Erection Supplements- Do They Work to Improve ED?

Briefing: Erection Supplements and Erectile Dysfunction (ED)​

This briefing reviews information from the "Erection Supplements- Do They Work to Improve ED?" discussion on the Excel Male TRT Forum, focusing on the efficacy, safety, and regulatory aspects of supplements marketed for erectile dysfunction.

I. Key Themes & Main Arguments​

1. Lack of FDA Regulation and Unsubstantiated Claims for Most Supplements: A central theme is the general absence of FDA approval for herbal remedies and dietary supplements, allowing manufacturers to make "unsubstantiated claims" often accompanied by disclaimers like "this statement has not been reviewed by the FDA." This lack of regulation leads to a wide range in product potency and raises concerns about safety and effectiveness.
2. Safety Concerns and Potential for Harmful Side Effects: Many supplements, despite being perceived as "natural," can significantly impact body chemistry and cause "serious and even lethal side effects." Several specific examples are provided, highlighting risks ranging from mild gastrointestinal issues to severe conditions like kidney failure, seizures, coma, and life-threatening reactions.
3. Limited Scientific Evidence for Efficacy (with some exceptions): The overwhelming consensus is that "There is no evidence that any herbal product, vitamin, or dietary supplement can improve erections or sexual performance in men or women" for most advertised aphrodisiacs. However, the discussion acknowledges a few supplements with some promising, albeit often limited or mixed, scientific evidence.
4. Prescription ED Medications as a Preferred and Proven Option: The forum consistently points towards FDA-approved prescription drugs like Cialis, Viagra, and Levitra as the most effective and reliable treatments for ED. It also highlights that many "all-natural" supplements are illegally spiked with these very pharmaceutical ingredients.
5. Importance of Physician Consultation and Caution: Throughout the discussion, there's a strong emphasis on the necessity of consulting a doctor before using any herbal remedies or dietary supplements, especially given potential interactions with medications and pre-existing health conditions. Regular monitoring of levels (e.g., zinc) is also advised.
6. Libido vs. Erectile Function: A crucial distinction is made between increased sexual desire (libido) and improved erectile function. As one user notes, Viagra and Cialis "will not work if there is no desire/interest in sex," indicating that while these drugs facilitate erections, they don't necessarily address underlying libido issues. TRT (Testosterone Replacement Therapy) is mentioned as a potential solution for libido, often effectively combined with PDE5 inhibitors for erection quality.

