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Health > Health Conditions > Impotence

Impotence

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General Information:

  • Evaluation and Treatment of Male Sexual Dysfunction  - American Association of Clinical Endocrinologists and The American College of Endocrinology -
    • "increased prolactin levels may also cause erectile problems, even in the presence of a normal testosterone level"
    • "Most problems revolve around dysfunction of the hypothalamic-pituitary-gonadal axis and are associated with either excess prolactin or decreased testosterone levels. Other endocrine disorders that may cause libido or erectile difficulties include hypothyroidism, hyperthyroidism, adrenal insufficiency, or excessive levels of adrenal corticosteroids."  - see prolactin and cortisol
    • "With any form of testosterone treatment, the patient may have a slow and steady increase in libido and erectile capacity during a course of months. If no improvement is noted after 3 months, the hormone deficiency may not be the only cause of the sexual dysfunction"
  • Hypertension can cause impotence. Angiotensin II receptor blockers (ARBs) can treat hypertension without sexual side effects and of all the hypertensives, have fewer side effects.  See Blood pressure drug reverses sexual dysfunction - Life Extension Magazine, 7/01 - "the active ingredient in Cozaar and Hyaar (losartan) can significantly improve sex lives of men who suffer from sexual dysfunction" - also see alternative ways to lower blood pressure
  • Sexual Dysfunction Guidelines - aace.com - "Other endocrine disorders that may cause libido or erectile difficulties include hypothyroidism, hyperthyroidism, adrenal insufficiency, or excessive levels of adrenal corticosteroids."
  • Sexual Dysfunction Guidelines - aace.com - "With any form of testosterone treatment, the patient may have a slow and steady increase in libido and erectile capacity during a course of months. If no improvement is noted after 3 months, the hormone deficiency may not be the only cause of the sexual dysfunction."
  • Patient's Fact Sheet: Prolactin Excess (.pdf format) - American Society for Reproductive Medicine - "In men, hyperprolactinemia may be associated with impotence and can affect fertility." - see prolactin

Alternative Therapies:

  • Effect of rutin on diabetic-induced erectile dysfunction: Possible involvement of testicular biomarkers in male rats - Andrologia. 2016 Oct 26 - "Diabetic-induced alterations in male sexual behaviour and sperm count, motility and viability were markedly corrected following 5 weeks of rutin treatment to the diabetic animals. Rutin also attenuated the inhibited serum testosterone and penile cGMP content, while improved diabetic-associated inflammation and testicular lipid peroxidation and oxidative stress. Histopathological evaluation revealed damaged testicular tissues in diabetic rats, which was protected following rutin treatment. In conclusion, treatment with rutin improved sexual functionality and also protects against diabetic-induced testicular damage" - See rutin at Amazon.com.
  • Pomegranate juice causes a partial improvement through lowering oxidative stress for erectile dysfunction in streptozotocin-diabetic rat - Int J Impot Res. 2016 Sep 1 - "Erectile dysfunction (ED) is associated with diabetes mellitus (DM). Pomegranate juice (PJ) is a potent antioxidant in diabetes induced oxidative stress ... This is the first study to show that PJ treatment ameliorates partially ED and completely oxidative stress and fibrosis in a diabetic rat model. Our results highlight the success of antioxidant mechanism of PJ in ED with diabetes and open the way for future understanding in alternative treatment combinations with PDE5 inhibitors" - See pomegranate extract at Amazon.com.
  • Waist circumference is superior to weight and BMI in predicting sexual symptoms, voiding symptoms and psychosomatic symptoms in men with hypogonadism and erectile dysfunction - Andrologia. 2016 Jul 12 - "We investigated whether three measurements of obesity, weight, body mass index and waist circumference, correlate with the International Index of Erectile Function-5 (IIEF-5), the Aging Males' Symptoms (AMS) and the International Prostate Symptom Score (IPSS) questionnaires ... waist circumference was significantly inversely proportional to IIEF-5 and directly proportional to AMS and IPSS. Weight was inversely proportional to IIEF and directly proportional to IPSS but not associated with AMS. BMI had no proportionality to measurements of sexual function and quality of life. These results suggest that among weight, BMI and waist circumference, the latter is the best predictor of health-related QoL in men with hypogonadism"
  • Testofen, a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease, increases testosterone levels and improves sexual function in healthy aging males in a double-blind randomised clinical study - Aging Male. 2016 Jan 20:1-9 - "Sexual function improved, including number of morning erections and frequency of sexual activity. Both total serum testosterone and free testosterone increased compared to placebo after 12 weeks of active treatment. Trigonella foenum-graecum seed extract is a safe and effective treatment for reducing symptoms of possible androgen deficiency, improves sexual function and increases serum testosterone in healthy middle-aged and older men" - [Nutra USA] - See Trigonella foenum-graecum at Amazon.com.
