Erectile-Dysfunction-Protocol.pdf

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Table of Contents Introduction

4

Chapter 1: Formerly Known as Impotence

21

Chapter 2: Misconceptions

31

Chapter 3: Life is Full of Surprises

37

Chapter 4: Getting Help – Short session of questions

41

Chapter 5: Becoming a Botanist? Rather not!

64

Chapter 6: Dietary Supplements

68

Chapter 7: Becoming a Stronger Man

71

Conclusion 13030

“Drinking when we are not thirsty and making love at all seasons, madam: that is all there is to distinguish us from other animals.” Pierre Augustine Caron de Beaumarchais (1732-1799, French Playwright, Inventor, Musician, Diplomat and Satirist)

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Disclaimer No part of this publication may be reproduced in any form or by any means, including printing, scanning, photocopying, or otherwise without the prior written permission of the copyright holder. The Author has strived in every way to be as accurate and complete as possible in the creation of this book, notwithstanding the fact that he does not warrant or represent at any time that the contents within the book are accurate due to the rapidly changing nature of the subject. While all attempts have been made to verify every piece of information provided in this publication, the Author assumes no responsibility for any errors, omissions, or contrary interpretation of the subject matter present in this book. Please note that any guidelines or advice given hereof are not a substitute to medical advice. You agree to use some or all of the information given in this book at your own risk. The Author will not be responsible for any injury that may result by following the advice given in this book. If you are under medication or have doubts following the advice given here, consult your doctor without delay!

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Introduction We have lived, for millennia, in predominantly patriarchal societies, and though theories about a distant, matriarchal past abound, man has dominated history as the essence of physical prowess. Through the ages then, for nearly all of recorded history, women have largely been delegated to looking after the children and the household, or have otherwise been objectified as delicate things of beauty that men “possess”. The purpose of men, on the other hand, has been to “protect” their women, and to accomplish all the other tasks that have historically been deemed too rough, hard, and inappropriate for the fairer sex. So hunting and building, crafting weapons and making war, providing for the family, leadership and the rule of kingdoms and empires, and basically all feats of strength, including sports and games have generally been the sole province of men over the centuries. From religion to war and from politics to business, men have dominated the planet, and in doing so, have become rather used to certain ideas and privileges.

The idea of being the dominant, stronger, and more capable - physically, at the very least - gender has thus been ingrained into the very fabric of our DNA, and small wonder. Yet, perhaps the greatest source of masculine pride, of all the machismo and

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the boasts of strength and valor, and of the intrinsic belief that we are indeed the superior gender, is the male organ of sex and reproduction. We walk as tall and proud as we do, as we have done since prehistory, for no other reason than because we have the ability to impregnate women so they can bear our children and bring them forth into this world. We are able to create life, and in such capacity, we are gratified, assume self-importance, and even a degree of arrogance. However, all of our confidence, our pride, and arrogance - hubris even - in the fact that we are men, born and bred to rule and govern, and to be strong and courageous, all of it can be quite astonishingly fragile. It is shattered in but a moment, and scattered into a million pieces, as a result of one reality-altering occurrence. A simple thing, temporary too, yet it can completely dethrone us, and take us from our lofty heights, only to slam us into the ground, hard - and it is ground which is layered with mud, and we get buried deep in it, and in shame, embarrassment, and selfloathing as well. So, what is it that can so humble all men, regardless of race, age, ethnicity, and social status? It is a little - well, maybe not too little, eh? - thing called erectile dysfunction. What is Erectile Dysfunction? Erectile dysfunction, formerly known as impotence, affects an estimated 18 million men in the United States alone. However, while it is no picnic, it is not as horrible nor as permanent as it sounds or as is generally believed to be. All the terror and the shame usually associated with this problem is only so because the condition is most often completely misunderstood. According to the National Institutes of Health, approximately 5% of 40-year-old men and between 15% and 25% of 65-year-old men experience ED on a long-term basis. 5 [email protected] 2014

A much more common problem which affects the majority of men at some point in their life is the occasional failure to achieve an erection, which can occur for a variety of reasons, such as from drinking too much alcohol or being extremely tired. Therefore, let us first attempt to define and to understand exactly what erectile dysfunction is, and how it is caused. Then we will discuss how it can and does affect the lives of men who suffer from it, and how it affects the people around them, for it does influence partners, family, and friends too, even if indirectly. Once we have a comprehensive understanding of the condition and what it entails, we shall then discuss how to cure it, and you will be surprised at what is in store for you in this eBook. So, without any further ado whatsoever, let us properly and clearly define erectile dysfunction. To Define the Problem Erectile Dysfunction (ED) is generally defined as the inability to achieve or to maintain an erection long enough to engage in sexual intercourse. However, to be able to fully understand erectile dysfunction, one first has to understand how the process of erection works. Well first of all, you need to realize that the penis contains two chambers. They are called the corpora cavernosa, which are filled with spongy tissue, and run the length of the organ and contain a maze of blood vessels shaped like cavernous spaces. An erection is achieved - and this is where you should pay full attention - when the blood vessels of the corpora cavernosa relax and open up - because of nerve messages which stimulate the penis, and impulses from the brain and local nerves - and blood

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rushes in through the cavernous arteries to fill them, before getting trapped under high pressure, which expands the penis, and voilá - you have taken off. So, under normal circumstances, when you are sexually stimulated, your brain will send a message downstairs, through your spinal cord and into the nerves of your penis. The nerve endings of the penis then release chemical messengers, called neurotransmitters, which signal the arteries that supply blood to the corpora cavernosa to relax and fill with blood. As they expand, the corpora cavernosa close off other veins which would normally drain blood from the penis. As the penis becomes engorged with blood, it enlarges and stiffens, causing an erection. Problems with blood vessels, nerves, or tissues of the penis can interfere with an erection. In essence then, erectile dysfunction is simply a problem with your blood flow, and thus, is a problem that can be easily resolved. No need to be embarrassed about it, or to throw away your relationships, and be distressed and depressed, for it could happen to anyone, no? Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50% of the time, however, generally indicates there is a problem requiring attention. The Symptoms of Erectile Dysfunction Sometimes, Erectile Dysfunction only occurs in certain situations. For example, you may be able to obtain an erection during masturbation, or you may find that you sometimes wake up with an erection. However, you may be unable to obtain an erection when you are with your sexual partner.

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In these circumstances, it is likely that the underlying cause of ED is primarily psychological. However, if you are unable to obtain an erection under any circumstances, it is likely that the underlying cause is primarily physical. What Causes Erectile Dysfunction? In order to achieve an erection, these conditions must occur. If there is something interfering with any or all of these conditions, a full erection will be prevented. 

The blood circulation into the penis must be adequate.

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The veins must be able to "trap and keep" the blood inside the penis.

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There must be a stimulus from the brain.

Common causes of Erectile Dysfunction include diseases which affect blood flow, such as atherosclerosis (hardening of the arteries) or venous leakage (weak veins). Furthermore, psychological factors, such as stress, depression, and performance anxiety can lead to ED too, as well as an injury to the penis. Additionally, chronic illness, certain medications, and a condition called Peyronie's Disease (scar tissue in the penis) can also cause ED. All the Distress! Now, as most men fail to truly understand Erectile Dysfunction, its causes, and how it can effectively be cured, through entirely natural means at home, they tend to get scared, and then leap to panicked and irrational conclusions. The lack of understanding breeds unfounded fears, which spawn a series of misguided thoughts and rash actions, and those in turn, engender significant distress, and a host of other problems in life. All the distress, and each of those problems, can however be easily avoided by accomplishing two rather simple things:

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1. Understand and believe - truly, absolutely believe - that Erectile Dysfunction is not the end of the world. It is not permanent, you are not “broken” for the rest of your life, and it can be cured without even having to visit the doctor. 2. Read this eBook from cover to cover, take what is said to heart, and then follow the instructions and guidelines to the letter. It will help too, to learn about and to understand the various problems which can arise post Erectile Dysfunction, before you can attempt to find a solution for them, or to avoid them altogether. Now, some of these problems are simply the natural collateral of suffering from ED, and there is not much you can do about them, but you still need to learn how to deal with them. Others, however, are usually imposed by men upon themselves, and therefore can be easily avoided if you keep the two points mentioned above foremost in your mind. Complications from Erectile Dysfunction 

An Unsatisfactory Sex Life

The most obvious complication to accompany Erectile Dysfunction - and you can just see this one coming from a mile away, can you not? - is an unsatisfactory sex life. It will become considerably - OK, a LOT - less rewarding, and you will have barely any fun. Your partner too, will suffer as a result, because well, you know. The real tragedy here though, is there isn’t too much you can do about this problem, at least not until you effectively cure yourself of Erectile Dysfunction. See, with most other complications arising from ED, you can work around them, wait the situation out, or simply not allow that particular problem to arise. It is difficult, however, to work around an unsatisfactory sex life, you would hardly want to just wait it out, and this is one issue you simply cannot prevent from coming 9 [email protected] 2014

up. Not unless you are an absolute genius at all things sweet and sexual, and you can discover or invent highly creative ways to enjoy sex, even with a malfunctioning organ. There just have to be ways, right? Finding them though, can prove to extremely tricky, and hey, not all of us are good at innovative love making, now are we? Fortunately then, there are easier and more readily available methods of solving this problem. Continue reading this eBook, and you will discover them all. Worry not at all friends, and do not be scared for even a moment, for you will lead an exciting, fulfilling, enjoyable, and entirely satisfactory sex life again - with one partner or various - and perhaps, with all the natural and extremely healthy treatment methods you are going to learn about, you might even have more fun than you ever did before. However, an unsatisfactory sex life can, and often enough does, lead to other problems, and these are the issues you really need to prevent from occurring. 

Depression

Now, this is where you can get trapped into what they call a vicious circle. It is one you need to prevent from closing around you at all costs. Depression is a chronic disease, and it is as increasingly common nowadays, or perhaps even more so, than Erectile Dysfunction. It is when the two problems combine, however, that you will find yourself in deep, deep trouble. Studies have shown Erectile Dysfunction and depressive symptoms to be positively correlated, and have demonstrated that there is indeed, a bidirectional relationship between the two ailments. A five year study revealed that more men with depression are affected by ED than those who do not suffer from depression. Moreover, men with ED have also shown a higher incidence of depression. Furthermore, studies have also shown that the incidence of ED in those who have depression is 1.82 times more than 10 [email protected] 2014

those who do not, and this association is not influenced by age or by factors associated with, such as lifestyle choices and circumstances, and medication use. Erectile Dysfunction is generally not a primary cause of depression, but rather a contributing factor to it as it does not cause depression directly. Most of the men, if not all, see their sexual ability as a measurement of their masculinity and place high priority on it. As a result, those who suffer from ED are likely to feel frustrated, and embarrassed at their diminished sexual ability which will exert stress on their daily lives as the fact that they are unable to achieve a proper erection the same way as healthy men have a huge impact on their self-esteem. Most of them will think that it is their own fault which results in ED and will blame themselves for it, even though that is not necessarily the case. Erectile Dysfunction causes depression, and depression causes Erectile Dysfunction cruel, isn’t it? Still, worry not, for the solution to your problems is soon to be revealed! 

Anxiety and Stress

Yet another potential vicious circle - it is becoming a tale of circles, no? - and one which you need to prevent from closing around you as well, is where stress and anxiety cause Erectile Dysfunction, and ED, being the vengeful mistress it is, whips up a healthy dose of anxiety and stress in return. It can prove to be quite the morbid cocktail too, and to be frank, you will be so much better off without experiencing it. Stress and anxiety are, however, constant companions of Erectile Dysfunction, and it is highly essential that you ditch them at the very first opportunity you get. How can I though, you ask? Well, for one, is ED not enough of a problem for you, but you must go

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and seek out other complications in your life? For another, there truly, absolutely is no cause at all for you to be either stressed out or anxious at all. Erectile Dysfunction is not, as you perhaps previously believed, permanent. In fact, it is easily treatable, and you do not even have to pay embarrassing visits to the doctor, nor do you have to spend bucket loads of your hard earned money on prescription drugs which do not help anyways. So, why sweat yourself, eh? Just sit back and relax, and follow the instructions outlined in the chapters to come. You have no cause, none at all, to worry. Your sex life will return to normal soon enough, and it might even improve as a result of the healthy diet recommended. You will be treating yourself at home, so no one at all has to know except your partner, and your costs will be low too, for you probably got everything you will need when you purchased your groceries at the supermarket. So relax, and kick the vicious circles out of your life, and let in some harmony. Calm down, for it will help with the treatment as well, and believe that everything which is stressing you out right now will soon be gone forever. 

Embarrassment or Low Self Esteem

Failure is as much a part of our lives as is success, and most of us have faced at least some failures - less for some and more for others, in one form or another - in life. However, failing to achieve, or to obtain, an erection is a failure quite unlike any other. It is the first, and probably only, hurdle in life which can make you feel like you are less of a man. Erectile Dysfunction threatens our very egos, it challenges our machismo, and it tears away at our core, innermost beliefs in our own superiority - nay, invulnerability. We

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attempt to rise, we fail and stay flaccid, and the glass shatters. Then several things happen, in the most fleeting of moments, and we are left but empty shells. 

Our fragile self-esteem receives the telling blow, and breaks apart into a million pieces, seemingly never to come together just right ever again.

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Our pride takes a fatal hit, and dies immediately. Buried soon after, it would require a Dr. Frankenstein to resurrect and to patch it back together, and it may never be the same again.

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We are embarrassed, no longer men, but shadows of our former selves, unable to function and to perform, unwilling to face another human being ever again, our lives torn apart.

This is what happens to men who experience Erectile Dysfunction, even if temporarily. This, however, is what should happen: nothing, nil, nada, zilch, zero, and nought! Why should you lose your self-esteem, and what cause do you have for embarrassment? What have you done wrong? Again, nothing! Erectile Dysfunction is a medical problem, just like flu, fever, typhoid, measles, or any other from a host of ailments you experience in life. You do not beat yourself up over them, do you? 

Marital or Relationship Problems

An intimate relationship between two people is extremely personal and private, and it is beautiful. When a man has Erectile Dysfunction, however, it may affect and change his relationship, both with himself and his partner, and things can often get ugly, as evident from the fact that an estimated one in five failed marriages are a direct or indirect result of Erectile Dysfunction. The man may be embarrassed, and might even feel guilty, which makes it difficult for him to talk to his partner about the issue, yet ED has an impact not only on the man, but 13 [email protected] 2014

on his partner as well. A common issue among couples dealing with ED starts with the failure of sexual advances. This can have an adverse effect on issues of trust, intimacy, and closeness. The man withdraws emotionally and physically because of embarrassment and the fear of failure. The partner starts to believe that the man is losing interest in them, thereby impacting their own self-esteem and feelings of attractiveness. The relationship suffers, and romance dies a slow, agonizing death. In reality though, the man is not losing interest, but may be manifesting signs of frustration and humiliation at not being able to effectively participate in any love making or sexual acts. Furthermore, many men think it is inappropriate to need nurturance, or to admit that he needs a hug, or to seek affection. History and matters of DNA - ah, what will become of us men? Similarly to the other complications arising from Erectile Dysfunction, marital or relationship problems do not necessarily have to occur, and can in fact be easily avoided or prevented. All you need to do is believe that you can cure ED, and be whole once again, and thus steer clear of all the psychological issues which lead to failed relationships and marriages ending in divorce.

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The Inability to Get your Partner Pregnant

We are able to create life, us men, and therefore, we walk tall. Take the ability away though, and what are we then? It is an idea as frightening for men as it is embarrassing, 14 [email protected] 2014

a thought which leaves us crippled and devastated. To not be able to impregnate your partner, to know that you cannot have children, can be both tragic and terror inspiring. Men who suffer from Erectile Dysfunction, and thus lose the ability to get their partner pregnant, often begin to feel unworthy, both as lovers and as husbands. More importantly, they begin to feel unworthy as men, and this leads to decreased intimacy with their spouse or the woman they love. For many men, their entire self esteem is wrapped up in the ability to perform like a man, in every way, including sexually. When you are alone with your spouse and are unable to perform, you immediately think to yourself, “I am a failure.” Similarly, when you are unable to impregnate the woman you love, you begin to think of yourself as a failure - as less than a man. The failure to get pregnant affects the woman adversely too, even though the problem may lie entirely with the man. It becomes increasingly frustrating for her, and even more difficult is the fact that any frustration or irritation at all may lead to alienation and a strained relationship. A fear of abandonment and rejection may set in too, while they may also worry that their mates may be impotent with them, but potent with another person, leaving them with fantasies of betrayal and infidelity. You could say most comfortably that the most common complication of erectile dysfunction is that it makes life, well, complicated. However, that doesn't have to be true. Continue reading, and follow this eBook’s guidelines, and you will be able to put Erectile Dysfunction and all related complications behind you for good. Why You Should Not Worry Just Yet You need not worry just yet, or at all, because anxiety and depression are not the true causes of your Erectile Dysfunction, but they may be contributing effects which serve to

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aggravate your situation. The real reason your penis refuses to react is that not enough blood reaches it.

See, a true cause for worry would be if your condition was permanent, if you could do nothing about it, and if there was no treatment or cure available for it. Yet, Erectile Dysfunction is not permanent but temporary, there is plenty you can do if you suffer from the condition, and there is a cure - one you can impart yourself, and what is more, you can do it at home. Furthermore, you do not have to bear awkward visits to the doctor, or share your embarrassment with anyone, or incur huge expenses in medical bills and prescriptions, especially when most of the drugs you will be prescribed are not even effective for the treatment of Erectile Dysfunction.