II. Most Important Ideas/Facts & Supporting Quotes​

• Regulatory Landscape:
• "Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products."
• "Most companies make a lot of unsubstantiated claims as long as they have a tiny sentence on their label that says ‘this statement has not been reviewed by the FDA’."
• The FDA has "banned from the market many of these dietary supplements and warns that they contain the same or similar chemical ingredients used in PDE5 inhibitor prescription drugs."
• "All supplements that actually increase testosterone, such as androstenedione, are considered performance-enhancing drugs. They have been banned in the United States."
• Specific Supplements and Their Reported Effects/Risks:
• Yohimbe/Yohimbine:Derived from West African tree bark, marketed as an aphrodisiac.
• Side effects: "nausea, insomnia, nervousness, and dizziness. Large doses... can increase blood pressure and heart rate and may cause kidney failure."
• "It is best to use this under physician supervision."
• Some limited evidence when "studied in combination with L-arginine," but "All the related studies were very small."
• Gamma-Butyrolactone (GBL): "can convert to a chemical that can cause toxic and life-threatening effects, including seizures and even coma."
• Gingko Biloba: "increased risk for bleeding at high doses and interaction with vitamin E, anti-clotting medications, and aspirin and other NSAIDs. Large doses can cause convulsions."
• L-arginine:"may cause gastrointestinal problems. It can also lower blood pressure and change levels of certain chemicals and electrolytes in the body. It may increase the risk for bleeding. Some people have an allergic reaction to it... It may worsen asthma."
• Works by increasing nitric oxide, which helps relax blood vessels for erections.
• "Multiple studies, including randomized controlled trials (RCTs), have shown that L-arginine can improve erectile function, particularly in men with mild to moderate ED."
• "Oral arginine supplements may increase nitric oxide levels in the penis and elsewhere."
• "L-arginine has been advertised as 'natural Viagra' but there is little evidence that it works."
• "Large doses of L-arginine can activate the herpes virus in those who have been exposed to it."
• Dehydroepiandrosterone (DHEA): "Studies show inconclusive results in its treatment for erectile dysfunction. DHEA may interact dangerously with other medications." Prohormones like DHEA "do not produce either anabolic or ergogenic effects in men."
• Spanish Fly (Cantharides): "can be particularly harmful. It irritates the urinary and genital tract and can cause infection, scarring, and burning of the mouth and throat. In some cases, it can be life threatening."
• Korean Red Ginseng (Panax Ginseng): "Two double-blind, placebo-controlled trials... found evidence that Korean red ginseng may improve erectile function when compared with placebo." "Meta-analyses and systematic reviews have found it to be effective in improving ED symptoms, though more rigorous studies are needed."
• Carnitine (Propionyl-l-carnitine & Acetyl-l-carnitine): "both carnitine and testosterone improved erectile function." Propionyl-l-carnitine "enhanced the effectiveness of sildenafil (Viagra) in a small group of men with diabetes who were not responding to sildenafil."
• Zinc: "Severe zinc deficiency is known to negatively affect sexual function." "Supplementation with zinc may be helpful for some men." Caution: "You can take too much zinc, so check with your doctor about how much is enough."
• Maca (Lepidium meyenii): "use of maca at 1,500 mg or 3,000 mg increased male sexual desire but no data was shown on the quality of erections." "The claims that it increases testosterone have not been substantiated with data."
• Tribulus Terrestris: "Evidence from clinical trials shows mixed results, but it appears to benefit some men with mild to moderate ED." One study "No changes in testosterone, androstenedione and luteinizing hormone blood levels were observed with either dose."
• Pycnogenol (Pine Bark Extract): "has been shown to improve erectile function when combined with L-arginine in some studies."
• Saffron (Crocus Sativus): "has shown potential benefits for ED in small studies... However, the evidence is limited compared to other supplements."
• Ashwagandha (Withania Somnifera): "may indirectly improve ED by addressing psychological factors such as anxiety and stress. Limited studies support its direct effect on erectile function."
• Vitamins (D, B9/Folic Acid) & Antioxidants (C, E): Low levels linked to ED; supplementation "may help improve endothelial function and blood flow."
• Recommendations and Caveats:
• "Patients should always check with their doctors before using any herbal remedies or dietary supplements."
• "Always consult a healthcare provider before starting any supplement regimen, especially if you have pre-existing health conditions or take medications."
• Regarding prescription ED pills: "I would say the majority of members here at EM take either Cialis, Viagra, or Levitra."
• "The best and safest way to supplement your testosterone is to use approved products under your physician's supervision and care."
• "Be very skeptical about those claims and do not waste your money on them!" (referring to new supplements claiming to increase testosterone or growth hormone).

In summary, while the market is flooded with ED supplements making grand claims, the scientific evidence for most is weak or nonexistent, and many carry significant health risks. A few, like L-arginine and Korean red ginseng, show some promise, but their efficacy is not comparable to prescription medications, and medical supervision is always advised. Lifestyle changes are also highlighted as critical for improving erectile function.






Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from herbal products. Patients should always check with their doctors before using any herbal remedies or dietary supplements.


There is no evidence that any herbal product, vitamin, or dietary supplement can improve erections or sexual performance in men or women. Despite this, many herbs and dietary supplements are marketed as aphrodisiacs. Aphrodisiacs are substances that are claimed to increase sexual drive, performance, or desire. There are several special concerns for people taking alternative remedies for erectile dysfunction.


Yohimbe. Yohimbe is derived from the bark of a West African tree. Side effects include nausea, insomnia, nervousness, and dizziness. Large doses of yohimbe can increase blood pressure and heart rate and may cause kidney failure.
Viramax is a commercial product that contains yohimbine, the active chemical ingredient of yohimbe, and three other herbs: catuaba, muira puama, and maca. It has not been proven to be either effective or safe, and interactions with medications are unknown


Gamma-Butyrolactone (GBL). GBL is found in products marketed for improving sexual function (such as Verve and Jolt). This substance can convert to a chemical that can cause toxic and life-threatening effects, including seizures and even coma.