  • Dietary flavonoid intake and incidence of erectile dysfunction - Am J Clin Nutr. 2016 Jan 13 - "In analyses stratified by age, a higher intake of flavanones, anthocyanins, and flavones was significantly associated with a reduction in risk of ED only in men <70 y old and not older men (11-16% reduction in risk; P-interaction = 0.002, 0.03, and 0.007 for flavones, flavanones, and anthocyanins, respectively). In food-based analysis, higher total intake of fruit, a major source of anthocyanins and flavanones, was associated with a 14% reduction in risk of ED"
  • Blueberries, citrus fruits, red wine associated with reduced erectile dysfunction - Science Daily, 1/13/16 - "Of all the different flavonoids, Anthocyanins (found in blueberries, cherries, blackberries, radishes and blackcurrant), flavanones and flavones (found in citrus fruits) were found to offer the greatest benefits in preventing the condition ... It is already known that increased exercise can improve erectile function, but this research shows that eating a flavonoid-rich diet is as good for erectile function as briskly walking for up to five hours a week"
  • Most top-selling, over-the-counter sexual treatments unproven, some could be harmful, review shows - Science Daily, 1/12/16 - "DHEA ... Fenugreek ... Ginkgo Biloba ... Ginseng ... Horny Goat Weed ... L-arginine ... Maca ... Tribulus ... Yohimbine ... Zinc"
  • Vitamin D Deficiency Might Be Tied to Impotence - WebMD, 11/13/15 - "The researchers concluded that men with vitamin D deficiency were 32 percent more likely to be impotent than those with sufficient vitamin D levels. This association held even after the study authors accounted for other factors associated with erectile dysfunction, such as drinking, smoking, diabetes, higher blood pressure, inflammation and certain medications" - See vitamin D at Amazon.com.
  • Erectile Dysfunction and cardiovascular risk factors in a Mediterranean diet cohort - Intern Med J. 2015 Oct 20 - "ED presence and severity were associated with age, obesity, waist circumference, hypertension, antihypertensive treatment and ischemic disease. Patients with ED were more frequently smokers, sedentary and consumed more alcohol. In multivariate analysis, consumption of nuts (> twice a week) (OR 0.41 [95% CI 0.25 to 0.67] and vegetables (≥ once a day) (OR 0.47 [95% CI 0.28 - 0,77]), were inversely related to ED. Obesity (as BMI ≥ 30 kg/m2 ) (OR 2.49 [95% CI 1.48 -4.17]), ischemic disease (OR 2.30 [95% CI 1.22 to 4.33], alcohol consumption (alcohol-units a day) (OR 1.14 [95% CI 1.04 to 1.26], and age (year) (OR = 1.07 [95% CI 1.04-1.10] were directly related to ED"
  • Association between serum folic acid level and erectile dysfunction - Andrologia. 2015 Aug 25 - "The mean serum FA concentrations were 7.2 ± 3.7, 7.1 ± 3.2, 10.2 ± 4.6 and 10.7 ± 4.6 ng ml(-1) in the severe, moderate and mild ED and control groups respectively. The mean serum FA concentration was significantly higher in the control group than in the severe and moderate ED groups (both P < 0.001), but not the mild ED group (P = 0.95). Considering the significant differences in the serum FA levels between the control and ED groups, serum FA deficiency might reflect the severity of ED" - See folic acid products at Amazon.com.
  • Treatment With Metformin Improves Erectile Dysfunction in a Murine Model of Obesity Associated With Insulin Resistance - Urology. 2015 Jul 18 - "Treatment with metformin restored the erectile function in obese mice, through improvement of in vitro endothelial and nitrergic cavernosal relaxations. Therefore, use of metformin may be a good pharmacologic approach to treat insulin resistance-associated erectile dysfunction" - See metformin at IAS.
  • Caffeine intake associated with reduced levels of erectile dysfunction - Science Daily, 5/20/15 - "Men who drink the equivalent caffeine level of two to three cups of coffee a day are less likely to have erectile dysfunction (ED) ... men who consumed between 85 and 170 milligrams of caffeine a day were 42 percent less likely to report ED, while those who drank between 171 and 303 milligrams of caffeine a day were 39 percent less likely to report ED compared to those who drank zero to seven milligrams a day ... Even though we saw a reduction in the prevalence of ED with men who were obese, overweight and hypertensive, that was not true of men with diabetes. Diabetes is one of the strongest risk factors for ED"
  • Exercise linked to improved erectile, sexual function in men - Science Daily, 3/23/15 - "men who reported more frequent exercise, a total of 18 metabolic equivalents, or METS, per week, had higher sexual function scores, regardless of race. MET hours reflect both the total time of exercise and the intensity of exercise. A total of 18 METS can be achieved by combining exercises with different intensities, but is the equivalent of two hours of strenuous exercise, such as running or swimming, 3.5 hours of moderate exercise, or six hours of light exercise ... In contrast, men of any ethnicity who exercised less reported lower levels of sexual function. Additional contributors to low sexual function included diabetes, older age, past or current smoking and coronary artery disease"
  • Effect of Ginkgo biloba Extract (EGb-761) on Recovery of Erectile Dysfunction in Bilateral Cavernous Nerve Injury Rat Model - Urology. 2015 Mar 12 - "Forty-three male Sprague-Dawley rats underwent cavernous nerve crush injury and were randomized into 4 groups, including: vehicle only, high-dose GBE, medium-dose GBE, and low-dose GBE ... Administration of GBE increases neuron survival and preserves the neural nitric oxide synthase nerve fiber and contents of the corpus cavernosum after bilateral cavernous nerve injury. These implications indicate the beneficial effects of GBE use in the repair of the cavernous nerve and recovery of erectile function after radical prostatectomy" - See Ginkgo biloba at Amazon.com.
