In conclusion, aerobic training can successfully treat ED in selected patients with arterogenic ED. However, there are very few high-quality randomized trials regarding aerobic training and ED. Practitioners should bear in mind that aerobic training and other risk factors modification is associated with higher rates of ED management success.Since these results are based on small studies, the evidence would be stronger if confirmed by large trials. Effectiveness data were limited; however, the effectiveness of ED is largely determined by the patient health status and associated condition. In addition, work is needed in the standardization of follow-up protocols, evaluation of ED management success and failure, patient selection, and statistical analysis. More randomized studies that compare various exercise techniques are warranted. These studies should evaluate efficacy, complications, quality of life, cost implications, and long-term outcomes of ED management compare to other therapeutic modalities available. Also more database search is also warranted to further broaden the data search on the topic.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of hims, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.

Over the years, myriad treatments and gadgets have been invented to assist with issues related to erections. They run the gamut from vacuum pumps to constriction bands, surgical implants, male hormone therapy, herbal supplements (ginkgo biloba, saw palmetto,  L- arginine, and yohimbe), and even shock-wave therapy. Lifestyle changes include: increasing exercise, decrease smoking, losing weight, and eating healthier. More natural alternative treatments include acupuncture and watermelon juice. In her hilarious and informative book entitled Bonk, researcher Mary Roach explores coupling of science and sex, and dedicates a couple of chapters to in-depth analysis of erectile dysfunction treatments.


SOURCES: John P. Mulhall, MD, associate professor and director of sexual medicine, departments of urology, Weill Medical College of Cornell University and Memorial Sloan-Kettering Cancer Center, New York. Frank Sommer, MD, chief of andrology, department of urology, University of Cologne, Cologne, Germany. American Urological Association's 99th Annual Meeting, San Francisco, May 8-13, 2004.
The availability of phosphodiesterase type 5 inhibitors (PDE5i) has resulted in increasing numbers of patients seeking medical help for erectile function problems, but has also altered dramatically the medical management of ED (Hatzichristou and Pescatori 2001; Lewis et al 2001; Steers et al 2001). More physicians are treating ED, especially in the primary care setting, including minimal patient work-up and prescription of PDE5i due to their proven efficacy and safety profile. The management of ED by non-specialists includes minimal patient work-up and prescription of exclusively first-line treatment options in most cases, mainly due to the lack of time and background knowledge (Hatzichristou 2002). Sildenafil was the first available PDE5i that revolutionized ED treatment (Goldstein et al 1998). More than 30 million of men are treated worldwide with sildenafil accompanied by vast experience and research with more than 2600 papers published in Medline as of July 2006. Furthermore, new data suggest that sildenafil has beneficial effects in several chronic conditions. It has been recently approved for the treatment of idiopathic pulmonary hypertension (Galie et al 2005), and numerous articles have suggested that PDE5i may improve endothelial function (Katz et al 2000; Desouza et al 2002; Halcox et al 2002; Vlachopoulos et al 2003; Vlachopoulos et al 2004; Gori et al 2005; Hirata et al 2005). PDE5i have been also suggested to be beneficial for patients with premature ejaculation (Abdel-Hamid 2004). However, clinical studies have shown controversial results so far (Salonia et al 2002; Chen et al 2003; Atan et al 2006) and it remains uncertain, whether PDE5i act on the physiologic process of ejaculation, or indirectly, improving erectile function and therefore, reducing performance anxiety in men with ED.
Arginine. The amino acid L-arginine, which occurs naturally in food, boosts the body's production of nitric oxide, a compound that facilitates erections by dilating blood vessels in the penis. Studies examining L-arginine's effectiveness against impotence have yielded mixed results. A 1999 trial published in the online journal BJU International found that high doses of L-arginine can help improve sexual function, but only in men with abnormal nitric oxide metabolism, such as that associated with cardiovascular disease. In another study, published in 2003 in the Journal of Sex & Marital Therapy, Bulgarian scientists reported that ED sufferers who took L-arginine along with the pine extract pycnogenol saw major improvements in sexual function with no side effects. Arginine can be helpful, says Geo Espinosa, ND, director of the Integrative Urological Center at NYU Langone Medical Center. Espinosa says that men with known cardiovascular problems should take it only with a doctor's supervision; L-arginine can interact with some medications.