Gingko Biloba. Although the risks for gingko biloba appear to be low, there is an increased risk for bleeding at high doses and interaction with vitamin E, anti-clotting medications, and aspirin and other NSAIDs. Large doses can cause convulsions. Commercial gingko preparations have also been reported to contain colchicine, a substance that can be harmful in people with kidney or liver problems.


L-arginine (also called arginine). Arginine may cause gastrointestinal problems. It can also lower blood pressure and change levels of certain chemicals and electrolytes in the body. It may increase the risk for bleeding. Some people have an allergic reaction to it, which in some cases may be severe. It may worsen asthma.


Dehydroepiandrosterone (DHEA). DHEA is a supplement related to certain male and female hormones. Studies show inconclusive results in its treatment for erectile dysfunction. DHEA may interact dangerously with other medications.


Spanish Fly. Spanish fly, or cantharides, which is made from dried beetles, is the most widely-touted aphrodisiac but can be particularly harmful. It irritates the urinary and genital tract and can cause infection, scarring, and burning of the mouth and throat. In some cases, it can be life threatening. No one should try any aphrodisiac without consulting a doctor.


Other Dietary Supplements Marketed for Erectile Dysfunction. There are numerous products marketed as "all-natural" dietary supplements and promoted as treatments for erectile dysfunction and sexual enhancement. The FDA has not approved any of these products. In recent years, the FDA has banned from the market many of these dietary supplements and warns that they contain the same or similar chemical ingredients used in PDE5 inhibitor prescription drugs.

1. Are "all-natural" or herbal erection supplements safe and effective for treating ED?​

Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. This lack of regulation means that the safety and effectiveness of these products are often not substantiated. There is no definitive evidence that any herbal product, vitamin, or dietary supplement can reliably improve erections or sexual performance. In fact, many of these "all-natural" products have been found to contain the same or similar chemical ingredients used in prescription ED drugs like Viagra or Cialis, without proper labeling or dosage control, leading to potential health risks. Patients should always consult their doctors before using any herbal remedies or dietary supplements due to the potential for harmful side effects and interactions with other medications.

2. What are some commonly marketed supplements for ED, and what are their associated risks or lack of proven efficacy?​

Several supplements are commonly marketed for ED, but many carry significant risks or have inconclusive evidence:

• Yohimbe/Yohimbine: Derived from West African tree bark, it can cause nausea, insomnia, nervousness, dizziness, increased blood pressure and heart rate, and may lead to kidney failure. Its effectiveness is not well-proven, and it presents significant safety risks.
• Gamma-Butyrolactone (GBL): Found in products like Verve and Jolt, it can convert into a chemical that may cause toxic and life-threatening effects, including seizures and coma.
• Gingko Biloba: While generally low risk, high doses can increase bleeding risk, interact with anti-clotting medications, and may cause convulsions. Some commercial preparations have been found to contain harmful substances like colchicine.
• L-arginine: May cause gastrointestinal issues, lower blood pressure, and alter electrolyte levels. It can also increase bleeding risk, cause allergic reactions (some severe), and worsen asthma. It may activate the herpes virus in those exposed. While it aids in nitric oxide production, studies show mixed results for ED, and it's unlikely to help if ED is due to factors other than low nitric oxide.
• Dehydroepiandrosterone (DHEA): A supplement related to hormones, studies show inconclusive results for ED treatment. It can also interact dangerously with other medications. Prohormones like DHEA were banned for sale without a prescription in the US due to safety concerns and lack of proven anabolic or ergogenic effects.
• Spanish Fly (cantharides): Made from dried beetles, it's highly dangerous, irritating the urinary and genital tract, causing infection, scarring, burning, and can be life-threatening.
• Maca: While one small human study showed an increase in male sexual desire, there's no data on the quality of erections, and claims of increased testosterone are unsubstantiated.
• Tribulus Terrestris: Though traditionally used, clinical studies have shown mixed results for ED, and some studies indicate no change in testosterone levels.

