How to get erectile dysfunction

How to get erectile dysfunction

Maintain an Erection

Test Testosterone Levels

Help a Partner with Erectile Dysfunction

Treat Erectile Dysfunction

Deal with Sexual Performance Anxiety

Tell if You Have Erectile Dysfunction

How to Cure Erectile Dysfunction: Can Natural Remedies Help?

Cope With Erectile Dysfunction

Tell Your Partner You Have Erectile Dysfunction

Treatment for Erectile Dysfunction

How can I treat erectile dysfunction?

You can work with a health care professional to treat an underlying cause of your erectile dysfunction (ED). Choosing an ED treatment is a personal decision. However, you also may benefit from talking with your partner about which treatment is best for you as a couple.

Lifestyle changes

Your health care professional may suggest that you make lifestyle changes to help reduce or improve ED. You can

You can seek help from a health professional if you have trouble making these changes on your own.

Go to counseling

Your counselor may suggest that you bring your partner to counseling sessions to learn how to support you.

How do doctors treat erectile dysfunction?

Change your medicines

If a medicine you need for another health condition is causing ED, your doctor may suggest a different dose or different medicine. Never stop taking a medicine without speaking with your doctor first. Read about which medicines make it more likely that you’ll develop ED.

Prescribe medicines you take by mouth

A health care professional may prescribe you an oral medicine, or medicine you take by mouth, such as one of the following, to help you get and maintain an erection:

All of these medicines work by relaxing smooth muscles and increasing blood flow in the penis during sexual stimulation. You should not take any of these medicines to treat ED if you are taking nitrates to treat a heart condition. Nitrates widen and relax your blood vessels. The combination can lead to a sudden drop in blood pressure, which may cause you to become faint or dizzy, or fall, leading to possible injuries.

Also talk to your health care professional if you are taking alpha-blockers to treat prostate enlargement. The combination of alpha-blockers and ED medicines also could cause a sudden drop in blood pressure.

A health care professional may prescribe testosterone if you have low levels of this hormone in your blood. Although taking testosterone may help your ED, it is often unhelpful if your ED is caused by circulatory or nerve problems. Taking testosterone also may lead to side effects, including a high red blood cell count and problems urinating.

Testosterone treatment also has not been proven to help ED associated with age-related or late-onset hypogonadism. Do not take testosterone therapy that hasn’t been prescribed by your doctor. Testosterone therapy can affect how your other medicines work and can cause serious side effects.

A health care professional may prescribe you an oral medicine to help you get and maintain an erection.

Prescribe injectable medicines and suppositories

Many men get stronger erections by injecting a medicine called alprostadil into the penis, causing it to become filled with blood. Oral medicines can improve your response to sexual stimulation, but they do not trigger an automatic erection like injectable medicines do.

Instead of injecting a medicine, some men insert a suppository of alprostadil into the urethra. A suppository is a solid piece of medicine that you insert into your body where it dissolves. A health care professional will prescribe a prefilled applicator for you to insert the pellet about an inch into your urethra. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes.

Discuss alternative medicines

Some men say certain alternative medicines taken by mouth can help them get and maintain an erection. However, not all “natural” medicines or supplements are safe. Combinations of certain prescribed and alternative medicines could cause major health problems. To help ensure coordinated and safe care, discuss your use of alternative medicines, including use of vitamin and mineral supplements, with a health care professional. Also, never order a medicine online without talking with your doctor.

To help ensure coordinated and safe care, discuss your use of alternative medicines, including use of vitamin and mineral supplements, with a health care professional.

How will side effects of erectile dysfunction medicines affect me?

ED medicines that you take by mouth, through an injection, or as a pellet in the urethra can have side effects, including a lasting erection known as priapism. Call a health care professional right away if an erection lasts 4 hours or longer.

A small number of men have vision or hearing loss after taking oral ED medicines. Call your health care professional right away if you develop these problems.

Prescribe a vacuum device

A vacuum device causes an erection by pulling blood into the penis. The device has three parts:

The elastic ring maintains the erection during intercourse by preventing blood from flowing back into your body. The elastic ring can remain in place up to 30 minutes. Remove the ring after that time to bring back normal circulation and to prevent skin irritation.

You may find that using a vacuum device requires some practice or adjustment. Using the device may make your penis feel cold or numb and have a purple color. You also may have bruising on your penis. However, the bruises are most often painless and disappear in a few days. Vacuum devices may weaken ejaculation but, in most cases, the devices do not affect the pleasure of climax, or orgasm.

A vacuum device causes an erection by pulling blood into the penis.

Recommend Surgery

For most men, surgery should be a last resort. Talk with your doctor about whether surgery is right for you. A urologist performs surgery at a surgical center or hospital to

Implanted devices. Implanted devices, known as prostheses, can help many men with ED have an erection. Implants are typically placed by a urologist. The two types of devices are

You usually can leave the hospital the day of or day after the surgery. You should be able to use the implant 4 to 6 weeks after the surgery.

Once you have either implant, you must use the device to get an erection. Possible problems with implants include breaking and infection.

Artery reconstruction. Surgery to repair arteries can reverse ED caused by blockages that stop blood flow to the penis. Usually men younger than 30 are the best candidates for this type of surgery.

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

Erectile Dysfunction (ED) Treatment

If you’re suffering with erectile dysfunction, you might feel like the only man in the world with this anxiety inducing problem. But that’s far from the truth.

Statistics state that about 5% of men over 40 years old have total erectile dysfunction, and when it comes to men over 70 the figure rises to 15%. This is an all too common with many causes, and as an anabolic steroid user you could be at higher risk of experiencing ED at a much younger age.

As we will see though, the underlying causes of ED can vary and this condition is often an indication of more serious health issues that may or may not relate to steroid use at all.

Experiencing erectile dysfunction is not only physically frustrating, but can quickly lead to anxiety, depression and relationship problems. Thankfully, it’s now easier than ever to treat ED and you have a range of options at your disposal which can be decided on with your doctor.

In this guide, you’ll learn:

What is Impotence (Erectile Dysfunction)?

