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This supplement is extracted from the bark of the African yohimbe tree.

Some studies have shown positive effects on sexual performance with use of this drug. However, the American Urological Association doesn’t recommend yohimbe as an ED treatment.

This is because there’s not a lot of evidence proving it works.

These include increased blood pressure and heart rate, irritability, and tremor.

If you decide you want to try yohimbe, be sure to talk to your doctor beforehand.

Other alternative therapies thought to help ED include zinc supplements (especially for men who are low in zinc), the herb ashwagandha (also called Indian ginseng), and ginkgo biloba, but more studies are needed to know with certainty.

If you have symptoms of ED, it’s important to check with your doctor before trying any treatments on your own.

This is because ED can be a sign of other health problems. For instance, heart disease or high cholesterol could cause ED symptoms.

With a diagnosis, your doctor could recommend a number of steps that would likely improve both your heart health and your ED.

These steps include lowering your cholesterol, reducing your weight, or taking medications to unclog your blood vessels. If other health issues aren’t found to be the cause of your ED, your doctor will likely prescribe some common treatments. However, you may also choose natural options — just be sure to discuss them with your doctor first.

Whichever route you take, keep in discount sale viagra mind that ED is a common condition that’s very treatable. With some trial and error, you’re likely to find a treatment that works for you and your partner. Food and Drug Administration doesn’t regulate quality, strength, purity, or packaging of herbs.

If you choose to take herbs, be sure to get them from a reliable source.

In many cases, changes to your lifestyle and diet can help ease ED symptoms. Lifestyle changes that could help improve your sexual function include exercising and losing weight.

They also include stopping smoking and curbing your alcohol intake. For information on which foods might benefit you, such as cocoa and pistachios, check out this article on diet and ED. Can you run as fast as you did when you were 20 years old?

But even as we age, there are still plenty of ways to stay in the game and enjoy it.

Erectile dysfunction (ED) can occur for many reasons. Sometimes it is as simple as the side effect of a particular medication. But for roughly 75% of men, the cause is more complex.

ED may result from vascular disease, neurological disease, diabetes, or prostate-related treatments or surgeries. Whether you currently suffer from ED or are hoping to sidestep this condition, try these tips to overcome ED for better health and a better sex life.

According to one Harvard study, just 30 minutes of walking a day was linked with a 41% drop in risk for ED. Other research suggests that moderate exercise can help restore sexual performance in obese middle-aged men with ED.

In the Massachusetts Male Aging Study, eating a diet rich in natural foods like fruit, vegetables, whole grains, and fish — with fewer red and processed meat and refined grains — decreased the likelihood of ED.

High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the heart (causing heart attack), in the brain (causing stroke), and leading to the penis (causing ED). Check with your doctor to find out whether your vascular system — and thus your heart, brain, and penis — is in good shape or needs a tune-up through lifestyle changes and, if necessary, medications.

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.

Move a muscle, but we're not talking about your biceps. A strong pelvic floor enhances rigidity during erections and helps keep blood from leaving the penis by pressing on a key vein. In a British trial, three months of twice-daily sets of Kegel exercises (which strengthen these muscles), combined with biofeedback and advice on lifestyle changes — quitting smoking, losing weight, limiting alcohol — worked far better than just advice on lifestyle changes. For more on diagnosing, treating, and learning how to overcome ED, read What to do about Erectile Dysfunction, a Special Health Report from Harvard Medical School.

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Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Everything You Need to Know About Erectile Dysfunction (ED) What is erectile dysfunction (ED)? Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse.

It’s sometimes referred to as impotence, although this term is now used less often.

Frequent ED, however, can be a sign of health problems that need treatment.

It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional. ED can occur because of problems at any stage of the erection process. An erection is the result of increased blood flow into your penis. Blood flow is usually stimulated by either sexual thoughts or direct contact with your penis. When a man is sexually excited, muscles in the penis relax.

This allows for increased blood flow through the penile arteries, filling two chambers inside the penis.

As the chambers fill with blood, the penis grows rigid. An erection ends when the muscles contract and the accumulated blood can flow out through the penile veins.

