Natural Remedies for Erectile Dysfunction
Experts give their take on remedies such as ginseng, acupuncture, and pomegranate juice.
By David Freeman
WebMD Feature
Reviewed by Louise Chang, MD
From acupuncture to arginine, from ginseng to pomegranate juice, men have tried all
sorts of natural remedies for erectile dysfunction (ED) -- which doctors define as the
repeated inability to get or maintain an erection firm enough for sexual intercourse. But
are these alternative remedies safe? Do they really work?
The scientific evidence to support the use of natural remedies for impotence is sketchy;
many of the studies that seem to give the remedies a thumbs-up were so poorly designed
that their findings are suspect.
"Just because there is evidence doesn't mean it's good evidence," says Andrew
McCullough, MD, associate professor of clinical urology at New York University
Langone Medical Center in New York City, and one of the original clinical investigators
for the ED drug Viagra (sildenafil). "And before men with ED start down the
naturopathic route, it's smart to make sure that there isn't some underlying medical
condition that needs to be corrected."
That's good advice. An estimated 30 million American men have erectile dysfunction,
and seven out of 10 cases are caused by a potentially deadly condition like
atherosclerosis, kidney disease, vascular disease, neurological disease, or diabetes. ED
can also be caused by certain medications, surgical injury, and psychological problems.
Experts who spoke with WebMD agree that treating erectile dysfunction on your own,
without consulting a doctor, is a dangerous game. "If you have ED, the first thing you
need is a diagnosis," says impotence expert Steven Lamm, MD, a New York City
internist and the author of The Hardness Factor (Harper Collins) and other books on
male sexual health. He says men with severe erectile dysfunction probably need one of
the prescription ED drugs, which include Levitra (vardenafil) and Cialis (tadalafil) as
well as Viagra. But, he says, mild ED -- including the feeling that "you're not as hard as
you could be" -- often responds to natural remedies. But which remedies? Here's a look at
the evidence for and against six of the most popular ones:
Acupuncture. Though acupuncture has been used to treat male sexual problems for
centuries, the scientific evidence to support its use for erectile dysfunction is equivocal at
best. In 2009 South Korean scientists conducted a systematic review of studies on
acupuncture for ED. They found major design flaws in all of the studies, concluding that
"the evidence is insufficient to suggest that acupuncture is an effective intervention for
treating ED."
Arginine. The amino acid L-arginine, which occurs naturally in food, boosts the body's
production of nitric oxide, a compound that facilitates erections by dilating blood vessels
in the penis. Studies examining L-arginine's effectiveness against impotence have yielded
mixed results. A 1999 trial published in the online journal BJU International found that
high doses of L-arginine can help improve sexual function, but only in men with
abnormal nitric oxide metabolism, such as that associated with cardiovascular disease. In
another study, published in 2003 in the Journal of Sex & Marital Therapy, Bulgarian
scientists reported that ED sufferers who took L-arginine along with the pine extract
pycnogenol saw major improvements in sexual function with no side effects. Arginine
can be helpful, says Geo Espinosa, ND, director of the Integrative Urological Center at
NYU Langone Medical Center. Espinosa says that men with known cardiovascular
problems should take it only with a doctor's supervision; L-arginine can interact with
some medications.
DHEA. Testosterone is essential for a healthy libido and normal sexual function, and
erectile dysfunction sufferers known to have low testosterone improve when placed on
prescription testosterone replacement therapy. Similarly, studies have shown that taking
over-the-counter supplements containing DHEA, a hormone that the body converts to
testosterone and estrogen, can help alleviate some cases of ED. But DHEA can cause
problems, including suppression of pituitary function, and its long-term safety is
unknown, says McCullough. For this reason, many experts discourage use of the
supplements.
Ginseng, Panax. Korean red ginseng has long been used to stimulate male sexual
function, but few studies have tried systematically to confirm its benefits. In one 2002
study involving 45 men with significant ED, the herb helped alleviate symptoms of
erectile dysfunction and brought "enhanced penile tip rigidity." Experts aren't sure how
ginseng might work, though it's thought to promote nitric oxide synthesis. "I would
recommend ginseng [for men with ED]," says Espinosa. Discuss with your doctor before
taking it since ginseng can interact with drugs you may already be taking and cause
allergic reactions.
Pomegranate juice. Drinking antioxidant-rich pomegranate juice has been shown to
have numerous health benefits, including a reduced risk for heart disease and high blood
pressure. Does pomegranate juice also protect against ED? No proof exists, but results of
a study published in 2007 were promising. The authors of this small-scale pilot study
called for additional research, saying that larger-scale studies might prove pomegranate
juice's effectiveness against erectile dysfunction. "I tell my patients to drink it," says
Espinosa. "It could help ED, and even if it doesn't, it has other health benefits."