Erectile dysfunction is diagnosed as a disorder when a man experiences difficulty or complete inability to obtain or keep an erection, with a three month period being the general medical basis for diagnosing the condition. It is most common in men over 40 years old, but can affect men of any age, especially those with certain risk factors relating to health and lifestyle.

Causes of ED

ED can be caused by either physical or psychological factors – or sometimes both. Erectile function is a complex process that involves many parts of the body including the brain, so when something becomes unbalanced it can lead to partial or complete impotence.

Sometimes, an unknown underlying health problem can be the cause of ED, but there are many reasons why you might start experiencing this very distressing problem. These include:

Mental stress

When you’re dealing with excessive life stress, whether it be work related, relationships, financial or anything else this will have a negative effect on the brain. The brain is a critical part of erectile function, therefore ongoing stress is a common cause of erectile dysfunction.

Cardiovascular

Heart disease, atherosclerosis, high blood pressure and high cholesterol are all risk factors for a man to get erectile dysfunction. Vascular related diseases or disorders can affect how much blood can get to the penis and how long it can stay there, which has a direct impact on erection quality. Some anabolic steroids pose a risk to increasing blood pressure, cholesterol or both. In these cases it is critical to monitor your levels regularly not only to help avoid ED, but for your general health.

Diabetes

Men with diabetes often have decreased levels of testosterone, but that is not the main driver of ED in diabetic men. People with this disease can have abnormal blood supply to the penis, resulting in an inability to gain or keep an erection. When blood sugar levels are not managed correctly by a male diabetic it results in less production of nitric oxide, contributing further to erectile dysfunction.

Obesity

Being very overweight brings with it a host of health problems, so ED can be either a direct or indirect consequence of obesity. Obese men are more likely to have diabetes, high blood pressure and other conditions which are known to cause erectile dysfunction. Being obese can cause blood vessels to become damaged, testosterone to lower, and the body to succumb to increased inflammation – all things which are linked to impotence.

Depression and anxiety

Normal functioning of the penis is as much psychological as it is physical, and men who are suffering from even mild to moderate depression, anxiety or stress can find themselves experiencing erectile dysfunction. Counseling and other psychological therapy can often assist with relieving ED that’s caused solely by anxiety and other mental health related conditions.

Drugs and medications

Many over the counter, prescription and recreational or illicit drugs are known to potentially cause ED. Many medications have side effects that can affect blood circulation, hormone function, the nervous system or mental health; all potentially leading to erectile difficulties. The list of drugs that could contribute to ED is extensive, but includes many blood pressure medications, diuretics, anti-anxiety and anti-depression medications, antihistamines, NSAID’s, and cancer treatment drugs.

Sleeping disorders

Problems with sleep quality can impact all parts of your life, including sexual function. Besides chronic tiredness from lack of sleep, sleep disorders like sleep apnea can negatively impact your testosterone levels and even your oxygen levels. Studies have shown that men with obstructive sleep apnea have a high tendency to report suffering from ED and males with this sleep condition are more likely to suffer from ED than men without sleep apnea.

Anabolic steroids

These can work in several ways to hamper erectile function. We know that some anabolic steroids can cause high blood pressure and high cholesterol, and those two factors can bring about ED, especially in men who might have already had cholesterol or hypertension but wasn’t aware of it.

Depending on the cause of your ED, there are steps every man can take to at least reduce the risk or severity of erectile dysfunction provided there’s not a serious health issue as the cause. Quitting smoking, getting regular exercise and living a healthy lifestyle all reduce the risk of ED, as does limiting alcohol intake and reducing stress.

Keeping your blood pressure, blood sugar and cholesterol levels at a healthy level is perhaps the most critical part of avoiding ED for bodybuilders, as these are aspects which can be negatively affected by a number of the most popular steroids used.

Symptoms of ED

The most obvious symptom of ED is of course the inability to get an erection. This can include not being able to get an erection at all, or not being able to sustain an erection for long enough.

A decrease in sexual desire is another recognized symptom of impotence.

While any of these symptoms are not a cause of concern if they only happen every now and then, it’s when you are experiencing a persistent inability to get or keep an erection that ED becomes a medical concern. Medical professionals consider three months of erectile difficulty as a suitable time period to consider this to be diagnosed as a medical condition.

Some men with ED find that it happened literally overnight, while for others it can be a much more gradual process, with increased erection difficulty being noticed over time until it finally gets to a point where can no longer get an erection at all. When ED is being cause mostly for psychological reasons, such as stress or performance anxiety, you might find it comes and goes and may get better on its own.

It’s important to be aware that ED symptoms can be different depending on what’s causing the problem. Chronic impotence – when it usually begins to happen gradually and gets worse over time without ever getting better – is almost always a sign that there’s a physical underlying cause such as diabetes or cardiovascular conditions.

Psychological related ED tends to be more sporadic, with periods of normal functioning combined with other times where you struggle to get an erection. In some men, it’s a combination of both and only your doctor can give you a proper diagnosis of the real cause of your erectile dysfunction.

When should you speak to your doctor about your ED concerns? This is a potentially embarrassing situation for men, but keep in mind that millions of men have spoken to a doctor about this very issue, and doctors will professionally evaluate your unique situation and medical history.

If your ED is causing anxiety and bringing stress to your relationship, a visit to the doctor and discussion of treatment options is the best way to get on top of the problem as soon as possible.

Types of Erectile Dysfunction Treatments

Phosphodiesterase Type 5 (PDE5) Inhibitors

These drugs are a standard medical treatment for erectile dysfunction and include the famous drug Viagra, amongst others. PDE5 drugs causes dilatation of the blood vessels in the penis. They work by blocking the phosphodiesterase type 5 enzyme.

These drugs increase nitric oxide which brings about relaxation to the penis muscles so that blood is able to flow through the penis better and increase the chances of an erection being achieved.

Sexual stimulation is still needed when you use one of these medications. This is when the release of nitric oxide occurs. In healthy men, this results in an erection, but those needing a PDE5 inhibitor for ED will then rely on the drug to stimulate the release of nitric oxide after stimulation, so that blood can then flow to the penis and an erection can occur.

While they are now very well established, widely used and considered safe for the vast majority of men who are prescribed them, like most medications PDE5 inhibitors come with their potential side effects which you can find out more about below.

