1. Although the internet is awash with promotions for natural sex remedies such as Avena Sativa, Damiana, Ginseng, Ginkgo Biloba, Maca, Muira Puama, or Zinc, there is no credible scientific evidence to show that any of them improve libido, or sexual function. More importantly, they can be dangerous if you mix them with other drugs, or take too much of them.
2. There is some evidence that the supplement Yohimbine works. A 1996 review of 16 studies at Syracuse University, and a 1998 British analysis of seven studies both showed it to be an effective treatment for erectile dysfunction, however an American Urological Association (AUA) review of 208 studies concluded that it is no better than a placebo. The side effects of Yohimbine include rapid heart rate, high blood pressure, insomnia, panic attacks, hallucinations, headaches, dizziness, skin flushing, seizures and renal failure. And there is a very narrow margin between an effective dose and an overdose. The suggested dose for sexual dysfunction is 15-30 mg, but doses over 40g can trigger hallucinations and cause paralysis.
3. Another supposed alternative is the amino acid Arginine. In a study of 50 men at Tel Aviv University, 31% of those with impotence found their erections had improved after six weeks of taking 1 gram of L-Arginine three times a day. However, the side effects; abdominal pain, bloating, diarrhoea, gout and aggravation of pre-existing asthma are not particularly sexy, and in 2006, a clinical trial of L-arginine was abandoned after six cardiac patients taking the over-the-counter supplement died. No patients in in the placebo group died.
4. In 2008, Italian scientists caused a minor stir when they published a paper suggesting that a compound called Icariin which is made from 'Epimedium Brevicornum' (Horny Goat Weed), had a similar effect to Sildenafil, the active ingredient in Viagra.
5. Further research, which didn't grab so many headlines, revealed that Sildenafil is 80 times more potent than Icariin and it would have to be used at unachievably high concentrations in humans to achieve just one tenth of the effectiveness of Sildenafil.
6. Its not what you want to read, but there is a mountain of research to demonstrate that sexual function is undermined by lifestyle choices such as over-eating, smoking, alcohol abuse and lack of exercise. The Massachusetts Male Aging Study and the Androx Vienna Municipality Study have both shown that men who have a sedentary lifestyle are more at risk of ED and a 2007 study from John Hopkins Medical School has shown that men who watched television for more than five hours a day increase their odds of getting ED by 300 percent.
7. The good news is that the risk is modifiable. By switching to a lower calorie mediterranean-style diet, rich in whole grains, fruits, oily fish, vegetables, pulses, walnut, and olive oil and burning more than 200 calories a day doing exercise, you can improve your erectile function by up to 70%.
8. You can exercise your penis too. Professor Grace Dorey, author of several snappily titled books such as "Use it or Lose it", "Stonger and Longer" and "Clench it or Drench it" is a staunch promoter of the link between Kegel exercises and improved erectile function. She says that in her research, 40% of men who had experienced erectile difficulties for six months or more, regained normal erections after strengthening their pubococcygeal (PC) muscle for three to six months, and a further 35% of men improved their rigidity.
9. To identify your PC muscle, stop yourself peeing midstream. If you clench the same muscle while looking in the mirror (without peeing obvs) you'll see that the base of your penis moves closer to your abdomen and your testicles lift a little too. Once you've mastered this contraction, empty your bladder and lie on your back with your knees bent and slightly apart. Breathe normally, tighten your pelvic floor for three seconds, relax for three seconds and repeat. Work your way up to three sets of 10 repetitions a day and once your muscles get stronger, you can do Kegels while sitting, standing or walking.
10. Kegel exercises are also helpful in restoring continence, and since bladder control is something we all need as we age, the exercises will definitely do you some good, and unlike natural remedies, they certainly won't do you any harm.