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.”
Patients reporting satisfaction with treatment effect on erections and improvement in ability to engage in sexual activity at end of 1 year, 2 years, and 3 years of open-label treatment with sildenafil. Copyright © 2002. Carson CC, Burnett AL, Levine LA, et al. 2002. The efficacy of sildenafil citrate (Viagra) in clinical populations: an update. Urology, 60:12–27.

A 2011 study of 160 men with moderate or severe erectile dysfunction divided the group in two—80 men were given niacin supplements, and 80 a placebo. The group given niacin reported improved ability to “maintain an erection versus the control group.” It’s not exhaustive research, but still promising. The best part about niacin is that it’s naturally found in foods like turkey, avocado, and peanuts (yum). If you’re not a turkey sandwich fan, you can supplement with a vitamin B complex.
As we mentioned before, there are a lot of treatment options that you could use to treat a condition as erectile dysfunction. A lot of the men diagnosed with erectile dysfunction decide to try some of the natural remedies before they refer to some of the top men enhancement pills. Exercise is one of the most commonly recommended ways as a natural remedy for erectile dysfunction. We all know that exercising has a lot of different beneficial effects on our bodies so why not use it as a part of the treatment for this condition? 

When it comes to keeping your gut healthy and immunity strong, consuming fermented foods and probiotic supplements is essential. Probiotic foods and supplements fortify the ‘good’ bacteria that live in the gut – the all-important microbiome – which in turn protects the gut wall, regulates inflammation, and assists with hormone and neurotransmitter production. Also essential… View Article
Erectile dysfunction is obviously a frustrating health condition caused from different types of physical body problems. This may cause struggle with the self-esteem for both the man as a patient and his life partner. Luckily, individuals may take various supplements in the form of vitamins to deal with the root cause leading to the problem of erectile dysfunction. In this article, we will discuss about the role of Vitamin B3, known scientifically as Niacin to overcome the condition of erectile dysfunction among men.
In the analysis of the study, the niacin group showed a significant increase in both IIEF-Q3 scores and IIEF-Q4 scores compared to the initial baseline values. While the placebo group also showed a significant increase in IIEF-Q3 scores (high hopes, no doubt), it did not for IIEF-Q4 scores. In other words, the “placebo effect” did not extend to maintaining erections. Also, when patients were stratified according to the baseline severity of ED, the patients with moderate and severe ED who received niacin showed a significant improvement in IIEF-Q3 scores (0.56 and 1.03, respectively) and IIEF-Q4 scores (0.56 and 0.84, respectively) compared with baseline values. These results were not significantly increased for the placebo group.
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).
If ED continues to be a problem even after making certain lifestyle changes, talk with your doctor. ED is an uncomfortable subject for many men to discuss, but it’s treatable in most cases, so there’s no reason to avoid getting help. Doctors see patients every day about ED, so you’re simply one of millions of men dealing with this common condition.
Erectile dysfunction (ED) is a highly prevalent disease associated with aging as well as with several risk factors including hypertension, heart disease, obesity, dyslipidemia, diabetes, hypogonadism, drugs-related, and pelvic surgery. Many of these factors are components of the metabolic syndrome, a multiplex risk factor for cardiovascular disease (CVD). ED shares common risk factors with CVD. Endothelial dysfunction seems to be the early underlying pathophysiology across both conditions. The efficacy, tolerability and cardiovascular safety of sildenafil has been evaluated in numerous large, randomized, double-blind, placebo-controlled clinical studies in the broad population of men with ED including men with several co-morbid conditions. Sildenafil is effective in several specific patient populations including the difficult-to-treat subpopulations such as diabetes mellitus and after radical prostatectomy. It is associated with rapid onset of action – within 14 minutes for some men – and an extended duration of action for up to 12 hours. Sildenafil improves quality of life and satisfaction for treated men and is well tolerated with a favorable safety profile. New data suggest that sildenafil has beneficial effects in several chronic conditions. It has been approved for the treatment of idiopathic pulmonary hypertension. Numerous articles have suggested that it improves endothelial function and a possible role on premature ejaculation or treatment of lower urinary tract symptoms has been suggested.
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.
