The neurovascular mechanism of erection is complex and involves multiple factors including hormones, neurotransmitters, elements of the autonomic nervous system (sympathetic and parasympathetic) and vasodilators such as NO. The common causes of ED include psychogenic disturbance with failure to relax cavernous smooth muscle, arterial insufficiency as a result of atheromatous disease, damage to the parasympathetic nervous system, spinal cord injury, diabetes or following pelvic surgery such as radical prostatectomy, radical cystectomy or bowel resection [4]. It is important to note that cavernous nerves are unique in that although they belong to the autonomic nerves system they do not release either acetylcholine (Ach) or norepinephrine; however, they release NO in the penis. NO relaxes the smooth muscle of the corpora cavernosa via cyclic GMP (cGMP), allowing expansion of the cavernosal lacunar spaces, blood flow and erection. Thus, NO is not a direct dilator of the smooth muscle of cavernosal bodies, but it is an important mediator in this process. Erectile function may also be adversely affected by cigarette smoking, excess alcohol consumption, obesity and systemic diseases such as mononucleosis, hepatitis, HIV and cancer. Some men are prone to develop an erection that fails to subside after ejaculation (ie, priapism). The condition is associated with sickle-cell disease and leukemia, or may be a result of intracavernosal injection of drugs such as prostaglandin E1 [4]. Peyronie’s disease causes a physical bend in the erect penis and also contributes to ED.
In this day and age, there is a wide spectrum of innovative drug and other methods of treatment including psychosexual therapy and counseling, topical and systemic drug therapy, device-assisted therapy, electromagnetic stimulation to improve nerve and vascular function of the pelvis and perineal muscles. Electro-ejaculation and the less often done surgical techniques are currently available. The simpler electrovibration can help create or maintain erection or stimulate ejaculation. Although we give so much emphasis on ejaculation, in the Chinese traditional medical teaching, there is reference to improving health by ejaculatory control and abstaining from ejaculating during sexual activity—hence the popular belief that EJACULATING TOO MUCH will lead to WEAKNESS and ILL HEALTH!
For centuries, men have tried all sorts of natural remedies for erectile dysfunction (ED) -- the repeated inability to get or maintain an erection firm enough for sexual intercourse. But do they really work? It is simply not scientifically known at this point. Furthermore, you take these remedies at your own risk, because their safety profiles have not been established. What follows are commentaries by experts and reviews in the field of alternative treatments that are available over the counter for erectile dysfunction and impotence.
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.
Although there are few men who are born absolutely impotent, the number of men with erectile problems are many especially those tending to 50 years and above. Pfizer28 reported that about 40% of men above years, 50% of men above 50 years, 60% of men above 60 years and in any population are affected by ED. ED has profound effect on psychological well being, it can be devastating, it can lead to low self-esteem, depression, negative effect on relationships and reduced life satisfaction28. Among several other causes, aging is one of the factors leading to ED. There are some other social causes of ED such as high unemployment rates, and diseases like diabetes, hypertension, HIV/AIDS, high cholesterol levels, stress, smoking and obesity28. ED is slowly creating adverse problems in homes in Uganda and particularly, among the mid-aged and old men. The men with sexual impotence and erectile dysfunction deserve proper diagnosis of the conditions and treatment. Thus, the plant remedies described may be healthy if administered
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This is the vegetable root from Peru that meets the entire health benefits. If you can add this to your diet, you will surely see the difference. Maca is highly rich in iodine, amino acids, iron and magnesium. There are three types of Maca; black, red and yellow. The black one appears to get rid of stress as you boost your memory. Stress could cause ED.
In the East, many herbal tonics and preparations are used to assist the aging male improve his sexual drive or ability to perform penetrative sex by increasing sexual stimulation, erectile, ejaculatory, orgasmic and other responses for sexual function and satisfaction. The herbs and tonics act as or as “pick-me-ups” and energizing tonics which help the tired and fatigued male and those with sexual asthenia. The myths and realities concerning Tongkat Ali, sea horse, cobra meat and blood, animal penises and testicles amongst many other herbs and portions for oral intake or local application used by traditional “medical” practitioners and village doctors will be discussed.
For centuries, men have tried all sorts of natural remedies for erectile dysfunction (ED) -- the repeated inability to get or maintain an erection firm enough for sexual intercourse. But do they really work? It is simply not scientifically known at this point. Furthermore, you take these remedies at your own risk, because their safety profiles have not been established. What follows are commentaries by experts and reviews in the field of alternative treatments that are available over the counter for erectile dysfunction and impotence.

