An erection problem, or dysfunction, is one of the commonest disorders of male sexuality. Penile erection depends on a complex interaction of psychological, neural, vascular and endocrine factors. Testosterone hormone has an important role in this process. Neurotransmitters are also involved in starting and maintaining a better penis erection including dopamine and nitric oxide. Men who have difficulty with erection or a weak erection seek an erection ring, erection pump, erection vacuum device, erection cream, or search for an erection pill such as Viagra or herbal erection pills. To maintain a strong penis erection, it is best to have a good sleep at night, have low stress, eat a healthy diet with plenty of vegetables and fish, have a moderate amount of exercise, do yoga, meditation, or relaxation techniques, and have an open heart and close intimacy. All these steps can lead to a longer erection time in a man. Before you take any prescription medications or natural supplements and aphrodisiacs for erection problems, please make sure you read the cautions listed on this impotence page. Get research information on several studies on various supplements and natural medicine topics -- including ways for a better erection without the need for Viagra, Levitra, Cialis or other pharmaceutical medications.

Passion Rx -- Medical Doctor formulated for Erection Enhancement
This natural libido and performance booster provides an erection problem solution that are sometimes noticed within a day or two, but most often it takes three to five days to be appreciated. Our feedback thus far indicates more than 80% user satisfaction by the end of the first week, and higher by the end of the second and third weeks.

Dr. Sahelian and his research staff have tested various doses and extracts of dozens of herbs from a number or raw material suppliers to determine the ideal dosage and combination for optimal erection enhancement with the fewest side effects. After years of research, a unique proprietary blend with more than a dozen herbal extracts from the best raw material suppliers has been created. The exact dosages and potencies of this effective erection pill blend is a close kept secret only known to the doctor and his research staff. You will only find this exact combination in Passion Rx.

How an erection happens - control
A complex interaction of neural, vascular, and biomolecular activity results in normal erectile function. Two chambers in the penis, the corpus cavernosa, contain sinusoids, which fill with blood and expand to become rigid when smooth muscle is relaxed. Blood flow out of the penis is temporarily stopped (veno-occlusion) to maintain and keep the erection. Neural control is complex but, in general, the sympathetic nervous system inhibits, and the parasympathetic system excites erection. The central nervous system can induce erections without peripheral stimuli, e.g. in nocturnal erections. In general, there are 5 recognized phases in erectile response: latent, tumescent, full erection, rigid erection, and detumescent. The key biochemical event in erectile function is an increase in levels of cyclic guanosine monophosphate, which causes smooth-muscle relaxation and allows an erection to occur. This process is mediated by nitric oxide, produced by neurons and elsewhere, which acts as a gaseous messenger molecule. Average erection length is about 5 to 6 inches, a large size would be over 7 inches. Small is considered less than 4 inches.

Erection problems due to poor blood flow
If hardening of the arteries has made your coronary arteries narrow and stiff, that means arteries elsewhere in your body are probably also affected. Atherosclerosis can prevent enough blood flow from reaching your heart, legs, brain and penis. When atherosclerosis affects blood flow to your penis, the blood can't sufficiently fill the penis to allow a suitable erection.

Prescription medications
There is no doubt that Viagra, Cialis, and Levitra improve an erection problem. However, there are risks to these erection pills including optic nerve damage and blindness. I prefer natural erection enhancers such as aphrodisiac herbs.

Erection pill products
Quite a number of erection pills are available, from the pharmaceutical ones to single erection herb products to combination erection herbal products. Even though the drugs work quicker for erection dysfunction, many of the herbal erection pills, over several days, provide a more natural approach to a hard erection. After several days, a spontaneous erection may occur with erection herbs, including a nocturnal erection and morning erection.

Erection vitamin supplements, herbs
There are some vitamin or supplement products that offer natural erection help. Most of the regular vitamins, such as vitamins A, B, C, D, and E do not have much of an immediate influence on penile erection and do lead to a harder erection. However, certain vitamin like nutrients, for instance choline, can be considered an erection vitamin.

Which herbs or dietary supplements should be avoided because they hinder erection function?
   Kava herb and 5-htp could interfere with optimal erection and sensation. 5HTP use could reduce sexual urge and interest.

NO erection - NO meaning nitric oxide, a neurotransmitter
Nitric oxide is a chemical in the bloodstream that helps dilate blood vessels, including those in the penis, thus maintaining and improving blood flow.