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A Fully Functional Guide is Here So, what is this miracle cure, and how does it keep you away from the doctors? Can it really, effectively rid you of Erectile Dysfunction? Even if you can be cured, is it really possible to do it at home, without the help of pharmaceutical drugs and doctors? Your miracle cure is this eBook, the Erectile Dysfunction Protocol, a fully functional guide to the treatment of Erectile Dysfunction which keeps you away from the doctors by offering to you an entirely natural solution, with a full list of amino acids, enzymes, and proteins to be added to your diet. Yes, the guidelines presented in this eBook can really, effectively rid you of Erectile Dysfunction, and by extension, all the complications that can arise with it. The solution presented here aims to cure Erectile Dysfunction by targeting the root causes of the condition, instead of the superficial ones, and it does so through completely natural, diet-based, effective methods. Yes, it really is possible to cure Erectile Dysfunction yourself, without the help of doctors or any pharmaceutical drugs, and yes, you can do it yourself at home. How? Well, because the fundamental problem here is improper flow of blood to your penis, and therefore, all you need to do to cure the condition is restore the blood flow. The Erectile Dysfunction Protocol will teach you exactly how to do that, by incorporating a variety of amino acids, enzymes, and proteins into your diet. Furthermore, a host of recipes and tables have been included in the eBook to help you establish and follow the diet required to restore proper blood flow through your body and into your penis.

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The Causes of Erectile Dysfunction Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles, and blood vessels. Erectile dysfunction - meaning not enough blood reaches the penis - can result from a problem with any of these. Likewise, stress and

mental health problems can cause or worsen erectile dysfunction. Sometimes, it is a combination of physical and psychological issues which causes erectile dysfunction. For instance, a minor physical problem that slows your sexual response may cause anxiety about maintaining an erection. The resulting anxiety can, in turn, lead to or worsen erectile dysfunction. Psychological Causes of Erectile Dysfunction The brain plays a key role in triggering the series of physical events which cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include: 

Depression, Anxiety or Other Mental Health Conditions

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Stress

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Relationship Problems Due to Stress, Poor Communication, or Other Concerns

Physical Causes of Erectile Dysfunction 18 [email protected] 2014

In most cases, erectile dysfunction is caused by something physical. Common causes include: 

Alcoholism and Other Forms of Substance Abuse

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Certain Prescription Medications

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Clogged Blood Vessels (Atherosclerosis)

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Diabetes

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Heart Disease

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High Blood Pressure

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High Cholesterol

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Low Testosterone

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Metabolic Syndrome - A Condition involving Increased Blood Pressure, High Insulin Levels, Body Fat around the Waist, and High Cholesterol

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Multiple Sclerosis

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Obesity

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Parkinson's Disease

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Peyronie's Disease - Development of Scar Tissue inside the Penis

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Surgeries or Injuries that Affect the Pelvic Area or Spinal Cord

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Tobacco Use

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Treatments for Prostate Cancer or Enlarged Prostate

A Hint of a Solution Different from many other solutions, what this eBook offers is simple, natural, and without any side effects. You will be getting a list of foods and supplements which have shown their efficiency in the men who had the opportunity to test them. What did exactly happen to them and how were they afterwards? Folks like you and me, friends, acquaintances suffering and not suffering from erectile dysfunction. This method

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offered success to them, as they later reported experiencing considerably better, stronger erections. The foods and supplements presented here have one thing in common - they have all been chosen according to the amino acids, enzymes, and proteins they contain - and have been recommended in a newly discovered combination according to a particular schedule, so that their effect is to help bring more blood into the corpora cavernosa. I aimed for two things primarily when writing this eBook: 1. To both draw attention towards the peril of popular pharmaceutical drugs, such as Viagra and Cialis. 2. To offer an effective, successful solution to the men who suffer from Erectile Dysfunction problems. I know what Erectile Dysfunction is, and how it can make you feel - anxious, nervous, and ashamed! Leave all of that to the past, however, for these problems will not be your concern much longer, and start reading!

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Chapter 1: Formerly Known as Impotence Of Impotence and Erectile Dysfunction Impotence is an old fashioned, non-specific, and pejorative - therefore, medically improper - term which is no longer used to describe male sexual problems. The current terminology describing difficulty achieving and/or maintaining an erection is "Erectile Dysfunction". A Brief History of No Power Herbal, Culinary, and Pharmaceutical Cures The most extensive catalog of stimulants was provided in the first century by Pliny the Elder in his Natural History. The leek, he asserts, “is an aphrodisiac.” The turpentine tree or terebinth “is a gentle aperient and an aphrodisiac.” Garlic “is believed to act as an aphrodisiac, when pounded with fresh coriander and taken in neat wine.” The water of boiled wild asparagus serves the same purpose. “The Cyprian reed, called donax … taken in wine is an aphrodisiac.” The leaves of clematis “eaten with vinegar … act as an aphrodisiac … Sexual desire is excited by the upper part of the xiphium root given in wine as a draught; also by the plant called cremnos agrios and by ormenos agrios crushed with pearl barley.” In ancient Greece and Rome, cures for impotence used parts of animals associated with potency. Snakes - since they were popularly believed to rejuvenate themselves were popular, and the genitalia of roosters and goats were widely consumed. On the forehead of a newborn foal was found a growth called the hippomanes, which, reported Aristotle, was a powerful aphrodisiac. The

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penis was often likened to the lizard, which leads Pliny to note the powers of a large one known as the skink: “Its muzzle and feet, taken in white wine, are aphrodisiac, especially with the addition of satyrion and rocket seed. (…) One-drachma lozenge of the compound should be taken in drink.” In De Animalibus, Albertus Magnus, the thirteenth-century friar, provided exotic remedies for impotence: “If a wolf’s penis is roasted in an oven, cut into small pieces, and a small portion of this is chewed, the consumer will experience an immediate yen for sexual intercourse.” Since sparrows were given to frenetic copulation, it followed that: “sparrow meat being hot and dry enkindles sexual desire and also induces constipation.” He described the starfish as a violent aphrodisiac which could lead to the ejaculating of blood, but could be cured by cooling plants, such as lettuce. The Ladies Physical Directory (1739) declared that absolute impotence was rare. More common was a “languid or faint Capacity” due to a “Deficiency of the Animal Spirits, or their ceasing to flow in such abundance to the particular Muscles, and other Parts administering to Generation.” Such problems could be caused by strains, excesses, selfpollution, and gleets. Other men shed their semen “almost as soon as they entertain any amorous thoughts.” Still others, given to “fast living” and drink, had infertile or effete semen or a “Want of Animalcula.” All would benefit from the author’s Prolifick Elixir, the Powerful Confect, and the Stimulating Balm that promised to “fortify the Nerves, increase the Animal Spirits, restore a juvenile Bloom, and evidently replenish the crispy Fibres of the whole Habit, with a generous Warmth and Moisture.” They would, moreover, allow men to prolong the embrace, and so provide their partners with “prior Endearments and proper Dalliance to raise their Inclination.” At the end of the eighteenth century, Dr. Brodum offered his Nervous Cordial and Botanical Syrup to repair debility and make men ready for the married state. 22 [email protected] 2014

Ebenezer Sibley, like Brodum and other quacks, published testimonials from the supposedly happy consumers of his reanimating “Solar Tincture.” So did Samuel Solomon, who followed Samuel-Auguste Tissot in listing the forms of “debility arising from self-abuse” and offered his Cordial Balm of Gilead for “impotency or seminal weakness.” He advised patients to take the cordial and bathe their testicles in cold water or a mix of vinegar and alcohol. Solomon’s Cordial Balm of Gilead was a mixture of cardamom, brandy, and cantharides, which supposedly favored the production of semen and removed the flaccidity of the muscles. On analysis Brodum’s Nervous Cordial was revealed to consist of gentian, calumbo, and cardamom. Though such concoctions were unlikely to have fortified the constitution as promised, they probably did little harm. The same was likely true of Dr. Senate’s Steel Lozenges and Balm of Mecca, R. and L. Perry’s Cordial Balm of Syriacum, Blake and Company’s Neurosian Extract, and de Roos’s concentrated Guttae Vitae. In the nineteenth century, Frederick Hollick condemned the search for a drug that would cure impotence, but concluded by asserting that there was one substance that, in causing warmth, cheerfulness, and leaving no depressive aftereffect, did restore sexual power and desire - cannabis. Like Hollick, most doctors provided tonics and stimulants, if only to counter their competitors. An 1830 French work recommended ginseng. William Acton prescribed strychnine and phosphoric acid with either syrup of orange-peel or syrup of ginger. Nux vomica (strychnine), yohimbe, and damiana were especially popular. W. Frank Glenn claimed damiana to be the most effective medicine. In cases of complete inability to produce an erection, he employed a combination of phosphide of zinc, damiana, arsenious acide, and cocaine.

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Not until long ago, people used arsenic in cosmetics and were even proud of that. Here we have a newspaper ad from 1918. What is worst is that arsenic, just like cadmium and other toxins, is still used by well-known cosmetics producers. The only difference is that when discovered, this generates a scandal, the companies are fined and the public reorientates to safer products.

On March 27, 1998, Viagra became the first oral medication to be approved by the United States Food and Drug Administration to treat erectile dysfunction. Viagra immediately became the fastest selling pharmaceutical in history. Pfizer’s stock went up 24 [email protected] 2014

150 percent in 1998. Its sale of Viagra topped one billion dollars in 1999 and it enjoyed a profit margin of 90 percent. Pfizer soon had competitors. The year 2003 saw the arrival of Cialis, made by Eli Lilly and Company and Icos, and Levitra, manufactured by Bayer AG and GlaxoSmithKline. Mechanical and Surgical Cures When electrical experiments came into vogue in the eighteenth century, it was soon asserted that electricity and magnetism could also counter flaccidity. Galvanic cures began to be offered in the 1770s by orthodox and quack practitioners. The famous Dr. James Graham touted the dangers of impotence caused by either masturbation or marital excesses, both of which could be cured by cold bathing, moderation, and his amazing electrical bed.

John J. Caldwell described in detail the composition and function of the erectile tissue and how an erection was produced by nervous force. If it was impaired he called for 25 [email protected] 2014

electricity - “either static, dynamic, or interrupted” - to stimulate the production of nerve force. Damiana in combination with electricity was used, he claimed, in “many cases of partial loss of virility with marked success.” Hammond explained how galvanism could be applied with electrodes attached to the spine, perineum, testicles and penis, though he described the effect as “rather unpleasant.” To distinguish themselves from quacks, doctors disparaged all belts, disks, and other apparatuses. Nevertheless Vincent Marie Mondat—a distinguished French physician—was credited with the most outlandish of the various external appliances. He invented the “congestor,” a vacuum pump or “exhausting apparatus,” which in drawing blood into the penis was designed to promote erection. Between the twentieth-century's world wars, some physicians recommended sex aids. “The penile splint, devised by Dr. Thad W. Williams is really practicable and enables the introducing of the non-erected penis into the vagina under all circumstances,” wrote Victor Vecki. “Dr. Joseph Loewenstein provided the fullest account of such “mechanotherapy.” He noted that suction pumps such as those of Dr. Zabludowski provided only an illusionary erection that disappeared as soon as the penis was removed from pump. Equally flawed were the Erector-Sleigh, Gassensche Spirale, Gerson’s Constriction Bandage, and Virility, a double cylinder connected to a bellows to produce a vacuum that, Loewenstein reported, “gives great bulk to the penis and makes it look grotesque.” Loewenstein sang the praises of penis supports made of light metal, especially his own Coitus Training Apparatus, a sort of training wheels for the penis. Consisting of two rings for each end of the penis and rubber covered wires in between, the support was covered by a condom before penetration. Though he cautioned that care be taken that 26 [email protected] 2014

the support and the penis went in the same direction, Loewenstein promised that the partner of the “dexterous man” would not know he was using it. He called it a “training” apparatus because he believed that in many cases the erection of the flaccid penis would occur after entry, and once learnt could occur normally. Women were presumably entranced by neither the device nor the care needed to “extricate the apparatus.” In 1913 Victor Lespinasse, a Northwestern University professor of genitourinary surgery, reported that he had planted slices of human testicle into the muscle of a man who had lost his testicles. Four days after the operation, Lespinasse claimed, the patient had strong erections and insisted on leaving hospital in order to gratify his desires. The first experiment in grafting an entire testicle was performed by Dr. G. Frank Lydston on himself, on January 16, 1914. Expressing his disappointment that vulgar prejudices heretofore had prevented the exploitation of the sex glands of the dead, Lydston coolly reported how he transplanted into his own scrotum a suicide victim’s testicle. L. L. Stanley, resident physician of the California state prison in San Quentin, reported in 1922 that he had first implanted testicles from executed convicts and then moved on to inject into his subjects via a dental syringe solutions of goat, ram, boar, and deer testicles. Altogether he made 1000 injections into 656 men. Stanley had been inspired by work of Serge Voronoff, an eminent Russian-born medical 27 [email protected] 2014

scientist working at the Collége de France. Voronoff, in 1919, scandalized many by transplanting the testes of chimpanzees into men. He asserted that “marked psychical and sexual excitation” typically resulted, followed by a resurgence of memory, energy and “genital functions.” Surgeons from the 1970s on implanted silicon rods in the penis of impotent men. In the 1980s American Medical Systems offered three models, the Malleable 600 Penile Prosthesis consisting of two silicon rubber rods that could either be bent for comfort or straightened for penetration, the Dynaflex Penile Prosthesis with two fluid filled cylinders that when squeezed inflated the penis; and the 700 Ultrex Inflatable Penile Prosthesis complete with reservoir and pump hidden in the scrotum. Inflatable penile implants were not initially examined by the Food and Drug Administration and were plagued by failures and infections. Nevertheless it was estimated that within a decade 250,000 to 300,000 had been inserted.

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Magical, Ritual, and Psychological Cures Fourth-century medical man Theodorus Priscianus advised “reading tales of love.” He went on to suggest: “Let the patient be surrounded by beautiful girls or boys; also give him books to read, which stimulate lust and in which love-stories are insinuatingly treated.” To protect himself against impotence a Roman man might wear a stone talisman or amulet. It was claimed that the “right molar of a small crocodile worn as amulet guarantees erection in men.” In Rome males wore as protection against the evil eye a replica of the penis, called the fascinum from the word to “bewitch.” And finally one could make an appeal to the gods. “While you’re alive I’m hopeful rustic guard / Come. Bless me, stiff Priapus: make me hard.” Seventeenth-century astrologer-herbalist Nicholas Culpeper and midwife Jane Sharp recommended that a man, who due to magic could not give his wife “due benevolence,” should piss through her wedding ring. In France the man was enjoined to piss or pour white wine either through the wedding ring or through the keyhole of the church in which he had been married. A large painting titled Venus and Cupid by Lorenzo Lotto (c. 1480–1556) portrayed one version of this belief in sympathetic magic. William H. Masters and Virginia E. Johnson were the most important of the sex therapists who in the 1960’s dealt with both non-orgasmic women and impotent men. Their simple message was that, armed with

new,

overcoming

scientific marital

knowledge,

problems

was

relatively easy. All that was required was a

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two week training session costing $2,500. By teaching techniques of orgasmotherapy, starting with an education in masturbation, they claimed it was possible to ignore cultural conditioning and circumvent the psychoanalytic preoccupation with the psyche that might demand years of treatment. They reassured their patients that penis size was not important. Men needed only to relax, knowing that sexual intercourse was simply “a natural physical function.” Helen Singer Kaplan agreed that it was “surprisingly easy” to cure the 50 percent of the male population that experienced occasional impotence or what she preferred to call erectile dysfunction. Since anxiety was the key problem, she enjoined men to abandon an “over concern for partner” and “be selfish.” Nothing to be Ashamed Of! Erectile dysfunction can be an embarrassing subject. Most men don’t feel manly without being able to please a woman and have normal erections, when caused. Being a man means having erections, but that is not all there is to it. Being able to care, to provide, and to maintain a relationship is not all about sex. You can be a good worker, as well as you can be a good businessman, a good father, a good husband, by treating people right, and by respecting yourself, your loved ones, and the people near you. Having a good attitude can make a whole lot of difference to your recovery process. It will help you stick to the plan this eBook provides, in addition to reducing your mental suffering, by helping you avoid stress, anxiety, and depression. You need to be strong! Your body will become stronger in a short while, too!

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Chapter 2: Misconceptions In

19th

claimed

century that

England,

the

main

quacks

cause

of

impotence, that we now know is the old term for erectile dysfunction, including this condition, was masturbation. Swiss physician Samuel Auguste Andre David Tissot, a well reputed Calvinist Protestant neurologist,

professor

and

Vatican

adviser, published L’Onanism in 1760. The book was printed in New York in 1832. As a shameful subject, Tissot accused masturbation for the reduction of strength, memory and reason reduction, blurred

vision,

nervous

disorders,

appetite disturbances, headaches and other disorders. According to him: “Impotency is another evil produced by onanism and is sometimes difficult to remove. (…) The most useful tonics are the cinchona or the Sulph of Quinine, a different preparation of iron, wine, cold bathing and a generous nutritive diet”. Let’s analyze his ideas. Iron and nutritive diet? They are both recommended nowadays in anemic patients and are good for increasing the amount of red blood cells. Anemia, also defined as a low ability of the blood to carry oxygen, requires iron and a healthy diet to help your blood regenerate. Wine? It raises blood pressure and makes your blood “move much faster”. These remedies could have good effects over ED, but I wouldn’t advise you to take iron supplements and drink wine to escape your problems; you could face side effects.

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A Separation of Myth from the Facts For millennia, doctors, shaman, and fishwives have been looking for the secret to male enhancement. Men have ingested everything from Spanish flies to concoctions of ground roots to find some way to enhance their sexual experience. The term “male enhancement” actually covers quite a bit of ground. It can focus on increasing a man’s size, increasing libido, or supplying blood flow for erections. Naturally, many myths have cropped up around this problem, mainly due to the universal drive toward better sex, but also due to the somewhat desperate nature of sufferers. Charlatans, well-meaning physicians, and hopeful men still have some misconceptions, however, about what male enhancement is and what modern medicine can and cannot do. With the advent of Viagra, the issue of male enhancement has been thrust into the spotlight, and it has led to a spate of myths which can discourage a man with erectile issues. 

Myth: Erectile Dysfunction should be accepted as a natural part of the aging process. Fact: While ED is more common in older men, it is not a normal part of the aging process. It should, therefore, be viewed as a medical problem, which requires treatment just like all other ailments, and it is one which can be effectively cured. Just as you would not leave high blood pressure untreated as you age, ED and its effects on the body should not be ignored.



Myth: Men should not worry about Erectile Dysfunction if they are less than 40 years old. Fact: Again, while ED is more common in older men, it can affect men of all ages. This is becoming increasingly true today, as younger men are developing 32 [email protected] 2014

medical conditions which can contribute to ED, such as diabetes, high-blood pressure, and heart conditions. 