Having your current medication checked – if you are taking medication already, it could be that your erection problems are a side effect. Have a doctor check whether this is the cause of your problems and if it is, you might be able to switch medications and then find that your erectile dysfunction goes away completely – or at least improves. Medications that can cause erection problems include:
Eleutherococcus senticosis (Siberian Ginseng) is an overall system toner and improves performance and stamina. In the 1950's it was used extensively by Soviet athletes to enhance athletic performance. It can combat stress and is a tonic stimulant for the adrenal hormones. One of the most important active ingredients in Siberian or Oriental Ginseng is the ginsenosides, which greatly promote blood flow to the brain and peripherals, including the penis. In oriental medicine, Ginseng is highly respected and prized as a herb which promotes male or 'yang' energy, improving circulation, boosting vitality and acting as an overall systemic invigorator.
Animal testicles: derived from bulls and wild boars, the orchic substance has been used as a way to possibly increase testosterone levels and sperm counts. In Singapore, testis soap was once very popular (Figure 2). It is still sold in parts of China and Japan. The dried Dog testis and penis (canis familiaris) is believed to tonify the kidneys and strengthen the yang II. Kidney deficiency is believed to be the cause of impotency in Chinese literature.

There’s one more thing to remember: A visit to a physician can be helpful even if a man doesn’t want to go near Viagra or try one of the alternatives. In some cases, a treatable medical condition such as low testosterone or depression could explain a case of ED. “Sexual health should not be viewed as a luxury, but rather as an essential component to wellness,” said urologist Ryan P. Terlecki, MD, of Wake Forest Baptist Health in North Carolina.
Acupuncture. Acupuncture has been used for centuries to treat ED and impotence in China. A recent review of studies on acupuncture for erectile dysfunction was published in the British Journal of Urology International. After reviewing four studies, the authors concluded that there was not sufficient evidence to say that acupuncture worked. However, some experts believe it's worth trying. "Acupuncture can work," says Gilbert. "It probably works best to treat the psychological component of ED. There is very little downside to trying it."
"Just because there is evidence doesn't mean it's good evidence," says Andrew McCullough, MD, associate professor of clinical urology at New York University Langone Medical Center in New York City, and one of the original clinical investigators for the ED drug Viagra (sildenafil). "And before men with ED start down the naturopathic route, it's smart to make sure that there isn't some underlying medical condition that needs to be corrected." Moreover, it is estimated that 30 million American men have erectile dysfunction, and 70% of cases are a result of a potentially deadly condition like atherosclerosis, kidney disease, vascular disease, neurological disease, or diabetes. Additionally, ED can also be caused by certain medications, surgical injury, and psychological problems.
"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
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.

Ginseng is the root of some Araliaceae plants, which grows in northeast China. Ginseng is the number one herb in TCM that is used to maintain the balance of the body and enhance the vital Qi energy. ED is said to be caused by Qi deficiencies in the Kidney and Liver and Ginseng helps to improve Qi flow to these organs, especially when used with acupuncture. It has been confirmed clinically to enhance erectile function. The ginsenosides are the main active components in ginseng that give it anti-inflammation, anti-tumor, antioxidant, as well as apoptosis inhibition and preventing the degeneration of neurons in dorsal penile nerves while reducing the oxidative stress in the corpus cavernosum. 1


