Erectile dysfunction is a male sexual dysfunction characterized by the inability to achieve or maintain an erection of the penis. The causes of erectile dysfunction commonly involve reduced blood flow to the penis or nerve damage. The most common treatment is through the use of oral drugs. These are usually selective enzyme inhibitors and are available by prescription. However, people with certain medical conditions, or those taking nitrate drugs or alpha-blockers should not take these drugs. They are also associated with side effects such as headache, flushing, indigestion, nasal congestion, muscle aches and back pain. Recently, the Food and Drug Administration (FDA) had approved important changes to the drug labels for these medications, warning about the potential risks of sudden hearing loss.

Before the introduction of the first approved drug for erectile dysfunction, sildenafil (trade name: Viagra), in the 1990s, herbal remedies were used for treatment. Today, herbal remedies are used as alternative treatments for erectile dysfunction or in conjunction with medical drugs. Asian ginseng and ginkgo biloba are Asian herbs believed to improve erectile function in men. Ginkgo is said to be particularly useful for people who experience sexual dysfunction due to the side effects of antidepressant drugs. It appears to relax muscles and stimulate blood flow in the penis. At high doses however, there is an increased risk of bleeding, convulsion and interaction with other drugs. Ginseng affects hormonal function and should not be used with oestrogen. Unfortunately, ginseng has also been found to be associated with hypoglycaemia (low blood sugar) and uterine bleeding.

L-arginine is an amino acid which is used by the body to make nitric oxide, a substance which relaxes the smooth muscle in the penis, allowing for increased blood flow and an erection. L-arginine is naturally-occurring in foods such as meat, dairy, poultry and fish. Side effects of L-arginine use may include digestive problems and high doses may increase stomach acid. It may also alter potassium levels in the body. L-arginine should not be taken by people with ulcers and those who are on medications which affect the stomach or alter potassium levels.

Some drug manufacturers have capitalised on the benefits of these herbal remedies and produced supplements consisting of a mix of these compounds. One such example is Argin-Max, which contains a mix of vitamins, L-argine, ginseng and ginkyo. It is to be noted, however, that studies on all these herbal agents have been small and have produced mixed results. Ginseng, ginkyo and L-argine have possible side effects and the products containing them are not regulated.
Another popular herbal medicine called Yohimbine has been found to stimulate blood flow to the penis, increase libido and the frequency of ejaculations. It is acquired from the bark of the West African Yohimbe tree. The American Urologic Association does not recommend using Yohimbine due to its potential dangers. Side effects include dizziness, anxiety, nausea, high blood pressure, abdominal pain, heart failure and paralysis. One death has been reported from taking standard dose tablets. People suffering from anxiety or hypertension should not take Yohimbine. Like the rest, Yohimbine is not regulated.

Many of these herbal products are marketed as "Natural Viagra", however, they are not specific for blood vessels in the penis as Viagra is. Therefore, they may cause generalized low blood pressure and restrict blood flow to vital organs. Moreover, these products have not been subject to rigorous clinical trials and are not regulated by government bodies. Therefore, it is very difficult to know what you are getting and whether it is safe. As such, it is very important to consult your doctor before taking any herbal supplements.

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