Myth: Oral Medications are the most effective way to treat Erectile Dysfunction. Fact: While oral medications may, on occasion, contribute to improved blood flow, they usually prove to be a considerably expensive waste. The most effective way to treat Erectile Dysfunction is the one outlined in this eBook.



Myth: There are limited treatment options for men with such medical conditions as diabetes, high blood-pressure, and heart conditions. Fact: While men with certain medical conditions should avoid oral medications and pills, their treatment options for Erectile Dysfunction do not automatically become limited, as pharmaceutical drugs should not be used to treat ED anyways. The proper way to cure ED is through entirely natural methods, with a diet plan that is highly beneficial for men, even those with such medical conditions as diabetes, high blood-pressure, and heart conditions.



Myth: Many herbal products exist on the market today which can treat Erectile Dysfunction. Fact: There are indeed various herbal products available today which claim to provide effective treatment for Erectile Dysfunction. Using these products can, however, prove to be dangerous for your health. Better then, to stick to the solution offered in this eBook.



Myth: You will have to visit a physician numerous times before you can begin treatment.



Fact: The Erectile Dysfunction Protocol offers to you a solution where you do not need to visit a physician even once - not before your treatment, nor during or afterwards. In fact, you can begin your treatment for Erectile Dysfunction immediately, and you can do it without the help of any physician.

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

Myth: Erectile Dysfunction affects only the man who suffers from the condition. Fact: Erectile Dysfunction does have a massive impact on the man, but it does not spare his partner and loved ones either. ED often causes feelings of inadequacy, frustration, and low self-esteem, and can ultimately lead to near constant stress and anxiety, in addition to depression and/or aggressiveness. As a result, personal, family, and business relationships may also be adversely affected if the condition is left untreated.

Pills Solve All Erectile Problems in Men (?!) If you believe the commercials, modern male enhancement medications can help you cool down an overheated car, wrangle a sailboat back on course, and allow you to enjoy a carefree life. Surely, helping you achieve an erection is no problem for these pills, so taking them will make your life spectacular. In fact, these medications have a very limited window of conditions they treat. Erectile dysfunction has a physical element to it: blood flow to the penis is restricted. However, not all erectile dysfunction stems from a lack of blood flow. Some impotence is caused by a lack of libido, and Viagra does nothing for that. In a few cases, the problem is psychological - relationship issues, depression, or performance anxiety - and drugs are therefore unlikely to help a man’s sex life if he suffers from these issues. Medications are not a magic bullet. Medications, Supplements, or Techniques can Increase Penis Size (?!) Men have a love/hate relationship with their penis size. They want to know where they measure up when compared to other men, and if they feel they will not win any blue ribbons for size, they want to find a way to increase their length and width. History is full of hilarious, sometimes even dangerous ways through which men have attempted

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to increase the length of their member, and sadly, none of them worked for the earnest fellows who dared to try them. Viagra never makes claims to increase penis size, and many supplements do not tout this feature, either. However, countless websites are available for men to sample, demonstrating exercise techniques, creams, and supplements which purport to add inches of length to the penis. Unfortunately, the only way to increase penis size is through costly and painful surgery, and many men fortunately draw the line at allowing a surgeon anywhere near their manhood. Only Old Men Need Help with Erectile Dysfunction (?!) The idea that a man needs help with erections at all is so culturally taboo that conditions are applied to it to make it more palatable. If you are 70 years old, and cannot get an erection, then that is one thing. That is allowable and forgivable, though still embarrassing. However, it is not truly the case. Despite taboos, Erectile Dysfunction is a common problem in men of all ages. Some clinical conditions can lead to this problem, such as diabetes, high blood pressure, atherosclerosis, and major depression, to name but a few. Since men of all ages are subject to these common conditions, any man is at risk for erectile dysfunction. A 40 year old man who cannot get an erection is not an aberration, deserving of shame. He is likely a man with co-morbid conditions which are preventing him from enjoying a healthy sex life. Erectile Dysfunction is all in a Man’s Head (?!) Men get blamed with many things and for many reasons when they are having erectile issues. People may call their sexuality into question, wonder if they are attracted to their partner, or secretly dislike sex because they are prudes. As discussed earlier however, 35 [email protected] 2014

so many physical problems can cause Erectile Dysfunction that it usually has nothing to do with a man’s inner psychology, though it certainly can affect it. Diabetes, antidepressants, and chronic pain conditions are just a few of the non-psychological reasons for Erectile Dysfunction. This myth has a kernel of truth to it, though. A lot of times, mental issues can affect a man’s libido and the ability to achieve or sustain an erection. Performance anxiety and concerns about their body plague men as much as they do women. Psychological conditions, such as depression and post-traumatic stress disorder, can leave a man disinterested in any sort of physical activity, and not just sex. In these cases, meeting with a qualified therapist who can work on sexual and life issues is the best course. Erectile Dysfunction Never Gets Better (?!) The good news is that Erectile Dysfunction does get better, and so many solutions are available now which were unheard of 20 years ago. It is true that a man’s sex drive decreases with age, but sexuality remains a large part of our healthy make up for much longer than most people think. Men and women having sex in their 50’s, 60’s, and 70’s is possible, and even common, so if an erectile or libido issue is uncovered early in life, you still have plenty of time to take action. Erectile Dysfunction medications and supplements cannot perform miracles, but they can give you an edge in defeating your condition. Although they tend to be less helpful for psychological issues, they are definitely well suited for sexual problems brought on by age, disease, or medication. Simply because you have Erectile Dysfunction now does not mean you cannot get help and overcome it. 36 [email protected] 2014

Chapter 3: Life is Full of Surprises In fact, the sooner you accept the fact that Erectile Dysfunction can actually be treated, and rather effectively at that, the quicker you can reach out for help, and overcome the condition. You need to believe that there really is no need to panic or to feel depressed, for a cure does exist, and by following the guidelines in this eBook, you can return to a life of fulfilling, satisfactory, and enjoyable sex. If you still have doubts, and fear that your condition might just be permanent, so that you may never again be able to enjoy sexual activities or father children, then read the stories below, of people who suffered, and then recovered, from Erectile Dysfunction. Learn how they coped with the situation, managed and cured their affliction, and perhaps you too will realize that life, as tough as it can be, can also be full of surprises. 

57 years old Dean is the ultimate family man. He has been married for 25 years, has a college girl of 19, and has stayed loyal to his wife through all the years of marriage. Once their daughter moved to campus, Dean thought he would enjoy a second youth with his wife. This is the story of his battle with Erectile Dysfunction.

“I was raised with the belief, and have held onto it through life, that family is the single most important thing to man. It is his joy, his responsibility, and his burden - to provide for, to care for, to look after, and to protect and love. So I have cared for and loved my wife Anna, as dearly as I was able, and when my daughter came along, I loved her too, as truly and deeply as possible. My wife and I nurtured her, protected her, educated her, and cherished her for 19 years, and we put all else on hold, including our sexual life. No parents could be prouder of a daughter than we are of our own, and not once has either of us regretted the sacrifices and compromises which we have had to make over the years. 37 [email protected] 2014

However, once she reached an independent age, and moved away to live at campus, we thought to rekindle our romance, and to reignite our sex life. Little did I know though, that such ideas were to be put on hold yet again, and that this time, I was to be the reason. I discovered I was suffering from Erectile Dysfunction, and for a while there, I became extremely depressed. The longer I was unable to achieve an erection, or to sustain one on those rare occasions when I could manage one, the more stressed out and anxious I became. Even more unfortunately, my moods began to affect Anna, and how could they not? She became frustrated, as I became irritable, and how could she not? All the years of waiting, only for life to throw ED at us - it seemed extremely unfair. Suffice it to say, the following months did not represent the best of times in my life, and I do not remember Anna being as unhappy at any other time during our 30 years together. Yet, where life takes away, it sometimes gives back to you as well, and I was to learn a lesson in exactly how fickle it really can be. Just before we gave in completely to despair, Anna discovered the Erectile Dysfunction Protocol, and everything changed for us. Though I will admit, I followed the eBook’s solution only halfheartedly at first, and even then, Anna had to constantly remind and push me to stick to the diet. I was hesitant, as I was wont to be I think, for how could a diet plan from an eBook help where several physicians and their medicine had failed? And yet, I was proven wrong, and the solution provided by the Erectile Dysfunction Protocol proved to be the miracle cure Anna and I had been praying for. Not only did the treatment outlined help me with the condition, allowing me to once again enjoy a healthy sex life with my wife, but it renewed hope in me too, and most importantly, it helped save our marriage for I really do believe that Erectile Dysfunction, and its effects on me, would have led to us separating from each other.” 38 [email protected] 2014



Joe is the guy you would run into at every party in town. 32 years old, and he could party like a teenager. He used to change women like socks too, that is, until his Erectile Dysfunction problem socked him.

“At age 32, I was diagnosed with Type 1 Diabetes. When you are diagnosed, the doctors go over all of the things you have to beware of - problems with your eyes, heart, kidneys, liver, circulation in your feet, and eventually, you get to Erectile Dysfunction. Initially, in a cocktail fit of panic, shame, embarrassment, anxiety, and stress, I tried everything - the vacuum pump, oral medications, suppositories, and shots. The vacuum pump was the first thing I tried - in fact, I tried it twice. My life was falling apart at the seams! It had seemed like the right thing to do at the time. I cannot begin to tell you just how very uncomfortable it was. You put your penis into the cylinder, pump the blood into your penis, slide the band onto the base of the shaft, and the band holds the blood in. You should see this thing! Not helping matters - I mean, not even a little bit - was the fact that I was completely, utterly, not ready to give up on my lifestyle. I love women, and I love making love to them. I was not about to give up without a fight. I had a little trouble with the suppositories. I could not get over the idea of putting something into my penis, not where everything is supposed to come out. So I tried the oral medications next. Sometimes they would work, but ineffectively at best, and at other times, they would completely fail me. The only thing I could always count on though was an upset stomach. The shots came next. They worked fine in the beginning, but nothing kills the mood faster than having to excuse yourself to go to the bathroom, get your needle ready, and give yourself a shot. I gave myself a shot every time I found myself with a girl, at least until it became unbearable, which was quite soon. As my Erectile Dysfunction 39 [email protected] 2014

worsened, the amount of medicine in the shot increased. My stress increased, as did my anxiety, and soon the shots stopped working at all, even when I could find the courage to inject myself. I could not fathom why this was happening to me. Neither Erectile Dysfunction nor diabetes runs in my family, and I have always tried to lead a very active and healthy lifestyle. I had been happy as a man could be, healthy at 32 years old, and leading a fantastic sex life. When your manhood stops working, especially for someone like me, you shut down. It affects your self-esteem. It hits your pride hard! I thought it was my fault. I felt so alone, and started problems even talking to women, let alone seduce them. Needless to say, I sank into a deep depression. Not only did I stop having sex, I sort of faded away from social life altogether. It was in my deepest moments of despair when I came across the Erectile Dysfunction Protocol, and how I wish I had discovered it sooner. I could have avoided so much embarrassment, pain, and anguish. Yet, I am glad now, for it has taught me so much, and has restored to me the life I so cherish.”

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Chapter 4: Getting Help – Short session of questions Erectile dysfunction, commonly referred to as ED, is the inability to achieve and sustain an erection suitable for sexual intercourse. This condition is not necessarily considered normal at any age and is different from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems regarding ejaculation and orgasm. How Common Is Erectile Dysfunction? According to the National Institutes of Health, approximately 5% of 40-year-old men and between 15% and 25% of 65-year-old men experience ED on a long-term basis. A much more common problem that affects the majority of men at some point in their life is the occasional failure to achieve an erection, which can occur for a variety of reasons, such as from drinking too much alcohol or being extremely tired. Failure to achieve an erection less than 20% of the time is not unusual and treatment is rarely needed. Failure to achieve an erection more than 50% of the time, however, generally indicates there is a problem requiring attention. What Causes Erectile Dysfunction? In order to achieve an erection, these conditions must occur: 

The blood circulation into the penis must be adequate.



The veins must be able to "trap and keep" the blood inside the penis.



There must be a stimulus from the brain.

If there is something interfering with any or all of these conditions, a full erection will be prevented.

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Common causes of ED include diseases that affect blood flow, such as atherosclerosis (hardening of the arteries) or venous leakage (weak veins); psychological factors, such as stress, depression, and performance anxiety; and injury to the penis. Chronic illness, certain medications, and a condition called Peyronie's disease (scar tissue in the penis) can also cause ED. Can ED Be Prevented? For people who are at risk of developing ED due to personal behavior, such as drinking too much alcohol, steps may be taken to prevent it. However, other causes of ED may not be preventable. What Doctors Treat ED? The type of medical specialist who treats ED will depend on the cause of the problem. Based on your family's medical history as well as your own medical history and current health, your doctor may treat you with oral medications such as Viagra or similar drugs. If this fails, he or she may refer you to an urologist or psychologist. What Should I Do If I Am Having Problems Achieving/Maintaining an Erection? If you suspect you may have erectile dysfunction, see your doctor. He or she can perform a variety of tests to identify what is causing your problem and refer you to a specialist if needed. Once the cause is identified, there are several treatments to consider. How Is Erectile Dysfunction Treated? There are many different ways erectile dysfunction can be treated, including oral medications, sex therapy, penile injections, suppositories, vacuum pumps, and surgery. Each type of treatment has its own advantages and disadvantages. 42 [email protected] 2014

Does Insurance Cover ED Treatment? Insurance coverage of ED depends upon the type of treatment prescribed. If there is a documented medical condition that is shown to be causing ED, insurance will usually cover at least some of it. Sex therapy and medications that have not yet been approved by the FDA, however, are generally not covered. Talk to your insurance provider to determine if the treatment you are considering will be covered. Why Can’t I Get an Erection? Like the stock market and foreign-car engines, erections are mysterious things that seem to have a mind of their own. When they don’t happen, it can be hard (so to speak) to figure out why. But these answers should help. Is It All in My Head? Probably not. Most cases of erectile dysfunction (ED) are caused by physical problems or a combo of physical and emotional ones. Decreased blood flow -- in particular, narrowing of the vessels that supply blood to the penis -- is often the cause of ED in older men. Emotional issues are more often a cause with younger men. Regardless of the reasons, ED can lead to performance anxiety, depression, stress, and guilt. So it’s important to look for answers. Is the Problem Physical or Psychological? Stress, anxiety, and depression can cause ED. Do you have erections in the morning or while sleeping? If so, the problem probably is not physical. If you’re not sure, there are tests available to check for nighttime erections. Just about any medical condition that affects your nerves or blood vessels could hurt your ability to have erections. 43 [email protected] 2014

High blood pressure, heart disease, multiple sclerosis, and diabetes can all lead to ED. In fact, as many as 60% of men with diabetes have problems with erections. Hormonal issues such as low testosterone levels can also factor in, more often in older men. Prostate cancer treatments (surgery, radiation) can also cause ED. Can I Blame My Medicines? Maybe. Several types of medications, like blood pressure drugs (especially betablockers) and certain antidepressants, can make it tough to get an erection. If you think your medicine may be causing your problem, don’t just stop taking it. Could My Lifestyle Play a Role? Absolutely. Being overweight, getting too little exercise, and smoking all can work against the good blood flow that is key to erections. And while for some men, a little alcohol may help take the edge off, too much, as Shakespeare wrote, “provokes the desire, but it takes away the performance.” How About My Age? Aging doesn’t cause ED, but ED is more common in older men, as we already know. According to the National Institutes of Health, about 4% of men in their 50s and almost 17 percent of those in their 60s are unable to get erections. For men older than 75, the percentage rises to 47%. Treatments can help men of any age. What Can I Do? Experts agree these are good first steps: 

If you smoke, stop.



Get your blood pressure, cholesterol, and blood sugar levels under control.

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What would a doctor say about your options? ED medications -- sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) -- are usually effective and can help whether your problem is performance anxiety or poor blood flow. Selfinjections, vacuum devices, and squeeze pumps implanted under the skin are other options. For men with low testosterone, replacement therapy may help, though it won’t necessarily solve the ED. Counseling can help you work through any relationship or emotional troubles that may be in play. Physical Causes of Erectile Dysfunction Behind the scenes, a lot goes into achieving an erection. When you're turned on, nerves fire in your brain and travel down your spinal cord to your penis. There, muscles relax and blood flows into the blood vessels. The result, if all goes well, is a rigid penis, ready for sex. Unfortunately, all does not always go well. Many diseases -- and, in some cases, their treatment -- can lead to erectile dysfunction (ED). So can injuries, lifestyle choices, and other physical factors. ED can often be treated, and finding the right cause can lead to successful treatment. 

Diabetes: This chronic disease can damage the nerves and blood vessels that aid in getting an erection. When the disease has not been well controlled over time, it can double a man's risk of erection problems.



Kidney disease: Kidney disease can affect many of the things you need for a healthy erection, including your hormones, blood flow to your penis, and parts

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of your nervous system. It can also sap your energy level and rob you of your sex drive. Drugs for kidney disease can also cause ED. 

Neurological (nerve and brain) disorders: You can't get an erection without help from your nervous system, and diseases that disrupt signals between your brain and your penis can lead to ED. Such diseases include stroke, multiple sclerosis (MS), Alzheimer's disease, and Parkinson's disease.



Blood vessel diseases: Vascular diseases can block the blood vessels. That slows the flow of blood to the penis, making an erection difficult to get. Atherosclerosis (hardening of the arteries), high blood pressure, and high cholesterol are among the most common causes of ED.



Prostate cancer: Prostate cancer doesn't cause ED, but treatments can lead to temporary or permanent erectile dysfunction.

The physical causes of ED are not only disease-related. There are many other potential causes, including: 

Surgery: Surgery for both prostate cancer and bladder cancer can damage nerves and tissues necessary for an erection. Sometimes the problem clears up, usually within 6 to 18 months. But the damage can also be permanent. If that happens, treatments exist to help restore your ability to have an erection.



Injury: Injuries to the pelvis, bladder, spinal cord, and penis that require surgery also can cause ED.