Erectile dysfunction (ED) or male impotence is defined as inability of a man to achieve or maintain penile erection sufficient for sexual activity. It is primarily a neuronal and endothelial dysfunction of the corpus cavernosum of penile tissue, and is partly characterized by reduced production of nitric oxide (NO). Other factors that may contribute to the pathogenesis of ED include androgen deficiency in aging men, hypertension, high cholesterol levels, atherosclerosis, diabetes mellitus, diseases of the prostate and heart, and anatomical deformity of the penis. ED may also be caused by some medications, prostate surgery and spinal cord injury. Psychological and social conditions such as stress, depression and unhappy marital relationship may contribute to the problem. Chronic infections and inflammation can also contribute to the disease process. ED is linked to an increased risk for cardiovascular diseases and stroke. Several orally active drugs (sildenafil, vardenafil, tadalafil, avanafil) are currently prescribed for treating ED to improve the arterial blood flow to the penile tissue. Medicinal plants and their extracts have been used in traditional medicine in southwest Asia and other countries to treat ED. The current review focuses on four medicinal plants that have been used as aphrodisiacs for enhancing sexual performance and for the treatment of ED. These plants include Eurycoma longifolia Jack (tongkat ali); Chlorophytum borivilianum (safed musli); Withania somnifera (ashwagandha); and Pausinystalia johimbe (formerly known as Corynanthe johimbe). Suggested mechanisms of action for each of the plant extracts will be discussed.
Consider this:  penicillin, the first successful antibiotic, was derived from molds that inhibit bacterial growth.  Scientists had to figure out why the molds slowed bacteria, and refine the active ingredients.  Using herbal supplements is somewhat like putting mold on a wound.  It might help, a little, but it’s certainly not going to help as much as using penicillin.
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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."
Pumpkin seed: besides having a pleasant flavor, pumpkin seeds are revered by the Chinese for its antidepressant properties (5). More importantly, pumpkin seed ingestion can impact prostate health, which is very important for male sexual health. It is commonly used to strengthen the prostate gland and promote healthy hormone function in men. Myosin, an amino acid found in pumpkin seeds, is known to be essential for muscular contractions.
The herbal medicines used in the management of sexual impotence and erectile dysfunction are mainly prepared by pounding, chewing and boiling and are mainly orally administered. The traditional healers treat sexual impotence and ED by prescribing some of these herbs in tea or using local beers, fermented milk and porridge. Some herbs are herbs are roasted or smoked such as coffee before administration. The dispensing of herbal medicines used in sexual impotence and ED using local beers, fermented milk and porridge possibly the alcoholic content improves on the kind of active chemicals extracted than water alone12.
L-arginine, an amino acid that is naturally present in the body and helps make nitric oxide, supports a successful erection. Nitric oxide is responsible for making the blood vessels relax, which helps sustain an erection for men. A 1999 study, observed the effects of six weeks of high-dose (5 grams/day) orally administered nitric oxide (NO) donor L-arginine on men with organic ED. Thirty-one percent of those who took 5 grams/day of L-arginine experienced significant improvements in sexual function. Burns told Medical Daily, “l-arginine and deer antler velvet” have been the most popular go-to natural treatments for men.

Tufan capsules are reckoned as the best ED pills as these possess only natural herbs as ingredients. Using Tufan herbal ED pills is safe as the herbs present in these pills are highly effective and completely safe; these are the best ED pills as these are capable of providing complete natural treatment by supplementing wide range of herbs which address all the possible causes of the problem.


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Nettle leaf (Urtica dioica): amongst its many properties, nettle leaf has lately shown itself possibly effective for prostate health and prevention of prostate conditions, especially prostatitis, which is an inflammation of the prostate gland (16). There is speculation that nettle leaf may help with male pattern baldness. Prostate health is essential for men, no matter how young or old. Prevention starts when men are young, so as to avoid problems associated with aging. Prostate problems can interfere with a healthy sex life. Nettle is also considered to be an overall restorative for the body, as well as a natural diuretic and anti-inflammatory remedy (16). It is rich in iron, zinc, and chlorophyll.

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.


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.
The Science: Some studies have implied that feeding maca to domestic cattle increases sperm production, but there is very little data about any sexual effect on humans. One very small randomized double-bind trial of men with erectile dysfunction found that men taking maca extract reported a small increase in their ability to get erections. But so did the control group. As with the fenugreek study, a similar study with a larger group of people is needed to see whether any differences between the controls and the maca-eaters are real.
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Most sincere gratitude to the sponsors, Third World Organisation for Women in Sciences (TWOWS), NUFU Medicinal plants Project through Botany Department, Faculty of Science, Makerere University, UNESCO-MAB Young Scientist Research Award, 2000, Gender studies, Makerere University and WHO-Uganda. The Staff of Queen Elizabeth National Park, Field assistants, local leaders, the resource users and all respondents, particularly the TBAs and traditional healers in Bushenyi, Mbarara and Kasese Districts who provided the information.
A plant like Cleome gynandra is a popular vegetable used all over Uganda and is on sale in most markets. Other medicinal plants that are food stuff include Allium cepa (onions), Allium sativum (garlic), Rhus vulgaris, Capsicum frutescens(red pepper) and Zingiber officinale (Ginger) are also on sale in most markets of Uganda and internationally. In addition, the roots of Mondia whiteii are used as an aphrodisiac for males and for improving female sexuality (women's Viagra) in most areas of Uganda11 particularly in urban centres and the Kampala City. To date, Mondia whiteii has been an old traded medicinal plant in most in Kampala. Recently the patented ‘Mulondo Wine’ a drink flavoured by the roots of Mondia whiteii has hit the national and international markets35. The Mulondo Wine is also believed to be an aphrodisiac for both men and women.

