The researchers reasoned from other studies that when the degree of endothelial dysfunction and atherosclerosis are more severe, the effects of niacin and statins as lipid-lowering agents are also more apparent. Their current study seemed to bear this out. Also, in another study assessing the effect of a PDE5 inhibitor in patients using a statin, patients with higher baseline serum LDL-C had better improvement in erectile function after the use of a PDE5 inhibitor. This supports the researchers’ hypothesis that patients with potentially more serious endothelial dysfunction, such as those with higher LDL-C levels, may have better response to the combination usage of a PDE5 inhibitor and niacin.
What are the alternatives to viagra? Erectile dysfunction, when a man cannot achieve or maintain an erection, is a common condition that causes much distress. Viagra is just one of several drug treatments that can help relieve the problem. Other methods and treatments can help, too, including alternative herbal remedies that people may wish to try. Read now

If you suffer from premature ejaculation, erectile dysfunction or are unable to reach orgasm, it’s important that you reach a higher level of fitness than you currently have. This is also a requirement for you to become a healthier human being. These best exercises to improve sexual function are aimed at redeveloping your groups of muscles directly involved in the sexual act. Increasing the health of your sex muscles can naturally increase blood flow and can lead to improving your sexual performance.
Viagra is eliminated mainly by the cytochrome p450 system in the liver. Elderly men and men with liver or kidney dysfunction have reduced ability to eliminate the drug. Therefore, these patients should start with the lowest dose (25 mg) to avoid problems with toxicity. Medications that interfere with cytochrome p 450 (such as erythromycin, cimetidine, and ketoconazole) can also decrease the elimination of Viagra. These other medications should preferably be stopped when using Viagra, or Viagra should be used cautiously starting with the lowest dose.
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)
Several new studies have proven not only the cardiovascular safety of sildenafil, but have also suggested that sildenafil may have a cardioprotective role. PDE5A inhibition by sildenafil blunts systolic responses to beta-adrenergic stimulation suggesting a possible role in modifying stimulated cardiac function (Borlaug et al 2005). Chronic inhibition of cGMP phosphodiesterase 5A by sildenafil prevents and reverses cardiac hypertrophy (Takimoto et al 2005). Finally, sildenafil is the only PDE5i that improved arterial oxygenation in patients with pulmonary hypertension (Ghofrani et al 2004) and it has been recently approved in doses of 20 mg and 40 mg, taking every 8 h life-long by patients with pulmonary hypertension (Galie et al 2005).
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.
However, our friend is not in fact some sort of unthinking, unfeeling sex bot and as such is going to have his resolve softened by a number of external factors such as the ones mentioned above. As Kerner says, Viagra can help with the non-physical hurdles in between him and a prize winning hard-on, and it's probably not going to do him any serious or permanent damage.
*all photos are models and not actual patients.If you are interested in a prescription product, Hims will assist in setting up a visit for you with an independent physician who will evaluate whether or not you are an appropriate candidate for the prescription product and if appropriate, may write you a prescription for the product which you can fill at the pharmacy of your choice.

Erectile dysfunction supplements and other natural remedies have long been used in Chinese, African and other cultures. But unlike prescription medications for erectile dysfunction, such as sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis, Adcirca) and avanafil (Stendra), erectile dysfunction herbs and supplements haven't been well-studied or tested. Some can cause side effects or interact with other medications. And the amount of the active ingredient can vary greatly from product to product.

Impotence, also called erectile dysfunction (ED), can be a very frustrating problem. Some men are able to achieve an erection but are not able to maintain one. Others are not able to achieve one at all. Causes of impotence can be both physiological (affecting mostly the body and organs) or psychological (affecting the mind). Luckily, there are natural remedies for impotence you can try.


Regular cardiovascular exercise can not only improve erectile function, it can boost energy levels, lower blood pressure, and improve muscle tone. Furthermore, by reducing body fat and stress, regular cardio can improve a person’s self-image, improve sleep, and result in a more rested overall feeling. For maximum benefit, 20 to 30 minutes of cardiovascular exercise four or five times a week is ideal, and it may take time to work up to this. It’s smart to discuss this with your doctor if you have been living a sedentary lifestyle or haven’t had a physical in a while. The key to sticking with cardio is choosing an activity you enjoy so it won’t feel like a chore. Great choices in the cardiovascular exercise include:
There’s a reason why Casanova developed his reputation: He was alleged to scarf two dozen oysters a day, which is the food highest in zinc. In the modern era, people with higher levels of zinc in their system have been shown to have a higher sex drive than those with lower levels. That’s because the mineral is essential for testosterone production. In one Nutrition study, zinc-deficient men who supplemented with zinc for six months doubled their T levels. And another eight-week trial published results in the Journal of the International Society of Sports Nutrition found that college football players who took a nightly zinc supplement showed increased testosterone levels as well.