3. Are there any natural supplements that show more promising evidence for improving erectile function?​

Yes, some natural supplements have shown more promising, albeit often limited, evidence in scientific studies:

• L-Arginine: As an amino acid that boosts nitric oxide production, it can improve blood flow essential for erections. Multiple studies indicate it can help, particularly in mild to moderate ED. However, caution is advised due to potential side effects and interactions.
• Panax Ginseng (Red Ginseng): Often called "herbal Viagra," it may relax smooth muscle and improve penile blood flow. Meta-analyses suggest it can be effective for ED symptoms, but more rigorous studies are needed.
• Pycnogenol (Pine Bark Extract): When combined with L-arginine, some studies show it can improve erectile function by enhancing nitric oxide production and acting as an antioxidant.
• Tribulus Terrestris: While evidence is mixed, some studies suggest it may benefit men with mild to moderate ED, possibly by increasing nitric oxide and testosterone levels.
• Saffron (Crocus Sativus): Small studies suggest potential benefits for ED due to its antioxidant properties, though evidence is limited.
• Withania Somnifera (Ashwagandha): Primarily known for stress reduction, it may indirectly improve ED by alleviating psychological factors like anxiety, with limited direct evidence on erectile function itself.

4. How does L-arginine work, and what are the considerations for its use?​

L-arginine is an amino acid crucial for the body's production of nitric oxide. Nitric oxide helps relax blood vessels, which is vital for achieving an erection. Drugs like Viagra work by increasing the body's sensitivity to this natural rise in nitric oxide during sexual excitement. The idea behind L-arginine supplementation is to raise nitric oxide levels.

While some small studies show it can improve sexual performance, particularly in men with low nitric oxide levels causing their ED, other studies have found no benefit. The discrepancy might be due to significant differences in dosage and treatment duration.

Considerations:

• Large doses may be required (e.g., 5 grams daily, equivalent to 10 capsules of 500mg each).
• It may activate the herpes virus in those who have been exposed.
• Side effects can include gastrointestinal problems, lowered blood pressure, changes in chemical/electrolyte levels, increased bleeding risk, and allergic reactions (potentially severe).
• It may worsen asthma.
• It's unlikely to help if ED is due to factors other than low nitric oxide levels, as erectile dysfunction is complex.

5. Why are most claims about "testosterone-enhancing" supplements unreliable?​

Most claims about "testosterone-enhancing" supplements are unreliable because they are largely unregulated by the FDA. Companies can make unsubstantiated claims as long as they include a disclaimer. Prohormones like androstenedione and DHEA, once heavily marketed, have been classified as controlled substances and banned for sale without a prescription due to safety concerns and a lack of evidence. Research consistently indicates that these prohormone supplements do not produce significant anabolic (muscle-building) or ergogenic (performance-enhancing) effects in men, and they can pose risks like liver problems. New supplements constantly appear, but consumers should be highly skeptical of claims to increase natural testosterone or growth hormone production. The safest and most effective way to supplement testosterone is under a physician's supervision using approved products.

6. What role do prescription medications like Viagra and Cialis play in ED treatment compared to supplements?​

Prescription medications such as Viagra (sildenafil), Cialis (tadalafil), and Levitra are widely used and often preferred by members for treating ED. These are PDE5 inhibitors, meaning they work by increasing the body's sensitivity to nitric oxide, which helps relax blood vessels and improve blood flow to the penis when a man is sexually excited.

Unlike unregulated supplements, these drugs are FDA-approved, meaning their efficacy and safety have been rigorously tested. While supplements like L-arginine aim to increase nitric oxide levels, PDE5 inhibitors work more directly on the physiological response. It's important to note that even these prescription drugs require sexual desire or interest to be effective; they do not create libido. Many ED cases require a combination approach, such as Testosterone Replacement Therapy (TRT) to address libido, alongside a PDE5 inhibitor for erections.