Morning erection cause
What is the significance of "morning erections", aka "morning wood", or the apparent lack of them? I tend to be under the impression that they're associated with higher testosterone levels in the mornings when a man wakes up; is this correct? Does the absence of these spontaneous erections on waking represent a "dip" in testosterone levels - assuming there is no erectile dysfunction? I'd like to know what should a guy be doing to maintain good healthy testosterone levels and libido when he avidly participates in exercise programs such as martial arts and especially weight-training? Does weight-training decrease libido? I was under the impression that exercise, especially weight-training, actually helped to INCREASE testosterone and growth hormone levels, but sometimes I wonder if they decrease them? Sometimes I swear I feel a bit "less" in terms of sex drive, and I've read suggestions that weight-training can decrease testosterone. Apart from generally eating healthy, avoiding over-training and trying to get adequate rest, what can an exercising male do to keep healthy testosterone and libido levels? Does weight-training decrease libido? I'd like to keep a good healthy high sex drive as part of my overall approach to health.
    I have not studied morning erection causes in any detail but it seems to be related to REM sleep and perhaps testosterone levels. Exercise usually improves libido and sexual health since it promotes deep sleep. Sunlight exposure by being outside can also help with deep sleep. However, too much exercise of physical exertion can reduce sex drive. Occasional use of Passion Rx or other sexual herbal formulas or single herbs can be helpful in maintaining a healthy sex drive.

Research and studies
Recent insights into androgen action on the anatomical and physiological substrate of penile erection.
Asian J Androl. 2006 January.
Erectile response is centrally and peripherally regulated by androgens. In contrast to younger men, elderly men might require higher levels of testosterone for normal sexual functioning. Several studies have indicated that PDE5 inhibitors are not always sufficient to restore erectile potency in men, and that testosterone improves the therapeutic response to PDE5 inhibitors considerably. The synthesis of PDE5 is upregulated by androgens, and the arterial inflow into the penis is improved by giving androgen.

Melanotan-II: investigation of the inducer and facilitator effects on penile erection in anaesthetized rat.
Neuroscience. 2005 Dec 14;
The effects of melanotan-II, a non-specific agonist of melanocortin receptors, on erection and its possible sites of action were investigated in anesthetized rats. These results lead to the conclusion that central and peripheral melanocortin pathways are recruited by melanotan-II, depending on its route of delivery, to exert both inducer and facilitator activities on erection. Improve erection.

Emails
Q. I have a 4 inch erection of my penis but I am looking for a huge erection that is rock hard and stronger. Do you recommend a pill for this?
   A. I am not aware of an erection pill that increases your size to more than 4 inches. But, it is possible keeping a big erection with some of the suggestions listed at the top of the page.

Q. I can't get an erection and I'm only 41. There has been a lot stress in my life lately.
   A. Stress can certainly inhibit penile engorgment. See stress for information on how to reduce this.

Q. Will sex herbs cure my problem over time i have a weak vein on the one side of my penis so its hard to maintain an erection and is this true the thicker the semen is the harder your erection is cause i was told that if i improve it i could cure my problem that way did you ever hear of that.
   A. It's difficult to say what your exact medical problem is since we don't have a doctor's diagnosis. We are not familiar with semen thickness having anything to do with erections.

Q. According to your personal experience what herb (other then Yohimbe) works best for increasing the erection duration? I don't use yohimbe anymore and I don't like the feeling.
   A. I am not aware of any herbs that work as quickly as yohimbe for erection enhancement, but you can see some of the herbs mentioned on this erection pill site (see link top of page) that could work after a few days.

Q. I get embarrassed when I have a massage since I get an erection. Is there anything I can do to prevent a massage erection?
   A. Just let go of the embarrassment. This is perfectly normal.

Q.  Have been experiencing erection problem and climaxing difficulties. Recently taken off Atenolol 25 mg. On Tildiem Retard 90 mg twice daily. Atorvastatin 80 mg. Ezetimibe 10 mg. Clopidogrel 75 mg. Been on Prozac 20 mg for 17 years and recently been put on Modafinil 400 mg (last 5 months). Can I take 5 mg DHEA and Passion-Rx without Yohimbe.
   A. We don't advise taking Passion Rx if you are on multiple medicines. As to DHEA, that is the decision of your doctor since we can't provide individual advice.

Q. I am looking for an erection enhancer. Have been experiencing erection problem and climaxing difficulties. Recently taken off Atenolol 25 mg. On Tildiem Retard 90 mg twice daily. Atorvastatin 80 mg. Ezetimibe 10 mg. Clopidogrel 75 mg. Been on Prozac 20 mg for 17 years and recently been put on Modafinil 400 mg (last 5 months). Can I take 5 mg DHEA and Passion-Rx without Yohimbe.
   A. We don't suggest Passion Rx for those with a cardiovascular condition, cardiovascular medicines, or those on stimulants such as modafinil. Tildiem is a calcium channel blocker, atorvastatin is a statin drug, clopidrogel is a platelet inhibitor, ezetimibe is used for high cholesterol. Some of these drugs could influece erection, particularly Atenolol and Prozac and to a lesser extent Tildiem.

Q. My erection is four and a half inches. I am also not circumcised. Does a circumcision affect erection size? and if not, what natural vitamins and or minerals should i take to enhance my erection? Are there any tools you know of that can make my erection larger, an erection enhancer?
   A. Certain herbs and sexual herbal products can improve blood flow to the penis and make it fuller and lead to stronger erection. We have not studied the topic of erection enhancer tools. Circumcision has only a millimiter or two effect on erection size.

