Erection is a complex physiological process in which vascular factors play a pre-eminent role. Therapeutic options for men with arteriogenic erectile dysfunction (ED) are mainly administration of phosphodiesterase type 5 inhibitors, intracavernous injections of vasoactive agents (for example, prostaglandin El, papaverine/phentolamine, or triple drug), intraurethral administration of prostaglandin El, and administration of centrally acting drugs (11, 12). However, all of these methods circumvent the patient's problem temporarily, and patients are not cured of impotence, they will remain dependent on these treatments for the remainder of their sexually active lives. An effective treatment that cures the problem permanently is needed where penile revascularization and exercise remain treatment options for such patients. However, due to the complexity of penile revascularization such as cost ineffectiveness, unavailability of experts, side effects of surgery and high failure rates among the elderly (13) have left people with ED at the mercy of exercise.
Latest research studies highlighted that a daily dose of Vitamin B3 or Niacin brings a drastic improvement in the erectile function of men dealing with the problem of high cholesterol. This result reveals that about 80 men, who consumed Niacin and started the study with either moderate or severe level of erectile dysfunction highlighted a significant improvement in the ability of maintaining an erection.
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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.


Before a man concludes that oral drugs don’t work for him, he should have his testosterone levels checked to rule out hormone deficiency as the cause of (or as a contributor to) his sexual dysfunction. Other symptoms of low testosterone include a low sex drive and infertility. Checking testosterone levels requires a blood test. If a man’s levels of testosterone are decreased or at the lower end of normal, his doctor may prescribe supplemental testosterone therapy, either as testosterone injections or testosterone gel, which is applied daily to the skin. In some cases, testosterone therapy alone can resolve sexual dysfunction, or it can be combined with the use of oral erectile dysfunction drugs.
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. 
These meds only work when sexually aroused because the brain really is the master sex organ. Only when visual, tactile, or other stimuli cause the "thought" of sex are hormones released from the brain to begin the cascade of events that result in an erection. Sometimes something blocks a step toward that end. Viagra removes the block so things can proceed normally. Until the process begins, there is nothing for Viagra to do.
Geraerts, I., van Poppel, H., Devoogdt, N., de Groef, A., Fieuws, S., & van Kampen, M. (2016, January–February). Pelvic floor muscle training for erectile dysfunction and climacturia 1 year after nerve sparing radical prostatectomy: A randomized controlled trial [Abstract]. International Journal of Impotence Research, 28(1), 9–13. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26538105
In 2015, a meta-analysis of 150 trials determined that while Viagra is the most effective of the various ED drugs on the market, it also has the highest incidence of side effects—things like headache, upset stomach, vision loss or becoming blue-tinged, nasal congestion, back pain, muscle pain, nausea, and dizziness. Another rarer side effect can be having a rock hard erection that doesn't abate—the medical name for this perma-stiffy is called priapism. While priapism might sound appealing to a guy who has been thumbing-in softies for years, it's important to know that an erection that won't go away can cause permanent damage. But we'll get into that in a moment.
Besides that, dyslipidemia (and hypercholesterolemia in particular), remain undertreated in many patients diagnosed with coronary artery disease. High triglycerides, a contributor to cardiovascular dysfunction by many but not all studies, are somewhat treatable with fibrates, yet there are significant limitations for their use. Elevated fasting triglyceride levels have been shown to be a strong risk factor for ischemic heart disease, independent of other known risk factors for atherosclerosis.
Nitric Oxide (NO) is released with sexual stimulation from nerve endings and endothelial cells in the corpus cavernosum of the penis. An enzyme then converts guanosine triphosphate (GTP) into cyclic guanosine monophosphate (cGMP). cGMP causes the smooth muscle of the penis to relax, which causes an inflow of blood which then leads to an erection. cGMP is then hydrolysed back to the inactive GMP by phosphodiesteras type 5 (PDE5).

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."