There are many possible causes of ED, and they can include both emotional and physical conditions. Common causes include: cardiovascular disease diabetes hypertension, or high blood pressure high cholesterol obesity low testosterone levels or other hormone imbalances kidney disease increased age stress anxiety depression relationship problems certain prescription medications, such as those used to treat high blood pressure or depression sleep disorders drug use consuming too much alcohol using tobacco products certain health conditions, such as Parkinson’s disease or multiple sclerosis (MS) damage to the pelvic area through injury or surgery Peyronie’s disease, which causes scar tissue to develop in the penis.

ED can be caused by only one of these factors or by several of them.

That’s why it’s important to work with your doctor so that they can rule out or treat any underlying medical conditions. Treatment for ED will depend on the underlying cause.

You may need to use a combination of treatments, including medication or talk therapy. Your doctor may prescribe medication to help you manage the symptoms of ED. You may need to try several medications before you find one that works.

The following oral medications stimulate blood flow to your penis to help treat ED: avanafil (Stendra) sildenafil (Viagra) tadalafil (Cialis) vardenafil (Levitra, Staxyn) Alprostadil (Caverject, Edex, MUSE) is another medication that can be used to treat ED. It can be administered in two ways: as a penile suppository or as a self-injection at the base or side of the penis. Testosterone therapy (TRT) may also be recommended if you have low levels of testosterone. Medications used for other conditions may cause ED. Talk to your doctor about your medications and whether they could be causing your symptoms.

Never stop taking medications without first talking to viagra tablet 25 mg price your doctor. If you’re experiencing unpleasant side effects, talk to your doctor.

They may be able to recommend a different medication. Get more information on the medications used to treat ED.

A number of psychological factors can cause ED, including: stress anxiety post-traumatic stress disorder (PTSD) depression. If you’re experiencing psychological ED, you may benefit from talk therapy.

Over several sessions, you and your therapist will discuss: major stress or anxiety factors your feelings around sex subconscious conflicts that could be affecting your sexual well-being.

If ED is affecting your relationship, consider speaking with a relationship counselor as well. Relationship counseling can help you and you partner reconnect emotionally, which may also help your ED.

This treatment uses the creation of a vacuum to stimulate an erection.

Blood is drawn into the penis as the device is used, leading to an erection. A vacuum pump device consists of a few different components: a plastic tube, which you place over your penis a pump, which works to create the vacuum by drawing air out of the plastic tube an elastic ring, which you’ll move to the base of your penis as you remove the plastic tube. The elastic ring functions to maintain the erection, holding the blood in the penis and preventing it from returning to circulation. You may have ED if you regularly have: trouble getting an erection difficulty maintaining an erection during sexual activities reduced interest in sex.

Other sexual disorders related to ED include: premature ejaculation delayed ejaculation anorgasmia, or the inability to achieve orgasm after ample stimulation.

Speak with your doctor if you have any of these symptoms, especially if they’ve lasted for 3 or more months. They can help determine whether your symptoms are caused by an underlying condition that requires treatment.

Testing for ED can involve a variety of steps, including a physical examination and taking your health and sexual history.

Additional tests may be performed to determine if your symptoms are caused by an underlying condition. You should expect a physical exam where your doctor will listen to your heart and lungs, check your blood pressure, and examine your testicles and penis. They may also recommend a rectal exam to check your prostate.

Your doctor will ask you questions or request that you fill out a questionnaire about your symptoms, health history, and sexual history.

The responses can help them evaluate the severity of your ED. Some questions that you may be asked include: How long have you been experiencing ED?

Are you having any problems with feeling sexual desire, ejaculating, or reaching orgasm?

Is this affected by particular situations or types of stimulation? Do you wake up in the morning or in the middle of the night with erections?

What expectations do you and your partner have for each other?

Have you recently been experiencing a lot of stress? Do you use tobacco, alcohol, or nonprescription drugs? Do you have any underlying conditions or have you had any surgery on or injury to your pelvic area? Your doctor may perform additional testing to help diagnose your ED.

An ultrasound can be used to examine the blood vessels of the penis to determine if there’s a problem with penile blood flow.