Q. i wanted to know what should i be ordering as far as helping me consistently achieving solid erections. I been ordering individual items like Reishi mushroom, maca, eurycoma longifolia extra powder, yohimbe 2000 mg , tribulus nothing seemed to work. I dont have sex with the wife on a normal basis maybe once a year personal issues ie marital insecurities etc but i notice since i stopped having sex i dont have hard erection like when i was 25-30 yrs old im 39 now gained a few extra pounds im working on to loose, any suggestions. Will cordyceps work maybe for erection enhancer.
   A. There are dozens of herbs for sexual health and to improve erection, it is difficult to predict which will work in any particular person. Cordyceps is not a potent erection enhancer like some other sexual herbs.

After prostate removal, the nerve bundles that provide the chemical needed for an erection were not cut, but damaged. Result - no erection without Viagra, and then not very satisfying. Do you have any herbal help? How to get that chemical into the penis? How to stimulate the nerve bundles?
   In some people Passion Rx has helped but this is a a difficult condition to treat effectively.

I have had prostate cancer and the prostate removed by radical surgical procedure. I am 59 years old and in good health, want to have sex but cannot get an erection hard enough for intercourse.
   There are a number of herbs and combinations that can be of benefit. It is impossible to predict in any person which one or which combination will work.

I am very much worried about my sexual life with my wife because I have destroyed my massive erection power by using Viagra too much now I am getting married soon and I am very much worried about that. I can't use Viagra for my whole life.
   Natural herbs for erection enhancement are good options to try.

Firstly, I would like to thank you for preparing such a great site. I have been suffering from venous leak and erection problems for such a long time. I have just begun using maca pills. I plan to associate them with Horny Goat Weed or other sex and erection enhancing herbs. I can not maintain an erection, that's my problem.
    It is not clear when you say venous leak whether that was a diagnosis confirmed by a urologist or perhaps you think that is the problem based on not being able to maintain an erection adequate for sexual activity. Nevertheless, it is possible that sexual herbs such as maca, horny goat weed, tribulus, mucuna pruriens or a combination such as Passion Rx could help with erection problems. It is impossible to predict which sexual herb or which sexual formula will be effective. As a general rule, it is a good idea to use lower dosages when combining since side effects could occur when high amounts are used.

I'm having trouble maintaining an erection during sex especially in the woman on top position. I have been prescribed Viagra 100 mg. I'm 23 and have taken many sex aphrodiasiac herbs, including Passion Rx (which works well for me but i still cant maintain a full erection in every position in sex). I used to smoke marijuana heavily and I did extasy about 11 times. i haven't done extasy in about 2 yrs and i havent smoked in 3 months but even with Viagra and herbs i still have erection problems. rarely my penis works the way i like it to, and my testicles don't feel as healthy as they used to even with the testosterone boosting herbs like tongkat ali (and yes i do take breaks). I was wondering if u have any advice on how to help me maintain a strong erection during intercourse, my girlfriend is becoming frustrated.
    Sometimes it's good to go back to basics with eating healthier, eating more fish and taking fish oil capsules, eating ginger herb every day, walking at least a half hour to an hour a day, sleeping well, and reducing stress. It may be a good idea to take a break from all supplements and medications for a couple of weeks and then resume. If one version of Passion Rx was not good enough to lead to a strong erection, the other version may work better. Another option is to try different herbs such as mucuna pruriens, catuaba, or tribulus terrestris.

Is alprostadil effective for erection enhancement as a prescription medication?
    Yes. However, alprostadil did not become very popular since it has to be injected into the penis shaft.

I have seen websites selling several products for male erection enhancement including Irexis and Orexis. Do the work?
    We have not tried these supplements so we don't know.

Am glad to get in contact with you guys because I need advice on this problem. I first had sex when I was 21 years that’s like 4 years ago and it kind of freaked me out and that night I lost my erection for the first time in my life, I was scared. But before that, I got addicted to masturbation for years though am clearing that habit out now…..But I feel like since the first time I had sex, my erection has not been like it was before. Now I feel like am not satisfying my gal friend who am planning to wed soon. Is it possible that I can overcome this problem that came up later in my young life? Such herbal sexual enhancement products, do they clear the problem that after 3-4 months, the problem permanently? How can I achieve that mental confidence and physical performance excellence again?
    There are many causes of erectile difficulties. Certain herbal supplements can be helpful but often only work during the time they are used, although it is possible to have some longer lasting benefits.

I have recently had a stroke and am reluctant to take any type of supplement, but, I am experiencing difficulty with performance since the stroke. It seems that an great amount of stimulus is needed to achieve any erection and I have trouble maintaining it. I know this is the result of the stroke as I had no troubles before. Do you have a supplement that is SAFE and effective for someone in my situation?
    A number of factors have to be taken into consideration regarding the use of natural supplements for erectile enhancement in those with heart conditions or those who have had a cardiovascular event such as a stroke. We are not in a position to give specific suggestions since that is the role of your health care provider.