In Uganda gender specific malfunctions or complications or diseases and conditions in reproductive health care are not given the due regard and the suffering persons tend to shy away. Sexual impotence and ED in men is considered a secret affair and the suffering persons keep quite or seek medical help in privacy. The psychologically affected men will try other women to test the viability of their manhood. The same is true, women with spouses with such erectile problems may be tempted to go outside their marriage vows to satisfy their sexual needs. This can also lead to HIV/AIDS exposure and result in broken homes and marriages12. The consequential outcomes of promiscuity, low self-esteem, polygamy, sexually transmitted diseases including HIV/AIDS are more detrimental to the individuals and society.
Erectile dysfunction is a common problem in men of all ages than publicly perceived. Since, I started the research in reproductive health care; the commonest question asked by men is related with medicinal plants that empower male sexuality. So far, several males have been consulting on the treatment of ED using herbal remedies, either by themselves or through friends12.

It doesn’t look good for the herbs. So far, there’s no data from controlled human trials that support the erection-promoting claims for any 5 of the most frequently used herbs. The icariin in the horny goat weed can help get it up, but since you’re getting the herb rather than a purified molecule, the concentration probably isn’t high enough to have much of an effect. Worse, it turns out that Viagra is much better at blocking that erection-killing enzyme than icariin is.
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 herb is particularly effective for those whose willy woes are based on other medications: An older study from the University of California found ginkgo biloba is 76% effective in treating sexual dysfunction caused by antidepressants. “Gingko helps counteract sexual dysfunction caused by certain antidepressants called SSRIs by blocking serotonin activity in the erectile centers of the brain, ultimately leading to better synthesis and bioavailability of nitric oxide,” Walker explains.
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.
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).
Erectile dysfunction (ED) or male impotence is defined as inability of a man to achieve or maintain penile erection sufficient for sexual activity. It is primarily a neuronal and endothelial dysfunction of the corpus cavernosum of penile tissue, and is partly characterized by reduced production of nitric oxide (NO). Other factors that may contribute to the pathogenesis of ED include androgen deficiency in aging men, hypertension, high cholesterol levels, atherosclerosis, diabetes mellitus, diseases of the prostate and heart, and anatomical deformity of the penis. ED may also be caused by some medications, prostate surgery and spinal cord injury. Psychological and social conditions such as stress, depression and unhappy marital relationship may contribute to the problem. Chronic infections and inflammation can also contribute to the disease process. ED is linked to an increased risk for cardiovascular diseases and stroke. Several orally active drugs (sildenafil, vardenafil, tadalafil, avanafil) are currently prescribed for treating ED to improve the arterial blood flow to the penile tissue. Medicinal plants and their extracts have been used in traditional medicine in southwest Asia and other countries to treat ED. The current review focuses on four medicinal plants that have been used as aphrodisiacs for enhancing sexual performance and for the treatment of ED. These plants include Eurycoma longifolia Jack (tongkat ali); Chlorophytum borivilianum (safed musli); Withania somnifera (ashwagandha); and Pausinystalia johimbe (formerly known as Corynanthe johimbe). Suggested mechanisms of action for each of the plant extracts will be discussed.
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.
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).
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.
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
And just because you’re using a “natural” herb doesn’t mean you won’t feel any side effects. Ginseng can cause hypoglycemia or bleeding in some people, and at high doses puncturevine can damage the kidneys. Plus, the FDA has found that a lot of supplement companies make sure their erection-enhancing products actually produce erections by tossing in some Viagra off-label. If you really need it, it’s probably better–and safer–to go see your doctor for a prescription.
Only the few elite (educated) and with money seek modern medical care privately and secretly. The description of impotent men in western Uganda among the Banyankore ethnic grouping is literally translated as the persons having no legs (Kifabigyere, Runyankore Dialect) to imply that the penis is dead (cannot bear children). There are other various terms used to describe such men with sexual impotence and ED like the one trampled by a goat, [Akaribatwa embuzi (empene), Kinyankore dialect]. In other places they called, such men who were unable reproduce as “Ekifera in Kinyankore meaning worthless). The men who were unable to have children were not supposed to be given the positions of responsibility or leadership because they were regarded as abnormal. Socially these men were excluded from society, even on drinking joints for the local brew or beer, they are not expected to talk and if they talked, they are hushed. Even women and children always taunted the suffering individuals. Socio-economically, sexual impotence and ED is demeaning and tortures the sufferers by reducing their self-esteem and worthiness in the society. Culturally, in olden days, the impotent men married wives and entrust their wives to very close friends and or relatives to bear them children. In central Uganda, the men with erectile problems are equalled to car engines that cannot start on their own [non-starters] or cars whose batteries have no or low charge (‘Takuba self’, Luganda dialect).
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Researchers at Johns Hopkins University last year looked at 3,400 healthy Americans and found that men who were vitamin D deficient were 32% more likely to have trouble getting it up than those with sufficient levels, even after adjusting for other ED risk factors. In fact, the connection is so common, Walker says D levels are something he always checks in ED patients. Why? The sunshine vitamin is crucial for keeping the endothelial cells that line blood vessels healthy. Without enough of the stuff, blood flow is inhibited, affecting everything from your heart to your hard-on.
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:
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.
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.