A portable, battery-powered device, worn on the thigh, is used to evaluate the quality of your nocturnal erections. Data is stored in the device, which your doctor can access later. During this test, a medication is injected into your penis to stimulate an erection.

This allows your doctor to evaluate the firmness of the erection and how long it lasts. Urine tests can be used to check for diabetes or other underlying health conditions. Blood tests can be used to check for conditions such as diabetes, heart disease, thyroid issues, and low levels of testosterone. These tests can help your doctor guide your treatment as well as determine if an underlying condition may be causing your ED. Find out more about how blood tests can be used to diagnose ED. Kegel exercises are simple movements you can do to strengthen your pelvic floor muscles.

The muscles you use to do this are your pelvic floor muscles.

Now that you know where these muscles are, contract them for 3 seconds.

Repeat this exercise 10 to 20 times in a row, three times a day.

A small 2005 study compared two groups of men with ED.

The first group of men performed regular pelvic floor muscle exercises with a physiotherapist. They also received biofeedback and advice on lifestyle changes. The second group only viagra tablet 25 mg price received advice on lifestyle changes.

Men in the first group saw their penile function improve significantly after 3 months of regular pelvic floor muscles exercises.

Men in the second group saw little improvement after 3 months. For the next 3 months, all participants were given at-home exercises to perform. After 6 months in total had elapsed, 40 percent of all participants (including some men who had belonged to the second group) had regained normal erectile function.

A 2019 literature review also concluded that pelvic floor exercises were effective at treating both ED and premature ejaculation. However, the ideal exercise plan (in terms of conditions such as frequency and intensity) wasn’t identified.

You may find that it’s easier initially to do Kegels while lying down.

Eventually, you can start trying them when you’re sitting or standing.

Moderate to vigorous exercise is not only good for your overall health, but also can increase blood flow, possibly helping with ED. A review of 10 studies examined the effect of aerobic exercise on ED. From their review, investigators concluded that 160 minutes of weekly exercise for 6 months could lead to a decrease in erectile problems.

Another study examined physical fitness and testosterone levels in 87 men with ED. Researchers found that testosterone levels were negatively correlated with levels of body fat and abdominal fat. This suggests that exercise may increase testosterone in addition to reducing body fat. Before you start a new exercise plan, you should always discuss it with your doctor. This is particularly important for people with heart disease or another underlying condition that could be aggravated by vigorous activity. Since stress or anxiety can cause or contribute to ED, practicing yoga may be an effective way to ease ED symptoms.

In fact, a 2010 study of 65 men between 24 and 60 years old found that sexual function increased significantly after a 12-week program of yoga sessions.

Erectile dysfunction, or ED, is the most common sex problem that men report to their doctor.

ED is defined as trouble getting or keeping an erection that's firm enough for sex. Though it's not rare for a man to have some problems with erections from time to time, ED that is progressive or happens routinely with sex is not normal, and it should be treated. Most often when blood flow in the penis is limited or nerves are harmed With stress or emotional reasons As an early warning of a more serious illness, like: atherosclerosis (hardening or blocked arteries), heart disease, high blood pressure or high blood sugar from Diabetes.

Finding the cause(s) of your ED will help treat the problem and help with your overall well-being.

As a rule, what's good for your heart health is good for your sex health. During sexual arousal, nerves release chemicals that increase blood flow into the penis.

Blood flows into two erection chambers in the penis, made of spongy muscle tissue (the corpus cavernosum). During erection, the spongy tissues relax and trap blood.

The blood pressure in the chambers makes the penis firm, causing an erection. When a man has an orgasm, a second set of nerve signals reach the penis and cause the muscular tissues in the penis to contract and blood is released back into a man's circulation and the erection comes down.

When you are not sexually aroused, the penis is soft and limp.

Men may notice that the size of the penis varies with warmth, cold or worry; this is normal and reflects the balance of blood coming into and leaving the penis.

With Erectile Dysfunction (ED), it is hard to get or keep an erection that is firm enough for sex.

When ED becomes a routine and bothersome problem, your primary care provider or a Urologist can help. ED may be a major warning sign of cardiovascular disease indicating blockages are building in a man's vascular system.

