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.
It doesn’t look good for the herbs. So far, there’s no data from controlled human trials that support the erection-promoting claims for any 5 of the most frequently used herbs. The icariin in the horny goat weed can help get it up, but since you’re getting the herb rather than a purified molecule, the concentration probably isn’t high enough to have much of an effect. Worse, it turns out that Viagra is much better at blocking that erection-killing enzyme than icariin is.
Muira puama (Ptychopetalum olacoides): although used in Asia, this potency wood is actually the best known Amazonian folk medicine which increases libido and penile hardness. It acts as a nerve stimulant to heighten receptiveness to sexual stimuli as well as physical sensation of sex (9). Rich in sterols e.g., sitosterol, campesterol and lupol it activates the body’s receptors for hormones like testosterone to heighten libido and enhance performance (5). Also present are volatile oils like champor which helps restore sex drive and inner depth of libido and mental ability to be aroused.
“Obecalp” is “placebo” spelled backwards. It might help – treatment with inactive placebos (inert substances used in evaluation of new drug treatments) works about one-third of the time in scientific studies when patients don’t know they’re getting a fake drug. Placebos are generally safe since they contain no known active agent. (However, I personally never give patients inactive placebos, and many physicians regard them as unethical.)
For many men, stopping smoking is an erectile dysfunction remedy, particularly when ED is the result of vascular disease, which occurs when blood supply to the penis becomes restricted because of blockage or narrowing of the arteries. Smoking and even smokeless tobacco can also cause the narrowing of important blood vessels and have the same negative impact. 
Cordyceps stem from Chinese traditional medicine and have been credited for everything from strengthening the immune system to increasing the male libido.  These mushrooms are parasitic, growing on caterpillar larvae and killing the tiny insects from within. There has been some limited research into Cordyceps’ medical potential. One study published in the American Journal of Chinese Medicine found that these fungi boosted testosterone levels and sperm count in a sample of rats.
Pomegranate juice. Drinking antioxidant-rich pomegranate juice has been shown to have numerous health benefits, including a reduced risk for heart disease and high blood pressure. Does pomegranate juice also protect against ED? No proof exists, but results of a study published in 2007 were promising. The authors of this small-scale pilot study called for additional research, saying that larger-scale studies might prove pomegranate juice's effectiveness against erectile dysfunction. "I tell my patients to drink it," says Espinosa. "It could help ED, and even if it doesn't, it has other health benefits."
Cavallini, G., Modenini, F., Vitali, G., & Koverech, A. (2005, November). Acetyl-L-carnitine plus propionyl-L-carnitine improve efficacy of sildenafil in treatment of erectile dysfunction after bilateral nerve-sparing radical retropubic prostatectomy. Urology, 66(5), 1080-5. Retrieved from http://www.sciencedirect.com/science/article/pii/S0090429505006515
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.

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.
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 Claim: If you squint and have an excellent imagination, mature ginseng roots vaguely resemble a human body. That ties into folk ideas for finding medicines–in this case, the idea that a plant that looks like a person must contain materials that help sick people. Ginseng was traditionally used as a tonic to treat erectile dysfunction and low sexual drive in men (as well as many other complaints).
These medications don’t work for everyone but they are easy to use and work for around 60% of people who try them. They work by making it easier to get an erection by reducing the effect of (inhibiting) the chemical PDE-5. This chemical is used in the body to make sure there isn’t too much blood in the penis during an erection, but if you have erectile dysfunction then this chemical ends up over-compensating.
Those men that took 3gm of the root daily for 8 solid weeks are said to have improvement in their sexual intercourse frequently when compared to those that did not take it. As Maca is very safe generally, research shows that it increased the blood pressure in the user that have cardiovascular disease that took 0.6 gm of the root daily. Therefore, it is highly suggested that your daily intake must be less than 1 g/kg or 1g/2.2 pounds.
Most importantly, herbal supplements are not well regulated in the United States.  Studies have shown that 40-50% of herbal supplements do not even contain the supposed main ingredient, and many contain substances that are not listed which may have dangerous side effects2.  Another study found that over two thirds of the products tested had substituted other plant species for the plants listed on the label, and a third of products also contained other fillers or contaminants3.  A study by the New York State Attorney General of herbal products sold at GNC, Target, Walgreens, and Walmart found that four out of every five products didn’t contain the ingredient they claimed!  Fourteen US states and territories have petitioned Congress to regulate the herbal supplements industry.
While the rationale behind why it would work is airtight, the research on arginine’s actual effect on erectile dysfunction is slim, points out Charles Walker, M.D., assistant professor of urology and cofounder of the Cardiovascular and Sexual Health clinic at Yale University. But given its solid safety profile, minimal side effects, and potential benefit on heart disease, it’s worth a try, he adds, especially when taken in conjunction with other herbs on this list, which studies have shown can be more effective.
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.
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
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.”