Yohimbe. Before Viagra and the other prescription erectile dysfunction drugs became
available, doctors sometimes prescribed a derivative of the herb yohimbe (yohimbine
hydrochloride) to their patients suffering from ED. But experts say the medication is not
particularly effective, and it can cause jitteriness and other problems. "It's not a great
drug," says McCullough. "And I suspect the herb is not as potent as the pharmaceutical
version." What's more, evidence shows that yohimbe is associated with high blood
pressure, anxiety, headache, and other health problems. Experts discourage its use.
Horny Goat Weed. Horny goat weed and related herbs have purportedly been treatments
for sexual dysfunction for years. Italian researchers found that the main compound in
horny goat weed, called icariin, acted in a similar way as drugs like Viagra.
Ginkgo biloba. Known primarily as a treatment for cognitive decline, ginkgo has also
been used to treat erectile dysfunction -- especially cases caused by the use of certain
antidepressant medications. But the evidence isn't very convincing. One 1998 study
published in the Journal of Sex and Marital Therapy found that it did work. But a more
rigorous study, published in Human Pharmacology in 2002, failed to replicate this
finding. "Ginkgo has come out of fashion in the past few years," says Ronald Tamler,
MD, assistant professor of medicine and co-director of the men's health program at
Mount Sinai Medical Center in New York City. "That's because it doesn't do much. I can
say that in my practice, I have not seen ginkgo work -- ever."
Vimax Ingredients:
Dodder seed (seman Cuscutae)
Dodder seed is known as a kidney yang tonic and is widely used to remedy
sexual problems like impotence, nocturnal emission, premature ejaculation.
Saw Palmetto Powder
Known to stimulate a low libido in males and to increase sexual energy.
BPH found that an extract of saw palmetto reduced prostate size by 13%.
Epimedium Sagittatum 4:1 Ext (bark)
Chinese top medical doctors report that horny goat weed boosts libido and
improves erectile function.
Hawthorne Berry (Fructus Crataegi)
Hawthorn helps to protect against heart disease and to control high blood
pressure and high cholesterol.
Gingko Biloba Pwd
The action of the herb may help support the brain, central nervous system
and impotence. Ginkgo improves peripheral circulation and oxygenation.
Inosine Anhydrous
Is a natural substance that can help increase the body’s ability to carry
oxygen, without effecting its uptake in the lungs, so it can work harder,
stronger. This is testament to it’s benefits during sexual activity.
Panax Ginseng (root)
Ginseng stimulates both physical and mental activity and has a positive effect
on the sex glands. The herb helps infertility, and premature ejaculation. It
tends to build blood and sperm.
Avena Sativa Ext 10:1 (Oat Straw Ext)
Pharmaceutical erection enhancers without the dangerous side effects. Also
known as Oats Milky Seed or Wild Oats, Avena Sativa is used to stimulate
both men and women quickly and effectively.
Tribulus Terestris Powder
T. terrestris is now being promoted as a booster for the purpose of increasing
sex drive. Its use for this purpose originated from a Bulgarian study conducted
in the 1970s, which found effects on free testosterone and lutenizing hormone
in men belonging to infertile couples.
Cayenne Pepper
Used to ward off disease and equalize blood circulation. It may also prevent
strokes and heart attacks by increasing the heart action but not the blood
pressure. It has the ability to rebuild tissue and also helps combat fatigue.
From http://www.naturalhealthbridge.net/articles/MaleHormones.pdf
1. Epimedium sagittatum (leafy herb native to China known as Yin Yang Huo; literally
"horny goat weed," or, "licentious goat."). Sexual stimulant: stimulates adrenals to trigger
hormone secretions, expands the circulatory system, increases the sperm count and semen
density. Also, promoter of kidney health.
2. Tribulus terrestris (herb in Europe, especially Bulgaria, and Orient) This is used to
improve sexual performance (improves duration of erection) and heighten desire/libido
(aphrodisiac). Can stimulate sperm production (spermatogenesis) in infertile men. May
increase testosterone.
3. Muira puama (Ptychopetalum olacoides) - bark and roots from a bush found in Brazil.
Also called "potency wood." Used internally or to bathe genitals (aphrodisiac). Helps
with erectile problems. Use the extract liquid form (where ingredients have been
extracted by heated alcohol; the ground bark or root powder doesn't work).
4. Ashwaganda (Withania somnifera) or "Indian ginseng" - an Ayurvedic herbal. Said to
help with stamina and strength. This will help with adrenal stress chemicals and also with
male hormones and libido. Take 300 mg of the powdered root once or twice a day or take
the tincture about 1/4 to 1/2 teaspoon a day.