  • Effects of swimming activity on the copulatory behavior of sexually active male rats - Int J Impot Res. 2014 Dec 18 - "Swimming significantly improved the sexual performance of highly active rats, as indicated by increased intromission frequency and intromission ratio, compared with the sedentary controls. Swimming improved both sexual desire and performance, as indicated by reduced mount latency and increased intromission ratio, respectively, in swimming moderately active rats compared with the sedentary moderately active controls. Therefore, swimming activity improves the copulatory behavior of both highly active and moderately active male rats"
  • Efficacy of a novel water-soluble curcumin derivative versus sildenafil citrate in mediating erectile function - Int J Impot Res. 2014 Aug 7 - "The present study was conducted to assess the efficacy of a novel curcumin derivative (NCD) versus sildenafil citrate in erectile signaling. The study was conducted on 10 control male rats and 50 diabetic male rats divided into the following groups: diabetic, curcumin, NCD, sildenafil and NCD combined with sildenafil ... NCD or its combination with sildenafil showed significant efficacy and more prolonged duration of action. In conclusion, NCD could enhance erectile function with more efficacy and more prolonged duration of action" - See curcumin products at Amazon.com.
  • Molecular signalling of a novel curcumin derivative versus Tadalafil in erectile dysfunction - Andrologia. 2014 Jul 25 - "novel curcumin derivative (NCD) ... curcumin (CURC) ... In conclusion, a tendency was observed that CURC and NCD have high efficacy and more prolonged duration of action in enhancing erectile function" - See curcumin products at Amazon.com.
  • Erectile dysfunction may be the first clinical sign of insulin resistance and endothelial dysfunction in young men - Clin Res Cardiol. 2013 Sep;102(9):645-51 - "Patients with ED had significantly higher levels of systolic blood pressure (SBP), high-sensitivity C-reactive protein (Hs-CRP), high Insulin resistance index (HOMA-IR) and carotid intima-media thickness (IMT), compared with controls ... ED may be the first clinical sign of endothelial dysfunction and a clinical marker of cardiovascular and metabolic diseases. Subclinical endothelial dysfunction and insulin resistance may be the underlying pathogenesis of ED in young patients without well-known etiology" - See metformin at IAS.
  • Association of ED with chronic periodontal disease - Int J Impot Res. 2013 Jul 4 - "To examine the relationship between chronic periodontal disease (CPD) and ED, the interview sheet including the CPD self-checklist (CPD score) and the five-item version of the International Index of Erectile Function (IIEF-5) was distributed to 300 adult men who received a comprehensive dental examination ... There was a statistically significant correlation between the CPD score and the presence of ED (P=0.0415). The results in the present study suggest that ED is related to the damage caused by endothelial dysfunction and the systematic inflammatory changes associated with CPD. The present study also suggests that dental health is important as a preventive medicine for ED"
  • Korean Ginseng Berry Extract Effect on Sexual Function in ED - Medscape, 5/6/13 - "were administered 4 tablets of either standardized Korean ginseng berry (SKGB, 350 mg ginseng berry extract per tablet), or placebo, daily, for 8 weeks. Efficacy was assessed with the International Index of Erectile Function (IIEF)-15 and premature ejaculation diagnostic tool (PEDT) at the end of the 4th and 8th week. We observed that the total and each of the individual domain scores of IIEF-15 increased from 40.95+/-7.05 to 46.19+/-12.69 significantly in the SKGB by the 8th week (P<0.05). The erectile function domain of IIEF changed slightly from 17.17+/-2.57 to 18.59+/-5.99 in the SKGB group by the 8th week (P<0.05). In addition, PEDT scores significantly improved from 9.14+/-4.57 to 7.97+/-4.4 and 7.53+/-4.26 in the SKGB group after 4 and 8 weeks of treatment (P<0.05). Safety markers including hormone and lipid in the blood were assessed at the end of the 4th and 8th week and they remained unchanged. Oral administration of the SKGB extract improved all domains of sexual function" - See ginseng at Amazon.com.
  • Saw Palmetto Extract Enhances Erectile Responses by Inhibition of Phosphodiesterase 5 Activity and Increase in Inducible Nitric Oxide Synthase Messenger Ribonucleic Acid Expression in Rat and Rabbit Corpus Cavernosum - Urology. 2013 Apr 23 - "The results suggest that SPE may have potential application value for the prevention or treatment of erectile dysfunction through an increase in iNOS mRNA expression and inhibition of PDE5 activity in corpus cavernosum smooth muscles" - See saw palmetto products at iHerb.
