If you’ve been to the health food store lately, you’ve seen shelves lined with vitamins and “organic” supplements, each claiming to boost immunity, revitalize organ function, or “promote health.” And it’s working. Supplements are currently a $30 billion industry in the US, with more than 90,000 products on the market, and vitamin use is on the rise. In fact, a recent survey in Journal of American Medicine Association showed that “52% of US adults reported use of at least 1 supplement product.”
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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].
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.
Generally, erectile dysfunction (ED) is a neurovascular condition directly involving the endothelium of the corpora cavernosal arterial blood vessels in the penis, and is indirectly linked to cardiovascular diseases. The underlying mechanisms of ED are, however, complex and involve psychogenic, neurogenic, hormonal and vascular factors. ED occurs in aging men, with a prevalence of 52% in men 40 to 70 years of age [1-3]. Conditions that may cause ED include hypertension, diabetes, diseases of the prostate and heart, and obesity. ED may also be caused by the effects of certain medications as well as physical injury or anatomical deformity of the penis [4], or may result from endocrine disorders such as low testosterone, hypogonadism, adrenal insufficiency and hypothyroidism. Changes in blood flow to the male reproductive organs as a result of hardening of the arteries or atherosclerosis, hypertension and hypercholesterolemia may result in ED. It is generally accepted that there are vascular and neuropathic components to the pathophysiology of the disease, and ED has been recognized as a potential indicator of underlying cardiovascular disease. Chronic infections and/or inflammation of the prostate and irritation of the bladder may contribute to the pathogenesis of ED.

Classically the neuro-physiology of ejaculation traces the 3 Phases in which ejaculation is a complex event involving the (I) the propulsion of sperm and seminal plasma into the prostatic urethra which is accompanied by (II) bladder neck closure and (III) coordinated contractions of the bulbocavernosus and ischiocavernosus muscles, striated muscles of the pelvic floor, lower limbs and trunk. In the Asian Society of the Aging Male Study [2004] 63% have reduced erection, 68% reduced or absent ejaculation and 19% pain or discomfort at ejaculation. Disorders of ejaculation can be due to: (I) disorders of production of sperm or seminal plasma/prostatic secretions (II) disorders of propulsion. In the case of anejaculation (absence of ejaculatory) which is the ultimate disorder of ejaculation, the causes can be best classified as (I) primary or secondary. After covering psychogenic causes of ejaculation failure, the organic causes due to non-dynamic and obstructive etiologies in the prepubertal and post pubertal male will be highlighted. More details will be given on retarded ejaculation, premature ejaculation, aspermia, painful and weak (poor propulsive force) ejaculation. The evaluation of the patient must include a detailed history taken from the patient and often his partner. Aside from haematologic tests, various forms of radiological and ultrasonic imaging, neurophysiologic studies may be required. For the general practitioner the commonest scenario will be in the ED Clinic with abundant men with performance anxiety presenting with premature ejaculation. In the male aging clinic lack of arousal is the commonest cause of retarded orgasm and ejaculation but this group is plagued by decreased touch sensitivity, the need for more direct stimulation, reduced drive to orgasm, a less intense orgasm, ejaculation being weaker and of reduced quantity and disturbing complaints of a longer recovery period and less number of attainable orgasms per day or week. Thus it is not mere rumor that “by the time a man reaches 55, the refractory period to ‘do it again for a man’ increases to 12 hours or even up to a week”. In the STD clinic, painful or bloody ejaculation is frequently seen. The Condom may cause condom retarded orgasm/ejaculation.
A cold slice of watermelon can do more than just satisfy thirst and hunger during the warm summer months; it can help with bedroom satisfaction. Citrulline, the amino acid found in high concentrations of watermelon, is found to improve blood flow to the penis. A 2011 study revealed men who suffered from mild to moderate ED and took L-citrulline supplementation showed an improvement with their erectile function and were very satisfied. Natural watermelon juice, or “nature’s Viagra,” can also be easier on the stomach, since taking pills like Viagra can cause nausea and diarrhea.
Erectile dysfunction (ED) is commonly called impotence. It’s a condition in which a man can’t achieve or maintain an erection during sexual performance. Symptoms may also include reduced sexual desire or libido. Your doctor is likely to diagnose you with ED if the condition lasts for more than a few weeks or months. ED affects as many as 30 million men in the United States.
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