Some studies have shown men with ED are at significant risk of getting a heart attack, stroke or circulatory problems in the legs.

ED also causes: Low self-esteem Depression Distress for the man and his partner. If ED is affecting a man's well-being or his relationships, it should be treated.

Treatment aims to fix or enhance erectile function, help circulatory health and help the quality of a man's life. ED can result from health problems, emotional issues, or from both. Some known risk factors are: Being over age 50 Having high blood sugar (Diabetes) Having high blood pressure Having cardiovascular disease Having high cholesterol Smoking Using drugs or drinking too much alcohol Being obese Lacking exercise.

Even though ED becomes more common as men age, growing old is not always going to cause ED. ED can be an early sign of a more serious health problem. Finding and treating the reason for ED is a vital first step.

ED happens when: There is not enough blood flows into the penis Many health issues can reduce blood flow into the penis, such as hardened arteries, heart disease, high blood sugar (Diabetes) and smoking.

The penis cannot trap blood during an erection If blood does not stay in the penis, a man cannot keep an erection.

Nerve signals from the brain or spinal cord do not reach the penis Certain diseases, injury or surgery in the pelvic area can harm nerves to the penis.

Diabetes can cause small vessel disease or nerve damage to the penis Cancer treatments near the pelvis can affect the penis' functionality Surgery and or radiation for cancers in the lower abdomen or pelvis can cause ED.

Treating prostate, colon-rectal or bladder cancer often leaves men with ED. Cancer survivors should see a Urologist for sexual health concerns. Drugs used to treat other health problems can negatively impact erections Patients should talk about drug side effects with their primary care doctors. Normal sex needs the mind and body working together. Emotional or relationship problems can cause or worsen ED. Some emotional issues that can cause ED are: Depression Anxiety Relationship conflicts Stress at home or work Stress from social, cultural or religious conflicts Worry about sex performance.

Finding the cause of your ED will help direct your treatment options.

Diagnosing ED starts with your health care provider asking questions about your heart and vascular health and your erection problem. Your provider may also give you a physical exam, order lab tests or refer you to a Urologist. Your doctor will ask you questions about your health history and lifestyle.

It is of great value to share facts about drugs you take, or if you smoke or how much alcohol you drink. He/she will ask about recent stressors in your life.

Speak openly with your doctor, so he/she can help you find the best choices for treatment. Questions about your health: What prescription drugs, over-the-counter drugs or supplements do you take? Have you had surgery or radiation therapy in the pelvic area?

Do you have other health problems (treated or untreated)?

Knowing about your history of ED will help your health provider learn if your problems are because of your desire for sex, erection function, ejaculation, or orgasm (climax). Some of these questions may seem private or even embarrassing.

However, be assured that your doctor is a professional and your honest answers will help find the cause and best treatment for you.

Questions about your ED symptoms: How long have you had these symptoms?

Do you wake up in the morning or during the night with an erection? Do your erections change at different times, like when going in a partner, during stimulation by mouth, or with masturbation? Do you have problems with ejaculation or orgasm (climax)?

How is this problem changing the way you enjoy sex? Do you have painful with erections, viagra tablet 25 mg price feel a lump or bump in the penis or have penile curvature?

These are signs of Peyronie's Disease which can be treated but calls for an expert in urology to assess and manage.

Your health care provider may ask you questions about depression or anxiety. He or she may ask about problems in your relationship with a partner. Some health care providers may also ask if they may talk to your sex partner.

Are you often under a lot of stress, or has something recently upset you? Do you have any anxiety, depression or other mental health issues? Examination focusing on your genitals (penis and testicles) is often done to check for ED. Based on your age and risk factors, the exam may also focus on your heart and blood system: heart, peripheral pulses and blood pressure. Based on your age and family history your doctor may do a rectal exam to check the prostate.

Most patients do not need a lot of testing before starting treatment. Your health care provider may order blood tests and collect a urine sample to look for health problems that cause ED. Questionnaires are often used by health experts to rate your ability to initiate and keep erections, gauge your satisfaction with sex and help identify any problems with orgasm.