E longifolia is a medicinal plant (family Simaroubaceae) native to Indonesia, Malaysia, Thailand, Vietnam and Laos. The root extract has been found to be the most powerful herbal aphrodisiac [17]. Tongkat ali extracts contain many alkaloids, quassinoids, phenolic compounds, tannins, high-molecular-weight glycoproteins and mucopolysaccharides. The main bioactive compounds are eurycomaoside, eurycolactone, eurycomalactone, eurycomanone and pasakbumin-B. It is considered to be natural ‘Viagra’. It increases sexual desire, and enhances performance and general well-being [17- 19]. In addition to its aphrodisiac effect, other medicinal effects, such as antimalarial, antibacterial, antipyretic, antiulcer and antitumour effects, have been reported [20,21]. Root decoction has been used as a general tonic (18,22]. Laboratory animal studies show that root extract enhances sexual characteristics and performance in rodents [22-25]. In a study involving a boar model, it was found that E longifolia root extract-treated boars increased sperm counts and semen volume; the effect was attributed to increased level of plasma testosterone [26]. Reports also suggest that E longifolia extract reverses the inhibitory effects of estrogen on testosterone production and spermatogenesis in rats [27]. Oral administration of E longifolia extract to inexperienced castrated male rats produced dose-dependent increases in sexual performance [28]. Zakaria et al [29] found that eurycomanone, a potential bioactive compound in the root extract of E longifolia, induced apoptosis in hepatocarcinoma (Hep G2) cells. Furthermore, their work suggested that eurycomanone was cytotoxic to Hep G2 cells and less toxic to normal Chang’s liver and WLR-68 cells. Tambi and Imran [19] investigated the effects of water-soluble extract of the root of E longifolia Jack and found that the extract increased semen volume, sperm concentration, percent of normal sperm morphology and sperm motility in male partners of subfertile couples with idiopathic infertility. Supplementation with E longifolia elevated the testosterone levels and upregulated osteoprotegerin gene expression in male Sprague-Dawley rats [30].

An increase in nitric oxide helps in a smooth circulation of blood throughout the body. The consumption of this herb helps men in gaining full control over the blood flow in the body, which eventually leads to a full control in their erection. Adding this herb in the diet can significantly improve the condition of men, suffering from an erectile dysfunction.


As you can see, there are many different options to choose from when looking for a solution to helping you with your erectile dysfunction. While a lot of people look at Viagra or similar over-the-counter medications, there might be better options for you in the herbal and natural remedies section. Of course, everybody is different, so it’s important to find the solution and medication that works best for you.
Red Ginseng — One small randomized trial found evidence that red ginseng may offer modest improvements in ED symptoms (as compared with placebo). A meta-anaylsis published in the British Journal of Clinical Pharmacology states, “Traditionally red ginseng has been used to restore and enhance normal well-being, and is often referred to as an adaptogenic….Possible mechanisms of action of red ginseng include hormonal effects similar to those of testosterone. Others have postulated that red ginseng might induce relaxation of the smooth muscles.”  (5)

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)


Maca is a plant root that comes from Peru, where it has a history dating all the way back to the Incan empire. According to Peruvian myths, it can restore sexual vitality and increase energy in all aspects of your life. In our present day, Maca is one of many ingredients in Moon Juice’s notorious “Sex Dust” powder that’s marketed as an aphrodisiac for both men and women. The Moon Juice website encourages customers to sprinkle and mix the dust in their “coffee, milk, water, smoothies, or ice cream.” Is there any scientific proof backing this magical herb?
The medicinal plants used such as Citropsis articulata, Cannabis sativa, Cleome gynandra and Cola acuminata are frequently utilized. Some of these plants (Citropsis articulata, Cola acuminate) are already under sale for treating these conditions. Their propagation is on-going in western Uganda in places like Rukararwe Partnership Workshop for Rural Development Centre in Bushenyi District36 and researchers personal experience at Rukararwe. Rukararwe is a non-governmental organisation that is processing herbs, running a famous herbal clinic and with a medicinal plants arboretum and medicinal plants agro-forestry.
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.