7. What general advice should someone follow when considering supplements for ED?​

When considering supplements for ED, it's crucial to follow general precautions:

• Consult a doctor: Always check with your doctor before using any herbal remedies or dietary supplements, especially if you have pre-existing health conditions or are taking other medications, as supplements can have harmful side effects and interact dangerously with drugs.
• FDA Regulation: Be aware that most herbal remedies and dietary supplements are not FDA-approved, meaning their claims of efficacy and safety are often unsubstantiated.
• Skepticism about "all-natural" claims: Many "all-natural" products have been found to contain unlisted pharmaceutical ingredients (like those in Viagra or Cialis) and have been banned by the FDA.
• Dosage and Potency: Due to lack of regulation, the potency of supplements can vary widely between manufacturers, making it difficult to verify their effects.
• Focus on underlying causes: ED is a complex condition with many potential causes (chemical, psychological, cardiovascular, etc.). Supplements alone are unlikely to be a universal fix and do not replace addressing underlying medical conditions or lifestyle factors.
• Consider lifestyle changes: Regular exercise, stress management, and a healthy diet are crucial for improving erectile function and overall health.

8. Besides specific supplements, what other factors can impact erectile function, and how can they be addressed?​

Erectile dysfunction is a complex issue influenced by various factors beyond specific supplements. These include:

• Nitric Oxide Levels: Foods like arugula and beets, as well as supplements like L-citrulline malate (which converts to L-arginine), can help naturally boost nitric oxide levels, improving blood flow.
• Hormonal Balance: Low testosterone (Low T) can impact libido, and while testosterone replacement therapy (TRT) can increase desire, it may not always resolve erection issues on its own, often requiring combination with PDE5 inhibitors. Prohormones like DHEA are not effective or safe for this purpose.
• Psychological Factors: Stress and anxiety can significantly affect erectile function. Supplements like Ashwagandha, known for stress-reducing properties, might indirectly help by addressing these psychological barriers. However, managing stress through lifestyle changes is also vital.
• Cardiovascular Health: ED is often linked to underlying cardiovascular issues, as healthy blood flow is essential for erections. Conditions like high blood pressure, elevated homocysteine levels (addressed by folic acid), and low Vitamin D can contribute to ED. Improving overall cardiovascular health through diet, exercise, and medical management is crucial.
• Other Deficiencies: Severe zinc deficiency can negatively affect sexual function and libido, and mild deficiency is common. However, zinc supplementation should be discussed with a doctor to avoid excessive intake.
• Lifestyle: Regular exercise and a healthy diet are fundamental for improving blood flow and overall health, which directly impacts erectile function.
• Underlying Medical Conditions: Conditions like diabetes can lead to ED, and addressing these primary health issues is paramount for improving erectile function.

 

From the book Testosterone: A Man's Guide http://smile.amazon.com/Testosteron...=1418263137&sr=8-1&keywords=testosterone+book


Supplements That Claim to Improve Sexual
Function and/or Testosterone

Many people either don't trust big drug companies or they prefer the idea of using products that they see as “natural” or “herbal”. Therefore I'm going to address a few of these. Please keep in mind a general rule about supplements: They are not regulated by the FDA. Most companies make a lot of unsubstantiated claims as long as they have a tiny sentence on their label that says “this statement has not been reviewed by the FDA”. Lack of regulation leads to a wide range in potency of the product between manufacturers (one reason it can make some studies hard to verify).ConsumerLabs.org is a good resource since they test supplements to determine who is lying about their ingredients, but you need to have a paid subscription to the site.

Testosterone prohormones such as androstenedione, androstenediol, and dehydroepiandrosterone (DHEA) have been heavily marketed as testosterone-enhancing and muscle-building nutritional supplements for the past decade. Concerns over the safety of prohormone supplement use prompted the United States Food and Drug Administration to call for a ban on androstenedione sales, and Congress passed the Anabolic Steroid Control Act of 2004, which classifies androstenedione and 17 other steroids as controlled substances. As of January 2005, these substances cannot be sold without prescription. Contrary to marketing claims, research to date indicates that the use of prohormone nutritional supplements (DHEA, androstenedione, androstenediol, and other steroid hormone supplements) does not produce either anabolic or ergogenic effects in men.

Korean red ginseng

Two double-blind, placebo-controlled trials, involving a total of about
135 people found evidence that Korean red ginseng may improve erectile function when compared with placebo. A dose of 900 mg was given three times daily and the study period was 8 weeks.
In an analysis combining the results of six controlled trials, researchers
found some evidence supporting the benefits of Korean red ginseng. There are doubts about this conclusion as these studies were small size and non- validated.