The informal conversations were held with the specialist resource users and other knowledgeable people on particular ailments. The meeting places were the gardens, women group meetings, at their homes, and any other places convenient to them. Through conversations, the sources of knowledge of the healers on medicinal plants, the medicinal plants used and changes in the availability of medicinal plants were established. Those who were more knowledgeable were later followed and interviewed further especially the TBAs, and some knowledgeable men healers. Focused discussions were held with them later for formal recording. In some instances, young mothers were visited too. This was done to verify the information gathered and the spread of the indigenous knowledge (IK) in reproductive health care among the different reproductive groups particularly on ED management.


L-arginine is used by the body to increase and precursor to the production of human growth hormone, prolactin and several amino acids It even increases our sensitivity to insulin, analogously to body when we exercise, by accepting more glucose to enter into our cells and improve better cellular energy therefore less fatigue with much more stamina. L-arginine’s function in supporting our metabolic health are also extremely important for building stronger muscle tissue and potentially to help fight inflammation.
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].
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.
Tufan capsules are reckoned as the best ED pills as these possess only natural herbs as ingredients. Using Tufan herbal ED pills is safe as the herbs present in these pills are highly effective and completely safe; these are the best ED pills as these are capable of providing complete natural treatment by supplementing wide range of herbs which address all the possible causes of the problem.
By doing Kegels, it’s actually possible to tone up the bulbocavernosus muscle. This muscle is extremely important for men. Thus, it lets the penis to fill with blood in order an erection could occur. The muscle also pumps during the process of ejaculation. In addition, it allows emptying the urethra after you urinate. The study has indicated that it’s necessary to perform Kegel exercises 2 times per day for at least 3 months to achieve considerable results.
This is another herb used for centuries in Chinese medicine to treat erectile dysfunction and low libido. A study from 2008 found  that the herb blocks the effects of an enzyme that restricts blood flow to the penis. Researchers believe horny goat weed, also known as epimedium, acts as a natural phosphodiesterase inhibitor, the same action as seen in erectile dysfunction drugs such as Viagra or Cialis. However, the research indicated that horny goat weed can work more effectively and cause fewer side effects than the drugs.
The art of acupuncture has become the new treatment for everything from back pain, depression, and even ED. Impotence could be more of a state of mind, and acupuncture may help. Through this alternative therapy, fine needles are placed in various parts of the body to relieve pain or stress. Although there are many mixed studies for acupuncture and ED, many tend to confirm positive results. A 1999 study found acupuncture improved the quality of erection and even restored sexual activity in 39 percent of participants.

Of the most prominent studies done on ED and ginkgo biloba, men who took this herb who were on antidepressants saw an increase in sexual activity and performance. As you may know, taking antidepressants can be a reason why men experience erectile dysfunction—and these studies have shown that the reason those specific men were experiencing ED was more than likely from the antidepressant medications that they were taking.

Males suffering with ED, even after proper persuasion and in appropriate circumstances are unable to gain optimum stiffness to penetrate a woman, even if a male achieves stiffness he tends to lose it very quickly without performing lovemaking for satisfactory duration. All of these are symptoms of ED and also growing impotency in a male. Impotency can be severely hurtful to male’s pride and ego and make him depressed. Tufan herbal ED pills alleviate this condition by providing natural erectile dysfunction treatment; these best ED pills resolve the problem in male of any age in a short time.
The Science: Chemicals inside these plants called ginsenosides are thought to ramp up the physiological pathway that makes nitric oxide, the neurotransmitter that gets the blood flowing during penile erection. Some studies support that idea: one found that ginsenoside-rich ginseng berry extracts relaxed smooth muscle inside rabbit erectile tissue. But so far there haven’t been high-quality double-blind and randomized trials of the chemicals’ effect on humans. The jury’s still out on whether ginsenosides have any effect on people at all, or (if they do) whether they work as well as medications like Viagra.
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
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