How it works: Rhodiola works in supporting our adrenal glands by preventing the breakdown of too much dopamine and serotonin during stressful times, leaving enough for us to remain buoyant and energized. What’s extra fun about Rhodiola is that it works fast – in 30 minutes – to change your energy levels and focus – so pop one before you think you want to get frisky.


In the Hong Kong study, the researchers postulated that niacin might be as beneficial as statins on erectile function, and have other related benefits too. Niacin is known to produce a flushing effect (see “Toleration Despite Adversity,” above), which is related to prostaglandin D2 (PGD2) release in the skin. This can lead to vasodilation and concomitant flushing. The production of PGD2 can also occur in macrophages, a type of protective white blood cell. Consequently, when PGD2 production is induced by niacin, it may affect all body tissue, including the cavernosal tissue in the penis. Indeed, PGD2 is one of the potential agents causing the vasodilation and engorgement of cavernosal tissue, thereby leading to erection. Thus, niacin improves erectile function by stimulating the production of PGD2.
Gutiérrez-González, Enrique; Castelló, Adela; Fernández-Navarro, Pablo; Castaño-Vinyals, Gemma; Llorca, Javier; Salas-Trejo, Dolores; Salcedo-Bellido, Inmaculada; Aragonés, Nuria; Fernández-Tardón, Guillermo; Alguacil, Juan; Gracia-Lavedan, Esther; García-Esquinas, Esther; Gómez-Acebo, Inés; Amiano, Pilar; Romaguera, Dora; Kogevinas, Manolis; Pollán, Marina; Pérez-Gómez, Beatriz. “Dietary Zinc and Risk of Prostate Cancer in Spain: MCC-Spain Study.” Nutrients. Jan 2019, 11(1).
I never thought i could smile and be in a happy marriage again if not for the help of Dr salato. I got dr salato on his website https://drsalatosolutionte.wixsite.com/drsalato on the internet and i emailed him, and he got back to me with some encouraging words, he got me some herbs which i took for just 5 days and i began to feel the enlargement of my penis, and without surgery. This went on for a little period of about 14 days and to my surprise my wife keeps screaming that she love my big dick
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.

Whether you’re looking to bulk up, or are just concerned about having enough protein to keep your body strong and healthy, zinc is an absolute must have! When we eat protein, it gets broken down by the body into amino acids, and then resynthesized into the different proteins needed by the body, and zinc is a vital part of this process. So even if you are eating lots of protein, without zinc you won’t be able to use it properly!
Controlling stress, having a healthy diet, and getting enough sleep to create a good foundation for sexual satisfaction. But sometimes the basics aren’t quite enough. Millions of men experience erectile dysfunction (ED), but ED can usually be successfully treated with prescription medications like Viagra, Levitra, Staxyn, and Cialis. These drugs have helped men understand that ED isn’t all in their mind, have opened up the topic to a more honest discussion, and have transformed many men’s sex lives.