L-arginine

L-arginine is an amino acid with many functions in the body. One of these is its role in the production of nitric oxide which helps relax blood vessels. This relaxation is essential in the development of an erection. Drugs like Viagra increase the body's sensitivity to the natural rise in nitric oxide that occurs when we get sexually excited. Another approach might be to raise nitric oxide levels, which led to the idea of trying L-arginine.
Oral arginine supplements may increase nitric oxide levels in the penis and elsewhere. The main data that generated some interest in the use of arginine for erectile dysfunction came from a small double-blind trial in which 50 men with erectile dysfunction received either 5 g of L-arginine or placebo daily for six weeks (NOTE: a capsule contains 500 mg, so 10 capsules a day!). More men in the treated group experienced improvement in sexual performance than in the placebo group. However, a double-blind crossover study of 32 men found no benefit with 1,500 mg of arginine given daily for 17 days. The significant difference in dose and shorter course of treatment may explain the discrepancy between these two trials.
L-arginine has been advertised as “natural Viagra” but there is little evidence that it works. Drugs based on raising nitric oxide levels in the penis have not worked out for pharmaceutical developers; the body seems to adjust to the higher levels and maintain the same level of response.
Arginine supplementation appears to work only in those whose erectile dysfunction is due to low nitric oxide levels. In other words, arginine would be unlikely to help those whose decreased libido is due to factors other than low NO levels. Remember, erectile dysfunction is a complex syndrome and may be due to many different factors, both chemical and psychological.
NOTE: Large doses of L-arginine can activate the herpes virus in those who have been exposed to it. You may want to take medication for herpes treatment if you decide to use this supplement. L-arginine is also commonly used in bodybuilding supplements since it can cause transient increases in growth hormone.


Yohimbine and yohimbe

Yohimbine HCl is an indole alkaloid found in the bark of the Pausinystalia yohimbe tree. Yohimbe bark has been used in Africa for centuries as an aphrodisiac. It is available as a supplement but is also available by prescription in the United States under the trade-name Yocon. It too helps with erections by relaxing blood vessels in the penis.
Yohimbine has been studied in combination with L-arginine. One study of 45 men found that one-time use of this combination therapy an hour or two before intercourse improved erectile function in those with only moderate erectile dysfunction. Arginine and yohimbine were both taken at a dose of 6 g, which would require a lot of capsules (if taken in powder form a tea spoon has 5 g). All the related studies were very small. I doubt that there are future larger studies planned since we now have effective erectile dysfunction drugs that work.
NOTE: Yohimbine (and yohimbe) present a number of safety risks related to increased heart rate, blood pressure, insomnia, anxiety, and liver/ kidney dysfunction. It is best to use this under physician supervision.


Carnitine is a compound that helps transport fatty acids for the generation of metabolic energy. In addition to its apparent benefit for diabetes, the heart and affecting bone mass it may have benefit with erectile dysfunction. Propionyl-l-carnitine at 2 g/day plus acetyl-l-carnitine also at 2 g/day and testosterone (testosterone undecanoate 160 mg/week) were separately compared with placebo. The results indicated that both carnitine and testosterone improved erectile function; however, while testosterone significantly increased prostate volume, carnitine did not. Other studies seem to indicate that propionyl-l-carnitine at 2 g/day enhanced the effectiveness of sildenafil (Viagra) in a small group of men with diabetes who were not responding to sildenafil on at least eight occasions.



Zinc

Zinc is a trace mineral that is second only to iron in the body. Zinc is involved in many physiological processes in the body such as wound repair, proper functioning of the immune system, cell division, cell growth, proper taste and smell sensation. This important mineral also plays a role in the proper metabolism of carbohydrates and for normal childhood growth and sexual development. Men who are deficient in zinc may have an issue with fertility and libido, while women who are deficient in zinc may have an upset menstrual cycle.
Severe zinc deficiency is known to negatively affect sexual function. Since marginal zinc deficiency is relatively common, it is logical to suppose that supplementation with zinc may be helpful for some men. This hypothesis has only been studied in men receiving kidney dialysis but the results were promising. You can take too much zinc, so check with your doctor about how much is enough.
NOTE: I take 50 mg of zinc plus 3 mg of copper a day to support my immune system. Zinc can lower copper, which is also important for the immune system. I take a product made by Jarrow that combines the two. But zinc does not increase testosterone, but can help support testosterone production.