Hormone problems: Testosterone and other hormones fuel a man's sex drive, and an imbalance can throw off his interest in sex. Causes include pituitary gland tumors, kidney and liver disease, depression, and hormone treatment of prostate cancer. 46 [email protected] 2014



Venous leak: To keep an erection, the blood that flows into your penis must stay in your penis. If it flows back out too quickly -- a condition called venous leak, in which the veins in your penis don't constrict properly -- you will lose your erection. Both injuries and disease can cause venous leak.



Tobacco, alcohol, or drug use: All three can damage your blood vessels. That makes it difficult for blood to reach the penis, which is essential for an erection. If you have hardened arteries (arteriosclerosis), smoking will dramatically raise your risk of ED.



Prescription drugs: There are more than 200 prescription drugs that can cause ED.



Prostate enlargement: Prostate enlargement, a normal part of aging for many men, may also play a role in ED.

Drugs Linked to Erectile Dysfunction If you are having problems achieving or maintaining an erection and you are interested in the drugs that might help you, then you may want to take a look at your medicine cabinet first. There are a number of prescription and over-the-counter drugs that may cause erectile dysfunction. While these drugs may treat a disease or condition, they can also affect a man's hormones, nerves, or blood circulation, resulting in ED or increase the risk of ED. If you experience ED and think that it may be a result of medication, do not stop taking the drug without first consulting your doctor. If the problem persists, your doctor may be able to prescribe a different medication. Other substances or drugs that can cause or lead to ED include recreational and frequently abused drugs, such as: 47 [email protected] 2014



Alcohol



Amphetamines



Barbiturates



Cocaine



Marijuana



Methadone



Nicotine



Opiates

Aside from the well-known complications that the use and abuse of these drugs can cause, ED is not often mentioned. However, use of these drugs can cause ED. These drugs not only affect and often times suppress the central nervous system, but can also cause serious damage to the blood vessels, resulting in permanent ED. Erectile Dysfunction and Lifestyle Factors Most of us know by now that smoking is bad for the lungs, being overweight is bad for the heart, and stress can lead to headaches and anxiety. But, did you know that all of these factors can also cause erectile dysfunction? Learn how smoking and other lifestyle factors cause ED. 

Smoking: Smoking increases a person's risk of atherosclerosis (hardening of the arteries) which can reduce blood flow throughout the body, including to the penis, impairing a man's ability to gain an erection. Quitting smoking can help some men partly or fully restore erectile function.

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

Being Overweight: According to The American Urological Association (AUA), overweight men are more likely to have ED. Being overweight increases a person's risk of vascular disease, a known cause of erectile dysfunction.



Sedentary Lifestyle: Regular exercise can reduce the risk of ED, according to the AUA.



Poorly Managed Diabetes: Uncontrolled diabetes can impact blood flow to and nerve endings of the penis. By maintaining a healthy diet, getting regular exercise, and taking the appropriate medication, men with diabetes may be able to avoid diabetes-related ED.



High Cholesterol: High cholesterol can damage the linings of blood vessels throughout the body, including those in the penis. Cholesterol also can harden, narrow, or block the arteries leading to the penis. By maintaining a healthy diet, getting regular exercise, and taking the appropriate medication, men can lower their cholesterol and reduce their risk of ED.



Excessive Use of Alcohol: Excessive drinking (more than two drinks a day) can inhibit erectile functioning by causing a restriction in blood flow to the penis and can affect production of the male hormone testosterone, affecting sex drive and

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erections. 

Illegal Drug Use: Marijuana, cocaine, and other illegal drugs can cause impotence by damaging blood vessels and/or restricting blood flow to the penis.



Stress and Anxiety: Stress and anxiety are leading causes of temporary ED. Too much stress can prevent relaxation, making it difficult to achieve or maintain an erection. Less stress can mean improved erectile functioning.

Men can take active steps to prevent ED or improve their condition by adopting a healthier lifestyle. Erectile Dysfunction and Vascular Disease Vascular diseases affect blood vessels. They restrict blood flow to organs such as the heart, brain, and kidneys. In erectile dysfunction, vascular diseases restrict blood flow to the penis. Vascular diseases may be responsible for causing ED in as many as 50% to 70% of men who develop the condition. Restriction of blood flow caused by a vascular disease is usually caused by a buildup of cholesterol and other substances that may block blood vessels. In some men, the blood vessels in the penis, and the rest of the body, may not function properly. They may restrict blood flow when they're not supposed to. The good news is that lifestyle measures and drug treatments typically work for types of vascular disease that can cause erectile dysfunction. Conditions Associated With Vascular Disease and Erectile Dysfunction The following conditions are associated with vascular disease and clogged arteries. 

Coronary artery disease (clogged arteries in the heart)



High blood pressure

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Diabetes 50 [email protected] 2014

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High cholesterol

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Obesity

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Peripheral vascular disease -- This disease particularly affects blood vessels that supply blood to the legs.

If you have one of these conditions, it’s more obvious a problem with the blood vessels in your penis may cause erectile dysfunction. Also, smoking greatly increases the chance of developing clogged arteries and vascular disease. If you have erectile dysfunction, quitting smoking can help. What Is a Venous Leak? Your penis must store blood to keep an erection. If the veins in the penis cannot prevent blood from leaving the penis during an erection, you'll lose your erection. This is called venous leak. Venous leakage may occur with vascular disease. Venous leakage is also associated with diabetes, Peyronie's disease (buildup of scar tissue in the penis that leads to curved, painful erections), certain nerve conditions, and even severe anxiety. Erectile Dysfunction: Preventing It For people who are at risk of developing erectile dysfunction, taking active steps to prevent its occurrence will also help you lead a healthier life overall. Some steps you can take to prevent ED include: 

Stop smoking (if you are a smoker I’m sure you heard this lots of times. Even in this eBook, but sorry, that’s how things work).

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Exercise regularly.

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Maintain a healthy weight.

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Review your medications. 51 [email protected] 2014

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Take prescribed medications as directed.



Avoid excessive use of alcohol (more than two drinks a day).



Avoid the use of illegal drugs (duh!).

If you have a chronic illness such as diabetes or kidney disease, follow your doctor's guidelines to keep these conditions in control. Treatment Years ago, the standard treatment for erectile dysfunction was a penile implant or longterm psychotherapy. Although physical causes are now more readily diagnosed and treated, individual or marital counseling is still an effective treatment for ED when emotional factors play a role.

There are three prescription medications available in the United States to treat the physical causes of ED: sildenafil citrate (Viagra), vardenafil (Levitra), and tadalafil (Cialis). They help about three-fourths of all men who try them in the general population. Several studies have indicated that their success rate in diabetic men may be slightly lower, averaging around 60-65%. All three pills work by enhancing the effects of nitric oxide. This chemical relaxes muscles in the penis to allow more blood to flow in. These pills do not cause an erection by themselves. Sexual stimulation is also 52 [email protected] 2014

required. Sildenafil or vardenafil should be taken about an hour before sex. Each is effective for roughly four hours. Tadalafil lasts for up to 36 hours. Men should not have sex more than once every 24 hours after using these drugs. Before Viagra's approval in 1998, drug treatment of erectile dysfunction was limited to alprostadil (prostaglandin [E.sub.1]), either injected into the penis or inserted as a pellet into the urethra. Sales of the three newer ED drugs reached $3.4 billion in 2004, according to the research firm IMS Health. In 2004, Viagra had about 66% of the market share for ED drugs compared to 19% for Levitra and 14% for Cialis. Let’s take a closer look on these drugs’ effects over your organism and Erectile Dysfunction. Viagra Sildenafil citrate was originally developed in 1991 as a treatment for angina, or chest pain. The drug, marketed under the name Viagra, received FDA approval as a treatment for erectile dysfunction in March 1998, and since that time it has been prescribed for more than 20 million men worldwide. It was the first oral medication approved for ED treatment. Viagra is a vasodilator, a drug that has the effect of dilating the blood vessels. It works by improving blood circulation to the penis, and by enhancing the effects of nitric oxide, the agent that relaxes the smooth muscle of the penis and regulates blood vessels during sexual stimulation, allowing the penis to become engorged and achieve an erection. The average recommended dose of Viagra is 50 mg. It comes in doses of 25 mg., 50 mg., and 100 mg. The medication is taken approximately one hour before sexual activity is planned, and may remain effective for up to four hours. One drawback is that to be effective, it should be taken on an empty stomach. Also, high-fat foods can interfere 53 [email protected] 2014

with the absorption of Viagra. Viagra does not increase sexual desire. Sexual stimulation and arousal are required for it to be effective. Many insurance plans cover the cost of Viagra, provided it is prescribed to treat erectile dysfunction. The pills cost approximately $10 each, and insurers may limit coverage to a specific number of pills each month. The primary drawback to Viagra, which works about an hour after it is taken, it that the FDA cautions men with heart disease or low blood pressure to be thoroughly examined by a physician before obtaining a prescription. At least 130 men have died while taking Viagra. However, the FDA said the men—most over the age of 64—died of heart attack or stroke due to health problems exaggerated by sexual activity, not the drug itself. Levitra In early 2003, a second prescription drug to treat erectile dysfunction, Levitra, was approved by the FDA. Like Viagra, Levitra helps increase blood flow to the penis and may help men with ED get and keep an erection. Once a man has completed sexual activity, blood flow to the penis should decrease and the erection should go away. Levitra should be taken approximately 60 minutes prior to sexual activity. In clinical trials, most patients were able to begin sexual activity before that time. A 2004 study showed that about 50% of men taking Levitra experienced a firm erection within 25 minutes and a small percentage in as quickly as 10 minutes. Studies also showed that Levitra improved erectile function in men who had other health factors, such as diabetes or prostate surgery.

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Men taking nitrate drugs, often used to control chest pain (also known as angina), should not take Levitra. Men who use alpha-blockers, sometimes prescribed for high blood pressure or prostate problems, also should not take Levitra. Such combinations could cause blood pressure to drop to an unsafe level. Levitra is available in 2.5 mg, 5 mg, 10 mg, and 20 mg tablets and should be taken no more than once a day. The average cost per pill is about $10 and is covered by many insurance plans. Cialis Cialis is the third oral drug prescribed to treat erectile dysfunction, approved by the FDA in November 2003. Its most notable difference from Viagra and Levitra, which work for about four hours, is that Cialis works for up to 36 hours. Cialis helps increase blood flow in the penis when a man is sexually stimulated. It can help men with ED get and keep an erection satisfactory for sexual activity. Once a man has completed sexual activity, blood flow to his penis decreases, and his erection goes away. Cialis is clinically proven to improve erectile function in most men with ED, including those with mild, moderate or severe ED. The most common side effects with Cialis are headache, upset stomach, back pain, and muscle aches. These side effects usually go away after a few hours. Patients who get back pain and muscle aches usually get it 12 to 24 hours after taking Cialis. Back pain and muscle aches usually go away by themselves within 48 hours. Cialis comes in 5 mg., 10 mg. (the recommended starting dose), and 20 mg. tablets. The average cost per tablet is about $10 and it is covered by many insurance plans. Since the absorption of Cialis is not affected by food or high-fat foods, it does not need to be 55 [email protected] 2014

taken on an empty stomach. Studies show that in most men, Cialis begins working in about 30 minutes and may be taken up to once per day by most patients. Priapism, a prolonged erection, is a very rare potential side effect of all prescription ED medications. Persons taking Viagra, Levitra, or Cialis who have a prolonged erection, lasting more than four hours, should seek immediate medical attention. Priapism can cause damage to the penis potentially leading to the permanent inability to have an erection. Because sexual activity can stress the heart, men who have heart problems should check with their physician to see if sexual activity is recommended. Erectile dysfunction drugs may trigger temporary hypotension (low blood pressure) and is known to increase cardiovascular nerve activity, so physicians should prescribe them with caution in men with a history of heart attack, atherosclerosis (hardening of the arteries), angina, arrhythmia, and chronic low blood pressure problems. ED drugs are not labeled or approved for use by women or children, or by men without erectile dysfunction. Anyone experiencing cardiovascular symptoms such as dizziness, chest or arm pain, and nausea when participating in sexual activity after taking an ED medication should stop the encounter. They should also not take any ED drug again until they have discussed the episode with their healthcare provider. It is recommended that men with kidney or liver impairments, and men over age 65, start at the lowest possible dosage of ED medications. Other Treatment Options Although the commercial availability of Viagra, Levitra, and Cialis has been useful in many men, prostate cancer patients and ED caused by psychological problems often 56 [email protected] 2014

require alternative treatment. A commonly used alternative consists of a three-drug injection containing alprostadil, papaverine hydrochloride, and phentolamine mesylate. Though it is commonly referred to as the "Knoxville formula," apparently for the city of its original introduction, a number of slightly varying formulas have been in use around the country. The three-drug preparation is administered by injection into the corpora cavernosa to induce erection. Other traditional therapies for ED include vacuum pump therapy, injection therapy involving injecting a substance into the penis to enhance blood flow, and a penile implantation device. In rare cases, if narrowed or diseased veins are responsible for ED, surgeons may reroute the blood flow into the corpora cavernosa or remove leaking vessels. In vacuum pump therapy, a man inserts his penis into a clear plastic cylinder and uses a pump to force air out of the cylinder. This forms a partial vacuum around the penis, which helps to draw blood into the corpora cavernosa. The man then places a special ring over the base of the penis to trap the blood inside it. The only side effect with this type of treatment is occasional bruising if the vacuum is left on too long. Injection therapy involves injecting a substance into the penis to enhance blood flow and cause an erection. The FDA approved a drug called alprostadil (Caverject) for this purpose in 1995. Alprostadil relaxes smooth muscle tissue to enhance blood flow into the penis. It must be injected shortly before intercourse. Another, similar drug that is sometimes used is papaverine. Either drug may sometimes cause painful erections or priapism that must be treated with a shot of 57 [email protected] 2014

epinephrine. Alprostadil may also be administered into the urethral opening of the penis. In MUSE (medical urethral system for erection), the man inserts a thin tube the width of a spaghetti noodle into his urethral opening and presses down on a plunger to deliver a tiny pellet containing alprostadil into his penis. The drug takes about 10 minutes to work and the erection lasts about an hour. The main side effect is a sensation of pain and burning in the urethra, which can last about five to 15 minutes. The injection process itself is often painful Implantable penile prostheses are usually considered a last resort for treating erectile dysfunction. They are implanted in the corpora cavernosa to make the penis rigid without the need for blood flow. The semi-rigid type of prosthesis consists of a pair of flexible silicone rods that can be bent up or down. This type of device has a low failure rate but, unfortunately, it causes the penis to always be erect, which can be difficult to conceal under clothing. The inflatable type of device consists of cylinders that are implanted in the corpora cavernosa, a fluid reservoir implanted in the abdomen, and a pump placed in the scrotum. The man squeezes the pump to move fluid into the cylinders and cause them to become rigid. (He reverses the process by squeezing the pump again.) While these devices allow for intermittent erections, they have a slightly higher malfunction rate than the silicon rods. Men can return to sexual activity six to eight weeks after implantation surgery. Since implants affect the corpora cavernosa, they permanently take away a man's ability to have a natural erection. Alternative Treatment A number of herbs have been promoted for treating erectile dysfunction. The most widely touted is yohimbe (Corynanthe yohimbe), derived from the 58 [email protected] 2014

bark of the yohimbe tree native to West Africa. It has been used in Europe for about 75 years to treat ED. The FDA approved yohimbe as a treatment for ED in the late 1980s. It is sold as an over-the-counter dietary supplement and as a prescription drug under brand names such as Yocon, Aphrodyne, Erex, Yohimex, Testomar, Yohimbe, and Yovital. There is no clear medical research that indicates exactly how or why yohimbe works in treating ED. It is generally believed that yohimbe dilates blood vessels and stimulates blood flow to the penis, causing an erection. It also prevents blood from flowing out of the penis during an erection. It may also act on the central nervous system, specifically the lower spinal cord area where sexual signals are transmitted. Studies show it is effective to some degree in 30-40% of men with ED. It is primarily effective in men with ED caused by vascular, psychogenic (originating in the mind), or diabetic problems. It usually does not work in men whose dysfunction is caused by organic nerve damage. In healthy men without ED, yohimbe in some cases appears to increase sexual stamina and prolong erections. The usual dosage of yohimbine (yohimbe extract) to treat ED is 5.4 mg three times a day. It may take three to six weeks for it to take effect. Ginkgo biloba, is also used to treat erectile dysfunction, although it has not been shown to help the condition in controlled studies, and probably has more of a psychological effect. In addition, ginkgo carries some risk of abnormal blood clotting and should be avoided by men taking blood thinners, such as coumadin. Other herbs promoted for treating ED include true unicorn root Aletrius farinosa, saw palmetto Serenoa repens, ginseng Panax ginseng, and Siberian ginseng Eleuthrococcus senticosus. Nux vomica Strychnos nux-vomica has been recommended, especially when ED is caused by excessive alcohol, cigarettes, or dietary indiscretions. 59 [email protected] 2014

Nux vomica can be very toxic if taken improperly, so it should be used only under the strict supervision of a physician trained in its use. There are quite a few Chinese herbal remedies for erectile dysfunction usually combinations of herbs and sometimes animal parts such as deer antler and sea horse. Acupuncture is also used to treat ED, although Western doctors question its effectiveness. Natural Remedies for Erectile Dysfunction From acupuncture to arginine, from ginseng to pomegranate juice, men have tried all sorts of natural remedies for erectile dysfunction (ED) -- which doctors define as the repeated inability to get or maintain an erection firm enough for sexual intercourse. But are these alternative remedies safe? Do they really work? The scientific evidence to support the use of natural remedies for impotence is sketchy; many of the studies that seem to give the remedies a thumbs-up were so poorly designed that their findings are suspect. "Just because there is evidence doesn't mean it's good evidence," says Andrew McCullough, MD, associate professor of clinical urology at New York University Langone Medical Center in New York City, and one of the original clinical investigators for the ED drug Viagra (sildenafil). "And before men with ED start down the naturopathic route, it's smart to make sure that there isn't some underlying medical condition that needs to be corrected." That's good advice. An estimated 30 million American men have erectile dysfunction, and seven out of 10 cases are caused by a potentially deadly condition like atherosclerosis, kidney disease, vascular disease, neurological disease, or diabetes. ED can also be caused by certain medications, surgical injury, and psychological problems. 60 [email protected] 2014

Some experts say treating erectile dysfunction on your own, without consulting a doctor, is a dangerous game. "If you have ED, the first thing you need is a diagnosis," says impotence expert Steven Lamm, MD, a New York City internist and the author of The Hardness Factor (Harper Collins) and other books on male sexual health. He says men with severe erectile dysfunction probably need one of the prescription ED drugs, which include Levitra (vardenafil) and Cialis (tadalafil) as well as Viagra. But, he says, mild ED -- including the feeling that "you're not as hard as you could be" -- often responds to natural remedies. But which remedies? Here's a look at the evidence for and against six of the most popular ones: Acupuncture: Though acupuncture has been used to treat male sexual problems for centuries, the scientific evidence to support its use for erectile dysfunction is equivocal at best. In 2009 South Korean scientists conducted a systematic review of studies on acupuncture for ED. They found major design flaws in all of the studies, concluding that "the evidence is insufficient to suggest that acupuncture is an effective intervention for treating ED." Arginine: The amino acid L-arginine, which occurs naturally in food, boosts the body's production of nitric oxide, a compound that facilitates erections by dilating blood vessels in the penis. Studies examining L-arginine's effectiveness against impotence have yielded mixed results. A 1999 trial published in the online journal BJU International found that high doses of L-arginine can help improve sexual function, but only in men with abnormal nitric oxide metabolism, such as that associated with cardiovascular disease. In another study, published in 2003 in the Journal of Sex & Marital Therapy, Bulgarian scientists reported that ED sufferers who took L-arginine along with the pine extract pycnogenol saw major improvements in sexual function with no side effects.