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!
Obesity is a state of chronic oxidative stress and inflammation (38). The increased oxidative stress associated with obesity may increase free radical formation, which could quench and deactivate nitric oxide, reducing its availability for target cells. Weight loss programs with dietary modifications and increased physical activity may lead to reduced oxidative stress associated with improved nitric oxide availability (39). As impaired nitric oxide activity appears to play an important role in the pathogenesis of erectile dysfunction (40), improved nitric oxide availability associated with weight loss may be implicated in the amelioration of erectile function in our series of obese men. A reduced CRP level due to sustained lifestyle changes may have contributed to amelioration of erectile function after treatment. Levels of CRP correlate significantly with reduced nitric oxide availability (41) and increasing severity of penile vascular disease as measured by penile Doppler (42). Moreover, consistent findings support a predictive role of CRP and IL-6 for cardiovascular events in different populations (43), while IL-8 is a potent chemoattractant (44).
You may also perform these exercises anywhere and anytime. Just take note in your calendar if you sometimes have problems remembering. On the other hand, aerobic exercises may also improve your cardiovascular health, aside from just your male sexual health. By doing so, you can also experience an improved capability of achieving and maintaining erection.
Eggs a supplement? Yup. Testosterone is derived from cholesterol, and eggs are the healthiest way to ensure you’re getting enough of the good kind (LDL cholesterol). Plus, eggs are rich in choline, a powerful natural chemical that not only burns fat but can help set your pants afire. Choline triggers the production of nitric oxide (NO), which relaxes arteries in the penis and enables blood flow to do its thing. Choline is a precursor to acetylcholine, a neurotransmitter which controls sexual behavior through its activity in the brain; having a higher level of AcH has been associated with more frequent sex and more intense, longer orgasms. And that’s not all: Check out these things that happen to your body when you eat eggs!

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.
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.
Along with promoting overall health, a sufficient daily magnesium intake can help significantly if you take zinc to promote healthy erectile function or to help alleviate ED. Zinc is often recommended as a natural ED remedy, particularly for men who have a zinc deficiency, according to MayoClinic.com. Magnesium helps regulate zinc levels in the body to support healthy erectile function. Herbs, vitamins and minerals, including magnesium, haven’t been widely studied in terms of their true benefits for men with ED or other erectile problems, but maintaining adequate levels of essential vitamins and minerals may help a doctor narrow down the cause of such problems.
Yohimbe. Before Viagra and the other prescription erectile dysfunction drugs became available, doctors sometimes prescribed a derivative of the herb yohimbe (yohimbine hydrochloride) to their patients suffering from ED. But experts say the medication is not particularly effective, and it can cause jitteriness and other problems. "It's not a great drug," says McCullough. "And I suspect the herb is not as potent as the pharmaceutical version." What's more, evidence shows that yohimbe is associated with high blood pressure, anxiety, headache, and other health problems. Experts discourage its use.
He and his co-investigators studied 76 men who had erectile dysfunction for at least six months. Group 1 took 50 mg of Viagra nightly at bedtime. Group 2 took 50-100 mg of Viagra when they wanted, presumably before sexual intercourse. The investigators also followed a third group of men with erectile dysfunction who received no treatment. The men were an average of 47 years old.
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.
Muse on the other hand can cause a burning sensation to the penis along the urethra (this happens around 20% of the time) and it takes a little longer to work than the injectable formulation. But for men that don’t want a needle in their penis, it is an alternative. I generally recommend starting with Muse prior to moving onto Caverject because of this.

Feeling fatigued, very stressed, depressed or dealing with another mood-related issue that can lower libido. Sources of stress and diminished quality of life — such as “deteriorating economic position,” unhappiness with one’s job or other aspects that lower emotional health — are believed to be major causes for sexual dysfunction in both men and women

A 2000 study conducted at the Institute of Sexology in Paris found that muira puama, a Brazilian shrub traditionally used in South African folk medicine as an aphrodisiac, increased libido and erection strength in a majority of men who complained of impotence and a lack of sexual desire. Other studies show this happy-making herb also counteracts chronic stress, depression and nervous exhaustion.

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.

