlarged prostate gland, such as difficulty urinating, and it has been recommended to treat ED caused by an enlarged prostate. However, several recent clinical trials did not show that saw palmetto works any better on an enlarged prostate than a placebo does. "There is no evidence that saw palmetto should be used to treat erectile dysfunction," says Dr. Gilbert. Like ginkgo biloba, saw palmetto can interact with some prescription medications.
Eleuthero, a distant relative of Panax ginseng, has been used in Chinese medicine for 2,000 years. Eleuthero, also called Siberian ginseng, has been shown to enhance physical performance in several studies. Research shows it has antioxidant, immune-boosting, and cholesterol-lowering properties. A study in the Journal of Ethnopharmacology concludes that the active constituents, eleutherosides, alleviate both physical and mental fatigue.
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.
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.
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.
Yohimbe (Pausinystalia yohimbe): again an Asian favorite which originates from an evergreen tree native to the West African Countries of Congo, Cameroon and Gabon, it is the only herb listed in the Physician’s Index Reference as supporting sexual function. Its Latin name is Pausinystalia yohimbe. The USA FDA approved yohimbe as the first plant derived drug for treating impotency long ago and was dubbed the herbal viagra II in the February 1999 edition of Environmental Nutrition. Alkaloid in yohimbe i.e., Iso Yohimbine, allo-yohimbine, yohimbinine, yohimbane, yohimbenine and corynantheine blocks alpha-2 adrenergic activity allowing vasodilation. It also acts as a monoamine oxidase inhibitor increasing serotonin in the brain. Yohimbine has a dual aphrodisiac function: it improves sexual function (10) by displacing epinephrine from alpha-2 adrenergic receptors in the pelvic area and it increases proneness to arousal thru supplying the epinephrine from the alpha-2 receptors to the central nervous system (brain) where it is active as a neurotransmitter. Side effects include nervousness, anxiety, insomnia, and possibly mild hypertension (5).

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.
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).
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.
×