There are four commonly prescribed PDE5 inhibitor drugs, with Viagra no doubt being the most familiar. Here is the full list:

All work in a similar core way to enhance nitric oxide so that blood flow to the penis is increased. Nitric oxide is critical in the process of causing the penile muscle to relax so that blood can flow and an erection can be both gained and maintained. Various health conditions (diabetes, high blood pressure) can cause natural nitric oxide function in the body to become impaired, which is then known to result in potential erectile dysfunction.

Nitric oxide, which is normally released from the penis’ nerve endings, allows the blood vessels to dilate so there is increased blood flow in the penis which then of course results in an erection. PDE5 inhibitors have been developed to simulate this natural action in men who struggle to gain or maintain an erection because of inadequate nitric oxide functionality.

The main differences to look for with these drugs is their active life or half life (how long they provide the desired effects for), and the different side effects for each one. All four are established medicines, but as you will see we have one relatively newer option that comes with some benefits over the older drugs.

It is important to point out that, contrary to what is often thought by the general public about these drugs, they are not aphrodisiacs. They don’t cause arousal in men but instead stimulate only the physical aspects of gaining an erection, not the psychological.

All of these medications are long proven to effectively treat erectile dysfunction and are considered safe for men who are not taking nitrate drugs, do not have heart disease and do not have hypotension (very low blood pressure).

Different ED drugs should never be combined, alcohol should be kept to a minimum, and your doctor should know of any other medications you’re taking because PDE5 inhibitors interact with a wide range of other drugs.

Viagra (Sildenafil)

The most famous of all ED drugs is Viagra. It is absorbed very quickly into the bloodstream and takes just one hour to reach its maximum level of concentration in the blood; meaning that Viagra starts working rapidly.

The majority of Viagra users experience no to only mild side effects and due to the drug’s short half life, side effects also disappear within three to five hours as the drug exits the body.

Cialis (Tadalafil)

Cialis has the longest acting effects of all four PDE5 inhibitors (Viagra, Cialis, Levitra and Stendra) at up to 36 hours from a single dose. It also starts working faster than Viagra in most men with effects beginning in as little as 15 minutes after a dose, and before 45 minutes for most people.

Side effects of Cialis are very similar to the other drugs in this category, although one unique downside is the risk of pain in the limbs and this side effect is not known to occur with the other three medications.

Selecting Cialis over Viagra usually comes down to preference for the length of time you wish to enjoy the effects without resorting to multiple doses as would be required with Viagra. Besides ED, Cialis is also used to treat benign prostatic hyperplasia and pulmonary arterial hypertension.

Levitra (Vardenafil)

Levitra has an active life slightly longer than Viagra but still much shorter than Cialis, at anywhere from four to eight hours for most men and noticeable effects should begin within an hour of taking your dose.

Levitra is considered to be much stronger than Viagra and as such is normally taken at lower doses with tablets as low as 2.5mg available for men who might be struggling with side effects.

Stendra (Avanafil)

Stendra is the newest PDE5 inhibitor. This drug is preferred by many men mostly because of its more selective targeting action which minimizes side effects compared to the three other medications. Studies show less than 14% of users experience mild side effects from Stendra.

There are several key differences between Stendra, Viagra and Cialis. Some of the advantages Stendra offers compared to older ED medications are:

While similar side effects are possible, like headaches and facial redness, the risk is lower and chances of more serious side effects like visual disturbance are significantly lower in this newer drug.

Avanafil can start working as quickly as fifteen minutes after taking a dose with the concentration reaching its peak within 30 to 45 minutes, and the drug’s effects can last for longer than 6 hours.

ED Drugs: Viagra vs Cialis vs Levitra vs Stendra

We know what Viagra, Cialis, Levitra, and Stendra have in common. They are all:

Despite the fact they are all PDE5 inhibitors, there are still some subtle differences between these four widely prescribed ED medications. Each drug comes with its own pros and cons, and aspects that differentiate it slightly from the others. For example:

Even though they are similar in their actions, some men find that one drug or another causes side effects while another one might not – therefore it’s positive that we have four different options to try.

PDE5 Inhibitors Side Effects

Not everyone will experience side effects when using a phosphodiesterase type 5 (PDE5) inhibitor medication, but it’s wise to be aware of the potential negative effects that you could notice after you start taking one of these drugs to treat ED.

As I’ve covered above, out of these four drugs Stendra comes with the least risk of side effects of any kind, and less risk of some of the more serious side effects. While that is not a sole reason to select that drug over the others, many men will take this into consideration as will your doctor.

The main reported side effects of any of these medications can include:

Facial flushing

Facial redness or hot flushes is another of the most common side effects. This should subside quickly in most men. This reaction is a result of these drugs encouraging blood vessel dilation in the penis, which might also occur in other parts of the body like face and neck.

Nasal congestion

Extra dilation of the sinus blood vessels can also bring about nasal congestion or stuffiness soon after taking your dosage. This is another effect which usually passes by very quickly.

Headaches

This is considered the most common side effect of most PDE5 inhibitors like Viagra. Studies have shown that up to 25% of men who take Viagra will experience headaches, which are mostly mild and short lived. However a smaller percentage of men might experience more painful headaches or migraines. These cluster headaches have not shown to be an issue with other PDE5 inhibitors like Vardenafil and Tadalafil.

Men who use Viagra and suffer with cluster headaches have seen improvements when either changing the drug to anther PDE5 inhibitor or lowering the dosage of Viagra and combining it with the non-steroidal anti-inflammatory medication Naproxen for pain relief.

Visual changes

A long known side effect, with more recent research indicating this problem could be much worse than originally thought. A urology physician notes that far more serious effects on the eyes are a risk factor for some people taking this drug, most notably the potential to develop a rare disease of the eyes called non-arteritic anterior ischemic optic neuropathy (NAION), with the FDA even changing labelling to list this as a potential side effect of PDE5 inhibitors. Out of the four PDE5 inhibitors, Avanafil has shown to produce much lower risk of this worrying adverse effect compared with the other three.

Back pain

Those taking Cialis might report back pain and other muscular aches within 12 to 24 hours of taking a dose. For most men these symptoms will disappear on their own. Back pain is a known side effect particularly with Tadalafil. Studies have shown an almost 100% success rate in preventing back pain with this drug when it’s combined with two other medications.