Erectile dysfunction is a self-reported condition by the patients and the results of different treatment modalities are also self-evaluated (Hatzimouratidis and Hatzichristou 2005). Recent data on ED treatment outcome have shown that many patients discontinue treatment, despite the availability of efficacious pharmacotherapies, because doctors fail to inform patients properly and to ensure continuity in care, as well as to be routinely involved in asking patients about their needs and expectations (Mulhall et al 1999; Hatzichristou et al 2005). Althof (2002) described several causes that may contribute, including the length of time the couple were asexual before seeking treatment, the man’s approach to resuming a sexual life with his partner, the female partner’s physical and emotional readiness to resume lovemaking, the meaning for each partner of using a medical intervention to enable intercourse and the quality of the nonsexual aspects of the relationship. It becomes apparent that patients’ needs and expectations vary widely and the treatment approach should always be individualized according to their preference for information and involvement in the decision-making process. Patient satisfaction is a complex issue that depends not only on therapeutic outcomes in terms of efficacy and adverse events or complications but also on expectations from treatment and relationship dynamics.
Many men make the mistake of taking Viagra, Levitra, or Spedra after a meal. This can impede the absorption of the drugs, making them only marginally effective. You should wait at least 2 hours after eating before taking the tablets so you can experience their full effect. Avoid eating fatty foods or drinking sour fruits, particularly grapefruit, as these may affect efficacy.
Combination therapy has proven effective for some men who don’t respond adequately to oral medicines. The idea is to use two drugs with different mechanisms of action for better results. Commonly, sildenafil is used in combination with pellets of alprostadil (synthetic prostaglandin E1) that are inserted into the urethra (the tube in the penis that carries urine from the bladder to the outside of the body). Alprostadil also increases the blood supply to the penis, but by different means.
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.
Niacin or Vitamin B3 has proved to be helpful in improving both lipid levels and cholesterol among patients suffering from the problem of atherosclerosis i.e. accumulation of waste fats across the walls of the human blood vessel. Because of this, Niacin is helpful in the treatment of erectile dysfunction, as ED and atherosclerosis have more or less similar causes.
PDE5i have been suggested to be beneficial for patients with premature ejaculation, possibly due to a peripheral inhibition of contractile response of vas deferens, seminal vesicles, prostate, and urethra as well as a reduced central sympathetic output through a prolonged NO effect (Abdel-Hamid 2004). Combination of sildenafil with paroxetine prolongs significantly intravaginal ejaculation latency time (IELT) and is associated with better intercourse satisfaction compared with paroxetine alone (Salonia et al 2002). In a group of nonresponders to other treatments, sildenafil combined with paroxetine and psychological -behavioral counseling alleviated premature ejaculation (Chen et al 2003). On the contrary, sildenafil was not superior to placebo or combination treatment with topical lidocain/prilocain cream. Further placebo-controlled, well designed studies are needed to determine whether there is any role for sildenafil in the treatment of premature ejaculation.
Have you heard about the famous Kegel exercises women often turn to for help? Well, these exercises are not for women only. You can perform them also and get the same beneficial effects as women. Kegel exercises for men are often recommended by many doctors to be used in the treatment of erectile dysfunction. Kegel exercises will strengthen your pelvic floor muscles. In order to perform these exercises, you will need to locate your pelvic floor muscles (to do that you will need to stop the process of urinating a couple of times) and squeeze them a couple of times. Start performing these exercises a couple of times a day and see the results for yourself.
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.
Patients reporting satisfaction with treatment effect on erections and improvement in ability to engage in sexual activity at end of 1 year, 2 years, and 3 years of open-label treatment with sildenafil. Copyright © 2002. Carson CC, Burnett AL, Levine LA, et al. 2002. The efficacy of sildenafil citrate (Viagra) in clinical populations: an update. Urology, 60:12–27.
David Gomes completed his M.S Professional degree in California Institute of Technology. He lives in Oakland, California, USA. He loves to write on a variety of topics such as joint health, weight loss, beauty and skin care for blogs and on-line publication sites. He also loves latest technology, gadgets. You can connect with him on Google+ and Twitter.
Our bodies are designed to be active and in motion. By keeping active and engaging in regular aerobic exercise, you increase the blood flow to your muscles, and your penis along the way. One of the most interesting things about increasing your blood flow is that it becomes a signal to your blood vessels to grow and get wider. It benefits your brain, your heart, and your erection. The principle of "use it or lose it" is the best advise one can follow. In fact, if you don't engage in sexual activity at least once or twice a week, it would be beneficial to masturbate. This not only helps with prostate health, but encourages the blood vessels that contribute to your erection to maintain their patency and flow. 