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.
Poor eating contributes to the intake of excessive amounts of triglycerides, fat, glucose, and cholesterol. This leads to hypertension, insufficient HDL production, and lack of nitric oxide. As a result, sexual disabilities develop. They primarily manifest themselves as an inability to attain and sustain a firm, big, and long-lasting erection needed for a pleasurable sexual intercourse.
Vitamins and minerals are used in systems all over the body. Everywhere from your cardiovascular to your nervous system. It’s a lot to understand. So to help dispel some of the myths and outlandish claims, we’ll take a look at how five common vitamins and nutrients affect one very specific aspect of men’s health—erections. Turns out, vitamins can do more than just ward off the common cold.
Cistanche is usually consumed in stem form, which grows in an extremely arid area with intensive sunshine. It contains various chemical constituents that have some bio-activities such as antioxidation, neuroprotection and overall antiaging. It is shown in a study to shorten erectile latency and prolong erectile duration in castrated rats. Cistanche extract also improves sex hormone levels, improving overall sexual health. The constituent known as echinacoside, promotes relaxation of aortic rings through the NO-cGMP pathway, in other words, it relaxes blood vessels in the penis and improves Nitric Oxide flow.

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.
Ashwagandha (Withania somnifera), used widely in Ayurvedic medicine, holds a similar role to that of ginseng in Chinese medicine. Though unrelated to ginseng, it appears to share similar properties and actions. Ayurveda considers this herb to be a rasayana, or particularly powerful rejuvenative. The name ashwagandha means “like a horse,” connoting that it is regarded as a premier sexual tonic.
Doing physical activities regularly boosts blood supply and improves your heart. This helps blood flow to all corners of the body, including the blood flow leading to the firm erections. Exercising also steps up your libido by releasing endorphins that make you feel good. Additionally, exercise produces nitric oxide that keeps the arteries open. Therefore, the flow of blood to the penis becomes speedier. Start with brisk walking at least 20 minutes a day or another activity to make more nitric oxide contributing to the maintenance of the erection and your health in general.
The medicinal plants used in male-related conditions will be very significant in the present and future generations. From the researchers point of view, the usage of herbal remedies in managing sexual impotence and erectile dysfunction is useful because of long history of utilisation of some herbs that are perceived as effective. Thus, the establishment of rapport between modern health workers through collaborative ventures with traditional healers, relevant NGOs like Rukararwe in Bushenyi by having close supervision and monitoring of herbal treatments in such conditions is noble. Ministry of Health through its research wing in traditional medicine the Natural Chemotherapeutics Research Laboratory in Wandegeya has role to play in advocacy of traditional medicine. In addition, Public-Private Partnership in Health Care Delivery Desk Office in Ministry of Health and distinguished researchers in herbal medicine need to network, collaborate and have policy in place for herbal medicine as an alternative form of health care in Uganda. The traditional herbal medicines, relevant to the needs of ailing Ugandans can be tried out after being licensed by the National Drug Authority. In our view, sexual impotence and erectile dysfunction are real silent conditions affecting Ugandan men. Additionally, further investigations into the safety and efficacy of these traditional herbal remedies used in the treatment of erectile dysfunction and other male-related conditions are recommended in Uganda.
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In reality, on a few and proven key herbs that shown to cure and improve on erectile dysfunction. A simple stack of 3 key supplements has proven to treat and cure erectile dysfunction, namely improving and restoring your libido, blood circulation and erectile strength.  As a naturally supplement combo, this 3 herbal combination is proven to reverse or cure erectile dysfunction.
Other factors that “stress” the body can also increase your risk for ED. These include: substance abuse, using marijuana, smoking cigarettes, depression, anxiety and low self esteem. Cigarette smoking — or using nicotine — leads to constricted blood vessels, which has negative effects for sexual health. Other mental/emotional obstacles can cause less desire for sex and decrease testosterone. Several ways to help manage stress include:
Erectile dysfunction at times regarded as a symptom and not a condition. An erection occurs due to complicated multi-system processes in the body of a man. Sexual arousal entails interaction between your body, hormones, nervous system, emotions and muscles. According to the report of the researchers, it has been estimated that ED cases will be increased within the next two and a half decades. This could imply that over 330 million men across the globe will be impotence.

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Coenzyme Q10, when taken in recommended dosage, under medical guidance is safe for most adults. However, it may sometimes cause mild side effects pertaining to digestion such as loss of appetite, stomach upset, nausea and diarrhea. It may also cause skin rash and is known to affect blood pressure. Experts say that dividing a single daily dose into 2 or 3 smaller doses per day can help in reducing these side effects.
Those men that took 3gm of the root daily for 8 solid weeks are said to have improvement in their sexual intercourse frequently when compared to those that did not take it. As Maca is very safe generally, research shows that it increased the blood pressure in the user that have cardiovascular disease that took 0.6 gm of the root daily. Therefore, it is highly suggested that your daily intake must be less than 1 g/kg or 1g/2.2 pounds.
The medical ethnobotanical indigenous knowledge were collected by visiting traditional healers and documenting the medicinal plants used and other socio-cultural aspects allied with sexual impotence and erectile dysfunction. The methods used to collect the relevant information regarding the medicinal plants used included informal and formal discussions, field visits and focused semi-structured interviews.
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:
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