  • Atorvastatin improves erectile dysfunction in patients initially irresponsive to Sildenafil by the activation of endothelial nitric oxide synthase - Int J Impot Res. 2013 Jan 17 - "This study aimed at comparing the effects of atorvastatin and vitamin E on erectile dysfunction in patients initially irresponsive to sildenafil, with investigation into the underlying possible mechanisms. Sixty patients were randomly divided into three groups: the atorvastatin group received 80 mg daily, the vitamin E group received 400 IU daily and the control group received placebo capsules ... glutathione peroxidase (GPO) ... nitric oxide (NO) ... Both atorvastatin and vitamin E showed a statistically significant GPO increase (P<0.05) and a statistically significant IL-6 decrease (P<0.05). Only atorvastatin showed a statistically significant increase in NO (15.19%, P<0.05), eNOS (20.58%, P<0.01), IIEF-5 score (53.1%, P<0.001) and Rigiscan rigidity parameters (P<0.01), in addition to a statistically significant decrease in CRP (57.9%, P<0.01). However, SOD showed a statistically significant increase only after vitamin E intake (23.1%, P<0.05). Both atorvatstain and vitamin E had antioxidant and anti-inflammatory activities. Although activating eNOS by atorvastatin was the real difference, and expected to be the main mechanism for NO increase and for improving erectile dysfunction" - See Jarrow FamilE (contains all eight members of the vitamin E family, includes Tocomin) at Amazon.com.
  • Effects of Korean ginseng berry extract on sexual function in men with erectile dysfunction: a multicenter, placebo-controlled, double-blind clinical study - Int J Impot Res. 2012 Dec 20 - "Ginseng is beneficial for many aspects of human physiology, including sexual function ... administered 4 tablets of either standardized Korean ginseng berry (SKGB, 350 mg ginseng berry extract per tablet), or placebo, daily, for 8 weeks. Efficacy was assessed with the International Index of Erectile Function (IIEF)-15 and premature ejaculation diagnostic tool (PEDT) at the end of the 4th and 8th week. We observed that the total and each of the individual domain scores of IIEF-15 increased from 40.95+/-7.05 to 46.19+/-12.69 significantly in the SKGB by the 8th week (P<0.05)" - See ginseng at Amazon.com.
  • Men with erection problems are three times more likely to have inflamed gums, study finds - Science Daily, 12/4/12 - "Turkish researchers compared 80 men aged 30 to 40 with erectile dysfunction with a control group of 82 men without erection problems ... the men with severe periodontal disease were 3.29 times more likely to suffer from erection problems than men with healthy gums"
  • Treating gum disease may fix erection troubles, too, study finds - nbcnews.com, 12/3/12 - "The study involved 120 patients with severe or moderate erectile dysfunction and chronic periodontitis. Half received treatment for their gum disease, while half did not. They filled out questionnaires about their erectile function, and patients who received treatment for their gum disease reported that levels of erectile function improved after three months ... I feel that the causal element is probably vascular disease, poor general health status, lack of medical attention (gum disease), underlying diabetes/hypertension, or all of the above"
  • The use of dehydroepiandrosterone in the treatment of hypoactive sexual desire disorder: A report of gender differences - Eur Neuropsychopharmacol. 2012 Oct 17 - "Data regarding the efficacy of dehydroepiandrosterone (DHEA) in the treatment of hypoactive sexual desire disorder (HSDD) are scarce and inconsistent. We aimed to determine possible gender differences in the efficacy of DHEA as a treatment for HDSS. Postmenopausal women (n=27), and men (n=21) with HSDD, were randomized to receive either DHEA 100mg daily or placebo for 6 weeks in a controlled, double blind study ... In women only, significant interaction effects were observed for sexual arousal (p<0.05), satisfaction (p<0.05), and cognition (trend; p=0.06). For arousal, a significant improvement was observed for the DHEA treated group at 6 weeks (p=0.001). Significant correlations were observed between bioavailable T and sexual cognitions, arousal and orgasm, while DHEAS was correlated with satisfaction. In the men, significant correlations were observed between testosterone and arousal (r=.45), sexual drive (r=.50) and orgasm (r=.55). In women with HSDD, DHEA treatment had a significant beneficial effect on arousal, whereas no efficacy was demonstrated in men, indicating a possible gender difference. This improvement seems to be mediated via DHEA's metabolism to testosterone. Our positive results suggest that the neurosteroid DHEA may be effective as a treatment for women with HSDD if administered at a dose of at least 100mg per day" - See DHEA at Amazon.com.
  • Propionyl-L-carnitine, L-arginine and niacin in sexual medicine: a nutraceutical approach for erectile dysfunction - Andrologia. 2011 Oct 4 - "In a group of 54 unselected men (35-75 years), consecutively presenting to our ED clinic and naive to other ED treatments, we carried out a single-blind, one-arm study to evaluate the effects of a 3-month supplementation with propionyl-L-carnitine, L-arginine and niacin on their sexual performance ... Analyses on GAQs revealed that treatment improved erections in 40% of cases, with a partial response occurring in up to 77% of enrolled subjects. These preliminary findings indicate that the favourable cardiovascular effects of nutraceuticals might also reflect on male sexual function with possible implication in the treatment and prevention of ED. This study documents a considerable patients' interest toward nutritional supplementation - as first-line or adjunctive treatment to PDE5 inhibitors - that goes beyond the measurable increment in penile rigidity" - See propionyl-l-carnitine products at Amazon.com, niacin at Amazon.com and L-arginine products at Amazon.com.