Dizziness

Another effect of a sudden drop in blood pressure after taking one of these drugs is dizziness or light headedness. Therefore you should never drive after taking one of these medications.

Sleep problems

Insomnia is a potential side effect of Viagra. Additionally, a study from 2006 suggested that even a single dose of Viagra can make obstructive sleep apnea worse for men who are already suffering with the condition.

Another study found that men with both severe obstructive sleep apnea and cardiovascular disease are high risk users of Viagra because the drug showed both a worsening of sleep apnea and an immediate negative effect on heart rate. As Viagra is the most studied of all PDE5 inhibitors, this side effect may or may not be restricted only to this drug.

Sore throat

This is a side effect mainly seen with Stendra. While this newer PDE5 inhibitor has less side effects overall compared with the others, this effect is unique to this drug; however it is considered a mild side effect that subsides quickly.

Stomach upset

Diarrhea and other gastrointestinal conditions are possible with any of these medications, however it should be kept in mind that this is a potential side effect of almost any medication and is mostly dependent on your individual reaction to the drug. If one PDE5 inhibitor has a bad effect on your digestive system, your doctor can prescribe a different one or lower the dosage.

Decreased blood pressure

A drop in blood pressure occurs usually within a short time of taking the medication. For example, with Viagra the blood pressure decrease happens within only the first couple of hours of taking the drug. This makes it important to factor in any existing low blood pressure issues and discuss it with your doctor before starting to use one of these drugs.

Sudden hearing loss

Another rare side effect that required a a change of labelling directed by the FDA in 2007 relating to a small number of PDE5 inhibitors experiencing sudden but temporary deafness. The results of an in depth scientific study on this issue led researchers to conclude that one person in every 5000 new users of a PDE5 inhibitor develops sudden hearing loss.

Another study on one man found that he developed sudden hearing loss and tinnitus. It’s still not certain whether PDE5 inhibitors are the direct cause of this effect, or whether it’s also due to an underlying health condition or use of other medications.

Abnormally long erections

Men who experience an erection lasting for more than four hours should consider going to the emergency department as this is not only a painful problem, but one that can cause permanent damage to the penis.

Androgens

This treatment option is mostly considered for men who are suffering with low libido, depressed mood and other factors that are caused by low testosterone. However there is no hard evidence that this therapy alone can effectively cure erectile dysfunction in men that isn’t being caused specifically by low testosterone.

When androgens are used to treat erectile dysfunction caused by low testosterone, these drugs can come in different forms including oral medication, gels, injectable and even transdermal application.

Some men take a combination of testosterone and PDE5 inhibitors as it is possible that this combo gives some men better results, although studies are still going on to determine if this is in fact the case and whether there is a higher risk of side effects when combining the two.

Penile Injections (Prostaglandins)

This is a treatment option that most men are likely to be very hesitant to consider, for good reason. Penile injections are a daunting thought, but it’s worth looking into what this particular treatment is beneficial for. By injecting a vasodilator like a prostaglandin directly into the penis, a doctor is able to very quickly determine whether the blood vessels are functional and able to dilate. This in fact makes this method a very good diagnostic tool as well as a treatment.

Within just five minutes of the injection being given, a doctor can determine whether the blood vessels are functioning correctly because an erection will occur if they are. The injection is given straight into the corpora cavernosa.

Some studies have found that prostaglandin E1 (PGE1) injections are the most effective non-surgical treatment for ED in men aged 65 and over.

Natural Male Enhancement Pills

One of the newest and most popular type of erectile dysfunction treatment we now have available are natural male enhancement pills. These pills are not prescription drugs, but instead can be bought without any prescriptions and without seeing a doctor and they contain nothing except purely natural ingredients.

As the popularity of natural erectile dysfunction pills has risen, so has the number of products available. There are now many dozens of products that claim to treat erectile dysfunction and other sexual problems naturally. So you’ll want to choose one that is really going to work as there is no doubt that some of these products work much better than others.

Erectile dysfunction is a distressing problem, but one that’s experienced by countless men. Sometimes it is caused by an underlying medical condition, so it’s important to see a doctor to rule out serious health problems. In other cases it can be related to confidence and anxiety.

Whatever the case may be, the first pill men with erectile dysfunction think of is Viagra. While Viagra is a highly effective treatment for erectile dysfunction, it comes with its own risk of serious side effects and it’s not an option that will suit all men.

Those wanting a more natural approach by using natural male enhancement pills can avoid the side effects that come with Viagra and other prescription ED drugs such as headaches, flushing, vision changes, nausea and muscle pain.

Most prescription drugs also come with a warning that they shouldn’t be used long term because of the risk of more serious side effects. This is not an issue with natural alternatives because the natural ingredients are much more gentle on the body, yet still effective at addressing many of the underlying causes of erectile dysfunction like lack of blood flow or reduced circulation, anxiety and stress, low testosterone, or a low level of some important essential minerals like zinc.

In natural erectile dysfunction products you’ll find ingredients ranging from proven plant extracts, vitamins and minerals, amino acids and other naturally occurring ingredients. Many of these have been tested and proven in clinical studies to improve function in one or more areas that benefit ED sufferers: whether it’s to increase blood flow and circulation to the penis by dilating the blood vessels, to boost energy, improve mental confidence and reduce stress, or raising testosterone.

Doing your research is critical before you decide on a natural male enhancement pill. Most products will need to be used for a minimum of 30 days to see results, while others are recommended to be used for up to three months if you want to get the greatest benefit. This means you’ll be committing to one product so you will want to choose the best one for you.

Learning about the best ingredients, clinical trials, and how each formula works to naturally treat ED and improve performance in the bedroom will mean you get on the right track with the right product sooner, so you can see those results faster.

Male Extra

Male Extra is one of the leading natural male enhancement products available today. It has three main goals:

Male Extra uses some unique ingredients that you won’t see in any other male enhancement formulas. These include L-Arginine HCL and pomegranate containing 40% ellagic acid.

Ellagic acid is a powerful antioxidant which can improve blood flow to the penis, improving erections and delaying fatigue. These results have shown to be effective in clinical studies.

