Preliminary research on a few herbal supplements — such as DHEA, ginseng and propionyl-L-carnitine — suggests that they may provide benefit as an erectile dysfunction treatment in some men. But no adequate clinical trials have evaluated either the effectiveness or the safety of supplements in treating erectile dysfunction.
Natural treatment can support erectile function by improving overall health. Erectile dysfunction due to vascular disease may readily respond to nutritional changes and herbal support.
Nutrition
Good nutrition may help improve erectile dysfunction.
- Eat whole, fresh, unrefined, and unprocessed foods. Include fruits (lots of richly pigmented berries to support vascular integrity), vegetables, whole grains, soy, beans, seeds, nuts, olive oil, and cold-water fish (salmon, tuna, sardines, halibut, and mackerel).
- Avoid sugar, dairy products, refined foods, fried foods, junk foods, and caffeine.
- Eliminate food sensitivities. Use an elimination and challenge diet elimination and challenge diet to determine food sensitivities.
- Drink 50% of your body weight in ounces of water daily (e.g., if you weigh 150 lbs, drink 75 oz of water daily).
Supplements
Supplements are intended to provide nutritional support. Because a supplement or a recommended dose may not be appropriate for all persons, a physician (i.e., a licensed naturopathic physician or holistic MD or DO) should be consulted before using any product.
Recommended doses follow:
- Bioflavonoids – Take 1000 mg daily.
- Flaxseed meal – Grind 2-4 tablespoons daily. Flaxseed meal is a better choice due to its fiber, lignan, and vitamin content, but flaxseed oil (1 tbsp daily) can be substituted.
- Inositol hexaniacinate – Take 1000-3000 mg daily to improve circulation and lower cholesterol. Diabetics should not take this supplement.
- Selenium – Take 200 mcg daily.
- Vitamin C – Take 1000 mg 3 times daily with meals.
- Vitamin E – Take 400 IUs daily.
- Zinc – Take 30 mg daily.
Herbal Medicine
Herbal medicines usually do not have significant side effects when used appropriately and at suggested doses. Occasionally, an herb at the prescribed dose causes stomach upset or a headache. This may reflect the purity of the preparation or added ingredients, such as synthetic binders or fillers. For this reason, it is recommended that only high-quality products be used. As with all medications, more is not better and overdosing can lead to serious illness and death.
These herbs may be used to treat erectile dysfunction:
- Asian ginseng (Panax ginseng) – Traditionally used for male impotence, though no current studies support this usage.
- Damiana (Turnera diffusa) – Traditionally used as an aphrodisiac and for various sexual disorders; however, there are no current studies to confirm its effectiveness.
- Ginkgo biloba – Increases arterial blood flow, which may have a positive effect on male sexual function.
- Muira puama (Ptychopetalum olacoides) – Used for erectile dysfunction and lack of libido.
In addition, one popular herbal medicine called yohimbe — which is marketed as a sexual stimulant — can be dangerous if used in excessive amounts. Adverse side effects include high blood pressure and heart failure.
Here are five natural remedies that are used for erectile dysfunction.
1) L-Arginine
L-arginine is an amino acid that the body uses to make nitric oxide, a substance signals smooth muscle surrounding blood vessels to relax, which dilates the blood vessels and increases blood flow. Relaxation of smooth muscle in the penis allows for enhanced blood flow, leading to an erection.
L-arginine is found naturally in foods such as meat, dairy, poultry and fish.
It is also available as oral L-arginine supplements, which some product manufacturers market as a "natural Viagra").
There have only been two studies to date, however, evaluating the effectiveness of L-arginine for erectile dysfunction.
One study involved 50 men who took L-arginine (5 grams a day) or a placebo. After six weeks, significantly more men taking L-arginine experienced an improvement in sexual function compared with men taking the placebo. Interestingly, it only benefited men who had initially low levels of nitric oxide.
Another study using a smaller dose of L-arginine and a shorter treatment duration found no benefit with L-arginine use. The study involved 32 men with erectile dysfunction who took oral L-arginine supplements (500 milligrams three times per day) or a placebo for 17 days. Oral L-arginine was no better than the placebo.