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Arginine can be helpful, says Geo Espinosa, ND, director of the Integrative Urological Center at NYU Langone Medical Center. Espinosa says that men with known cardiovascular problems should take it only with a doctor's supervision; L-arginine can interact with some medications. DHEA: Testosterone is essential for a healthy libido and normal sexual function, and erectile dysfunction sufferers known to have low testosterone improve when placed on prescription testosterone replacement therapy. Similar studies have shown that taking over-the-counter supplements containing DHEA, a hormone that the body converts to testosterone and estrogen, can help alleviate some cases of ED. But DHEA can cause problems, including suppression of pituitary function, and its long-term safety is unknown, says McCullough. For this reason, many experts discourage use of the supplements. Pomegranate Juice: Drinking antioxidant-rich pomegranate juice has been shown to have numerous health benefits, including a reduced risk for heart disease and high blood pressure. Does pomegranate juice also protect against ED? No proof exists, but results of a study published in 2007 were promising. The authors of this small-scale pilot study called for additional research, saying that larger-scale studies might prove pomegranate juice's effectiveness against erectile dysfunction. "I tell my patients to drink it," says Espinosa. "It could help ED, and even if it doesn't, it has other health benefits." Yohimbe: Before Viagra and the other prescription erectile dysfunction drugs became available, doctors sometimes prescribed a derivative of the herb yohimbe (yohimbine hydrochloride) to their patients suffering from ED. But experts say the medication is not particularly effective, and it can cause jitteriness and other problems. "It's not a great drug," says McCullough. "And I suspect the herb is not as potent as the pharmaceutical 62 [email protected] 2014

version." What's more, evidence shows that yohimbe is associated with high blood pressure, anxiety, headache, and other health problems. Experts discourage its use. Horny Goat Weed: Horny goat weed and related herbs have purportedly been treatments for sexual dysfunction for years. Italian researchers found that the main compound in horny goat weed, called icariin, acted in a similar way as drugs like Viagra. Ginkgo Biloba: Known primarily as a treatment for cognitive decline, ginkgo has also been used to treat erectile dysfunction -- especially cases caused by the use of certain antidepressant medications. But the evidence isn't very convincing. One 1998 study published in the Journal of Sex and Marital Therapy found that it did work. But a more rigorous study, published in Human Pharmacology in 2002, failed to replicate this finding. "Ginkgo has come out of fashion in the past few years," says Ronald Tamler, MD, assistant professor of medicine and co-director of the men's health program at Mount Sinai Medical Center in New York City. "That's because it doesn't do much. I can say that in my practice, I have not seen ginkgo work -- ever." No

matter

what

erectile

dysfunction

treatment or treatments a man ultimately decides upon, experts say it's important to eat healthfully and to avoid smoking and heavy drinking. In addition, says Lamm, "A

loving,

receptive,

and

responsive

partner is a home run. After all, this is still a couple's issue."

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Chapter 5: Becoming a Botanist? Rather not!

Erectile Dysfunction Many men experience symptoms of erectile dysfunction (ED), also known as impotence, particularly as they age. An occasional inability to get or keep an erection is nothing to be concerned about. However, when ED occurs frequently, there could be an underlying health issue causing the condition that requires treatment. While it can be embarrassing to talk about sexual dysfunction with your doctor, ED is an important health issue to address. Treatments for ED Erectile dysfunction can be caused by psychological problems, but in most cases there is a physiological cause, such as diabetes, nerve damage, or heart disease that is causing ED. Lifestyle changes, such as losing weight, exercising, and giving up smoking and alcohol, can often help with ED. Korean Red Ginseng Korean red ginseng is a plant that grows in Asia. It is known by several different names including Asian ginseng, Chinese ginseng, or panax ginseng. Korean red ginseng should not be confused with Siberian ginseng or American ginseng, which are different plants. The ginseng root is the part of the plant used as a natural remedy in supplement form. The plant must grow for at least five years before it can be used, which means that high quality ginseng can command a high price. When the root is dried but unprocessed, it is called white ginseng. Red ginseng is the root that has been steamed and then dried. 64 [email protected] 2014

Traditional Uses of Red Ginseng The root of Asian ginseng has been used in traditional Chinese medicine for thousands of years as an overall wellness supplement. It is believed to boost the immune system, improve heart health, treat diabetes, increase energy, decrease stress, and treat impotence. The root has been said to resemble the human body, with shoots for the arms and legs, and it is thought to be the reason that traditional herbalists considered ginseng as a treatment for the entire body. Today, research is shedding light onto just how effective ginseng is as a natural remedy. A Natural Remedy for ED Red ginseng has long been used to treat impotence, but researchers are catching up with traditional medicine and studying the effectiveness of the plant. In a study published in the American Journal of Urology, 45 men who had received diagnoses of ED were given either Korean red ginseng or a placebo. The men receiving the herb took 900 milligrams, three times a day, for eight weeks. At the end of eight weeks, the men who took Korean red ginseng experienced significant improvements in their ED symptoms compared to those who only received a placebo. The researchers concluded that red ginseng may be used as an effective alternative treatment for impotence. Ginseng for Women Another study published in the National Institute of Health (NIH) explored the effect of Korean red ginseng on menopausal women. Many women naturally experience a decline in sexual functioning during menopause. In the study, 32 women were given either three capsules a day of ginseng, or a placebo. Those who received the 65 [email protected] 2014

supplement had improved sexual functioning as a result and experienced no adverse side effects. The researchers concluded that red ginseng may be used by women as a supplement to improve sexual function. Ginseng Supplements Ginseng supplements come in several different forms. When purchasing Ginseng supplements, be sure that the type of ginseng is clearly marked. While both white and red ginseng are sold, research has been largely conducted on the red form. You can find red ginseng in liquid extracts, powders, and capsules. You may also be able to buy the dried root, which can be extracted in boiling water to make a tea. Be sure to talk to your doctor about the right dosage for you and never take more than recommended. Side Effects of Ginseng Red ginseng is considered safe for most people for short term use. Over the long term, there are some concerns about how the plant can affect your body. Side effects do not occur in everyone who take ginseng, but the most common side effect is trouble sleeping. Less common side effects include: 

Diarrhea

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Dizziness

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Elevated Blood Pressure

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Headache

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Increased Heart Rate

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Menstrual Issues

 Rash

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Drug Interactions There is a moderate risk that red ginseng could interfere with certain medications. Make sure you talk to your doctor before taking red ginseng if you take the following medications: 

A Stimulant



Blood Pressure Medicine

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Blood Thinner

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Immune System Suppressant



Insulin For Diabetes



Monoamine Oxidase Inhibitor (Maoi)

You should also avoid combining ginseng and caffeine, as the supplement can enhance the effects.

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Chapter 6: Dietary Supplements Propionyl-L-Carnitine Propionyl-L-carnitine is an amino acid that is naturally produced in the body. Amino acids are the building blocks of proteins. L-carnitine and acetyl-L-carnitine are also amino acids, and they are chemically related to propionyl-L-carnitine. In fact, the body can convert L-carnitine to propionyl-L-carnitine and acetyl-L-carnitine. But, no one knows whether the benefits of carnitines are interchangeable. Until more is known, don’t substitute one form of carnitine for another. Propionyl-L-carnitine is used for treating leg pain (intermittent claudication) due to poor blood circulation (peripheral vascular disease, PVD). PVD is often caused by diabetes or “hardening of the arteries” (atherosclerosis). Propionyl-L-carnitine is also used to treat congestive heart failure (CHF). Men with sexual performance problems (erectile dysfunction, ED) due to diabetes or poor circulation sometimes use propionyl-L-carnitine along with prescription medications. Older men who have symptoms of low testosterone levels sometimes use propionyl-L-carnitine in combination with acetyl-L-carnitine. The propionyl-L-carnitine/acetyl-L-carnitine combination is also used to treat chronic fatigue syndrome (CFS). Healthcare providers give propionyl-L-carnitine intravenously (by IV) for treating PVD and intermittent claudication; to improve wound healing in people with PVD; and to treat heart disease, including congestive heart failure, and chest pain (angina). How Does It Work?

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Propionyl-L-carnitine helps the body produce energy. It is important for heart function, muscle movement, and many other body processes. It also seems to help increase circulation. The Dosage You Should Take For Erectile Dysfunction (ED): A daily dose of 2 grams of PropionylL-carnitine should be used, taken twice weekly by mouth.

L-Arginine L-arginine is a chemical building block called “an amino acid.” It is obtained from the diet and is necessary for the body to make proteins. L-arginine is found in red meat, poultry, fish, and dairy products. It can also be made in a laboratory and used as medicine. L-arginine is used for heart and blood vessel conditions including congestive heart failure (CHF), chest pain, high blood pressure, and coronary artery disease. Larginine is also used for recurrent pain in the legs due to blocked arteries (intermittent claudication), decreased mental capacity in the elderly (senile dementia), erectile dysfunction (ED), and male infertility. Some people use L-arginine for preventing the common cold, improving kidney function after a kidney transplant, high blood pressure during pregnancy (preeclampsia), improving athletic performance, boosting the immune system, and preventing inflammation of the digestive tract in premature infants. L-arginine is used in combination with a number of over-the-counter and prescription medications for various conditions. For example, L-arginine is used along with ibuprofen for migraine headaches; with conventional chemotherapy drugs for treating 69 [email protected] 2014

breast cancer; with other amino acids for treating weight loss in people with AIDS; and with fish oil and other supplements for reducing infections, improving wound healing, and shortening recovery time after surgery. Some people apply L-arginine to the skin to speed wound healing and for increasing blood flow to cold hands and feet, especially in people with diabetes. It is also used as a cream for sexual problems in both men and women. How Does It Work? L-arginine is converted in the body into a chemical called nitric oxide. Nitric oxide causes blood vessels to open wider for improved blood flow. L-arginine also stimulates the release of growth hormone, insulin, and other substances in the body. The Dosage You Should Take For Erectile Dysfunction (ED): A daily dose of 5 grams of L- Arginine should be taken by mouth per day for maximum 6 weeks. Taking lower doses might not be effective.

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Chapter 7: Becoming a Stronger Man Sorry, guys! There's no miracle food to prevent erectile dysfunction. Well, at least not just one miracle food! You can still smile, because there is evidence that certain foods actually help! "Evidence that foods can help with ED is related to a vascular connection," says Firouz Daneshgari, MD, professor and chairman of the department of urology at Case Western Reserve University School of Medicine and University Hospitals Case Medical Center in Cleveland. "Erectile problems are usually due to not having a good blood supply to the penis, so foods that are good for your vascular system may also help prevent ED." Should you eat more of the foods containing these key nutrients? The answer is YES! All the Nutrients that Help 1. The Zinc in Your Diet Most likely, you’ve heard concerns about protein intake, bio-available calcium and heme vs. non-heme iron, but zinc is a mineral that seldom ever comes up, even though according to the National Institute of Health “Zinc is needed for the body’s defensive (immune) system to properly work. It plays a role in cell division, cell growth, wound healing, and the breakdown of carbohydrates. Zinc is also needed for the senses of smell and taste.” Deficiency symptoms include hair loss, slow growth, poor healing rate, and depression. And what’s more, while we can get nearly every nutrient on a vegetarian diet as easily as or more easily than the Standard American Diet, zinc is actually a little more problematic, and as the Vegetarian Society explains, “Only 20% of the zinc present in the diet is actually absorbed by the body” due to the presence of phytic acid, which is somewhat destroyed by cooking, a process raw foodists try to avoid.

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Good sources of zinc usually include liver, oysters, and other foods no vegetarian would want to include in their diet! But even while eschewing meat and animal products, we can get enough zinc. Rich plant based sources of zinc include sesame seeds (14%/oz), shiitake mushrooms (14%/oz), pumpkin seeds (14%/oz and a great source of amino acids). hemp seeds (20%/oz, a source of complete protein), tahini from whole, unroasted sesame seeds (20%/oz), cashew nuts and pine nuts (11%/oz), cacao powder (~15%/oz), avocado (10% per avocado) etc. Raw, organic seeds in general are a very good source of nutrition, and are a valuable addition to any diet. In Oysters and Other Shellfish The oyster has always had an aphrodisiac reputation. One reason may be that oysters have high levels of the mineral zinc, which plays an important role in the production of the male hormone testosterone, and low levels of testosterone could be one reason for erectile dysfunction. Research presented at an American Chemical Society meeting may offer another connection: Raw shellfish contain compounds that stimulate the release of sexual hormones in both men and women. 2. The Nitrates in Leafy Greens and Beets Leafy green vegetables, like celery and spinach, may increase

circulation

because

of

their

high

concentration of nitrates. Beet juice has been found to

be

really

high

in

nitrates.

Nitrates

are

vasodilators, and as such, they open up blood vessels and increase blood flow. Many years before the U.S. Food and Drug Administration approved 72 [email protected] 2014

the first ED drug in 1998, several case reports on the beneficial effects of nitrates for erectile dysfunction had already been published. The ED drugs used today are based on the relaxing effects of nitrates on the blood vessels that supply the penis. 3. The Flavonoids in Dark Chocolate A recent study in the journal Circulation found that flavonoids in dark chocolate improve circulation. That could be good for erection problems that are due to poor circulation.

Flavonoids

are

naturally-occurring

antioxidants that protect plants from toxins and help repair cell damage. Studies show that flavonoids and other antioxidants have similar effects on people. They help lower blood pressure and decrease cholesterol, both of which are factors that contribute to erectile dysfunction. 4. The Protein in Pistachios A recent study found that men with erectile dysfunction who ate pistachio nuts every day for three weeks experienced significant improvement in sexual issues, including ED, sexual desire, and overall sexual satisfaction. The benefits of pistachios for erection problems may be due to a protein called arginine, which may help relax blood vessels. "This is another example of how good circulation is good for sexual health, which is good news because I eat a lot of pistachios," says Dr. Daneshgari. 5. The Antioxidants in Watermelons Some studies show that watermelon may have effects on erectile dysfunction that are similar to the ED drug Viagra and may also increase sexual desire. Watermelon is rich 73 [email protected] 2014

in beneficial ingredients known as phytonutrients. Phytonutrients are also antioxidants. One of their benefits is that they relax the blood vessels that supply an erection. Although watermelon is 92 percent water, the other 8 percent may work wonders for your heart and your sexual enjoyment. 6. The Lycopene in Tomatoes and Pink Grapefruit Lycopene is one of those phytonutrients that is good for circulation and good for sexual issues. Lycopene is found in deep red fruits like tomatoes and pink grapefruits. Some studies show that lycopene may be absorbed best when mixed with oily foods like avocados and olive oil. So you might want to make yourself an ED-fighting salad. Research also shows that antioxidants like lycopene help fight male infertility and prostate cancer. 7. The Vitamin B3 [Niacin] in Beets, Tuna, and Salmon Everyone needs a certain amount of vitamin B3 from food or supplements - for the body to function normally. Having enough niacin, or vitamin B3, in the body is important for general good health. As a treatment, higher amounts of niacin can improve cholesterol levels and lower cardiovascular risks. Niacin occurs naturally in many foods, including greens, meat, poultry, fish, and eggs, though in a fraction of the dose shown to achieve changes in cholesterol. Many products are also fortified with niacin during manufacture. The recommended dosage for treating ED is maximum 1,500 mg per day, for maximum 12 weeks.

