Easy ways to increase penile erection in man with erectile dysfunction (ED)

I have followed the following ways to increase the erection function. Please read the basic physiology/pathology of erection and erectile dysfunction so as to have a better understanding and better cure of your condition.

The penile erection in males is largely governed by vascular health because the erection and flaccidity of penis is dependent upon blood flow and trapping of that blood inside the spongy penile tissue. The blood vessels should have appropriate elasticity to do this job. This elasticity is mediated by several mechanisms. Among them, nitric oxide (Chemical formula: NO) is important in mediating penile erection. This nitric oxide molecule is generated by the blood vessel (vascular endothelium) itself. Therefore, bad vascular condition will impair the synthesis of nitric oxide. Furthermore, nitric oxide is short-lived (decompose in few seconds). Antioxidant (endogenous and exogenous) molecules protect nitric oxide from decomposing quickly. Therefore, decreased levels of antioxidants in the body will cause less availability of nitric oxide subsequently leading to erectile dysfunction.

So, what causes decrease of antioxidants in body?

The core answer is inflammation and other related processes will lead to the decrease of antioxidant defense in the body.

Oh.. What causes inflammation in body?

Several chronic diseases/disorders cause inflammation and related processes to rise in the body such as diabetes, cardiovascular diseases, hyperlipidemia, and psychological stress disorders such as anxiety, depression etc. Even in people without these disorders, many young persons have metabolic syndrome. Metabolic syndrome also has inflammatory component in it. Many appear-to be healthy people have insulin resistance. Insulin increases nitric oxide production. So, insulin resistance (cells resist the normal levels of insulin; so higher levels of insulin are required to transport glucose into cells and transport amino acids into skeletal muscle cells). Insulin resistance appears to be a starting point in many people who develop erectile dysfunction as insulin resistance seems to be starting problem for diabetes and cardiovascular disorders. Insulin resistance appears to linked with inflammation.

Then, how to reduce inflammation and decrease insulin resistance?

No perfect medicine is available as of now. Various lifestyle modifications and supplements are recommended to decrease inflammation and insulin resistance. Exercise is the best in this category. Moderate aerobic exercise and weight training are recommended. Avoid heavy and strenuous exercises as it will increase oxidative stress and inflammation.

What should I eat/avoid?

a. Avoid refined sugar, white bread/white rice - these foods increase oxidative stress in body

b. Avoid high fat food - these foods increase oxidative stress in body

c. Eat low low glycemic foods and low-insulinemic foods.

d. Do fasting for at least 12 hours a day. Practice this regularly or in weekends. Consume all your food within 12 hours window and fast during the remaining 12 hours of a day. You can take water. But, strictly no calories.

c. Eat more antioxidants/take supplements

Hmm...I am already following one or more of the above recommendations. What supplements can I take further?

1. Consumption of vitamin C

I have taken 250 mg - 500 mg vitamin C daily 2-3 times after the food. It increases body heat and erection. If this works for you, probably you can assume that you have insulin resistance and inflammation in your body.

2. Folic acid

I have taken 1 mg - 3 mg of folic acid one time daily. This increases my mood and when combined with vitamin C gave better erections.

3. Multivitamin tablets/capsules

I usually take a multivitamin tablet/capsule everyday as it helps to reduce the inflammation and improve the general well-being feeling. Multivitamin with ginseng worked for me earlier. Nowadays, it is not working.

4. DL-phenylalanine

250 mg-500 mg of DL-phenylalanine increased the erections.

Reference:

Lifestyle and metabolic approaches to maximizing erectileand vascular health. International Journal of Impotence Research (2012) 24, 61–68.

Disclaimer: This is not a medical advice and I am not a medical doctor. The above statements are not authorized/validated/approved by any drug approving authority. Please do not take any supplement/medicine on your own. Please consult a doctor for your illness. 

Effect of folic acid

After stopping centrum energy (contains ginseng extract 40 mg), I have taken folic acid 1 mg daily at night after the meals. I am not taking any other drug/supplements. After stopping centrum energy, I have taken ginger coffee (added commercial ginger paste to coffee) morning and evening for two days. This caused left sided headache suggesting decreased serotonergic neurotransmission. After I stopped ginger intake, that headache disappeared. Taking ginseng for 1 month might have caused increased serotonergic neurotransmission.

Positive effects (probably due to increased doapminergic neurotransmission secondary to disinhibition by serotonergic neurotransmission):

1.  Increased speed of brain processing - I am able to read complex things and understand better and able to remain focused in a long conversation (more than 1 hour). I am able to do things at a faster rate.

2. Decreased post lunch sleepiness

3. Increased libido and strong erections

4. Increased loudness of voice and no hoarseness of voice even after talking for long time.

5. Decreased mucous formation in nose while eating. This increased mucous formation happens whenever I eat lunch despite the food is not spicy and hot. This increased mucous formation may be due to increased cholinergic drive secondary to disinhibition by dopaminergic neurotransmission.

 

Negative effects:

1. Slight stuttering

2. Slight feelings of stress

3. Increased cold feeling - reduced tolerance to cold climate

 

 

Easy ways to increase libido

I have followed the following practices to increase the libido. Sure, these practices increased libido. The effectiveness of the practice is given in the descending order.

1. Increased carbohydrate intake - rice or wheat

This practice increases good mood and libido. Many people, due to dieting, decrease their carbohydrate intake. This practice decreased my mood and libido. So, increased carbohydrate levels increased my libido.

