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In regards to Ashwagandha helping men get it up, the limited research has focused on psychogenic erectile dysfunction. Psychogenic ED is caused by psychological causes, rather than biological symptoms. These factors could be related to stress, anxiety, and pressure surrounding sex. Even though scientists have found that psychogenic ED is legitimate in some circumstances, there is a lack of research proving that “Indian ginseng” is a solution. One study published in the International Quarterly Journal of Research in Ayurveda  found that in fact, Ashwagandha didn’t have any impact on patients suffering from psychogenic ED.
Red Ginseng can serve as a harmless herbal replacement option for the most famous ED medication. The high potential of this plant to treat the impairment of male sexual function has been known since ancient times. Nowadays, when used as a supplement, it may also fight poor erections, make erections last longer, and increase sexual desire in men. In addition, the herb intensifies alertness and helps overcome heart diseases.

Catuaba (Erythroxylum catuaba): in Brazil, Catuaba Extract is considered to be a central nervous system stimulant (5), without the side effects of caffeine. This is used in some Asian remedies for sexual weakness and lowered libido. European herbalists have found that Catuaba may have aphrodisiac properties and can be used to combat sexual weakness.
Phytolacca dodecandra leaves and roots are pounded and smeared on ripe banana and then the ripe banana roasted before being eaten for treating erectile dysfunction. However, care has to be taken Phytolacca dodecandra is poisonous. Cola acuminata fruits are mixed with other plants in Benin to treat primary and secondary sterility24. Cola acuminata is also said to be diuretic and laxative when administered orally24. Some Acacia species are regarded as aphrodisiacs in Niger2. Cassia species have high repute as drugs and poisons. For instance, Cassia sieberiana is used urinary problems, impotence and kidney diseases in Mali24. In Burkina Faso, Cassia occidentalis is used as a stimulant24. Flueggea virosa is famous medicine in African cultures. Flueggea virosa used in sterility, aphrodisiacs, stimulant, rheumatism, arthritis, spermatorrhoea, kidney and liver problems among many other diseases treated17,24.
When you are stressed, your body has to overwork to fight off the stress. Hence you will lose much energy to deal with this condition. Besides, trying to have sex makes the body have to face new stress. This results in the lack of erections. So, if you want to prevent erectile dysfunction, stress is the thing you need to eliminate immediately. Dr. Julian Nesbitt said: “Stress releases cortisol which can negative physical effects as well as emotional psychological effects which you being stressed you may be less likely to maintain an erection. Try to take time for your self and try breathing/ relaxation exercises.” 
The truth is medication or psychosexual counselling are the first treatments a doctor will suggest because they’ve been proven to work. If a doctor has approved a medication for you then it’s safe. If you would still like to see if herbal supplements work for you, then there is a list below of supplements thought to work for erectile dysfunction. Just before you invest your money in them, remember they aren’t proven to work:
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.
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.

For this segment of Myth Busting, we delve into the esoteric world of ED herbal supplements and explore whether they live up to the hype. Last June, Quartz revealed that two wildly different brands — Goop and Infowars — sell products containing many of the same ingredients. While Goop was started by Oscar-winning wellness guru Gwyneth Paltrow, Infowars was created by notorious conspiracy theorist Alex Jones. However, both companies seem to share a love for dubious alternative medicine.
Aggressive and excessive sexual behaviour is most common cause of ED. Males practicing self-stimulation, coition, or gaining erections without ejaculation few times in a day suffer with problems like ED due to exhausted reproductive system. Tufan herbal ED pills provide natural erectile dysfunction treatment by handling effects of these practices as well. These are regarded as the best ED pills as these not only protect a male from ill-effects of these issues but also reverse their effects to improve health and energy levels of male reproductive system.
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Yohimbine is the principal alkaloid of the bark of the West African evergreen P johimbe (formerly known as C johimbe), family Rubiaceae. The main active chemical present in P johimbe bark is yohimbine hydrochloride (an indole alkaloid), which has stimulant and aphrodisiac effects. However, the levels of yohimbine that are present in P johimbe bark extract are variable and often very low. Therefore, although P johimbe bark has traditionally been used to treat ED [38], there is insufficient scientific evidence to form a definitive conclusion in this area. It is an antagonist of α2-receptors and has no direct relation to erection. It acts as a sex motivation stimulant. Yohimbine has been used as both an over-the-counter dietary supplement in the form of an herbal extract, and as a prescription medicine in purified form for the treatment of sexual dysfunction. Yohimbine 20 mg or adjusted dose has been found to be effective in the treatment of orgasmic dysfunction. Yohimbine was recently associated as a treatment for type 2 diabetes mellitus in animal and human models carrying polymorphisms of the alpha-2A adrenergic receptor gene [39]. The National Institutes of Health states that yohimbine hydrochloride is the standardized form of yohimbine that is available as a prescription medicine in the United States, and has been shown in human studies to be effective in the treatment of male impotence. Yohimbine hydrochloride USP has been used to treat ED. Controlled studies suggest that it is not always an effective treatment for impotence, and evidence of increased sex drive (libido) is anecdotal only. It cannot be excluded that orally administered yohimbine can have a beneficial effect in some patients with ED. The conflicting results available may be attributed to differences in drug design, patient selection and definition of positive response. Yohimbine has been shown to be effective in the reversal of sexual satiety and exhaustion in male rats, and has also been shown to increase the volume of ejaculated semen in dogs, with the effect lasting at least 5 h after administration. Yohimbine has also been shown to be effective in the treatment of orgasmic dysfunction in men, and has also been used for the treatment of sexual side effects caused by some antidepressants, and female hyposexual disorder. Yohimbine has significant side effects, such as anxiety reactions. Higher doses of oral yohimbine may create numerous side effects, such as rapid heart rate, high blood pressure, overstimulation, insomnia and/or sleeplessness. More serious adverse effects may include seizures and renal failure. Yohimbine should not be consumed by individuals with liver, kidney or heart disease, or psychological disorders. The therapeutic index of yohimbine is low; the range between an effective dose and a dangerous dose is very narrow. Side effects include gastrointestinal upset, increased blood pressure, headache, agitation, rash, tachycardia and frequent urination [40].
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.
Despite its cult following, there hasn’t been proper, objective research into its effects. One study published in the First International Journal of Andrology tested the herb out on a small group of young men and found that it did help with “mild ED.”  However, the researchers didn’t look into whether Maca could help with older patients who are suffering from more serious cases of impotence. On top of that, the study was focused on the patients’ perception of their own erectile issues. While ED can surely stem from psychological reasons, people deserve something that has a more credible history of solving the biological aspects to the problem.