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Foods and Erectile Dysfunction: The Bottom Line According to Daneshgari, "Your best bet is to eat a healthy diet that is good for your heart and your circulation." Other foods that are good for your circulation include cranberries, apples, peanuts, onions, tea, and red wine. Chances are, if you take good care of your vascular health, you will avoid many of the common causes of erectile dysfunction. You will be given a 5 days plan to treat E.D. Most people have reported results within the next 48 hours following the start of this program. The 5 Day Game Plan Monday: Eat Red Berries (personalized daily suggestion) Why? Poor diet can lead to vascular disease, which is one of the key causes of ED, and bright berries are just the job for supporting vascular integrity. What With? On Monday, make a smoothie with a handful of mixed berries, some lowfat yogurt, and skimmed milk. Enjoy it in a break, whenever you feel like drinking something refreshing. Monday: Foods and supplements (mandatory) Today’s foods and supplements (to be eaten in less than 30 minutes, between 10 and 11 in the morning, or between 4 and 5:30 in the evening): 

Propionyl-L-Carnitine: 2 gr



L-Arginine: 5 gr



Zinc & Proteins: 1 cup of pumpkin seeds and pistachios (50/50)



Vitamin B3, nitrates, flavonoids & lycopene: 8 oz. special fruit salad, consisting in 1 oz. dark chocolate, 2 oz. beets, 2 oz. grapefruit, 1 oz. apple, 2 oz. marshmallow

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Tuesday: Eat Garlic (personalized daily suggestion) Why? Although garlic might seem like the last place you’d go to stay perky, it contains allicin, which improves blood flow (one of the key factors for helping ED). What With? Roasting garlic softens its pungency, so for Tuesday’s dinner try roasting a whole head of garlic until soft and then squeeze over a piece of roast chicken. Tuesday: Foods and supplements (mandatory) Today’s foods and supplements (to be eaten in less than 30 minutes, between 10 and 11 in the morning, or between 4 and 5:30 in the evening): 

L-Arginine: 5 gr



Zinc, Vitamin B3 & Proteins: 1 ½ cup of cashew nuts, peanuts and pistachios (equal parts)



Lycopene: 1 medium seized mango



Antioxidants: 1 cup wild blueberry



Nitrates: 1 glass of rhubarb juice



Flavonoids: 1 oz. dark chocolate Wednesday: Eat Soy (personalized daily suggestion)

Why? Soy beans are rich in L-Arginine, a circulation-boosting amino acid. Soy is also good for your prostate, which is crucial for your reproductive system. What With? Stir-fry some greens such as bok choi (pak choi) with a splash of soy sauce. Wednesday: Foods and supplements (mandatory) Today’s foods and supplements (to be eaten in less than 30 minutes, between 10 and 11 in the morning, or between 4 and 5:30 in the evening):

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

L-Arginine: 5 gr



Zinc, Vitamin B3 & Proteins: 1 ½ cup of squash seeds, peanuts and pumpkin seeds (equal parts)



Nitrates & Lycopene: 1 large seized carrot



Antioxidants: 1 cup of cranberry



Flavonoids: 1 oz. dark chocolate Thursday: Eat Zinc (personalized daily suggestion)

Why? Zinc deficiencies can lead to erectile problems. What With? So on Thursday, go for a double whammy and order in some oysters - they deserve their reputation as an aphrodisiac, even if they are an acquired taste. Thursday: Foods and supplements (mandatory) Today’s foods and supplements (to be eaten in less than 30 minutes, between 10 and 11 in the morning, or between 4 and 5:30 in the evening): 

L-Arginine: 5 gr



Lycopene: 1 medium seized tomato



Proteins: 2 tablespoons of peanut butter



Zinc & Flavonoids: 2 oz. dark chocolate



Nitrates: 1 glass of rhubarb juice



Antioxidants: 1 medium seized Granny Smith apple



Vitamin B3: 1 cup of sunflower seeds

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Friday: Eat Omega 3 (personalized daily suggestion) Why? Omega 3 improves the nervous system and circulation and will aid blood flow to all the right places. Oily fish such as mackerel, sardines, and salmon are all high in Omega 3. What With? On Friday, barbecue or griddle some sardines and serve them with a crisp fennel, caper, sultana, and lemon slaw. Friday: Foods and supplements (mandatory) Today’s foods and supplements (to be eaten in less than 30 minutes, between 10 and 11 in the morning, or between 4 and 5:30 in the evening): 

Propionyl-L-Carnitine: 2 gr



L-Arginine: 5 gr



Zinc & Flavonoids: 2 oz. dark chocolate



Nitrates & Lycopene: 1 large seized carrot



Proteins: 1 cup of almonds



Antioxidants: 1 cup of strawberries



Vitamin B3: 1 medium seized avocado fruit Questions and answers

Q: Is there a specific order to eat the ingredients of each day’s diet? A: No, there is not. You just have to make sure you eat everything on the list in maximum 30 minutes. Q: Is this diet going to harm me somehow?

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A: As you can see, all the food products are natural and quite common ones. You must check to for allergies. If you are allergic to one product, don’t eat it! Skip to the next day’s diet plan. Q: How long would it take until I see some results? A: Usually, most men report feeling better in about 48 hours. If you don’t notice an improvement, continue your five days program, making sure you don’t miss any ingredient. Q: What if I get erections that bother me and I would like to reduce the doses. What should I no longer eat? A: The first thing you should quit on are the supplements. As you know, you are allowed to take daily doses of L-Arginine (5 gr per day for maximum 6 weeks) and 2 doses a week of Propionyl-L- Carnitine. These are the first ones you should quit on. If you are still bother by the intensity of this protocol’s results, you can skip a day of the five scheduled. Q: Why is there a cook book attached to this eBook? Are those recipes necessary to cure E.D.? A: The recipes are examples of a healthy diet that would help your plan to work better and faster. As you can see, the recipes come with some comments – some are rich in zinc, some are rich in iron or certain types of vitamins. They all help you better assimilate what you eat during your protocol. Q: Are the foods recommend for each day going to replace breakfast, lunch or dinner?

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A: No. You should take care of your daily meals and eat healthy foods. The each day plan is meant to bring more nutrients to what you ate for your main meals, not to replace them. Q: What if I want to create my own diet, according to the things I enjoy most and to avoid the things I am allergic to? What should I choose? A: It is not complicated. Please take a look at this table and see what foods are best for you. Just remember to eat everything within the same time schedule, morning or afternoon, in no more than a half an hour. Foods that cure and prevent E.D. Zinc

Oysters

Nitrates

Beans

Flavonoids

Apples

Proteins

Almonds

Beef

Garlic

Apricots

Seitan rice

Lamb

Onions

Blueberries

Wheat Germs

Eggplant

Pears

Spinach

Squash

Raspberries

Antioxidants Beans: red, pinto, black

Lycopene

Vitamin B3 Fish: tuna, makerel,

Guavas

Bluefin tuna, wild salmon, swordfish

Blueberry

Watermelon

Chicken

Cranberry

Tomato

Turkey

Yogurt

Artichoke

Papaya

Pork

Soy milk

Blackberry

Grapefruit

Lamb liver

Peanut butter

Dried beans: Pumpkin seeds

Arugula

Black beans

kidney, pinto,

Prune

Sweet Red Peppers

Peanuts

chickpeas, lentils Squash seeds

Carrots

Cabbage

Pumpkin seeds

Rasberry

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Asparagus

Mushrooms: brown, white,

Chanterelle Cashews

Beets

Onions

Quinoa

Strawberry

Red Cabbage

Green peas

Apples: red Cocoa

Celery

Parsley

Cottage

delicious,

cheese

granny Smith,

Mango

Sunflower seeds

Carrots

Avocado

Gala Dark chocolate

Rhubarb

Tomatoes

Pork

Eggs

Pecan

Pistachio

Sweet cherry

Chicken

Black plum

Kidney beans

Russet potato

Mushrooms: portabella,

Watermelon

white, Shitake

Pine seeds Sesame seeds

In the following pages you can read all about what a healthy diet means for people with Erectile Dysfunction problems.

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All the Recipes that Help Breakfast Recipes Several breakfast foods offer high levels of zinc. Consider including these breakfast foods as part of a well-rounded meal plan. The zinc quantities for each food type have been extracted from the United States Department of Agriculture’s (USDA) nutrient database. 

Almond Butter: A nutty spread, almond butter - no salt added - has .53 milligrams of zinc per tablespoon. Spread on toasted whole wheat bread or on a toasted whole wheat English muffin.



Whole Wheat Bread: Bread is a versatile breakfast food. It can be toasted, eaten as part of an egg sandwich as well as dipped in egg and milk to make French toast. One slice of whole wheat bread has .50 milligrams of zinc.



Whole Wheat English Muffins: Find these treats in the bread aisle. Whole wheat English muffins offer 1.06 milligrams of zinc per muffin. Don’t forget to top them with a tablespoon of almond butter.



Oat Bran Muffins: One medium oat bran muffin (about 4 ounces) has 2.08 milligrams of zinc. Pair it with a banana or a cup of raspberries for a delicious, nutritious zinc-rich breakfast.



Oatmeal: One cup of regular/quick oats (unenriched) made with water and no salt boasts 2.34 milligrams of zinc. Oatmeal can be topped with fruits with zinc: bananas, raisins, raspberries or blackberries.



Milk: A breakfast staple, 1 cup, or 8 ounces, of 2% milk with added vitamins A and D has 1.17 milligrams of zinc.



Yogurt: Dairy products are good sources of zinc. One cup of low-fat vanilla yogurt has 2.03 milligrams of zinc. Like oatmeal, yogurt can be topped with fruit, slivered almonds or even toasted wheat germ. 82 [email protected] 2014



Wheat Germ: Wheat germ in ready-to-eat cereal form has a large amount of zinc: 18.84 milligrams per cup or 4.73 milligrams per ounce.



Eggs: Eggs are one of the most versatile breakfast foods. They can be fried, hardboiled, scrambled, mixed into pancake batter or used as a coating for French toast. One cup of scrambled eggs has 2.29 milligrams of zinc. One large hardboiled egg has .52 milligrams of zinc.



Bacon: Include three slices of bacon as a side for your scrambled eggs for an additional .82 milligrams of zinc. Is Canadian bacon more your style? Two slices have .80 milligrams of zinc.

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1. Cheesy Cast-Iron Skillet Scrambled Eggs Cheese and eggs taste great together and may help combat osteoporosis. The reason: calcium in cheese is more easily absorbed into the body with the addition of vitamin Drich eggs.
This recipe calls for fresh goat cheese and a few chives snipped on top. Nutritional Benefit for Men with ED: 16g Protein Ingredients 

2 tablespoons unsalted butter



1 small red onion, finely diced



1 jalapeño, cut into thin rounds, seeds included



12 large eggs, lightly beaten



1/4 teaspoon salt



1/2 teaspoon freshly ground pepper



4 ounces goat cheese, crumbled



2 tablespoons finely chopped chives

Preparation 

In a large cast-iron skillet, melt butter over medium heat. Add onion and jalapeño and cook until soft (5–7 minutes). Stir in eggs, salt, and pepper, and cook, stirring, until soft curds form (about 3 minutes).



Remove skillet from heat and mix in the goat cheese and chives. Serve immediately with whole-grain toast or English muffin, if desired.

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2. Frittata with Ricotta and Mixed Greens Protein, healthy fats, and greens make this delicious, low-calorie frittata as healthy as it is delicious. Dark, leafy greens like kale, Swiss chard, or mustard greens are about 30 calories a serving and among the healthiest foods you can put on your plate, with loads of vitamins A, C, and K, plus fiber. Don't skimp on the fresh herbs called for in this recipe, for they deliver a healthy dose of antioxidants along with flavor. Nutritional Benefit for Men with ED: 14g Protein + Antioxidants Ingredients 

1/3 cup plus 2 tablespoons olive oil, divided



1 medium red onion, finely diced



Pinch of red pepper flakes



1 pound chopped mixed greens (such as kale, Swiss chard, or mustard greens)



10 large eggs



2 tablespoons freshly grated Parmesan cheese



1/2 teaspoon salt, divided



1/2 plus 1/8 teaspoon freshly ground black pepper, divided



1 tablespoon red-wine vinegar



8 ounces part-skim ricotta



1 cup fresh basil leaves



3/4 cup fresh parsley leaves



1/4 cup fresh mint leaves



1 clove garlic, chopped



1 tablespoon pine nuts

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Preparation 

Preheat oven to 350°.



In a large nonstick skillet, heat 1 tablespoon oil over medium-high heat. Add onion and cook, stirring, until soft (about 4 minutes). Add pepper flakes and half of greens and cook until wilted and crisp-tender (about 5 minutes); place sautéed greens in a colander. Repeat with remaining greens. Cool slightly and squeeze dry; transfer to a bowl. Using paper towel, wipe out skillet and reserve.



In a large bowl, whisk together eggs, Parmesan, and 1/4 teaspoon each salt and pepper until smooth. Add to bowl with greens, vinegar, ricotta, and 1/8 teaspoon pepper; stir to combine. Fold the ricotta mixture into egg mixture.



In reserved skillet, heat 1 tablespoon oil over medium heat. Pour egg mixture into pan and cook until the sides are set (about 8 minutes). Transfer to oven and bake until completely set (about 15 minutes).



To make pesto: Combine basil, parsley, mint, garlic, and pine nuts in a food processor and process until all ingredients are coarsely chopped. With the motor running, slowly add the remaining 1/3 cup oil and season with 1/4 teaspoon each salt and pepper.



Remove frittata from oven and invert onto serving platter. Slice into 8 wedges and serve with pesto.

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3. Tuna Cream Cheese Omelet Perfect for dinner on a busy night, this omelet is filled with luscious cream and mozzarella cheeses, sliced black olives, and flaky tuna fish. It is also the ideal breakfast for men with erectile dysfunction, with healthy doses of protein, zinc, and vitamin B3. Nutritional Benefit for Men with ED: 79g Protein + Zinc + Vitamin B3 [Niacin] Ingredients 

2 tsps vegetable oil



1/2 onion (small, chopped)



6 ozs tuna (drained)



1/3 cup sour cream



3 tbsps cream cheese



1/2 cup shredded mozzarella cheese



21/4 ozs sliced black olives



1/8 tsp dried dillweed



1/8 tsp garlic powder



5 eggs



1/4 cup milk



2 tsps vegetable oil

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Preparation 

Heat 2 teaspoons vegetable oil in a large skillet. Cook and stir onion over medium heat until onions begin to brown.



Combine tuna, sour cream, cream cheese, mozzarella cheese, olives, dill, garlic powder, and cooked onion in a large bowl.



Beat eggs with milk in a large bowl. Heat 2 teaspoons of oil in the skillet used to cook the onions. Pour the egg mixture into the hot pan. As eggs set, lift the edges to allow the liquid to run underneath for even cooking. When eggs are almost fully set, spoon tuna mixture onto one half of the eggs; fold the untopped half over the filling. Cover pan, and remove from heat. Allow omelet to rest in covered pan until the cheese is melted.

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4. Bacon and Jalapeño Egg Sandwich This crispy, meaty breakfast sandwich was inspired by the classic McMuffin, but it's so much better for you! This version calls for organic eggs, a whole-grain English muffin, reduced-fat cheese, and a metabolism-boosting jalapeno pepper. Low-fat, high-protein turkey bacon makes it hearty enough to keep you full and satisfied all day. This healthy breakfast egg sandwich is one of the tastiest and most nutritious ways to fuel up in the morning. Nutritional Benefit for Men with ED: 21g Protein + Lycopene + Zinc Ingredients 

1 piece turkey bacon, such as Applegate



1 whole-grain English muffin, split



Cooking spray



1 large organic egg



1/4 ounce reduced-fat cheddar, shredded



Pepper



1/2 small jalapeño, thinly sliced



2 thin slices red onion



1 thick slice tomato



4-5 sprigs fresh cilantro

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Preparation 

Warm a skillet over medium heat. Cook the bacon until crisp. Set aside.



Place muffin, cut-side down, in skillet. Press to toast - 2 minutes. Set aside.



Coat skillet with cooking spray. Cook egg about 30 seconds. Sprinkle with pepper and cheese. Cook until set. Transfer egg to muffin half. Top with the bacon, jalapeño, onion, tomato, cilantro, and second muffin half.

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5. Braised Kale Frittata Instead of your usual omelet, try this antioxidant-packed baked frittata that uses kale and tomatoes - both of which help fight erectile dysfunction. This delicious recipe is a good source of iron as well as protein, with only 7 grams of carbohydrates. Nutritional Benefit for Men with ED: 16g Protein + Lycopene + Zinc + Antioxidants Ingredients 

6 large eggs



4 large egg whites



3/4 teaspoon kosher salt



1/2 teaspoon black pepper



1/2 ounce Gruyère or Parmesan cheese, grated (3 TBSP)



2 tablespoons chopped oregano



Cooking spray



2 cups Braised Kale without cheese, drained, finely chopped



3/4 cup chopped cherry tomatoes

Preparation 

Preheat oven to 375°F. In a large bowl, whisk the first 6 ingredients (through oregano).



Lightly coat an 8-inch ovenproof cast-iron or nonstick skillet with cooking spray. Heat over medium. Add the kale and tomatoes. Cook, stirring, until hot (about 3 minutes). Add the eggs and swirl to distribute.



Transfer to the oven and bake until set and hot (about 20 minutes). Cut in wedges.

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6. Asparagus with Poached Eggs and Parmesan Poached eggs, asparagus, and Parmesan make this the ultimate brunch recipe, but it is light enough to enjoy any time. Asparagus, a seasonal spring veggie, is full of vitamin K and folic acid, which keeps your cardiovascular system healthy. Plus, with 18 grams of protein, you'll have plenty of energy for the rest of the day. Nutritional Benefit for Men with ED: 18g Protein + Zinc + Antioxidants Ingredients 

8 large eggs



1 teaspoon white vinegar



1 teaspoon salt, divided



2 bunches asparagus spears, trimmed (about 40)



1 tablespoon extra-virgin olive oil



1 garlic clove, chopped



1 tablespoon unsalted butter



2 tablespoons fresh lemon juice



2 teaspoons finely chopped fresh parsley



Freshly ground black pepper, to taste



4 tablespoons coarsely grated fresh Parmesan cheese, divided

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Preparation 

Break the eggs into 8 individual containers (such as teacups, prep bowls, or paper cups). Fill a large, low-sided pan with water, and add vinegar and 1/2 teaspoon salt; bring to a boil over medium-high heat.



Meanwhile, bring a separate pot of water to a boil in a medium saucepan over medium-high heat. Add asparagus spears, and cook 3–4 minutes or until crisptender. Remove asparagus with tongs, and set aside.



Dry the medium saucepan. Add olive oil, and heat over medium heat. Add garlic and then sauté about 1 minute. Turn off heat; add butter, and swirl pan. Add lemon juice, parsley, remaining salt, and pepper; swirl pan again to combine. Add asparagus and 2 tablespoons Parmesan; then toss with lemon-butter sauce to coat.



Slowly pour each egg into the boiling poaching water; cook 2 minutes. Turn off heat, and remove pan from burner. Divide asparagus among 4 plates. (Bring plates close to pan with poached eggs, and place a folded clean kitchen towel next to plates.)



Remove the eggs from water with a slotted spoon, 1 at a time, blotting bottom of spoon on towel to absorb excess moisture. Place 2 eggs on each mound of asparagus. Pour any remaining sauce over each serving, and sprinkle with remaining 2 tablespoons Parmesan. Serve immediately.