5. Schizandra (schizandra chinensis, known in China as Wu Wei Zi): from the berry:
improves libido in women and staying power (erection) in men. Said to quicken reflexes,
stimulate respiration. May promote labor in women. Taken as a fruit: 1200 mg three
times a day. Taken as a capsule extract about 125 mg twice a day.
6. Siberian ginseng root (Eleutherococcus senticosus): General tonic, increases energy,
stamina, vitality. Said to help increase libido and sexual performance. Total of 100 mg.
daily
7. Saw palmetto (Serenoa repens: berry or fruit is active source): shrub sized palm in
Southern US. Relieves prostate problems: excessive urination, dribbling, incomplete
emptying of bladder, sense of heaviness. Saw palmetto works for up to 88%. Clinical
studies show it is better than Proscar and Hytrin Use at least 160 mg twice per day saw
palmetto berry extract (standardized to 85 to 95% fatty acids and sterols). May help
increase libido, virility and performance. (Alternative for prostate enlargement: 100 mg
three times a day of beta-sitosterol.)
8. Ginkgo biloba: increases vascular circulation, including to the penis. Standardized to
24% flavone glycosides, take 40 to 60 mg. three times a day. Watch for possible stomach
or intestinal discomfort, headache or dizziness.
9. Bilberry (Vaccinium myrtillus): rich in anti-oxidants (anthrocyanosides), this herb has
many uses. It increases circulation to the genitals. Take 80 to 160 mg. extract capsule
three times a day (standardized to 25% anthocyanidin).
10. Ginseng (Panax ginseng): Contains ginsenosides. Shown to increase nitric oxide
which relaxes artery walls, increasing blood flow to penis (British Pharmacology, May
1995). Standardized, take 100 mg. once or twice a day. Don't take if you have high blood
pressure, are pregnant; don't take with MAO-inhibiting antidepressants, or blood thinners
(like warfarin). Don't take with caffeine. Take a one-week break after three weeks of use.
11. Androstenedione increases blood levels of testosterone in males ( 300 mg/d): Feb.
2000, JAMA (also females - spray helps with libido prior to intercourse). Increase in
estradiol and estrone as well (DHEA and androstenedione both increase levels of
testosterone in females at 100 mg/d (increased by androstenedione twice as much as by
DHEA).
12. DIM (diindolylmethane - preferred to I3C, indole-3-carbinol): phytonutrient from
cruciferous vegetables of Brassica genus (cabbage, broccoli, cauliflower, brussel
sprouts), with three-day old broccoli sprouts containing the highest content of DIM);
eliminates estrogen by increasing enzyme activity. DIM boosts "good" estrogens (2-
hydroxy), and reduces "bad" estrogens (16-hydroxy and 4-hydroxy) estrones (there are
high 16-hydroxy levels in beast cancer). Benign prostate enlargement and some prostate
cancer may be related to estrogen (not testosterone) buildup.
13. Royal Maca for libido and balancing of hypothalamus. Take per label instructions
(best source:
http://www.wholeworldbotanicals.com/royalmaca.html). It normalizes the hypothalmaus,
pituitary circuit to improve all hormones. Read the worldbotanicals website articles.
14. L-arginine HCl (amino acid): Increases nitric oxide which helps with achieving and
maintaining an erection. Use the powder: one gram in am and one gram in pm
15. Choline citrate powder: 1500 mg (1.5 grams), and, Calcium Pantothenate: 545 mg..
Take these about 30 minutes before sex to help with erection.
16. Avena sativa (wild oats or green oats extract): mentioned in German Pharmacopeia
200 years ago as an aphrodisiac. Increases interest in sex by freeing up testosterone. Take
250 mg per day total dose. Also helps with depression, stress.
17. Damiana (Turnera diffusa): Tonic for nervous system and hormones. Useful for type
of diabetes which is related to insulin insensitivity and decreased testosterone. Increases
libido and performance in men. Total of 50 mg. per day.
18. Conversion of testosterone to dihydrotestosterone (DHT) may result in low
testosterone. Progesterone supplementation may be necessary since it inhibits the
enzyme 5-alpha reductase (enzyme that converts testosterone to DHT). (This is also the
way that saw palmetto works.) DIM (mentioned above) also inhibits the conversion of
testosterone to DHT. DHT contributes to thinning of the hair and prostate enlargement.
19. A good nutritional plan and vitamin supplementation is helpful (zinc, natural vitamin
E, vitamin C, omega 3 fatty-acids, etc.) and should be planned carefully with the help of a
nutritional expert (usually not allopathic physicians who receive virtually no training in
this field).