The Plant: It’s true, the name’s hilarious. But as it turns out, it’s not just one plant: supplement manufacturers might put any one of 15 different species from this genus of shade-loving perennials inside that pill. That’s important to keep in mind, because the types and amounts of biologically active molecules the plant contains can differ from species to species.

Sleeping well is crucial for treating erectile dysfunction. As you may know, when we sleep, our body repairs itself. The brain gets the chance to remove waste and toxins. At the same time, your body produces testosterone, one essential substance for the sexual system to work properly. With the low level of testosterone, getting erections becomes difficult and this will lead to erectile dysfunction. Therefore, you need to have a 7-hour sleep every night to ensure the sexual health.
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.
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."
There are so many potential reasons a man might develop erectile dysfunction (ED), it's nearly impossible to generalize the best ways to treat it. What works for one man may not work for another simply because they are having problems for different reasons. That said, it may encouraging to hear that there are a variety of options that may be considered, from psychological counseling to lifestyle changes, medications to treatments and devices.
*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.
Epimedium extract (Horny Goat Weed) (11), (Figure 9): the Chinese refer to this herb as ‘yin yang huo’, which has been loosely translated as ‘licentious goat plant’; hence, its common name is well known as ‘horny goat weed’ by many Western cultures. Scientifically, studies have shown that Epimedium may restore low levels of both testosterone and thyroid hormone, bringing low levels back to their normal levels (5), which may account for some of its benefits in improving sexual libido. Other benefits to Epimedium involve increased muscle mass. Used for fatigue and aging, And vasodilatation effect; thus, most frequently used in treatment of sexual dysfunction in Traditional Chinese Medicine (12). The active substance from horny goat weed was reported by Xin Zhong Cheng at Beijing Medical University as Icarin—acts by increasing sexual activities and ICP levels in castrated rats after long term oral administration. It has no effects on serum testosterone level in castrated rats after long term oral administration. Instead Icariin increases nNOS and iNOS mRNA and protein expression in the corpus cavernosum after long term oral administration and hence may have long term efficacy on erectile dysfunction after oral administration.
Erectile dysfunction, sometimes, which also may imply to refer to “impotence,” is the repeated inability to get or keep an erection firm enough for sexual intercourse23,34. The word “impotence” may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm23. Roper29 defines erectile dysfunction as the total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections (premature ejaculation). Pamplona-Roger27 defines impotence as the inability to finish sexual intercourse due to lack of penile erection. These variations make defining ED and estimating its incidence difficult. For purposes of this publication, since ethnobotanical indigenous knowledge (IK) cannot clearly distinguish between these two terms, then erectile dysfunction and sexual impotence are both used. The local people who are providers of this information are not in position to classify these two conditions.
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.
Though there has been some research into Cordyceps, advertising them as an ED solution because of a handful of scattered conclusions is flawed. When you unpack each conclusion, the reasoning becomes faulty. Having low testosterone levels may seem like an obvious reason for not being able to get it up but doctors are adamant that this isn’t always the case.
Wild oats: a study in 1986 by the Institute for Advanced Study of Sexuality in San Francisco reported effects like heightened sexual awareness, increased sexual thoughts, more orgasms (36% in men and 29% in women) and some male subjects showed increased levels of testosterone attributed to unbinding of testosterone from TBG. Oats supply steroidal saponins which modulate hormonal balance (5).
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
A study published in May 2014 in The Journal of Sexual Medicine found that some men can reverse erectile dysfunction with healthy lifestyle changes, such as exercise, weight loss, a varied diet, and good sleep. The Australian researchers also showed that even if erectile dysfunction medication is required, it's likely to be more effective if you implement these healthy lifestyle changes.
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