No matter what erectile dysfunction treatment or treatments (whether herbal remedies or not) a man ultimately decides upon, experts say it's important to eat healthily and to avoid smoking and heavy drinking. Moreover, adequate exercise, stress reduction, and sleep can improve erectile dysfunction in many. In addition, says Lamm, "A loving, receptive, and responsive partner is a home run. After all, this is still a couple's issue."


“Obecalp” is “placebo” spelled backwards. It might help – treatment with inactive placebos (inert substances used in evaluation of new drug treatments) works about one-third of the time in scientific studies when patients don’t know they’re getting a fake drug. Placebos are generally safe since they contain no known active agent. (However, I personally never give patients inactive placebos, and many physicians regard them as unethical.)
Other factors that “stress” the body can also increase your risk for ED. These include: substance abuse, using marijuana, smoking cigarettes, depression, anxiety and low self esteem. Cigarette smoking — or using nicotine — leads to constricted blood vessels, which has negative effects for sexual health. Other mental/emotional obstacles can cause less desire for sex and decrease testosterone. Several ways to help manage stress include:
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.
According to the Cleveland Clinic, “because erectile dysfunction is caused by a complex set of psychosocial, neurologic, and vascular factors, a specific cause in a patient may remain ambiguous.” The root causes are often related to a blockage or dysfunction of blood vessels. For example, ED can be due to conditions like atherosclerosis or diabetes, hormonal imbalances or problems related to mental health. It’s been found that common causes typically include one or more of the following factors: (2)
However, you might actually be better off going one step back in the chain reaction and taking an L-citrulline supplement. While your body converts L-arginine to nitric oxide, it also metabolizes it too fast when the amino acid is taken in an oral supplement, according to a 2011 study from the University of Foggia in Italy. L-citrulline, which the body converts to L-arginine, is actually a better option to follow the same metabolic pathway and serve as a treatment for ED, the same study found.
Tribulus Terrestris is the fruit of the Zygophyllaceae plant and it grows primarily in North China. It is a well-known aphrodisiac with records that trace back to ancient times. There are plenty of animal experiments that verify the effectiveness of Tribulus for improving erectile function. These effects are mostly due to its androgen enhancing ability, namely increasing testosterone levels. Though testosterone doesn’t directly cause an erection, it does play a role. Erection is made possible by many factors, but mostly it's through receptors on cells lining our arteries that stimulate a chain reaction that relaxes the blood vessels that go to the penis, allowing blood flow to get in. Low testosterone is often associated with overall poor metabolic and cardiovascular health. When the test is low, estrogen is usually high, leading to oxidative stress and calcification of the arteries, including the penis, restricting blood flow to the penis. So, improving testosterone levels, and improving overall metabolic function, while reducing oxidative stress is a good plan for improving overall sexual function and erection.
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