L-Arginine HCL converts into nitric oxide in the body which brings about a dilation in blood vessels, allowing increased blood flow by assisting the blood vessels to relax and encourage circulation – including to the penis. L-arginine is also known to stimulate the release of growth hormone. Studies on men with erectile dysfunction showed that this ingredient significantly improved their ability to gain and maintain an erection.

You should start seeing positive results from Male Extra within the first 30 days and this will include harder and longer lasting erections as well as noticeably better stamina.

Viasil

Viasil targets the enhancement of stamina and sexual drive by boosting energy and encouraging better blood flow. And through an increase in nitric oxide production you’ll see stamina and vitality significantly improved. Blood flow and stamina are the keys to obtaining and maintaining an erection, so by boosting these physical processes, Viasil also boosts your mental confidence to perform at your peak in the bedroom.

Importantly, Viasil isn’t just about giving you a short energy spike but instead works to boost and maintain both short and long term energy and it does this by using natural, side-effect free ingredients with known benefits in increasing blood flow and circulation, ATP, nitric oxide, blood vessel health, stress reduction, and energy.

Anabolic Steroids and ED

Studies show that the longer and more frequently that anabolic steroids are used, the higher the chance of a man experiencing ED. But importantly, the study also found that men who make use of anti-estrogen drugs were able to more successful maintain normal erectile function after using anabolic steroids, indicating the critical important of post cycle therapy.

Why are steroids and Viagra taken together?

There are two reasons that men will choose to take Viagra while using anabolic steroids: one is to take advantage of the way this drug dilates the arteries for improved blood flow which is not only beneficial for performance enhancement, but can also get the steroids moving through the body more efficiently.

The second reason for Viagra being used with steroids is to treat potential erectile dysfunction as a side effects of the steroids, which is of course the main purpose of Viagra.

Is it safe to take steroids and Viagra together?

So far there is no evidence that shows it is unsafe to take Viagra and steroids together at sensible doses, including those prescribed by your doctor. The possible health risks come about when very high doses of either are used. There are however two areas where the combination of steroids and Viagra can cause problems: with sleep quality (insomnia) and blood pressure.

Common Q&A Related to ED

Do anabolic steroids cause erectile dysfunction?

Yes and no. Using some anabolic steroids can give you a higher risk of ED, but many steroid users will make use of a testosterone source during a steroid cycle as well and this has shown in studies to reduce the occurrence of erectile dysfunction, however if testosterone is stopped then ED and other problems like decreased libido are more likely.

Does taking testosterone help with erectile dysfunction?

When using anabolic steroids, taking an exogenous testosterone ester can help to prevent ED. But for men who do not use steroids and are suffering from erectile dysfunction for any other reason, testosterone is very unlikely to help with the problem when the man has normal testosterone levels, or even those who have low T but have no other symptoms like low libido and fatigue.

Does aging cause erectile dysfunction?

Even though men will see their levels of serum testosterone decrease as they age, this is rarely low enough to cause ED. The cause of impotence is usually related to other problems.

Can you take Viagra with testosterone?

There is no known benefit for combining these two for men with low testosterone levels, when it comes to treating ED. But when it comes to steroid users who might be using testosterone in a cycle, there is no known danger in using Viagra as well and this is sometimes done to reverse the ED side effects of some steroids.

Does Viagra raise testosterone?

Viagra and other PDE-5 inhibitor drugs have not been formulated to affect testosterone, but instead to encourage blood supply and muscle relaxation in the penis. However studies have shown that an unexpected effect of Viagra when taken by men with both ED and low testosterone is that it resulted in an increase in serum total and free testosterone, with researchers being confident that Viagra has a direct effect on the testicles which can benefit men with existing low testosterone.

Can Viagra kill you?

Most of the side effects from Viagra are mild, like headaches and facial flushing. But we know for a small percentage of men, the adverse effects can be much more serious. In the first nine years of Viagra’s existence starting in 1998, a study found that over 1800 men who were using the drug died, with most of them being heart attacks.

The main culprit is believed to be when men with existing heart problems combined Viagra with angina medications called nitroglycerin, their blood pressure dropped to dangerous levels. Now doctors never prescribe Viagra to men who are taking nitrate medications for angina.

What’s better: Viagra or Cialis?

The better drug is the one that works for you. Both are PDE5 inhibitors but one of the major differences is the length of time each one is effective: Viagra lasts for up to 5 hours while the effects of Cialis last much longer: up to 36 hours.

Another consideration is that Viagra works best when taken on an empty stomach, while Cialis is not affected by food. When it comes to treating ED, both drugs have shown to have a very similar rate of successful results.

Many men prefer neither of these two drugs and instead choose to use Stendra which comes with a lower chance of side effects.

Does Winstrol cause erectile dysfunction?

A possible side effect of Winstrol (Stanozolol) is actually the opposite to ED: some men can experience prolonged or frequent erections.

My Conclusion And Recommendation

If you’re embarrassed about seeing a doctor about your ED you might have thought about trying any available over the counter (OTC) treatment options. Potential options include the natural hormone Dehydroepiandrosterone (DHEA), the amino acid L-arginine, and herbs like yohimbine and ginseng. There is no scientific proof that any of these natural ED treatments are effective, especially in men who have serious underlying causes of ED like diabetes and high blood pressure.

But this is not the situation with the Phosphodiesterase Type 5 (PDE5) Inhibitors. These drugs are a standard medical treatment for erectile dysfunction and include the famous drug Viagra, amongst others.

Real-life Experience, not Theory

I don’t claim to know everything, what I talk about here is something I’ve done. From anabolic steroids to peptides, to HGH, insulin, and supplements, I’ve done it at some point in my life and I can relate.

Erectile dysfunction Part 1: the solution for your neurotransmitters

It’s predicted that by 2025 300 million men will have erectile dysfunction, yet it’s shown that less than 30% are willing to admit to it.

I’m sure you would agree that it’s because this is a very embarrassing thing to experience and deal with. It’s so to say one of the most embarrassing things. Lucky for me, When I went through ED related issues myself, my wife never made me feel bad and was very understanding and supportive. But none the less, it’s still embarrassing for us and something that definitely needs dealing with.