Saw palmetto. Saw palmetto comes from the fruit of a small palm tree. It has been used to treat symptoms in men with an enlarged prostate gland, such as difficulty urinating, and it has been recommended to treat ED caused by an enlarged prostate. However, several recent clinical trials did not show that saw palmetto works any better on an enlarged prostate than a placebo does. "There is no evidence that saw palmetto should be used to treat erectile dysfunction," says Dr. Gilbert. Like ginkgo biloba, saw palmetto can interact with some prescription medications.
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.

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.

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.
Many stores sell herbal supplements and health foods that claim to have sexual potency and fewer side effects. They’re also often cheaper than prescribed medications. But these options have little scientific research to back up the claims, and there’s no uniform method on testing their effectiveness. Most results from human trials rely on self-evaluation, which can be subjective and difficult to interpret.
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In modern medication of erectile dysfunction, the oral prescription medication of popular Viagra (Sildenafil) is effective, but in some men it is not compatible and Sildenafil works in less than 70% of men with various etiologies and has certain side effects23. The availability of Viagra has brought millions of couples to ED treatment. Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage34. Other drugs such as Yohimbine, papaverine hydrochloride [used under careful medical supervision]5, phentolamine, and alprostadil (marketed as Caverject) widen blood vessels. However, this available modern medication for the ED in men is very expensive for most of the rural people in Ugandan and other developing countries. Yet, in traditional medicine, there are several medicinal plants that have been relied on for use in the treatment of ED. This ethnobotanical indigenous knowledge has not been earlier documented and scientifically validated for efficacy and safety, future drug discovery and development.
Pycnogenol is the brand name of a product derived from the bark of a tree known as Pinus Pinaster. It is used for treating circulatory problems, asthma, allergies, high blood pressure, diabetes, women problems and as an anti-ageing supplement. It is acclaimed for its effect in boosting male fertility and is used widely in treatment of erectile dysfunction among men.

As per Massachusetts Male Aging Study, it is stated that 50% of male population is experiencing this erectile dysfunction at some point in their lifetime, especially at the age of 40 or above. However, men who are suffering from this problem unable to talk about it and suffer in silence, as it leads to low self-esteem, depression and guilty feeling.
Usually patients will try less invasive alternatives to treat impotence before opting for surgery. These alternatives may include supplements, herbs, lifestyle changes and even medications. In cases where other treatments do not work to resolve ED, surgery might be a last-resort option. Surgery involves implanting a penile prosthesis. This is a saline-filled silicone device or a malleable device. Although the likelihood of serious side effects is considered to be low, certain risks are associated with surgery to correct erectile dysfunction. These side effects may include: anesthetic risk, device infection, and device malfunction or mechanical failure. Some studies have found that five years following surgery around 10–20 percent of men experience device malfunction and failure. Infection rates are low. Around one percent of men who opt for this type of surgery get an infection.
L-arginine, or arginine, is an amino acid found in red meat, poultry, fish, and dairy products that helps expand blood vessels and increase blood flow. “The body uses this semi-essential amino acid as the primary building block for nitric oxide,” explains Harry Fisch, M.D., clinical professor of urology and reproductive medicine at Weill Cornell Medical College/New York Presbyterian Hospital.
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If you’re stressed about not being able to maintain an erection, there are more reliable and scientifically tested methods out there. Drinking less alcohol, eating healthier foods, staying away from sugar, and doing pelvic exercises have all been proven to partially help with ED. The best part to these alternatives to the “alternative”?  They are inexpensive and don’t require a shaman.

Many stores sell herbal supplements and health foods that claim to have sexual potency and fewer side effects. They’re also often cheaper than prescribed medications. But these options have little scientific research to back up the claims, and there’s no uniform method on testing their effectiveness. Most results from human trials rely on self-evaluation, which can be subjective and difficult to interpret.