Maca

The herb maca (Lepidium meyenii) is another supplement advertised as “herbal Viagra.” In one study of rats, maca enhanced male sexual function. For those of you who aren't rats, there is one published human trial. In this small, 12-week, double-blind, placebo-controlled study, use of maca at 1,500 mg or 3,000 mg increased male sexual desire but no data was shown on the quality of erections. The claims that it increases testosterone have not been substantiated with data.

Tribulus Terrestris

Tribulus terrestris L. (Zygophyllaceae) have been used as an aphrodisiac both in the Indian and Chinese traditional systems of medicine. Administration of Tribulus terrestris extract (TT) increased sexual behavior and intracavernous pressure both in normal and castrated rats and these effects were probably due to the androgen increasing property of TT.
In a study done in Bulgaria, twenty-one healthy young 20–36 years old men were randomly separated into three groups—two experimental (each n = 7) and a control (placebo) one (n = 7). The experimental groups were named TT1 and TT2 and the subjects were assigned to consume 20 and 10 mg/kg body weight per day of Tribulus terrestris extract, respectively, separated into three daily intakes for 4 weeks. No changes in testosterone, androstenedione and luteinizing hormone blood levels were observed with either dose.

Other Herbs

There are other herbs that have been promoted as improving sexual function in men. Among these are Ashwagandha, Avena sativa (oat straw), eleutherococcus (the so-called Siberian ginseng), L-citrulline, Macuna pruriens, molybdenum, muira puama or potency wood (you have to love the name), pygeum, Polypodium vulgare, Rhodiola rosea, saw palmetto, schisandra, suma, traditional Chinese herbal medicine, and deer or antelope velvet antle. There are no well-designed, controlled scientific studies that support any of those claims.

Many herbal supplements that claim to improve sexual function have been found to contain Viagra or Cialis purchased in China at cheaper prices. The FDA has stopped those companies from selling them but many keep reappearing in the unregulated supplement market.

All supplements that actually increase testosterone, such as androstenedione, are considered performance-enhancing drugs. They have been banned in the United States. This is just as well as they only increased testosterone for a few hours and had the potential to cause liver problems. New supplements keep appearing on the market and claim to increase the body's production of testosterone or growth hormone. Be very skeptical about those claims and do not waste your money on them!

The best and safest way to supplement your testosterone is to use approved products under your physician's supervision and care.

 

Maybe Zink isn´t so good after all? http://www.peaktestosterone.com/Zinc_Dangers.aspx

 

Tommy, sounds like we must be careful when supplementing, don't overdo it and get our levels checked.

 

Tommy, sounds like we must be careful when supplementing, don't overdo it and get our levels checked.

And -always - let your doctor know which supplements, and their respective strength, you are taking.

 

If you want to check for fake and dangerous tongkat ali, try ahelu.com.

 

Where to find syringes, ED drugs, supplements, etc

 

L-Citrulline DL-malate (2:1) has worked well for me.

 

Do you recommend any pill for ED?

 

Do you recommend any pill for ED?

I would say the majority of members here at EM take either Cialis, Viagra, or Levitra. It comes down to personal preference, cost, toleration of side effects.

 

Do you recommend any pill for ED?

Get some kind kind of starter pack from a foreign pharmacy that includes a variety and see what works. I like low dose cialis,5mg daily, and occasionally viagra when I know I am going to have sex. Viagra works the best for me, but needs to be timed around meals and has a shorter window of efficacy. Viagra can be dissolved under the tongue to get around the meal timing issue.

If your heart and cardiac signs are good, you'll be fine. The over the counter herbals work entirely due to placebo. All the macho sounding names- testo, alpha testo, alpha gen, etc and the fake testimonials are BS. Foreign pharmacies have legitimate products. I use All Day Chemist, an Indian source and prefer their products that are made by Cooper Pharma.