For men, sexual performance carries an identity and a sense of self-esteem in his society.

If you can’t get it up, you feel like you lose a large chunk of your confidence and manliness. ED can also lead to a reduction in libido and increase anxiety and depression, which, in a feedforward loop, makes the ED worse. In many cases, the wife/partner might even start to think the man is cheating on her, because of his avoidance and lack of performance.

In daily life, it is very easy for men to admit to having a sore throat or hemorrhoids. However, admitting to having erectile dysfunction is contrary to the male ego and especially so if the dysfunction occurs early in life.

It’s not so rare

ED has been thought to be an “old man’s disease”, but new stats are showing that one in four men under that age of 40 complain about ED (R).

It’s even been thought that the prevalence of ED can be as high as 50% in the non-healthy population. ED is one of the first symptoms someone gets when they progress with cardiovascular disease.

The first line of treatment for ED is the blue pill…viagra (sildenafil). Or other nitric oxide boosting drugs such as tadalafil and vardenafil.

Conventional treatments are not very effective

These drugs are generally well-tolerated, but about 5-40% do get symptoms such as headache, facial or chest flushing, dyspepsia, and sinusitis, which are just the most commonly reported adverse side effects.

Topical administration of nitroglycerin has demonstrated only moderate and inconsistent efficacy in improving erectile function, and also has been observed to cause headaches. Similarly, oral L‐arginine supplements in men with ED have yielded inconclusive results and may only be effective in men with reduced exogenous NO production.

In fact, data indicate that 50–80% of men discontinue the use of medical interventions (oral medications, ICIs or VEDs) for erectile dysfunction within 1 year, due to side effects and a desire for a permanent solution (R).

In this article, I want to explain how things work, what can be causing or contributing to ED, and what to do about it. And the goal is to go back to a state when no meds or supplements are needed and you’re just your high libido, naturally capable, competent self.

This article is the first part of a 5 piece series. All parts include:

How do things work

In the flaccid state (non-erect), the smooth muscle of the penis is contracted. Thus, no extra blood can flow in and promote an erection. So one can see it as a “flexed” state. When it becomes too flexed, as when it shrivels up and back, usually due to stress and low blood sugar, it’s in a very contracted state.

We’ll get into what promotes this contraction in just a bit. Unable to relax is the first “error” in ED.

In order to relax, calcium ions in the cells (which induce contraction), has to be pumped out. Nitric oxide is a main relaxor, but an erection can also be obtained via nitric oxide independent pathways as well.

So the first step is to get the smooth muscle to relax, the second is to get blood into the penis and the third is to pinch the outflow vein closed so that the blood remains in the penis. Kinda like blood flow restriction training. And yes, you do get a band you can put around the base to prevent blood from flowing out, but that leads to coldness, numbness, loss of color, possible gangrene, etc.

And lastly, sexual activity triggers the bulbocavernosus reflex, causing the ischiocavernous muscles to forcefully compress the base of the perfused corpora cavernosa, resulting in further, or full, rigidity.

As you can see in the pic above, noradrenaline and endothelins promote calcium entry into the cell, which promotes contraction (R). The binding of platelets to the endothelial cell receptor LOX-1 causes a release of endothelin. Aspirin, even in doses of 81mg daily, can have potent anti-platelet effects and can lower endothelin and promote vascular relaxation in the penis.

Noradrenaline also creates ROCK, of which testosterone is an antagonist, which also promotes contraction to maintain the flaccid state.

In the pic above, acetylcholine and non-adrenergic non-cholinergic nerves promote the release of nitric oxide (NO) and inhibit calcium entry, and this promotes relaxation.

Erection upon touch or stimulation is under the control of the peripheral nerves and the lower parts of the spinal cord, and the psychogenic erection is achieved by visual or mental stimuli (fantasies, etc), and uses the limbic system of the brain.

So both the reflex erection and/or psychogenic erection can be involved in ED.

Let’s get into what controls the erection.

What controls the erection

Many things have an influence on erection and I’m going to start with neurotransmitters in this article.

So hang in tight, it’s going to be a fun read.

Central nervous system controls erections

The central nervous system (CNS) consists of two branches, the sympathetic and the parasympathetic.

The sympathetic is what keeps you awake and full of energy, whereas the parasympathetic calms you down and promotes relaxation and sleep.

We want these two to be in balance. Too much sympathetic and we’re an anxious wreck, bouncing off the walls, constantly stressed and sweaty.

Too much parasympathetic and we have no energy, no libido and no drive in life.

The penis is controlled by nerves and loss of neural function can lead to loss of erectile function. Complete numbness, which is a horror story.

Catecholamines such as noradrenaline and adrenaline act as both hormones and neurotransmitters, so that’s why I’m including it together with the other neurotransmitters.

A. Sympathetic nervous system inhibits erections

The sympathetic nervous system promotes the secretion of noradrenaline and adrenaline which inhibit erectile function (R). It promotes contraction of the smooth muscle and vasoconstriction.

Noradrenaline and adrenaline bind to the adrenergic receptors, of which there are 5, namely α1-, α2-, β1-, β2- and β3-adrenergic receptors.

α1 activation induces vasoconstriction and antagonizing it promotes relaxation and erection. Antagonism of α1‐adrenoceptors is a frequent cause of priapism (prolonged erections). Phentolamine is an α1-adrenergic receptor inhibitor that helps to prevent vasoconstriction to maintain an erection.

α2 activation lowers noradrenaline levels, but it is also anti-erection. Inhibiting it, with yohimbine (R) for example, promotes penile smooth muscle relaxation and promotes blood flow. This can increase the ease with which you can be an erection, but will not facilitate one by itself.

Symptoms of too much noradrenaline include:

Copper is a cofactor necessary for the conversion of dopamine to noradrenaline. Too much copper and you can end up with an excess of noradrenaline. This is why zinc can help so much with sexual anxiety and erection because it lowers copper and noradrenaline.

Stress is one of the biggest contributors to elevated noradrenaline, so be sure to manage your stress to lower excess noradrenaline.