  • Effect of α-lipoic acid on sperm quality, reproductive tract measures in thinner exposed rats - Andrologia. 2011 Sep 15 - "The aim of this study was to investigate the effect of alpha lipoic acid (ALA, an universal antioxidant) on thinner-induced testicular toxicity regarding spermatological features, body and reproductive tract measures in rats. Adult male Sprague-Dawley rats were divided into five treatment groups, eight rats in each. Control group was treated with placebo. Group O was given only olive oil. The group L received only α-lipoic acid. Thinner + Lipoic Acid group received thinner + α-lipoic acid and group T received only thinner. Thinner alone administration caused significant decreases in body and some reproductive organ weights, sperm count, motility and sperm membrane integrity, and significant increases in seminal vesicle weight and abnormal sperm rates compared with the values in the control group. However, concomitant administration of thinner with α-lipoic acid provided significant improvements in sperm parameters compared with values in alone group T.  In conclusion, the results of this study suggest that α-lipoic acid has a protective effect against thinner-induced reproductive dysfunction in male rats" - See alpha lipoic acid products at Amazon.com.  I assume that the thinner is something like this:
  • Antioxidants of growing interest to address infertility, erectile dysfunction - Science Daily, 7/28/11 - "A growing body of evidence suggests that antioxidants may have significant value in addressing infertility issues in both women and men, including erectile dysfunction, and researchers say that large, specific clinical studies are merited to determine how much they could help ... Some commonly used antioxidants, such as vitamins C and E, could help, Hagen said. But others, such as lipoic acid, are a little more cutting-edge and set up a biological chain reaction that has a more sustained impact on vasomotor function and health ... Polyphenols, the phytochemicals that often give vegetables their intense color and are also found in chocolate and tea, are also of considerable interest"
  • Unhealthy lifestyle is associated with sexual dysfunction - Science Daily, 7/6/11 - "A new study published in The Journal of Sexual Medicine reveals that several unhealthy lifestyle factors, such as weight problems, physical inactivity, high alcohol consumption, tobacco smoking, and hard drugs are associated with sexual dysfunctions in men. Additionally, an unhealthy lifestyle is more common in persons who are sexually inactive ... Among those who had a sexual partner, risk of experiencing sexual dysfunction was greater in men who lead unhealthy lives by 71% in those with substantially increased waist circumference and more than 800% in men using hard drugs. Women who used hashish had almost 3 times increased risk of anorgasmia (difficulties or inability to reach climax during sexual activity with a partner) compared to non-users"
  • Clinical Assessment of a Supplement of Pycnogenol® and l-arginine in Japanese Patients with Mild to Moderate Erectile Dysfunction - Phytother Res. 2011 May 27 - "Subjects were instructed to take a supplement (Pycnogenol® 60 mg/day, l-arginine 690 mg/day and aspartic acid 552 mg/day) or an identical placebo for 8 weeks, and the results were assessed using the five-item erectile domain (IIEF-5) of the International Index of Erectile Function. Additionally, blood biochemistry, urinalysis and salivary testosterone were measured. Eight weeks of supplement intake improved the total score of the IIEF-5. In particular, a marked improvement was observed in 'hardness of erection' and 'satisfaction with sexual intercourse'. A decrease in blood pressure, aspartate transaminase and γ-glutamyl transpeptidase (γ-GTP), and a slight increase in salivary testosterone were observed in the supplement group. No adverse reactions were observed during the study period. In conclusion, Pycnogenol® in combination with l-arginine as a dietary supplement is effective and safe in Japanese patients with mild to moderate erectile dysfunction" - See Pycnogenol at Amazon.com, L-arginine products at Amazon.com and l-aspartic acid at Amazon.com.
  • Erectile dysfunction association with physical activity level and physical fitness in men aged 40-75 years - Int J Impot Res. 2011 May 12 - "This study showed that younger men with higher physical activity and better physical fitness are less likely to suffer from erectile dysfunction. Multivariable analysis through logistic regression showed that age (odds ratio (OD)=1.15; 95% confidence interval (95% CI)=1.07-1.23), physical activity (OD=10.38; 95% CI=3.94-27.39) and physical fitness (OD=4.62; 95% CI=1.75-12.25) were independent variables associated with erectile dysfunction. This study reinforces the concept that healthy habits have a direct effect on erectile function"
  • Natural aphrodisiacs: 'Spicing' up your love life possible, finds study of ginseng and saffron - Science Daily, 3/28/11 - "Ours is the most thorough scientific review to date. Nothing has been done on this level of detail before now ... They found that panax ginseng, saffron and yohimbine, a natural chemical from yohimbe trees in West Africa, improved human sexual function ... People report increased sexual desire after eating muira puama"
  • Fenugreek extract shows male libido boost: Human RCT - Nutra USA, 2/16/11 - "A formulation containing a standardized extract of Trigonella foenum-graecum and minerals was associated with an improvement in libido for 81 percent of the men in the study, and a 63 percent improvement in the ‘quality of sexual performance’, compared with no such improvements in the placebo group"  - See Fenugeek products at iHerb.