 

interesting never heard of cooper pharma myself

 

Kamagra works best for me. In the form of a tablet or jelly.

 

I take maca root, a 000 pill in the morning, and at night. I buy the powder and capsules and make myself. After a a week, libido effectively increased 2-3 times. Depending on the source of the problem of your erection, results may widely vary.

 

Just to chime in....

I have tried Viagra, Cialis, and some other ones (dr samples) and have found out that they will not work if there is no desire/interest in sex.

 

Just to chime in....

I have tried Viagra, Cialis, and some other ones (dr samples) and have found out that they will not work if there is no desire/interest in sex.

Yes, they will not. No desire, no erection. Libido is another issue. TRT can increase libido, but not necessarily your erections, thus TRT and a pde5 is a great combo. I wouldn't want more libido if I did not have an outlet for it.

 

I like agmatine sulphate .

 

FDA Warns Amazon Over Supplements Containing Erectile Dysfunction Drugs

Agency bought and tested products that were found to contain tadalafil and sildenafil

www.medpagetoday.com

 

Several supplements have been studied for their potential to improve erectile function, with varying levels of evidence supporting their efficacy. Below is a summary of the most promising supplements for erectile dysfunction (ED) based on scientific research:

Supplements with Strong Evidence​

1. L-Arginine:
   • L-arginine is an amino acid that increases nitric oxide production, which helps relax blood vessels and improve blood flow, a critical factor for erections.
   • Multiple studies, including randomized controlled trials (RCTs), have shown that L-arginine can improve erectile function, particularly in men with mild to moderate ED
     1
     4
     9
     .
   • It is generally safe but should be avoided by individuals with heart disease or those taking certain medications
     9
     .
2. Panax Ginseng (Red Ginseng):
   • Often referred to as "herbal Viagra," Panax ginseng contains ginsenosides, compounds that may relax smooth muscle and improve blood flow to the penis.
   • Meta-analyses and systematic reviews have found it to be effective in improving ED symptoms, though more rigorous studies are needed
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3. Pycnogenol (Pine Bark Extract):
   • Pycnogenol has antioxidant properties and has been shown to improve erectile function when combined with L-arginine in some studies.
   • It significantly improved International Index of Erectile Function (IIEF) scores in men with moderate ED
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4. Tribulus Terrestris:
   • This plant extract has been traditionally used to enhance male sexual health and may increase nitric oxide production and testosterone levels.
   • Evidence from clinical trials shows mixed results, but it appears to benefit some men with mild to moderate ED
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5. Saffron (Crocus Sativus):
   • Saffron has shown potential benefits for ED in small studies, likely due to its antioxidant properties. However, the evidence is limited compared to other supplements
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6. Withania Somnifera (Ashwagandha):
   • Known for its stress-reducing properties, ashwagandha may indirectly improve ED by addressing psychological factors such as anxiety and stress. Limited studies support its direct effect on erectile function
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Vitamins and Antioxidants​

1. Vitamin D:
   • Low levels of vitamin D have been linked to ED. Supplementation may help improve endothelial function and blood flow
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2. Folic Acid (Vitamin B9):
   • Folic acid may lower homocysteine levels, which are often elevated in men with ED, potentially improving vascular health and erections
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3. Antioxidants:
   • Antioxidants like vitamin C and E can enhance nitric oxide production and protect blood vessels from oxidative stress, which may benefit men with ED
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Considerations​

• While these supplements show promise, they are not a substitute for medical treatments like phosphodiesterase inhibitors (e.g., Viagra) or addressing underlying causes of ED such as cardiovascular disease or diabetes.
• Supplements can interact with medications or exacerbate certain conditions. For example, yohimbine, another supplement sometimes used for ED, has significant side effects and is not recommended in many regions
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• Lifestyle changes such as regular exercise, stress management, and a healthy diet often play a critical role in improving erectile function.

Always consult a healthcare provider before starting any supplement regimen, especially if you have pre-existing health conditions or take medications.

 

Foods like Arugula, beets, supps like l citrulline malate, exercise can all help you get that Nitric oxide back to younger levels!