A short story about myself. At the beginning of my marriage, I used to have occasional trouble getting him up and maintaining an erection. This made me very mad of course, which in turn just further made things worse. During that period I was under a lot of stress, in a caloric deficit and was doing intermittent fasting. These things stimulate the adrenals to release noradrenaline, adrenaline, and cortisol, all of which promote ED.

B. Parasympathetic nervous system promotes erections

The parasympathetic nervous system is the opposite of the sympathetic nervous system. Acetylcholine is the main parasympathetic neurotransmitter.

Acetylcholine produces concentration-dependent relaxation of erectile tissues that has been precontracted with norepinephrine. Acetylcholine counteracts the effect of noradrenaline and may also suppress the release of norepinephrine (R).

Getting enough choline and vitamin B1 in through the diet can help the body produce enough acetylcholine for proper erections.

You know that feeling where you’re just so tired (but can still get a good erection) and just want to lay in bed hoping your significant other will do all the work?…that’s most likely excess parasympathetic activation, elevated GABA and/or low pregnenolone-S and DHEA-S (more of that in part 2).

Erectile Dysfunction and L-Citrulline: What You Should Know

Erectile dysfunction is one of the most concerning problems a man can have.

Most of us have had one episode or two, especially if we are under heavy stress. But having the same symptom frequently can break our self-confidence and self-esteem.

What can you do if you’re experiencing a dysfunctional sexuality?

In many cases, the cause is not purely biological but psychological in nature. However, there are plenty of medications and supplements we can use. One of them is L-Citrulline.

What is L-Citrulline?

L-citrulline is a natural amino acid. Its name originates from the Latin term of watermelon “Citrullus,” from which it was isolated for the first time. It is found in foods such as watermelons and naturally produced by the body.

L-citrulline is an amino acid that the body usually produces. It is useful for heart disease, bodybuilding, rising strength, and enhancing athletic performance in sportspeople.

There’s a subset of amino acids called non-essential amino acids. They are often called “the building blocks of life.” They are considered “necessary amino acids,” and must be provided by your diet. Others are produced by the body, and we know them as “non-essential amino acids.” If you don’t consume them in your diet, your body will create them for you.

L-citrulline has been called a “conditionally essential amino acid.” In theory, it is a non-essential amino acid. But according to research, there is a group of people whose levels of L-Citrulline are alarmingly low. In these individuals, usually critically ill patients, supplementation is considered “essential” (1).

The body transforms L-citrulline into another amino acid, L-arginine. L-arginine improves blood circulation. This improvement is achieved by stimulating nitric oxide production. It stimulates an enzyme called nitric oxide synthase. Nitric Oxide (NO) is a gas that promotes vascular dilation. Because of its artery-expanding effects, L-arginine benefits many types of patients. It is useful for heart problems, obstructed arteries, and erectile dysfunction.

Thus, a higher level of L-citrulline ultimately helps the body generate nitric oxide and increase the blood flow. It is sold as a dietary supplement and a separate pharmaceutical drug.

Sometimes you will find it as malate citrulline. This is simply citrulline bound to malate, an organic salt of malic acid. This is the most studied type of Citrulline, and there is evidence regarding an independent function of malate in performance effects.

Still, there is inadequate work to equate citrulline malate with L-citrulline specifically. It is important to note that 1,76 g of citrulline malate are required for an equivalent of 1 g of Citrulline.

Why do people take L-Citrulline?

As stated above, L-citrulline increases the production of nitric oxide throughout the body. This helps to relax the smooth muscle and to improve different body functions. For example, people use it to improve lung function and enhance blood flow.

L-Citrulline may be useful in the diagnosis and prevention of diseases in the lungs and the circulatory system. Some evidence indicates that it can help lower blood pressure in prehypertensive individuals.

Prehypertensive individuals are those with early-notice hypertension. This means you have a blood pressure reading ranging from 120/80 to 139/89. This is considered slightly increased. In these cases, L-Citrulline is commonly used to counter the effects of prehypertension (2).

Animal studies show that L-citrulline can also benefit people with diabetes-related issues in the blood vessels. For example, it is useful in patients with slow wound healing by stimulating nitric oxide and arginase systems (3).

Other animal work indicates that L-citrulline may stimulate muscle protein synthesis. It works to prevent muscle mass decay and muscle fatigue. Thus, it has been proposed to prevent older adults from frailty and critically ill people from cachexia. It is also useful to increase muscle strength (4).

Other lines of research also suggest that L-citrulline can help to treat intestinal issues. For example, Short bowel syndrome, Celiac disease, and Small bowel damage caused by radiation. Their consequences can be prevented with L-citrulline supplements (5).

Many people can make use of citrulline supplementation. Endurance athletes and people who want to feel concentrated and alert without caffeine also consume L-citrulline.

In all of these cases, what it does is simply promoting vasodilatation (widening the blood vessels). By doing so, it increases the concentration of nutrients and oxygen to the muscles, the brain, and other tissues. It is very helpful to increase physical performance during your endurance training, too.

Can L-citrulline help erectile dysfunction?

L-citrulline supplements can alleviate symptoms of moderate to extreme erectile dysfunction (ED). Some scientists say L-citrulline doesn’t perform as well as ED medications like Viagra.

However, some people do not respond well to ED medications. Others do not have a serious condition and prefer not to use Viagra. For all of these patients, L-citrulline can be a useful alternative.

According to a study published in the medical journal Urology, oral citrulline supplementation is safe and effective in treating ED. It can improve erection hardness and works, especially if you have a mild case of ED (6).

We mentioned how L-citrulline stimulates the production of nitric oxide (NO). Then NO works in the penis as a vasodilator, but also as a neurotransmitter. Both functions are performed in the blood sinusoids. It creates a substance known as cGMP (or cyclic guanosine monophosphate).

In turn, this substance triggers smooth muscle relaxations in the penile sinusoids. This allows them to become filled with blood and compress the veins to prevent blood from scaping. Trapped blood in the penis is what causes an erection. We can achieve that by preventing cGMP breakdown (Viagra) or by increasing NO synthesis (L-citrulline) (7).

According to a more recent study published in the journal Andrology, a significant number of people with erectile dysfunction are likely to have a deficiency of L-citrulline. They evaluated 122 patients with different causes of erectile dysfunction. In each one of them, they evaluated the serum levels of arginine and citrulline.