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.
Ginkgo biloba. Known primarily as a treatment for cognitive decline, ginkgo has also been used to treat erectile dysfunction -- especially cases caused by the use of certain antidepressant medications. But the evidence isn't very convincing. One 1998 study published in the Journal of Sex & Marital Therapy found that it did work. But a more rigorous study, published in Human Pharmacology in 2002, failed to replicate this finding. "Ginkgo has come out of fashion in the past few years," says Ronald Tamler, MD, assistant professor of medicine and codirector of the men's health program at Mount Sinai Medical Center in New York City. "That's because it doesn't do much. I can say that in my practice, I have not seen ginkgo work -- ever."
Even in the absence of deficiency, L-carnitine supplementation has shown promise for improving erectile function in men. It is available commercially in tablet, capsule and liquid capsule form. Recommended dosage is in the range of 500 – 2000 mg of propionyl L-Carnitine once a day which is often used in combination with a 50 mg dose of Viagra which is given twice a week.
A variety of personal habits and lifestyle choices have been linked to ED. In some ways, this is a good thing, since habits can be broken and choices reconsidered. What's more, many of the lifestyle factors that contribute to sexual problems are ones that affect overall health and well-being, both physical and mental. Addressing these factors, therefore, can have benefits beyond improving erectile dysfunction.
The causes of ED are varies from one individual to another. For whatever cause, since an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. This sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa23. Thus, ED causes reported include, damage to nerves, arteries, smooth muscles, and fibrous tissues. These are often as a result of diseases, such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic diseases that account for about 70 percent of ED cases23. NIH23 reported that between 35 and 50 percent of men with diabetes experience ED. NIH23 further reported that the usage of many common medicines such as blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug) can produce ED as a side effect. Nevertheless, psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of ED cases. In addition, men with a physical cause for ED frequently experience the same sort of psychological reactions (stress, anxiety, guilt, depression)23. Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone23.
"Ikawe has really boosted my sex drive as you said it would! My wife used to complain that I was never interested. She said her friends always complained that their husbands wanted too much sex but she hardly got any. Seriously - it was affecting my marriage. After taking Ikawe for 10 days I could already feel the difference. I also have much more energy." - Derrick S., USA

The causes can be classified into physical (medical) and psychological (mental). As per BBC Health, about 70% of impotence cases are from physical causes (high cholesterol, sexual hormone changes, nutritional deficiencies, hypertension, thyroid, kidney disorders, diabetes, obesity, poor blood circulation, excessive drinking or smoking, certain medications, surgery or injuries, misuse of sexual organs for a long period, enlarged prostate or prostate cancer, etc.) and 30% from psychological causes (anxiety, stress, depression, mental health issues & relationship problems).

It is commercially available as soft gels and tablets. For treatment of male infertility and erectile dysfunction, dosage of 30-300 milligrams taken by mouth, once daily or in divided doses for up to 26 weeks is recommended by experts. The dose can be taken for up to 6 months. It has shown to be effective in treating erectile dysfunction among men.


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.

If you can't take one of these oral medications, your physician may have you try Caverject (alprostadil for injection), a hormone that you inject into your penis using a fine needle, or Muse (alprostadil urogenital), a tiny suppository that you insert into the tip of the penis. Both of these will bring on an erection within five to 15 minutes without sexual stimulation.
Panax ginseng is a Chinese and Korean herb that has a 2,000-year-long history as an herb that helps with medicinal purposes. This herb is used quite often when talking about longevity and overall health. This herb can also be used to help with concentration, stress, and stamina. However, Panax ginseng is also used quite often, and successfully, for erectile dysfunction.
Yohimbe A number of clinical trials have shown that the primary component of this bark from an African tree can improve sexual dysfunction associated with selective-serotonin reuptake inhibitors (SSRIs) used to treat depression. This herb has been linked to a number of side effects, including increased blood pressure, fast or irregular heartbeat, and anxiety. Yohimbe shouldn't be used without a doctor's supervision.
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