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.

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.
Sildenafil citrate, tadalafil and vardenafil hydrochloride are contraindicated in patients with a known hypersensitivity to any organic nitrates (oral, sublingual, transdermal or by inhalation) due to the risk of developing potentially life-threatening hypotension. Concomitant use of PDE-5 inhibitors is contraindicated with HIV protease inhihibitors (indinavir, ritinovir, saquinavir) as well as ketoconazole, itraconazole, cimetidine and erythromycin, because these drugs are potent inhibitors of cytochrome P450 3A4 and can raise the plasma levels of PDE-5 inhibitors. Coadministration of PDE-5 inhibitors to patients taking alpha-adrenergic blockers such as alfluzocin or tamsulosin may lead to symptomatic postural hypotension, including dizziness and lighheadedness in some individuals.
Between 2001–2006, one-third of the US population had insufficient amounts of vitamin D, according to the Institute of Medicine. Risk factors for vitamin D deficiency include obesity and high BMI, not enough sun exposure or outdoor activity, having darker skin and suffering from certain from inflammatory conditions like Crohn’s disease. You can get a blood test to find out if you’re vitamin D deficient.
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)
Sildenafil citrate, tadalafil and vardenafil hydrochloride are contraindicated in patients with a known hypersensitivity to any organic nitrates (oral, sublingual, transdermal or by inhalation) due to the risk of developing potentially life-threatening hypotension. Concomitant use of PDE-5 inhibitors is contraindicated with HIV protease inhihibitors (indinavir, ritinovir, saquinavir) as well as ketoconazole, itraconazole, cimetidine and erythromycin, because these drugs are potent inhibitors of cytochrome P450 3A4 and can raise the plasma levels of PDE-5 inhibitors. Coadministration of PDE-5 inhibitors to patients taking alpha-adrenergic blockers such as alfluzocin or tamsulosin may lead to symptomatic postural hypotension, including dizziness and lighheadedness in some individuals.
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 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.
Yohimbine. This chemical is found in the bark of an African tree called yohimbe. It has been used as a male aphrodisiac in Africa, and under medical supervision it has been used as a prescription drug to treat ED. Supplements made from yohimbe bark are also available without a prescription, but they can be life-threatening if used at high doses, according to the Natural Medicines Comprehensive Database. The supplement can interact in a harmful way with certain drugs, such as blood pressure medications, and should be avoided by anyone with liver, kidney, heart, or diabetes problems or problems with anxiety or depression. Like DHEA, yohimbine should not be taken without a doctor's supervision.
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!
Many products contain undocumented “fillers” that can cause allergic reactions.  In recent years, the FDA has found over 300 herbal products that contain hidden, deceptively labeled, or dangerous ingredients4. And since 2015, the FDA has released public warnings on more than 160 ED supplements and “male enhancement” products found to contain dangerous ingredients and contaminants5 .   An independent study of FDA data, conducted in 2018, found almost 800 herbal supplements that contained unlisted ingredients6.
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.
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.

Garlic is one of the most common vegetables found at home that's beneficial in the treatment of sexual impotence. Dr. Mani says, "Garlic has often referred to as "the poor man's penicillin" because it serves as an effective antiseptic and immune booster. Being a sex rejuvenator, it can improve sexual activities that have been damaged due to an accident or a disease. Garlic is important for people who overindulge in sex to protect themselves from nervous exhaustion."
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.
Nitric oxide is made internally from L-arginine, which is an amino acid found in red meat, poultry, fish, and dairy products. In other words, L-arginine is the building block for nitric oxide, which is essential for erections. A lack of one can lead to a lack of the other. However, there’s a problem when it comes to treating L-arginine deficiency with supplements.
Tribulus terrestris (6): this plant has long been used as a folk medicine in Eastern Europe and Bulgaria for sexual deficiency (5). The properties of this powerful ingredient have been associated with an increase in sperm production, sexual endurance, and testosterone levels. Also known as puncture vine, this herb has gained popularity over the past few years. Since testosterone plays a huge role for men, the addition of this herb can prove to be very beneficial. It is not a hormone as some believe. It is said that Tribulus terrestris can also help build muscle and strength, which enhances performance (5,7).
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].
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).

Cordyceps (Dongchongxiacao): this Chinese caterpillar fungus and the carcass of the larvae of various insects are collected in the period of the Summer Solstice (tenth solar term). They are cleaned and dried in the sun or baked and used for treating deficient kidneys manifested as impotence, seminal emissions and soreness and pain in the lower back and knees (17). Cordyceps (Dongchongxiacao) is used with Dogwood fruit (Shanzhuyu), Dioscorea (Shanyao) and Dadder seed (Tusizi). The herb can also be used alone.
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.
Nitric oxide is made internally from L-arginine, which is an amino acid found in red meat, poultry, fish, and dairy products. In other words, L-arginine is the building block for nitric oxide, which is essential for erections. A lack of one can lead to a lack of the other. However, there’s a problem when it comes to treating L-arginine deficiency with supplements.
Derived from the bark of a West African evergreen tree, yohimbe was the go-to ‘script for a wonky willy prior to the advent of wonder drugs like Viagra, Walker says. “Yohimbe enhances sexual performance both by blocking certain neurotransmitters in the brain and by increasing the release of nitric oxide in the cavernosal nerves of the penis,” he explains. And it pairs well with other erection-friendly tablets: A 2010 study in the Iranian Journal of Psychiatry found that a combination of yohimbe and L-arginine successfully helps guys get it up. However, yohimbe also has a handful of side effects, including elevated blood pressure and anxiety, so definitely talk to your doctor before you start on the supp.
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.
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.
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.
Yohimbine. This chemical is found in the bark of an African tree called yohimbe. It has been used as a male aphrodisiac in Africa, and under medical supervision it has been used as a prescription drug to treat ED. Supplements made from yohimbe bark are also available without a prescription, but they can be life-threatening if used at high doses, according to the Natural Medicines Comprehensive Database. The supplement can interact in a harmful way with certain drugs, such as blood pressure medications, and should be avoided by anyone with liver, kidney, heart, or diabetes problems or problems with anxiety or depression. Like DHEA, yohimbine should not be taken without a doctor's supervision.
L-arginine: L-arginine is an amino acid present in the proteins of all life forms. Also, referred to as arginine, this amino acid is required to carry out the synthesis of nitric oxide, which relaxes the blood vessels and allows more blood to flow through arteries (13). L-arginine has shown promise in the treatment and prevention of cardiovascular disease and in the treatment of male infertility (13). With its anti-oxidant properties, L-arginine can be an integral part of any sexual wellness supplement.
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.
Between 2001–2006, one-third of the US population had insufficient amounts of vitamin D, according to the Institute of Medicine. Risk factors for vitamin D deficiency include obesity and high BMI, not enough sun exposure or outdoor activity, having darker skin and suffering from certain from inflammatory conditions like Crohn’s disease. You can get a blood test to find out if you’re vitamin D deficient.
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