I never thought i could smile and be in a happy marriage again if not for the help of Dr salato. I got dr salato on his website https://drsalatosolutionte.wixsite.com/drsalato on the internet and i emailed him, and he got back to me with some encouraging words, he got me some herbs which i took for just 5 days and i began to feel the enlargement of my penis, and without surgery. This went on for a little period of about 14 days and to my surprise my wife keeps screaming that she love my big dick
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.
A study in the Journal of Sexual Medicine found that a large percentage of men with ED also have low levels of vitamin D. If you’re experiencing ED, you may want to have your level of vitamin D checked. Other symptoms of a low vitamin D level may be too subtle to notice. However, if you have serious vitamin D deficiency, you may have bone pain or muscle weakness. Vitamin D levels can be checked with a simple blood test and for most people corrected with a supplement.
We studied the involvement of zinc in the sexual behavioral response of male rats. The study design employed a rat model to predict the human sexual response to elemental zinc supplementation. Rats were used because they are very social and copulate under a variety of circumstances, regardless of the presence of a human experimenter. They are practical (small and easy to handle) and certain tissues and neuroendocrine systems are strikingly similar to humans.[13]
Zinc is a trace metallic element that occurs naturally in the earth. Certain vegetables, meats, and seafood have more zinc content than others. This makes it fairly easy to obtain zinc through a varied diet. An extreme zinc deficiency is rare in the United States, as most people get some zinc through the foods that they eat. However, when levels of zinc fall below the recommended threshold, problems begin.
Regardless of diet or exercise - to control a sexual act, it's imperative to balance your sexual focus during foreplay, penetration, and intercourse. When you feel safe throughout foreplay it's easy to penetrate and if you're not worried at penetration time then intercourse is easier. A happy and satisfying sex life is knowing when and where to put your attention. How to do this is explained step-by-step in my Sex Mastery Hard AND in Control program for men.
If you suffer from premature ejaculation, erectile dysfunction or are unable to reach orgasm, it’s important that you reach a higher level of fitness than you currently have. This is also a requirement for you to become a healthier human being. These best exercises to improve sexual function are aimed at redeveloping your groups of muscles directly involved in the sexual act. Increasing the health of your sex muscles can naturally increase blood flow and can lead to improving your sexual performance.
A drug called Alprostadil, either alone or sometimes in conjunction with others such as papaverine and/or phentolamine, can be injected directly into the penis to dilate the arteries, experts say. The drug produces an erection in about 10 minutes that can last up to an hour. But there are several disadvantages, says Teresa Beam, MD, a urologist with the Grey Clinic. Some patients are averse to using a needle, which is why many men abandon the therapy. Those who give it a try may experience pain at the injection site or priapism (a painful erection lasting too long).
Allow me to explain. We know that cardiovascular disease is the number-one killer of men in the United States. Well, the “vascular” part of cardiovascular disease means that the cause is really blockage of the arteries around the heart, a process called atherosclerosis. It’s proven that over half of heart attacks occur in men with normal cholesterol. And many times, heart disease develops without warnings, causing sudden cardiac arrest.  So any early warning sign can be a life saver — and might compel you to get checked out before the big one hits.
This study was designed to test the hypothesis that hydrochlorothiazide a diuretic used to treat hypertension depletes body zinc and thereby cause sexual dysfunction. Serum zinc and sexual dysfunction were measured in 39 middle aged hypertensive men who had been taking hydrochlorothiazide in average daily doses of between 25 and 50 mg daily for at least six months, and a control group of 27 unmedicated middle aged normotensive men. The medicated group had a higher incidence of sexual dysfunction (56 pc) as compared to 11 pc in the control group. The use of hydrochlorothiazide did affect serum zinc levels significantly in 20 patients. Sexual dysfunction occurred more often in older and overweight patients (p < 0.004). Three of the normotensive men experienced sexual dysfunction probably related to old age. Twenty two of the 39 on hydrochlorothiazide and experiencing sexual dysfunction were divided into two groups of 11 patients. Bloods were taken from the 27 normotensive and 22 hypertensive men receiving hydrochlorothiazide for the analyses of zinc. Subsequently one group of the patients were supplemented with zinc 500 mg daily for 30 days while the other group was supplemented with magnesium chloride 1 g daily for 30 days. The normotensive men were not treated. After 30 days, bloods were again taken from the three groups of analyses for zinc and magnesium. Serum zinc was significantly decreased (p < 0.05) by hydrochlorothiazide and a non significant decrease in serum magnesium (p = ns) was observed. After supplementation with zinc, the serum zinc levels returned to normal only in eight patients. There was improvement in the symptoms of sexual dysfunction in five patients. Two patients gained weight. Hydrochlorothiazide decreased serum zinc levels (p < 0.05) and was unchanged with magnesium supplementation but the serum magnesium returned to normal values. Improvement of symptoms of sexual dysfunction was positive in one patient. This study shows that low serum zinc levels may be associated with sexual dysfunction but the definitive role of zinc in the pathogenesis of sexual dysfunction will remain controversial.
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 is an embarrassing and frustrating condition among many men. There are several reasons behind this. Most of the time, it is caused by certain medical conditions such as diabetes, heart disease, obesity, as well as low testosterone. Other reasons may also include problems in blood flow, psychological issues, nerve damage, as well as hormonal fluctuations.
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.
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