In a double-blind, placebo-controlled study, sildenafil (50 mg–100 mg) taken every night for 9 months, starting 1 month after nerve sparing radical prostatectomy was associated with recovery of spontaneous erections in 27% of patients compared with 4% of patients taking placebo (Padma-Nathan et al 2003). Schwartz and colleagues (2004), in a study of 40 potent volunteers with prostate cancer who underwent RRP, showed that sildenafil administration every other night for 6 months, substantially increases corporal smooth muscle content. The most promising prophylactic role of sildenafil is clearly the preservation of the smooth muscle of the corpora cavernosa.
There are 16 NAION case reports published in association with sildenafil. A few of the cases associated with sildenafil use experienced temporary partial visual loss that became a fixed visual loss upon rechallenge (Hatzichristou 2005). As sildenafil has been used by more than 30 million men worldwide and the incidence of NAION has been reported as 2.3 per 100 000 persons, we would expect far more than the reported 16 cases associated with the use of sildenafil. According to the European Medicines Agency (EMEA) labeling however, patients taking or considering taking PDE5i should inform their healthcare professionals if they have ever had severe loss of vision, which might reflect a prior episode of NAION, as such patients are at an increased risk of developing NAION again and they should be referred to the ophthalmologist (Wespes et al 2006).
Long prescribed for women who want to restore muscle tone after childbirth, pelvic floor exercises, also known as Kegel exercises, can benefit men significantly too. A study by researchers at the University of West of England in Bristol showed that pelvic floor exercises can help men with erectile dysfunction and premature ejaculation. Furthermore, experts think these exercises can make orgasms stronger. Once learned, pelvic floor exercises can be done any time, even while doing other things.
Penile erection is a hemodynamic process involving increased arterial inflow and restricted venous outflow, coordinated with corpus cavernosum and penile arterial smooth muscle relaxation. Any problem in this mechanism results in ED, and its etiology is generally multifactorial (6). Diabetes, hypertension, high serum cholesterol level, peripheral vascular disease and cardiac problems are significantly found together with ED (7). However, vascular reasons predominate in the etiology of ED and it frequently appears along with atherosclerosis (7). It is known that atherosclerotic lesions prevent blood flow into cavernosal tissues resulting in ED (8).
The results, published earlier this month, show that the 80 men in the study with moderate or severe erectile dysfunction (ED) and high cholesterol reported an improvement in their ability to maintain an erection after supplementing their diet with niacin. The 80 men who took a placebo pill, who also began the study with only mild ED, did not experience a change in their symptoms, the researchers said.
Nitric Oxide (NO) is released with sexual stimulation from nerve endings and endothelial cells in the corpus cavernosum of the penis. An enzyme then converts guanosine triphosphate (GTP) into cyclic guanosine monophosphate (cGMP). cGMP causes the smooth muscle of the penis to relax, which causes an inflow of blood which then leads to an erection. cGMP is then hydrolysed back to the inactive GMP by phosphodiesteras type 5 (PDE5).
This African tree bark extract sends blood flow to the genitals, said herbalist Ed Smith, a founding member of the American Herbalists Guild, who adds a warning that Yohimbe can cause nervousness and raise already-existing high blood pressure (so avoid taking it if you have heart or kidney disease), and can also negatively interact with antidepressants.
Psychosexual Relationship Specialist at End the Problem, Jacqui Olliver is a published author who renews relationships by solving people's emotional and sexual issues. In the past 7 years, she has helped over 1,000 men, women, and couples restore a relaxed, happy, and fulfilling sex life and enhance their overall connection. Click here to check out her programs or to book a complimentary strategy session and start getting real answers to solve the real problems.
It is important that you exercise, not only to combat ED but also to maintain your general health. Any aerobic exercise such as running, cycling or swimming will be great for improving your overall health and fitness. These kinds of exercise improves your cardiovascular health, which is important to help you treat your ED. You may also find it helpful to review your general lifestyle and reduce factors which could be contributing to your ED, such as smoking, drinking alcohol and eating unhealthy foods.
The mind and body are intricately connected, and exploring this connection can help you combat stress and fatigue, both of which can contribute to erectile dysfunction. Adding mind-body exercise to your life helps lower stress, improve breathing, and reduce general tension. Yoga can also be terrific for improving your sense of well-being, and it’s great for helping keep you limber so you reduce the risk of sports-related injuries. Partnered yoga classes and routines let men engage in relaxing and beneficial exercise with their partners, and there are even specific yoga postures designed to improve blood circulation to the pelvic region.
Zinc distributes all over the body, so it’s difficult to test through a blood test. If you have problems with erectile dysfunction or suspect that you might have a zinc deficiency, talk with your doctor. A medical professional will be able to check your testosterone level and determine if using zinc supplements to treat your ED is an appropriate course of action.
Alpha adrenergic antagonists are commonly used drugs in patients with BPH-related LUTS. Although the adverse event profile of sildenafil is not worsened by a background of anti-hypertensive medicines, even when the patient is on multiple antihypertensive agents, it appears to have some interaction with alpha blockers, which may result in clinically significant orthostatic hypotension under some conditions (Kostis et al 2005). This is most likely to occur in patients treated with doxazosin (a long-acting alpha blocker). Today, alpha blockers are no longer considered a contraindication for sildenafil, but precautions in the use of these drugs are listed. Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of sildenafil. Therefore, patients should be stable on alpha-blocker therapy prior to initiating sildenafil. Treatment with sildenafil must be initiated at the lowest recommended dose, while it should be taken 3–4 h apart from antihypertensive administration.
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.
I got married to my wife about 1 month after we met on a photo studio, we lived happily for the first 3 months of our marriage until i and my wife started having quarrels at home because i couldn't satisfy her on bed with my little penis. Actually my penis was very small, it measured about 3 inch long on erection and i am 39 years old. my wife said it was forbidden by the women of this world. my wife started to fight with me . Sometimes i will return from
To locate the muscles these exercises engage, try to stop and restart the flow of urine mid-stream. Just do this once, because if you do it too much it can affect the passage of urine. Once you’ve located these muscles, you can tighten and draw the muscles in, feeling them lift upward. Hold for a count of five, then release. It’s recommended that men do 8 to 10 repetitions, resting in between. Ideally, each series of 8 to 10 should be followed by 5 to 10 quick squeezes and releases, and men should work up to doing the whole process four or five times per day for best results.
The nitric oxide stimulates an enzyme that produces something called a messenger cyclic guanosine monophosphate (cGMP). The cGMP relaxes the smooth muscle cells. One result of this is that the arteries in your penis dilate and the blood can flow into your penis more easily. Another result is that the erectile tissue itself fills with blood. Both of these process result in an erection. Viagra works by maintaining the level of cGMP in the smooth muscle cells.
Size matters, so get slim and stay slim. A trim waistline is one good defense — a man with a 42-inch waist is 50% more likely to have ED than one with a 32-inch waist. Losing weight can help fight erectile dysfunction, so getting to a healthy weight and staying there is another good strategy for avoiding or fixing ED. Obesity raises risks for vascular disease and diabetes, two major causes of ED. And excess fat interferes with several hormones that may be part of the problem as well.
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