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.


Clinical trials were included if they met all of the following inclusion criteria: study population defined; Men with arteriogenic ED were considered; the present review was concerned with studies that used aerobic exercise on ED; only randomized controlled trials on this topic were selected for review; The main outcome measure was satisfactory intercourse without additional therapy using the International Index of Erectile Dysfunction (IIED) scores. The present review utilized studies that had successfully undergone rigorous peer review (i.e., published peerreviewed journals), were included.

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.


Call this the Marvin Gaye of amino acids: L-arginine converts to nitric oxide (NO), a naturally occuring gas that causes blood vessels to relax and facilitate blood flow, helping you get and stay hard. You can find plenty of the nutrient in oysters, but in supplement form, the Mayo Clinic says that 400-6,000 milligrams is the maximum dose. And these are the best foods for arginine!
It’s important to note that high levels of zinc can reduce available copper in the body and affect iron levels. High levels of zinc can also interfere with different kinds of medications. Though it is estimated that 40 milligrams of zinc supplement are safe for men to take daily, there is no long-term research into the effects that this practice could yield.
Once you get checked out for artery blockage and low T, there are things you can do to help treat ED besides taking medications. Yes, Viagra is now available generically (it’s called sildenafil), but it is still expensive, and many men experience side effects, like heart palpitations or blue-ish vision. Here are a few proven natural ways to help improve E.D.
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.
Science is always on the search for the magic bullet for our sexual health problems – that female Viagra. Most women, however, experience poor sexual desire alongside other issues like PMS and fatigue. The solution requires a holistic approach. I want women to start by feeling good every day, in everything they do, as it’s then that you will find you have the ability to feel great about sex.
When Viagra (sildenafil) hit the market in 1998, some men thought it was the long-awaited answer to their problems. Many rushed to doctor's offices to give it a try. According to the Grey Clinic in Indianapolis, which specializes in erectile dysfunction, 17% of men between 18 and 55 experience occasional impotence, while 6% have regular erectile difficulties. For men over 55, that number jumps to about one in three. Some common causes of impotence are diabetes, heart disease, and psychological problems. It also frequently occurs after prostate cancer surgery.
Research has shown that the same eating patterns that can cause heart attacks due to restricted blood flow in the coronary arteries can also impede blood flow to and within the penis. The blood flow is needed for the penis to become erect. Diets that include very few fruits and vegetables along with lots of fatty, fried, and processed foods can contribute to decreased blood circulation throughout the body.
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