After gathering and examining the data, they found out that many patients with ED have low arginine levels and low citrulline levels. This deficiency is more likely in patients with ED of an etiology related to arterial function (8).

However, arginine supplementation may not be ideal for ED. Arginine cannot escape liver metabolism.

The liver breaks down arginine before it starts performing actions on the penile tissue. Instead, citrulline escapes this presystemic metabolism. It gets converted into arginine and triggers NO synthesis. Hence the rationale to use L-citrulline instead of arginine for erectile dysfunction.

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How can you get L-citrulline in your diet?

L-citrulline is not an essential amino acid. But you can get plenty of it by finding the most appropriate sources. You can increase your dietary intake by consuming these L-citrulline rich foods:

It is important to note that not all foods will contain enough citrulline levels to make a difference. If your symptoms of erectile dysfunction are recurrent, you may want to try supplements instead.

When to take L-citrulline supplements

Citrulline is usually added to pre-workout blends or taken early in the morning. To see the best results, you take them 30 minutes before exercise or after waking up. Many people like taking these supplements on an empty stomach to improve absorption.

Taking them in the morning can give you some extra energy and improve concentration. This may be especially effective if you take along Citrulline and caffeine. However, some people have replaced caffeine with citrulline supplements to get their morning boost.

To improve sexual activity, you need to take citrulline supplements continuously. It does not work like Viagra, which acts instantaneously. The benefits are rather seen in the medium-term, and you are required to continue supplementing to see the benefits.

How much Citrulline should you take?

The exact dosage of Citrulline you can take differs based on the type of Citrulline you’re consuming.

For example, if the supplement includes Citrulline Malate, you’ll want to have a higher dose. Remember that 1,76 g of citrulline malate are required for an equivalent of 1 g of L-Citrulline.

Your dose also depends on what you’re looking for. If you’re searching for general wellness advantages, you won’t need a high concentration. If you’re aiming for fitness-related benefits or improving erectile dysfunction, you will need a higher dose.

That said, a good starting dose of L-Citrulline is about three grams a day for general health. Increase the dose to three to five grams for better exercise performance and erectile dysfunction. As for Citrulline Malate, a good starting dose will be 5 to 6 grams for most people. But you can take up to 6 to 8 grams for better exercise performance.

Concerns and side effects

Significant side-effects are not documented. However, further work is required to validate its long-term safety in large doses. Unlike L-arginine and L-ornithine, large concentrations don’t appear to induce gastrointestinal distress (6).

As of yet, research to encourage the use of L-citrulline as a treatment for ED is minimal. The main focus of studies is placed on standard ED drugs such as Levitra, Viagra and Cialis. They are phosphodiesterase type 5 inhibitors and have proven to be very effective.

However, some men prefer not to use them due to potential risks or side effects. This may be true, especially for men with mild ED. In such cases, it may be preferable to use L-citrulline, at least for short periods.

L-citrulline is thought to be healthy, as no known side effects have yet been observed in studies. However, no large, randomized clinical trial was conducted to assess the safety of L-citrulline for ED treatment.

Still, if you’re planning to take supplements or other drugs, you must talk about potential complications with your doctor. It is particularly important if you’re already using other medications to dilate your blood vessels. L-citrulline supplements may contain additional, similar synthetic ingredients to traditional ED medicines.

An important thing to note is that no alternative supplements can manage erectile dysfunction symptoms definitively. Also, one-third to half of the additives marketed as natural products contain synthetic chemicals. The most popular are PDE-5 inhibitors or PDE-5 inhibitors analogs, which are used in Viagra.

There is also concern that people who take nitrates for heart problems while taking these supplements may experience harmful drops in their blood pressure. So, it is essential that you still talk to your doctor before you start taking this or any other supplement.

Other natural remedies for ED

Not every patient who experiences ED may choose to use traditional prescription drugs. That’s why many alternative therapies and remedies still exist.

If you are searching for natural treatments to improve ED, one of these or a combination may be the one for you. Be sure to consult your doctor about natural remedies before you use one of these:

Penile air pumps

Penile pumps provide a non-invasive method for treating ED. They’re used to increase blood flow to the penis before sexual intercourse. This can cause swelling and pain if misused.

Penile implants

Implants can be inserted into the penis surgically, and then inflated before sexual intercourse.

Ginseng

Multiple peer-reviewed studies have shown that Panax ginseng is a safe, effective treatment for ED.

Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal glands of the body, naturally. However, though there are no recent reports, one older study found that people with ED often have low DHEA levels. Adding to those levels may also help to improve muscle strength in older adults. More up-to-date research is, however, needed (10).

Acupuncture

As we all know, this complementary medicine involves sticking needles into the upper layers of the skin. For decades, this procedure has been used to relieve discomfort, reduce health disorders, and treat various conditions.

One research in the International Journal of Impotence Research found that about a quarter of the men who received acupuncture enhanced erections and were able to perform sexually, compared to placebo (11).

When to see a doctor

Many people hesitate to speak about these delicate things. But the sooner you ask for help, the sooner you will be able to find answers and the medical care you deserve.

Conclusion

L-citrulline is not an essential amino acid. However, some of us may have lower levels than others.

Low levels have been detected in patients with erectile dysfunction problems. They are especially low if the erectile dysfunction is caused by arterial problems. Supplementation with L-citrulline may be helpful in these cases.

What L-citrulline does is stimulating the synthesis of a substance called nitric oxide. In turn, nitric oxide expands the arteries by relaxing the smooth muscle. By doing so, it increases the blood flow to different tissues, including the penis. It facilitates penile erection and improves the hardness and maintenance of the erection.

We can find L-Citrulline in watermelon and other natural sources. They have been found to improve erectile dysfunction when consumed in sufficient amounts.

However, you can also supplement with L-citrulline. This supplement is associated with various health benefits besides improving erectile dysfunction. For example, it may reduce blood pressure readings and improve blood flow to the brain and muscles.

If you’re considering L-citrulline supplementation, it is important to talk to your doctor about it. Do not be afraid to talk about your concerns and find appropriate solutions according to your case.