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7. Crostini with Spinach, Poached Egg, and Creamy Mustard Sauce Eggs Benedict get a makeover! Low heat is the key to making perfect poached eggs, and low-fat sour cream and mustard transforms rich Hollandaise sauce into a flavorful, lowfat version. Tip: Use whole grain bread for the crostini to kick up the fiber. Nutritional Benefit for Men with ED: 13g Protein + Zinc + Antioxidants Ingredients 

1/4 cup reduced-fat sour cream



1 tablespoon Dijon mustard



1 teaspoon fresh lemon juice



1 tablespoon finely chopped chives



1/4 teaspoon kosher salt



1/4 teaspoon freshly ground pepper



2 teaspoons water



4 (1/2-inch thick) slices crusty whole-grain bread, toasted (1.5 oz per slice)



2 cups baby spinach



1 teaspoon white vinegar



4 large eggs

Preparation 

Stir together sour cream and next 5 ingredients (through pepper) in a small bowl with water. Place 1 slice toast on each of 4 serving plates and top each with spinach.



In a large saucepan, bring 2 inches of water to a simmer; add vinegar. Working one at a time, crack eggs into a cup and gently slip into water. Simmer 2-3 minutes. Using a slotted spoon, place a poached egg on top of spinach. Spoon about 1 TBSP sauce over each crostino before serving. 94 [email protected] 2014

Lunch Recipes 1. Egg Salad Sandwiches with Watercress Watercress, a cruciferous vegetable, adds a zesty note - and welcome phytonutrients - to this enlightened version of an American classic. Nutritional Benefit for Men with ED: 16g Protein + Vitamin B3 [Niacin] Ingredients 

8 large hard-boiled eggs



3 tablespoons nonfat sour cream, or nonfat plain yogurt



1 tablespoon reduced-fat mayonnaise



1 tablespoon grainy mustard



4 scallions, trimmed and chopped



Salt & freshly ground pepper, to taste



3/4 cup washed and stemmed watercress



8 slices pumpernickel bread

Preparation 

Scoop out egg yolks. Place 2 yolks in a small bowl and reserve the rest for another use. Chop egg whites and reserve. Mash the yolks with a fork and stir in sour cream (or yogurt), mayonnaise, and mustard. Add chopped egg whites and scallions and season with salt and pepper.



Arrange watercress on 4 bread slices. Top with the egg salad and cover with the remaining bread slices.

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2. Salmon Salad Sandwich Salmon salad served on tangy pumpernickel bread makes for an easy dinner—a double batch will give you lunch the next day. Nutritional Benefit for Men with ED: 22g Protein + Vitamin B3 [Niacin] + Lycopene + Antioxidants Ingredients 

2 6- to 7-ounce cans boneless, skinless wild Alaskan salmon, drained



1/4 cup minced red onion



2 tablespoons lemon juice



1 tablespoon extra-virgin olive oil



1/4 teaspoon freshly ground pepper



4 tablespoons reduced-fat cream cheese



8 slices pumpernickel bread, toasted



8 slices tomato



2 large leaves romaine lettuce, cut in half

Preparation 

Combine salmon, onion, lemon juice, oil and pepper in a medium bowl. Spread 1 tablespoon cream cheese on each of 4 slices of bread. Spread 1/2 cup salmon salad over the cream cheese. Top with 2 tomato slices, a piece of lettuce and another slice of bread.

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3. Chicken, Charred Tomato and Broccoli Salad This simple but substantial main-course salad gets its goodness from smoky skilletblackened tomatoes and a dressing prepared right in the pan - maximizing the flavor from the tomatoes. Nutritional Benefit for Men with ED: 24g Protein + Antioxidants + Lycopene Ingredients 

1 1/2 pounds boneless, skinless chicken breasts, trimmed, or 3 cups shredded cooked chicken breast (skip Step 1)



4 cups broccoli florets



1 1/2 pounds medium tomatoes



2 teaspoons plus 3 tablespoons extra-virgin olive oil, divided



1 teaspoon salt



1 teaspoon freshly ground pepper



1/2 teaspoon chili powder



1/4 cup lemon juice

Preparation 

Place chicken in a skillet or saucepan and add enough water to cover; bring to a simmer over high heat. Cover, reduce heat and simmer gently until the chicken is cooked through and no longer pink in the middle, 10 to 12 minutes. Transfer to a cutting board. When cool enough to handle, shred with two forks into bite-size pieces.



Bring a large pot of water to a boil, add broccoli and cook until tender, 3 to 5 minutes. Drain and rinse with cold water until cool.

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

Meanwhile, core tomatoes and cut in half crosswise. Gently squeeze out seeds and discard. Set the tomatoes cut-side down on paper towels to drain for about 5 minutes.



Place a large heavy skillet, such as cast-iron, over high heat until very hot. Brush the cut sides of the tomatoes with 1 teaspoon oil and place cut-side down in the pan. Cook until charred and beginning to soften, 4 to 5 minutes. Brush the tops lightly with another teaspoon of oil, turn and cook until the skin is charred, 1 to 2 minutes more. Transfer to a plate to cool. Do not clean the pan.



Heat the remaining 3 tablespoons oil in the pan over medium heat. Stir in salt, pepper and chili powder and cook, stirring constantly, until fragrant, about 45 seconds. Slowly pour in lemon juice (it may splatter), then remove the pan from the heat. Stir to scrape up any browned bits.



Coarsely chop the tomatoes and combine them in a large bowl with the shredded chicken, broccoli and the pan dressing; toss to coat.

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4. Turkey, Corn & Sun-Dried Tomato Wraps Fresh corn kernels, tomatoes and lettuce fill these hearty turkey wraps. This wrap is great for picnics or when you need to have dinner on the run. Add some crumbled feta or shredded Cheddar for another layer of flavor. Serve with carrot sticks, sliced bell pepper or other crunchy vegetables plus your favorite creamy dressing. Nutritional Benefit for Men with ED: 19g Protein + Antioxidants + Lycopene Ingredients 

1 cup corn kernels, fresh (see Tip) or frozen (thawed)



1/2 cup chopped fresh tomato



1/4 cup chopped soft sun-dried tomatoes (see Shopping Tip)



2 tablespoons canola oil



1 tablespoon red-wine vinegar or cider vinegar



8 thin slices low-sodium deli turkey (about 8 ounces)



4 8-inch whole-wheat tortillas



2 cups chopped romaine lettuce

Preparation 

Combine corn, tomato, sun-dried tomatoes, oil and vinegar in a medium bowl.



Divide turkey among tortillas. Top with equal portions of the corn salad and lettuce. Roll up. Serve the wraps cut in half, if desired.

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5. Crab Roll This healthier take on a lobster roll uses crab because it is usually easier - and less expensive - to buy. But by all means, use lobster if you prefer. Serve with coleslaw and an ice-cold beer. Nutritional Benefit for Men with ED: 21g Protein + Antioxidants Ingredients 

1/4 cup low-fat mayonnaise



1 tablespoon freshly grated lemon zest



3 tablespoons lemon juice



10 dashes hot sauce, such as Tabasco



1/2 teaspoon freshly ground pepper



1/8 teaspoon salt



1/4 cup finely chopped shallot



1/4 cup finely chopped celery



1/4 cup thinly sliced fresh chives, divided



12 ounces cooked crabmeat, drained if necessary, any shells or cartilage removed



8 leaves red or green leaf lettuce



4 whole-wheat hot dog buns (toasted, if desired)

Preparations 

Whisk mayonnaise, lemon zest, lemon juice, hot sauce, pepper and salt in a medium bowl. Thoroughly mix in shallot, celery and 3 tablespoons chives. Mix in crab very gently so it doesn’t break up too much.



Line each bun with lettuce and divide the crab filling among the buns. Garnish with the remaining 1 tablespoon chives. 100 [email protected] 2014

6. Chicken and White Bean Salad Zucchini and celery give this chicken-and-bean salad a nice crunch. Usually served over a bed of slightly bitter escarole and radicchio, but any type of salad greens will work. Nutritional Benefit for Men with ED: 34g Protein + Antioxidants + Zinc Ingredients VINAIGRETTE



1 medium clove garlic



1/4 teaspoon salt



5 tablespoons extra-virgin olive oil



6 tablespoons fresh orange juice, plus more to taste



1/4 cup white-wine vinegar or red-wine vinegar



1 tablespoon Dijon mustard

SALAD



1 15-ounce can cannellini or other white beans, rinsed and drained



2 1/2 cups diced cooked chicken breast (see Tip)



2 cups diced zucchini and/or summer squash (about 2 small)



1 1/2 cups diced celery



1/4 cup finely diced ricotta salata, halloumi (see Shopping Tip, above) or feta cheese



1/3 cup chopped, well-drained, oil-packed sun-dried tomatoes (optional)



1 cup coarsely chopped fresh basil, plus whole basil leaves for garnish



Salt & freshly ground pepper to taste (optional)



2 cups torn escarole or romaine lettuce



2 cups torn radicchio leaves 101 [email protected] 2014

Preparation 

To prepare vinaigrette: Peel the garlic and smash with the side of a chef’s knife. Using a fork, mash the garlic with 1/4 teaspoon salt in a small bowl to form a coarse paste. Whisk in 5 tablespoons oil. Add 6 tablespoons orange juice, vinegar and mustard; whisk until well blended. Taste and whisk in up to 4 tablespoons more juice to mellow the flavor; season with more salt, if desired. Set aside at room temperature.



To prepare salad: Combine beans, chicken, zucchini (and/or summer squash), celery, cheese and sun-dried tomatoes (if using) in a large bowl until well blended. Add chopped basil and 3/4 cup vinaigrette; toss until combined. Taste and season with salt and/or pepper, if desired.



Toss the remaining vinaigrette with escarole (or romaine) and radicchio in a medium bowl. Serve the salad on the greens, garnished with fresh basil leaves.

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7. The Eating Well Cobb Salad This Cobb salad is true to the original with all the good stuff—chicken, eggs, bacon, avocado, and a tangy dressing. But we cut the saturated fat in half and doubled the amount of healthy monounsaturated fat. We've left the blue cheese optional, but the salad is so nutritious you might just want to go ahead and indulge yourself with a little bit anyway. Nutritional Benefit for Men with ED: 21g Protein + Lycopene + Antioxidants + Zinc + Vitamin B3 [Niacin] Ingredients 

3 tablespoons white-wine vinegar



2 tablespoons finely minced shallot



1 tablespoon Dijon mustard



1 teaspoon freshly ground pepper



1/4 teaspoon salt



3 tablespoons extra-virgin olive oil



10 cups mixed salad greens



8 ounces shredded cooked chicken breast, (about 1 large breast half; see Tip)



2 large eggs, hard-boiled (see Tip), peeled and chopped



2 medium tomatoes, diced



1 large cucumber, seeded and sliced



1 avocado, diced



2 slices cooked bacon, crumbled



1/2 cup crumbled blue cheese, (optional)

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Preparation 

Whisk vinegar, shallot, mustard, pepper and salt in a small bowl to combine. Whisk in oil until combined. Place salad greens in a large bowl. Add half of the dressing and toss to coat.



Divide the greens among 4 plates. Arrange equal portions of chicken, egg, tomatoes, cucumber, avocado, bacon and blue cheese (if using) on top of the lettuce. Drizzle the salads with the remaining dressing.

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Dinner Recipes 1. Lamb Koftas with Spiced Yoghurt Zinc Rich Ingredients 

Lamb



Wheatgerm



Yoghurt

Lamb Koftas 

250g/10½ oz lean lamb mince



2/3rds Cup/140g/5 oz pine nuts, finely chopped



1 egg



2/3rds Cup/140g/5 oz wheat germ



1 onion, finely chopped



2 tbsp finely chopped fresh parsley



1 tsp olive oil, for frying

Yoghurt Dip 

200g/7 oz thick low-fat Greek yoghurt



1 tbsp finely chopped fresh coriander



1 red Thai chilli, seeds removed and finely chopped



1 tbsp finely chopped fresh parsley



½ tsp ground cumin



1 tbsp finely chopped fresh mint



1 clove garlic, crushed

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Preparation 

Place the wheat germ into a large bowl and cover with cold water. Leave to stand for ten minutes, then drain and pat dry with kitchen towels to remove excess water.



Place the wheat germ, lamb mince, egg, onion, pine nuts and parsley into a large bowl and mix. Take small quantities about the size of a golf ball and roll and place on a baking tray, cover with cling film and place into the chiller for half an hour.



While that cools make the yoghurt. Place the chilli, mint, parsley, coriander, garlic, cumin and yoghurt into a clean bowl and mix thoroughly.

Cooking 

Heat a tablespoon of oil in a large frying pan over a medium heat. Add the kofta balls and fry, turning regularly, until browned and cooked all the way through.

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2. Black Rice Curried Meatloaf Meatloaf need not be boring or dry. This version is moist with cooked rice and plenty of vegetables. Curry powder gives extra flavor to the meatloaf and mango chutney spread on top stands in for the traditional ketchup topping. Nutritional Benefit for Men with ED: 33g Protein + Zinc (45% Daily Value) Ingredients 

1/2 cup Black Japonica rice blend, or long-grain brown rice (see Note)



1 cup water



1 medium zucchini, shredded using the large holes of a box grater



1 tablespoon walnut oil, or extra-virgin olive oil



1 tablespoon minced fresh ginger



2 cloves garlic, minced



1 medium yellow onion, finely chopped



2 celery stalks, finely chopped



1 tablespoon curry powder



2 teaspoons Worcestershire sauce



1 teaspoon salt



2 pounds 93%-lean ground beef



1 large egg, beaten



1/3 cup mango chutney, plus more for serving, if desired

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Preparation 

Bring rice and water to a boil in a small saucepan over high heat. Reduce heat to low, cover, and simmer at the lowest bubble until the water is absorbed and the rice is tender, 30 to 50 minutes (see Test Kitchen Note). Remove from the heat and let stand, covered, for 10 minutes.



Meanwhile, squeeze any excess moisture from zucchini. Heat oil in a large skillet over medium heat. Add ginger and garlic and cook, stirring, until fragrant, 30 seconds. Add onion, celery and the zucchini; cook, stirring often, until softened, about 5 minutes. Stir in curry powder; cook 1 minute. Stir in Worcestershire sauce and salt until combined. Transfer to a large bowl and let cool for 15 minutes.



Preheat oven to 350°F. Coat a rimmed baking sheet or broiler pan with cooking spray.



Spoon the cooked rice onto a clean cutting board and chop the grains into small bits with a large knife. Transfer to the bowl with the vegetables, add ground beef and egg and gently mix until just combined. Place the mixture on the prepared pan and shape into a loaf, about 10 inches by 5 inches. Spread chutney evenly over the top.



Bake until an instant-read thermometer inserted into the center of the meatloaf registers 165°F, 1 hour to 1 1/4 hours. Let cool for 10 minutes before slicing. Serve with additional mango chutney, if desired.

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3. Chicken Cordon Bleu Burger The classic flavors of Chicken Cordon Bleu - ham, Swiss cheese and thyme - inspired this easy chicken burger. We like using regular ground chicken, which is a blend of thigh and drumstick meat, to help keep this burger juicy, but feel free to use 100% ground chicken breast if you’d like a leaner burger. You will cut 20 calories and 1 gram saturated fat. Serve with roasted broccoli. Nutritional Benefit for Men with ED: 29g Protein + Zinc (21% Daily Value) + Antioxidants Ingredients 

1/4 cup low-fat mayonnaise



1 teaspoon Dijon mustard



5 tablespoons finely chopped shallot, divided



1 1/2 teaspoons finely chopped fresh thyme, divided



1 pound ground chicken



1/3 cup finely diced ham



1/4 teaspoon salt



1/4 teaspoon freshly ground pepper



4 slices Swiss cheese



8 small slices pumpernickel bread or 4 large slices, cut in half, toasted



12 large leaves spinach, tough stems removed

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Preparation 

Preheat grill to medium-high (or see Stovetop Variation).



Combine mayonnaise, mustard, 1 tablespoon shallot and 1/2 teaspoon thyme in a small bowl. Set aside.



Place the remaining 4 tablespoons shallot, remaining 1 teaspoon thyme, chicken, ham, salt and pepper in a medium bowl. Gently combine without over mixing. Form into 4 patties, about 3/4 inches thick.



Oil the grill rack (see Tip). Grill the burgers, turning once, until an instant-read thermometer inserted in the center registers 165°F, 4 to 5 minutes per side. Top each burger with cheese and cook until melted, 1 to 2 minutes.



Assemble the burgers on toasted bread with the herb mayonnaise and spinach.

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4. Tomato and Spinach Dinner Strata This yummy lasagna-inspired casserole has cheese, vegetables, eggs and marinara sauce but uses sturdy whole-grain bread instead of noodles, which makes it even easier to make. Its hearty look hides the fact that it is made with all low fat, healthy ingredients. Of course, it makes a great brunch entree as well - don’t let the name fool you! Nutritional Benefit for Men with ED: 20g Protein + Zinc + Lycopene + Antioxidants Ingredients 

4 teaspoons extra-virgin olive oil, divided



1 medium onion, chopped



8 ounces mushrooms, thinly sliced



1/2 teaspoon freshly ground pepper, divided



1/4 teaspoon salt



1 15-ounce container part-skim ricotta cheese



1 10-ounce package frozen chopped spinach, thawed and squeezed dry, or 1 1/2 pounds fresh spinach, cooked, squeezed dry and chopped



1/8 teaspoon freshly grated nutmeg



2 cups prepared marinara sauce, divided



6 slices whole-grain sandwich bread, preferably day-old



1 cup shredded part-skim mozzarella cheese



3 large eggs



1 cup low-fat milk



1/4 cup freshly grated Parmesan cheese



2 tablespoons chopped fresh parsley

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Preparation 

Coat a 7-by-11-inch (or similar-size) baking dish with cooking spray.



Heat 2 teaspoons oil in a large nonstick skillet over medium heat. Add onion and cook, stirring often, until softened but not browned, 5 to 8 minutes. Transfer to a bowl. Add the remaining 2 teaspoons oil to the pan; increase heat to mediumhigh. Add mushrooms and cook, stirring, until the moisture has evaporated, 4 to 5 minutes. Transfer to the bowl with the onions, add 1/4 teaspoon pepper and salt and stir to combine.