Side effects may include digestive complaints. High dosees of L-arginine may stimulate the body's production of gastrin, a hormone that increases stomach acid. For this reason, L-arginine may be harmful for individuals with ulcers and people taking drugs that are hard on the stomach.
L-arginine may also alter potassium levels in the body, especially in people with liver disease. It should not be taken by people who are on medications that alter potassium levels, such as potassium sparing diuretics and ACE inhibitors. For more information about L-arginine, read the L-Arginine Fact Sheet.
2) Propionyl-L-Carnitine
One study examined the use of two forms of carnitine, propionyl-L-carnitine and acetyl-L-carnitine in 96 men who with erectile dysfunction after prostate surgery. One group were given a placebo, another group took propionyl-L-carnitine (2 grams per day) plus acetyl-L-carnitine (2 grams per day) and sildenafil (Viagra) when needed, and the third group used Viagra alone.
Propionyl-L-carnitine and acetyl-L-carnitine were found to enhance the effectiveness of sildenafil, and result in improved erectile function, sexual intercourse satisfaction, orgasm, and general sexual well-being compared to Viagra alone.
Another study examined the effectiveness of propionyl-L-carnitine supplements plus sildenafil in men with erectile dysfunction and diabetes who were previously unresponsive to Viagra alone.
Participants in the study received either propionyl-L-carnitine (two grams per day) plus Viagra (50 milligrams twice a week) or Viagra alone. After 24 weeks, propionyl-L-carnitine plus Viagra was significantly more effective than Viagra alone.
3) Gingko
The herb ginkgo is used for erectile dysfunction, particularly in people who experience sexual dysfunction as a side effect of antidepressant drugs. It appears to relax smooth muscle and enhance blood flow in the penis.
In one study of 60 men with erectile dysfunction, there was a 50 percent success rate after six months of ginkgo treatment. Two additional studies, however, found that ginkgo was no better than a placebo.
For more information about ginkgo, read the Ginkgo Fact Sheet.
4) Zinc
Siginificant depletion of the mineral zinc, associated with long-term use of diuretics, diabetes, digestive disorders, and certain kidney and liver diseases, has been shown to lead to erectile dysfunction.
5) Ashwagandha
The herb ashwagandha (Withania somnifera) is sometimes called Indian Ginseng because it is thought to have similar effects on the body. It is thought to increase energy, stamina, and sexual function. No studies, however, have examined whether it is effective for erectile dysfunction in humans.
Side effects of ashwagandha may include drowsiness. It should not be combined with sedative drugs.
Yohimbe (Not Recommended)
The bark of the west African yohimbe tree is a source of yohimbine, a compound that has been found to stimulate blood flow to the penis, increase libido, and decrease the period between ejaculations.
Yohimbe is not recommended, however, because it is potentially dangerous, even in small doses. Side effects may include dizziness, anxiety, nausea, a severe drop in blood pressure, abdominal pain, fatigue, hallucinations, and paralysis.
Kegel Excercises
The first step is to properly identify the muscle group to be exercised.
- As you begin urinating, try to stop the flow of urine without tensing the muscles of your legs. It is very important not to use these other muscles, because only the pelvic floor muscles help with bladder control.
- When you are able to slow or stop the stream of urine you have located the correct muscles. Feel the sensation of the muscles pulling inward and upward.
Helpful hint . . . If you squeeze the rectal area as if not to pass gas, you will be using the correct muscles.
Now you are ready to begin exercising regularly.
Once you have located the correct muscle, set aside two times each day for exercising. Morning and evening are good times for most people, but the important thing is to choose times that are convenient for you so you can develop a routine.
- Set 1: Quick Contractions (QC) -- tighten and relax the sphincter muscle as rapidly as you can.
- Set 2: Slow Contractions (SC) -- contract the sphincter muscle and hold to a count of 3 (gradually work at increasing the count to 10). Make sure you relax completely between contractions.
In the beginning you should check yourself frequently by placing a hand over your abdomen and buttocks during your exercises. You should not feel the muscles of your abdomen, buttocks, or thighs tighten. If there is movement of these muscles you should continue experimenting until you are able to isolate the pelvic floor muscles.
You should see improvement of your bladder control in 3 to 6 weeks. Keep a record of urine leakage to monitor your progress.
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