  • Physiological Aspects of Male Libido Enhanced by Standardized Trigonella foenum-graecum Extract and Mineral Formulation - Phytother Res. 2011 Feb 10 - "The aim of the clinical study was to evaluate the effect of Testofen, a standardized Trigonella foenum-graecum (Fenugreek) extract and mineral formulation, on male libido (sexual drive, urge or desire) in a double blind randomized placebo controlled study. The study recruited 60 healthy males aged between 25 and 52, without erectile dysfunction and randomized to an oral dose (two tablets per day) of the active treatment (600 mg Testofen per day) or placebo for 6 weeks. The primary outcome measure was the DISF-SR (male) self-administered QOL total score and the four domain scores. The secondary outcome was specific quality of life parameters. Testofen had an overall positive effect on physiological aspects of libido. In particular, there was a significant increase in the subdomains of sexual arousal and orgasm. Testofen had a positive effect on QOL in self-reported satisfaction with muscle strength, energy and well-being but did not have an effect on mood or sleep. Serum prolactin and testosterone levels remained within the reference range. It was concluded that Testofen demonstrated a significant positive effect on physiological aspects of libido and may assist to maintain normal healthy testosterone levels" - See Fenugeek products at iHerb.
  • Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction - Urology. 2011 Jan;77(1):119-22 - "L-arginine supplementation improves nitric oxide-mediated vasodilation and endothelial function; however, oral administration has been hampered by extensive presystemic metabolism. In contrast, L-citrulline escapes presystemic metabolism and is converted to L-arginine, thus setting the rationale for oral L-citrulline supplementation as a donor for the L-arginine/nitric oxide pathway of penile erection ... A total of 24 patients, mean age 56.5 +/- 9.8 years, were entered and concluded the study without adverse events. The improvement in the erection hardness score from 3 (mild ED) to 4 (normal erectile function) occurred in 2 (8.3%) of the 24 men when taking placebo and 12 (50%) of the 24 men when taking L-citrulline (P < .01). The mean number of intercourses per month increased from 1.37 +/- 0.93 at baseline to 1.53 +/- 1.00 at the end of the placebo phase (P = .57) and 2.3 +/- 1.37 at the end of the treatment phase (P < .01). All patients reporting an erection hardness score improvement from 3 to 4 reported being very satisfied" - See L-citrulline at Amazon.com.
  • Increasing BPA levels in urine associated with worsening male sexual function, study finds - Science Daily, 5/26/10 - "Increasing urine BPA level is associated with decreased sexual desire, more difficulty having an erection, lower ejaculation strength and lower level of overall satisfaction with sex life" - See stainless steel water bottles at Amazon.com.
  • Lack of omega-3 fatty acid linked to male infertility, study suggests - Science Daily, 4/12/10 - "In our experiment, we used 'knockout' mice that lacked the gene responsible for an enzyme important in making docosahexaenoic acid (DHA). In the absence of DHA, male mice are basically infertile, producing few if any misshaped sperm that can't get where they need to go ... But, when DHA was introduced into the diet, fertility was completely restored. "It was very striking. When we fed the mice DHA, all these abnormalities were prevented,"" - See Jarrow Max DHA at Amazon.com.
  • A new herbal combination, Etana, for enhancing erectile function: an efficacy and safety study in animals - Int J Impot Res. 2009 Jun 4 - "a new herbal combination called Etana that is composed of five herbal extracts including Panax quinquelotius (Ginseng), Eurycoma longifolia (Tongkat Ali), Epimedium grandiflorum (Horny goat weed), Centella asiatica (Gotu Kola) and flower pollen extracts. Most of the above-mentioned extracts have a long historical and traditional use for erectile dysfunction (ED) ... penile erection index (PEI) ... At a 7.5 mg kg(-1) single dose, the percentage of responding rats was 53+/-7 with a PEI of 337+/-72 compared with 17+/-6 with a PEI of 30+/-10 for control animals. This PEI was significantly (P<0.001) higher than each single component and than the sum of any two herbal components of Etana. When compared with sildenafil citrate, Etana induced more pronounced PEI than 0.36 mg kg(-1), but similar to 0.71 mg kg(-1) of sildenafil. Furthermore, full acute and sub-acute toxicity studies showed no toxic effects of Etana. In conclusion, this study describes a new and safe combination of herbal components that enhance erectile function in male rats"
  • Talking And Treating Erectile Dysfunction - Science Daily, 2/4/09 - "Stop smoking ... Control cholesterol ... Cut back on fat"
  • Ingredient in Chinese Herb Acts as a Natural Viagra - WebMD, 9/26/08 - "the main compound in horny goat weed, called icariin, acted the same way that Viagra does" - See horny goat weed products at iHerb.