Combine ricotta, spinach, nutmeg and the remaining 1/4 teaspoon pepper in another bowl.



Spoon 1 cup marinara sauce into the prepared baking dish. Break each slice of bread into 4 roughly equal pieces; arrange half the bread on the sauce (the bread doesn’t have to completely cover the sauce). Spoon the ricotta mixture over the bread. Arrange the remaining bread over the ricotta. Scatter the mushroom mixture over the bread. Top with mozzarella. Spoon the remaining marinara sauce over the top. The pan will be very full.



Whisk eggs and milk in a small bowl. Pour the mixture slowly over the casserole, poking the filling gently with the tip of a knife until the egg mixture is evenly distributed and the bread is saturated. Coat a piece of foil with cooking spray on one side and cover the casserole, sprayed-side down. Refrigerate for at least 2 hours or up to 1 day.



Preheat oven to 375°F. Bake the strata, uncovered, for 40 minutes. Sprinkle with Parmesan and bake until puffed and golden brown, 10 minutes more. Let stand for 10 minutes. Serve sprinkled with parsley.

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5. Salmon with Red-Wine Morel Sauce Dried mushrooms give this rich red-wine sauce an almost meaty flavor. Look for them in the produce department of well-stocked supermarkets or specialty grocers. If you’re not a fan of salmon, try the recipe with halibut instead. Serve with barley tossed with parsley and steamed broccolini. To Double: Prepare a double batch of sauce in the large skillet, increasing reduction time as needed. Cook 2 1/2 pounds of salmon in two batches, adding oil as necessary. Nutritional Benefit for Men with ED: 31g Protein + Zinc + Vitamin B3 [Niacin] + Antioxidants Ingredients 

1 1/2-ounce package dried morel or porcini mushrooms



1 cup boiling water



2 teaspoons cornstarch



2 teaspoons plus 1 tablespoon extra-virgin olive oil, divided



1/3 cup finely chopped shallots



3/4 cup dry red wine



1 cup seafood stock or bottled clam juice (see Note)



1 teaspoon butter



1-2 teaspoons lemon juice



1/2 teaspoon salt, divided



1/2 teaspoon freshly ground pepper, divided



1 1/4 pounds wild-caught salmon fillet, skinned (see Tip) and cut into 4 portions

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Preparation 

Combine mushrooms and boiling water in a small bowl. Soak until the mushrooms are softened, 12 to 15 minutes. Strain the soaking liquid through a paper towel-lined sieve into a bowl. Rinse the mushrooms; finely chop. Stir together 1 tablespoon of the soaking liquid and cornstarch in a small bowl.



Heat 2 teaspoons oil in a large skillet over medium heat. Add shallots and cook, stirring, until softened, about 2 minutes. Add the mushrooms and cook for 1 minute more. Stir in wine and cook, stirring, until reduced to about 1/2 cup, 2 to 3 minutes. Add the remaining soaking liquid and seafood stock (or clam juice) to the pan. Bring to a simmer and cook until the sauce is reduced to 1 1/2 cups, 10 to 14 minutes.



Stir the cornstarch mixture and stir it into the simmering sauce. Cook, stirring, until slightly thickened, 1 to 2 minutes. Remove from the heat and stir in butter, lemon juice and 1/4 teaspoon each salt and pepper.



Meanwhile, season salmon with the remaining 1/4 teaspoon each salt and pepper. Heat the remaining 1 tablespoon oil in a large nonstick skillet over medium-high heat. Add the salmon and cook until just cooked through, 3 to 5 minutes per side. Serve with the mushroom sauce.

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6. Creamy Garlic Pasta with Shrimp and Vegetables Toss a garlicky, Middle Eastern-inspired yogurt sauce with pasta, shrimp, asparagus, peas and red bell pepper for a fresh, satisfying summer meal. Serve with: Slices of cucumber and tomato tossed with lemon juice and olive oil. Nutritional Benefit for Men with ED: 34g Protein + Zinc + Antioxidants + Nitrates Ingredients 

6 ounces whole-wheat spaghetti



12 ounces peeled and deveined raw shrimp, cut into 1-inch pieces



1 bunch asparagus, trimmed and thinly sliced



1 large red bell pepper, thinly sliced



1 cup fresh or frozen peas



3 cloves garlic, chopped



1 1/4 teaspoons kosher salt



1 1/2 cups nonfat or low-fat plain yogurt



1/4 cup chopped flat-leaf parsley



3 tablespoons lemon juice



1 tablespoon extra-virgin olive oil



1/2 teaspoon freshly ground pepper



1/4 cup toasted pine nuts

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Preparation 

Bring a large pot of water to a boil. Add spaghetti and cook 2 minutes less than package directions. Add shrimp, asparagus, bell pepper and peas and cook until the pasta is tender and the shrimp are cooked, 2 to 4 minutes more. Drain well.



Mash garlic and salt in a large bowl until a paste forms. Whisk in yogurt, parsley, lemon juice, oil and pepper. Add the pasta mixture and toss to coat. Serve sprinkled with pine nuts (if using).

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7. Chicken with Creamy Braised Leeks A touch of heavy cream, a few garlic cloves, and thyme sprigs round out the flavor of tender braised leeks with chicken in this recipe. The rich, silky sauce is wonderful over whole-wheat egg noodles or mashed potatoes. Leeks grown in the garden and those that you find at the store can be vastly different in size. Garden leeks tend to be smaller, so if you’re using leeks from the garden, make sure you pick enough to fill up the pan. Nutritional Benefit for Men with ED: 32g Protein + Nitrates + Antioxidants + Zinc Ingredients 

8 medium or 4 large leeks



2 cups reduced-sodium chicken broth



6 cloves garlic, halved



6 sprigs fresh thyme



4 boneless, skinless chicken breasts (5-6 ounces each), trimmed and tenders removed



1/2 teaspoon salt, divided



1/2 teaspoon freshly ground pepper, divided



1 tablespoon extra-virgin olive oil



1/2 cup heavy cream

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Preparation 

Preheat oven to 425°F.



Trim roots and dark green tops from leeks, leaving 5 to 6 inches of white and light green parts. Cut the leeks in half lengthwise (or in quarters, if large); rinse well. Place the leeks in a single layer in a 9-by-13-inch baking dish, on their sides if necessary, nestling them together. Pour in broth; submerge the garlic and thyme in the broth between the leeks.



Bake the leeks for 40 minutes.



After about 30 minutes, sprinkle chicken with 1/4 teaspoon each salt and pepper. Heat oil in a large skillet over medium heat; add the chicken and cook until golden brown, 3 to 5 minutes per side. Remove from the heat.



After 40 minutes, remove the leeks from the oven and nestle the chicken into them. Add cream and the remaining 1/4 teaspoon salt to the hot skillet (but do not turn the burner back on). Stir up any browned bits and let the cream heat up from the warmth of the pan. Pour the cream mixture over the leeks and chicken.



Return the baking dish to the oven and bake until an instant-read thermometer inserted into the thickest part of a breast registers 165°F, 10 to 15 minutes. Serve the chicken with the braised leeks, spooning the sauce over both.

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Drinks Recipes 1. Warm and Frothy Hemp Cacao Recipe This warm and comforting raw vegan version of hot chocolate will be one of your best allies during the cold winter months! Rich in iron, protein and other life-giving minerals, this is a truly powerful drink! One serving will cover nearly half of your protein needs for the entire day. I like my cacao drinks fairly dark and bitter. For a sweeter beverage, use twice as much sweetener. Use hot water for a warming hot cocoa. Nutritional Benefit for Men with ED: Protein Ingredients 

¼ cup hemp seeds



1 cup water, warm or hot from a kettle



3 tbsp cacao powder



2 tbsp maple syrup or dark agave nectar



Optional: pinch cinnamon, lucuma, mesquite, and maca

Directions In a blender, combine all the ingredients until smooth. Taste, and pour in a mug.

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2. Fruit Smoothie Recipe Ingredients 

200ml natural fruit juice



1 handful berries



1 tbsp honey or agave



1tsp lecithin



1 tbsp LSA mix (ground linseed, sunflower and almond)



1 tbsp soaked goji berries



1 tbsp soaked chia seeds

Preparation Place all ingredients in a blender and blend until it resembles a luscious fruit smoothie. Here's a quick rundown on the nutritional status of the fruit smoothie ingredients: 

All fruits are anti-ageing and berries are extremely high in antioxidants. They also contain lutein and zeaxanthin that help to maintain healthy eyes. You can use a mix of blackcurrants, blackberries, strawberries, blueberries, cranberries and raspberries. Buying frozen is a great way to ensure you have a constant supply out of season.



Honey and agave are good sweeteners.



Lecithin helps to make your cells strong, flexible and healthy while also allowing toxins to pass out and nutrients to pass in. It also creates a creamy smoothie without the use of dairy products.



LSA is an easy way to make nuts and seeds available to your body.

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

Almonds are high in calcium, linseeds are the richest source of omega 3 (and great for relieving constipation) and sunflower seeds are rich in potassium, zinc, iron, calcium and vitamins D and E.



Goji berries, hailed as the Tibetan super food, are loaded with 21 minerals, vitamin C and antioxidants.



Chia seeds are said to have eight times more omega 3 than salmon, and are also a good source of potassium, phosphorous, folate, zinc, fibre and vitamins A, B12 and C. They are said to be one of the secrets of the Raramuri, the running people in Mexico known for their ability to run 48 hr or 500 mile stretches without stopping (and without getting out of breath) and the subject of a book by Christopher McDougall called Born to Run.

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3. Green Smoothie Recipe A great way to start the day is to load your body full of the nutrients contained in your favorite greens. The trick is to keep it simple when making a green smoothie. Ingredients 

1 banana



Handful of your favorite berries (fresh strawberries work well here)



1 giant handful of baby spinach



1/2 cucumber



2 apples



Handful of parsley



1/2 inch piece of ginger, peeled and sliced



Juice of 1/2 a lemon



Agave or honey to sweeten

or

Preparation 

Place all ingredients in a blender and blend until it resembles a luscious smoothie.

Nutritional Info Spinach is high in folic acid and iron. Cucumber is rich in silicone and sulphur which help with strong nails, hair and skin. Parsley is a great adrenal supporter, rich in iron, high in calcium as well as vitamin C.

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For your green smoothie recipes you can also consider using: 

Kale - rich in glucosinolates to help the liver detox



Watercress - vitamin C and glucosinolates



Swiss chard - high in magnesium, vitamins C, A and K



Dark green lettuce - anti-ageing minerals



Endive - potassium and iron



Mustard greens - rich in glucosinolates and vitamins A, C and E

Surprisingly delicious and incredibly good for you, you'll soon become a green smoothie advocate and begin experimenting with your own favorite fruits and greens to make more combinations for your own green smoothie recipes. These healthy smoothie recipes are a great alternative to your usual breakfast cereal. Both fruit smoothies and green smoothies make great healthy breakfast options for people interested in a healthier lifestyle or those who wish to have a simple, fast and nutritious start to the day.

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4. Beetroot, Spinach, and Apple Smoothie Recipe Ingredients: 

200 ml Chilled Beetroot Juice



100 ml Chilled Apple Juice



250 ml Plain Yoghurt - with Live Cultures



2 cups (80 g) Shredded Spinach

Preparation Pop all the ingredients in a mixing jug and blitz, or use your food processor/smoothie maker. You can add ice for something a little colder and you can play around with herbs and other flavors too. Nutritional Info: 

Energy: 315 kcal

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Carbohydrates: 50 g

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Protein: 15 g

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Fat: 5 g - Depending on Your Choice of Yoghurt

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Nitrates: 350 mg – Estimated

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5. Hot Chocolate Protein Shake Recipe Ingredients 

12 oz (1 1/2 cup) whole milk - almond or coconut milk can be used as substitutes

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1 large pastured egg

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1 rounded scoop unsweetened vanilla or plain whey protein powder (optional)

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2 tablespoons unsweetened cocoa powder

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1/2 teaspoon vanilla extract

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1 1/2 tablespoon raw honey or other sweetener of your choice

Preparation 

Heat the milk in a small saucepan over medium heat just until bubbles start to form.

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While the milk is heating up, combine the egg, protein powder, cocoa, vanilla, and honey in a blender and blitz a few times to mix.

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Gently pour in the hot milk and puree again until very smooth and thick.

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Taste and adjust sweetener, if desired and serve immediately.

A scoop of peanut butter or a banana proves to be a delicious addition, and you can use dark chocolate instead of the cocoa powder to add flavonoids, which help make this healthy drink even more beneficial for men with erectile dysfunction.

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6. Skinny Green Monster Smoothie Recipe A smoothie simply packed with vitamins and protein, the Skinny Green Monster is the ideal companion for breakfast or as your lunch on the go. The Greek yoghurt and the peanut butter serve up a healthy dose of protein, while the spinach provides a wealth of vitamins, including A, C, and K, in addition to calcium, fiber, and magnesium. Ingredients 

1 small frozen ripe banana, peeled

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2 cups baby spinach

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1 tbsp Peanut Butter

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3/4 cup unsweetened vanilla almond milk

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1/2 cup plain fat-free Greek yogurt

Preparation 

Place all the ingredients into the blender, add ice (optional) and blend until smooth.

You can make this smoothie in a variety of ways, such as by adding flax seeds or protein powder, and even by throwing in blueberries, and a lot more. Start with this basic recipe then, and play around with variations according to your preferences.

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7. Strawberry Banana Smoothie with Chia Seeds This delightfully delicious smoothie consists of fresh fruits, chia seeds, and coconut milk, and provides you with generous doses of protein and zinc. It can be enjoyed any time of the day, on any given day, and will offer you a refreshing and empowering boost. Ingredients 

1 cup (250 mL) fresh strawberries, hulled and cleaned

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1 peeled banana, frozen

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4 cubes of ice

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1 T chia seeds soaked in ¼ cup (60 mL) of water

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⅓ cup (160 mL) light coconut milk

Preparation 

Combine all ingredients in a blender.



Pulse to desired consistency, adding more water to thin if necessary.

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Dessert Recipes 1. Calcium-Rich Chia Pudding Chia seeds are an amazing source of calcium, a mineral which can be a little hard to get in sufficient quantities on a raw food diet. Add to that sesame seeds, and you’ve got more bioavailable calcium than virtually anyone would get in a bowl of dairy and cooked cereal! Sesame seeds also provide a wealth of zinc, which can be a little hard to find in a vegan diet. Ingredients 

1/2 cup sesame seeds

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1 1/2 cups water

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2-4 T agave nectar

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1-inch vanilla bean

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1/4 cup chia seeds

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1/4 t cinnamon

Directions Blend the sesame seeds, water, agave, cinnamon and vanilla until smooth. Strain through a nut milk bag. Add more agave, if desired. Sesame seeds can be a bit bitter, but as the chia seeds absorb liquid, the pudding will be creamy and mellower. Stir the chia seeds in the sesame milk. Drink right away, or set aside until thickened.

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2. Rich and Elegant Chocolate Mousse Feel virtuous while you indulge in this decadent chocolate mousse. Loaded with antioxidants and nutrients, your energy levels will soar with every spoonful! Ingredients (serves 2-3) 

2/3 cup maple syrup, agave nectar, or raw honey

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1/2 t organic vanilla extract

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2 ripe avocados

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1/4 c. to 1/2 c. cacao powder

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1/8 t. Celtic sea salt

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1 t lucuma powder

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2-4 T water

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2 T goji berries

Directions Blend the avocados in a food processor until smooth. Add the other ingredients except for the goji berries, and keep blending until you get a uniformly colored and fluffy mousse. Spoon the chocolate mousse into a bowl, and refrigerate for about an hour. Sprinkle with goji berries just before serving.

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Conclusion When a man cannot perform intercourse and satisfy his own and his partner's sexual needs, he can feel devastated and very much alone. From this cascade of events, the couple starts to alienate themselves emotionally and physically. Partners who measure their self-esteem, femininity, and desirability by how men respond to their sexuality are particularly vulnerable to fears of abandonment and rejection. Men's emotional detachment feeds into these fears. Partners may worry that their mates may be impotent with them, but potent with another person, leaving them with fantasies of betrayal and infidelity. This issue can drive a couple apart because of fears and misconceptions when in reality the couple needs to communicate. When a man or a woman loses a loving sexual relationship due to E.D., either or both individuals may choose to withhold their partner from any other type of sexual experience. After experiencing the pain associated with rejection and lack of empathy from their partner, men and women will divert their attention to other matters in order to compensate for the loss of their sexual partner. Sometimes potency problems are a screen for more serious emotional or relationship issues. At this point, there may be other relationship issues between the couple that take priority before focusing on ED issues. This is an appropriate time for a man or the couple to be referred to a marriage counselor or sex therapist. Even the most sophisticated couples can benefit from opening lines of communication about sex and learning how best to utilize their functional capabilities. Counseling may be able to rekindle the romance and redirect energies into the relationship. This eBook is addressed especially to men. Men who know what they want, to have a problem in admitting they have a problem and men who know that this problem needs to be fixed as soon as possible. This eBook is addressed to those who don’t want to lose 130 [email protected] 2014

their partner and want to enjoy life at its fullest. Reading the “Erectile Dysfunction Protocol” means you have taken a decision and you want to improve certain aspects of your life. There is nothing to be ashamed. After reading this guide you will not only know what to do to improve your sexual performance, but you could also find comfort in knowing you are not alone. Also, you are not crippled or good for nothing! You only have a temporary problem that will soon pass. So, good luck with your protocol and be optimistic, things will change for the better!

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Individuals who have never experienced trouser department problems at some point in their lives are rare indeed, as evident from the fact that erectile dysfunction (ED) affects one in every ten men. It does not necessarily have to be an embarrassing, traumatic, or life altering experience though. You do not have to suffer from awkward visits to the doctor, or drain your bank account for medication and supplements which do not even work in most cases. For why would you, when you can combat the issue yourself, and that too with completely natural methods and techniques? Through the ‘Erectile Dysfunction Protocol’ you can treat the condition successfully at home in a matter of days. All you need to do is read this book, truly understand the issue, and then follow the guidelines provided within, and you will become a stronger man in no time at all.

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