The search usually begins after one bad night
An erection fades, the man worries about it, and by the next afternoon he is reading about ginseng, beet juice and something called horny goat weed. Nobody wants one awkward experience to become a medical problem.
One bad night usually is not one. Poor sleep, too much alcohol, stress or merely not feeling particularly aroused can affect an erection. When it keeps happening for a few weeks, though, it is worth looking past the supplement adverts.
Erections depend greatly on circulation, which makes the useful “natural remedies ” somewhat predictable: move more, don’t smoke, sleep properly and get your blood pressure, cholesterol and blood sugar under control
Not glamorous, but true.
Work on the blood flow first
Aerobic exercise has better evidence than any herb sold for ED. Walking briskly, cycling or swimming improves circulation and can help the body manage blood sugar and blood pressure. The routine doesn’t need to be dramatic; thirty minutes on most days is a sensible start. A man who has spent three years sitting at a desk does not necessarily need to celebrate his health choice with knee injury.
Add some strength training. It helps maintain muscle and makes weight loss easier in the event of excess weight
Weight around the abdomen is linked with diabetes, sleep apnea, lower testosterone and vascular disease. Losing some of it is likely to improve erections, though the result takes time.
Eat in a way that would also make sense for the heart: vegetables, beans, fruit, fish, nuts, olive oil and fewer highly processed meals. Pomegranate, watermelon and ginger are fine foods. None work like a dose of PDE5 inhibitor, however.
Smoking is another obvious target. Nicotine constricts blood vessels, while years of smoke exposure damage their lining. Quitting won’t repair every case of ED, but continuing to smoke is unlikely to help.
Alcohol catches men out because it lowers anxiety before it lowers erection quality. One drink and five drinks are very different experiments. If the problem is mostly after nights out, try changing the drinking before changing the supplement.
Check the bedroom conditions
Some erection problems have less to do with damaged blood vessels than with what’s going on in the man’s head
After losing an erection once, he expects it to happen again. During sex, he keeps checking the firmness. Every small change feels like confirmation. Adrenaline rises, and blood flow becomes less co-operative.
This is a physical response to anxiety, not an imaginary condition
Morning erections can give a clue. If they remain firm and masturbation is usually fine, but erections disappear with a partner, performance pressure may be playing a large role.
The practical fix may be slower sex, more stimulation and less urgency to penetrate. A conversation with the partner can take away some of the sense that an erection is being graded.
Sex therapy is useful when the pattern has become established. It sounds more dramatic than it usually is. Much of the work involves changing the attention, expectations and communication.
Sleep belongs here too. A tired man may have less desire and weaker erections. Loud snoring, choking during sleep and morning headaches suggest possible sleep apnea. Treating that problem may help energies and sexual function while reducing heart risk.
Pelvic-floor training is worth trying. The muscles that stop urine also help keep blood inside the penis. Tighten them for a few seconds, then relax completely. Repeat regularly, without clenching the stomach or buttocks.
Do not practise by trying to stop urine midstream. Use this only to identify the muscles.
About the capsules
Panax ginseng has shown a possible mediocre benefit in some studies. “Modest” is the word sellers tend to leave out. Products differ in extract, dose and quality, so the bottle in a shop doesn’t necessarily have much to do with the one used in a clinical trial.
Ginseng can upset the stomach, disrupt sleep and interact with diabetes medicine or blood thinners.
L-arginine is involved in nitric oxide production, a process needed for blood vessel relaxation. Some men may benefit, particularly at larger doses or when it’s used in combination formulas.
It can also cause diarrhea, cramps and low blood pressure. Anyone taking nitrates or several blood pressure medicines should not experiment without talking to a clinician
Correcting low vitamin D or zinc is reasonable. Taking excessive amounts if there’s no deficiency is unlikely to improve erections. Zinc can cause copper deficiency when overused, which is a fairly poor trade for an unproven benefit.
Our guide to ED supplements covers the common products in more detail.
Yohimbe is not one I would recommend. The active dose is often unpredictable, and side effects may include panic, rapid heartbeat, high blood pressure and seizures.
The evidence for tribulus, maca and horny goat weed remains weak. Honey packs and gas station sex pills are more worrying. Regulators have repeatedly found hidden sildenafil- or tadalafil-like ingredients in supposedly natural products.
That becomes dangerous when the user takes nitroglycerin or another nitrate for chest pain. He thinks he swallowed herbs, and his blood pressure reacts like he swallowed an ED drug.
Persistent ED should be checked, particularly if morning erections have also died. Diabetes and cardiovascular disease can first become noticeable through erection problems. A medication review is also vital – antidepressants, prostate drugs and some blood pressure tablets may be involved.
If lifestyle changes aren’t enough, established erectile dysfunction treatments include prescription tablets, vacuum devices and other options.
There is no special virtue in refusing medicine. Start with the sleep, movement, weight, smoking and stress because they are good for the whole body. If the erection still needs help, treat it properly rather than turning the kitchen cupboard into a laboratory.