  • Antioxidant treatment with alpha-tocopherol improves erectile function in hypertensive rats - Hypertens Res. 2008 May;31(5):1007-13 - "Treatment with 24 mg alpha-tocopherol decreased TBARS levels and increased SOD activity in the serum and corpus cavernosum. Relaxation in response to acetylcholine chloride in the corpus cavernosum was improved with alpha-tocopherol treatment at each dose. These results suggest that alpha-tocopherol treatment increases the diminished relaxation in the corpus cavernosum of SHRs by improving neuronal or endothelial function related to nitric oxide and carbon monoxide. This, in turn, indicates that antioxidant therapy may play a role in treatment for ED in hypertensive patients"
  • Berries and pomegranate - the ultimate Valentine's combo? - Nutra USA, 2/14/08 - "The results of this study demonstrated, for the first time, that daily consumption of PJ for seven weeks caused increased spermatogenic cell density, epididymal sperm concentration, sperm motility and decreased abnormal sperm rate related with decreased lipid peroxidation in male rats ... Forty-seven per cent of subjects reported erections improvements as a result of pomegranate juice, compared to only 32 per cent in the placebo group" - See pomegranate at Amazon.com.
  • Exposure to the phytoestrogen daidzein attenuates apomorphine-induced penile erection concomitant with plasma testosterone level reduction in dose and time-related manner in adult rats - Urology. 2007 Sep;70(3):613-7 - "The phytoestrogen daidzein has the potential to adversely affect erectile function in a dose and time-related manner that is at least partly attributable to androgen deficiency. These findings implicate that phytoestrogens, especially isoflavones, if overconsumed for a long period, might be a novel risk factor for erectile dysfunction"
  • Erectile Dysfunction In Diabetes Is Due To Selective Defect In The Brain - Science Daily, 3/15/07
  • Erectile Function in Subjects With the Metabolic Syndrome - Medscape, 7/19/06 - "consumption of a Mediterranean-style diet in men with the metabolic syndrome and ED at baseline produced significant improvement of erectile and endothelial functions, together with a significant reduction of systemic vascular inflammation, as indicated by the reduced levels of CRP"
  • Restoring Sexual Potency? - Dr. Weil, 5/4/06 - "Arginine ... Ginkgo biloba ... Ashwaganda"
  • Sexual Enhancement Supplements (L-Arginine, Yohimbe, Horny Goat Weed) - ConsumerLab.com, 1/13/06
  • What about erectile dysfunction? - Dr. Murray Natural Facts, 8/24/05 - "by far the most common cause of impotence by far is atherosclerosis of the penile artery. Atherosclerosis refers to a process of hardening the artery walls due to a build up of plaque containing cholesterol, fatty material, and cellular debris"
  • Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes - Curr Med Res Opin. 2004 Sep;20(9):1377-84 - "Salvage therapy with PLC plus sildenafil was more effective than sildenafil in the treatment of ED in patients with diabetes refractory to sildenafil monotherapy" - See Ester Carnitine Propionyl at iHerb.
  • Erection Supplements Under Fire - WebMD, 9/23/04
  • Diet and Exercise Programs Have Benefits for Obese Men With Erectile Dysfunction - Doctor's Guide, 6/24/04
  • Daily 2-Mile Walk May Prevent Impotence - WebMD, 6/22/04
  • Carnitine Improves Symptoms of Male Aging - Medscape, 4/14/04 - "Carnitine is more active than testosterone for improving symptoms of male aging such as sexual dysfunction, depressed mood, and fatigue ... In this trial, 120 patients were randomized to receive testosterone undecanoate 160 mg/day, propionyl-L-carnitine 2 g/day plus acetyl-L-carnitine 2 g/day, or placebo for six months" [Abstract] - See iHerb acetyl-l-carnitine products and iHerb propionyl-l-carnitine.
  • Policosonal: Nature's Cholesterol Balancer - Vitamin Research News, 2/04 - "Statin drugs are also known to cause male impotence" - See policosanol at Amazon.com.
  • Regular Exercise Can Help Prevent Impotence - WebMD, 8/22/03 - "men over age 50 who kept physically active had a 30% lower risk of impotence than men who were inactive ... The fitter the man, the better the erection. Frequent, vigorous exercise, the equivalent of running at least three hours a week or playing singles tennis five hours per week, produced the most benefit -- with a 30% lower risk of impotence"
  • Korean Red Ginseng Benefits Men with Impotence - New Hope Natural Media, 1/2/03 - "Men experiencing sexual difficulties due to inability to achieve erection may be helped by Korean red ginseng (Panax ginseng), according to a study published in the Journal of Urology ... It is a problem that affects nearly half of men over age forty worldwide ... Some 60% of participants reported improved erections while receiving ginseng. Improved sexual desire was also reported during ginseng treatment. Testosterone levels did not change with treatment, leading the researchers to conclude that improvements observed with ginseng are not due to hormonal effects" - See iHerb Korean (Panax) ginseng.
  • Ginkgo Supplements Useful for SSRI-Related Sexual Dysfunction - Clinical Psychiatry News, 9/02 - "Ginkgo has multiple systemic effects. It acts as a free-radical scavenger, inhibits platelet aggregation, causes vasodilation, and allows more efficient cellular uptake of oxygen and glucose. The effects of ginkgo on sexual arousal are thought to result from increased blood circulation to the genital area ... The proprietary multi-ingredient ginkgo preparation ArginMax (Daily Wellness Co.) is “one of the best things I've ever seen for SSRI sexual dysfunction,”" - See ArginMax at Amazon.com
  • Natural Remedy for Erectile Dysfunction - New Hope Natural Media, 9/5/02 - "received three separate treatments for two weeks each, in random order: (1) 3.25 grams of arginine plus 6 mg of yohimbine, (2) yohimbine alone and (3) placebo ... Combination treatment was considered successful by 40% of the participants, compared with 28.9% with yohimbine alone and 17.8% with placebo ... Arginine is available in health food stores without a prescription, but yohimbine can be obtained only with a doctor's prescription. Although the herb yohimbe is sold in health food stores, it contains much less yohimbine than the amount used in the new study" - See iHerb arginine products.
  • Yohimbine Plus L-Arginine Potential Therapy For Mild To Moderate Erectile Dysfunction - Doctor's Guide, 7/31/02 - "randomly assigned 45 men with erectile dysfunction to treatment with 6 mg of L-arginine glutamate combined with 6 mg of yohimbine hydrochloride, to 6 mg of yohimbine hydrochloride alone, or to placebo ... They took the drugs orally one to two hours before intended sexual intercourse ... Changes in this score [Index of Erectile Function (IIEF)] were significantly greater among patients taking yohimbine plus L-arginine compared to those taking placebo" - Note: That "6 mg of L-arginine glutamate" has to be a misprint.  It probably should have been 6 grams as in a U. of Texas study on postmenopausal women.
  • Low testosterone levels can mean high health risks - Life Extension Magazine, 11/00
  • Study: Supplement Can Help Take the 'Dys' Out of Female Sexual Dysfunction, Researchers Promote Idea of 'Sexual Wellness' - WebMD, 6/5/01 - "ArginMax -- a dietary cocktail consisting of ginseng, ginkgo, B vitamins, calcium, folic acid, and other vitamins and minerals -- is being heralded as one component of a lifestyle that improves sexual performance and helps prevent problems associated with intimacy"
  • Want a love potion? What to know before you try - CNN, 6/15/00 - "a study of 21 men with "mild to moderate" impotence taking a supplement called ArginMax (3,000 milligrams per day) found big improvements in erection and sexual satisfaction."
  • When It Comes to Love, the Nose Knows - WebMD, 2/14/01- "Another spirit in the heady cocktail making us intoxicated with romantic love is phenylethylamine (PEA) ... I believe that PEA may be the hormone of libido ... high PEA levels help explain increased sex drive and activity in the manic phase of manic-depressive illness, while low PEA levels reflect loss of libido in depression. PEA is effective when given by mouth, but like Viagra, could be dangerous in patients with heart disease" -
    • Note: Amino Acids anyone? at DrBob.org says "L-phenylalanine can also be converted (through a separate pathway) to phenylethylamine, a substance that occurs naturally in the brain and appears to elevate mood."
  • Study: Oversexed Monkeys Immune - Intelihealth, 11/11/00 - "Promiscuous species of monkeys appear to have stronger immune systems than less-active ones, researchers say."
  • Herbal Viagra Alternative Works -- at Least on Rats - WebMD, 10/23/00 - "All the rats fed the high-cholesterol diet indeed ended up with high cholesterol levels -- and all became impotent. But those who drank the herbal mixture [BetterMAN] were later able to achieve erections, while the other eight rats remained impotent"
  • Study finds exercise reduces the risk of impotence - CNN, 10/2/00
  • Exercise May Reduce Impotence Risk - Intelihealth, 10/2/00
  • With Regular Exercise, You May Never Need Viagra - WebMD, 8/30/00
  • Laboratory Investigations of Erectile Dysfunction - WebMD - "men with erectile dysfunction frequently have low levels of high-density lipoproteins, the good form of cholesterol." - see HDL
  • Saving Yourself from AGE - Life Enhancement Magazine, 8/00 - with American Ginseng, "The researchers found a reduction in plasma prolactin, a hormone connected with passive "nesting" behavior, suggesting that this may play a role in the ability of American ginseng to stimulate sexual activity in the male rat."
  • Want a love potion? What to know before you try - CNN, 6/15/00 - "a study of 21 men with "mild to moderate" impotence taking a supplement called ArginMax (3,000 milligrams per day) found big improvements in erection and sexual satisfaction."
  • Natural Alternatives to Viagra with Ellen Kamhi - WebMD, 5/26/00
  • Replenish Testosterone Naturally - Life Extension Magazine, 1/00
  • Study finds new therapy for impotence [l-arginine] - CNN, 10/27/99
  • Be All That You Can Be - Life Enhancement Magazine, 7/99
  • Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study - Urology. 1999 Mar;53(3):590-4; discussion 594-5
  • Long Term Safety and Efficacy of Ginkgo Biloba in the Treatment of Anti-Depressant-Induced Sexual Dysfunction - Alan Jay Cohen, M.D., UCSF Faculty
  • Ginkgo biloba for antidepressant-induced sexual dysfunction - J Sex Marital Ther. 1998 Apr-Jun;24(2):139-43

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