2. Eat eggs daily

Take 2 eggs in the morning and 2 eggs in the evening. This practice increased my libido very much. Half-boiled eggs gave maximum benefit. Alternatively, the eggs can be mixed with chopped onions (small red onion-South Indian variety) and prepared as omelette and consumed.

3. Eat mutton and chicken weekly 2 times each

This practice increased my libido very good. I consumed mutton one day followed by chicken, then followed by mutton and chicken. This order can be continuous or can be with other type of meals in between. 

4. Walking for 30 minutes - 2 hours per day

In my experience, 30 minute walking is not that much effective. At least, 1 hour of walking improved my libido.

5. Taking supplements

Supplements such as folic acid, ginseng, general multivitamin, DL-phenylalanine increased my libido. This whole blog is about my trial and error on this practice. It is not easy to find a suitable supplement. This requires lot of trial and error. Sometimes, it requires taking supplements with unusual dosing regimens such as taking them on alternate days.

current medication and diet

Diet: Oats in morning and night; rice, vegetables and fish curry and one piece of sliced fish either fried or curry cooked.

Medications:
Morning: one tablet of Multi B + C after breakfast
Night: two capsules of mega-3, 1/2 tablet of folic acid 5 mg, 1/4 tablet of thiamine mononitrate 100 mg

This combination gives good balance between fluent speech, mood, focus, concentration and energy. In this combination, folic acid appears to be responsible for the improvement in mood. If I don't take folic acid, then dullness and negative thoughts start appearing.

Update on 18 Feb 2018:

Diet:
Morning: 1-2 Wheat dosa/Ragi dosa + 1 Egg (Organic selenium enriched - 44 mcg of selenium per 100 g of egg; each egg approximately weighs around 60 - 80 g)
Lunch: Rice + Two vegetables + 1 egg (normal egg - no selenium enriched)
Dinner: 1-2 Wheat/Ragi Dosa + 1 Apple + 1 Orange

Medications:
Morning: 1 capsule of Blackmore Multivitamins + Minerals; 1 capsule of Blackmore Vitamin D3 1000 mcg; 25 mg of Thiamine mononitrate
Night: 25 mg of Thiamine mononitrate; 1 capsule of 500 mg of L-Tryptophan

Effects: Thiamine mononitrate used to worsen the cold intolerance. That means, If I take thiamine mononitrate, I used to feel very cold whenever the temperature goes below 25 deg C. This effect seems to be countered by intake of L-tryptophan. The sugar intake (sugar added in tea - morning and evening) seems to decrease the frequency of vocal blocks. The most effect is experienced when the refined white sugar is taken. This clearly indicates that there could be some impairment of tryptophan transport into the brain. It appears that effective tryptophan transport across blood brain barrier requires significant amount of insulin to clear the other large neutral amino acids. However, there appears to be no problem with the phenylalanine and tyrosine transport into the brain. However, this cannot be concluded.

Effect of folic acid

I was taking folic acid (5 mg b.i.d) for one week. The folic acid gave me very good upliftment of mood and energy. The same effect was also observed with metyltetrahydrofolate 3.25 mg o.d. @ night. So it seems that folic acid deficiency may be present in my body. It could be genetical in origin or maybe acquired due to stress. At this time i am not taking any multivitamin tablets for the last three months. I am taking siddha medicine for hypercholesterolemia. When i am taking siddha medicine along with folic acid it gave me eye irritation and redness. So, i have to stop folic acid for a while. I need to explore further on this.

Effects of methylfolate

I took 5 mg of folic acid per day (2.5 mg in morning and 2.5 in night). I felt more energetic and motivated. So, I have started experimenting with methylfolate.

	L-methylfolate 7.5 mg/day (3.25 mg in morning and 3.25 mg in night) + one zincovit tablet  in morning + one Magcalzinc tablet in night (Elemental calcium 250 mg + Elemental magnesium 125 mg + elemental zinc 3 mg)	L-methylfolate 7.5 mg/day (3.25 mg in morning and 3.25 mg in night) + one zincovit tablet  in morning	L-methylfolate 7.5 mg/day (3.25 mg in morning and 3.25 mg in night)	L-methylfolate 7.5 mg/day (3.25 mg in morning and 3.25 mg in night) + one capsule of fluoxetine in night
Effects on anxiety	No anxiety	No anxiety	No anxiety	No anxiety
Effects on depression	No depressive feelings	No depressive feelings	No depressive feelings	No depressive feelings
Effects on stuttering and voice	Moderate stuttering was there. Cannot make a fluent conversation. Reduced loudness of voice	Moderate stuttering was there. Cannot make a fluent conversation. Reduced loudness of voice	Moderate to severe stuttering was there. Cannot make a fluent conversation or presentation. Reduced loudness of voice	Much reduced stuttering. Can make a good presentation and conversation. Good loudness of voice
Effects on motivation	Good motivation	Good motivation	Good motivation	Reduced motivation and increased lethargy
Effects on concentration	Good concentration throughout the day	Good concentration throughout the day	Good concentration on tasks in morning. Low concentration in afternoons. Then, concentration increases after 7 pm.	Reduced concentration
Effects on memory	Good	Good	Good	Good
Effects on mental fog and clarity of thinking	Good	Good	Good	Reduced clarity of thinking
Effects on telephonic conversation	Moderate stuttering	Moderate stuttering	Moderate stuttering	Reduced stuttering
Effects on affection and social life	Longing for love from family members but no interest in social life	Longing for love from family members but no interest in social life	Longing for love from family members but no interest in social life	Reduced affection towards family but increased participation in social gatherings probably due to less stuttering
Effects on sleep	No excessive sleepiness. Able to get up early in morning	No excessive sleepiness. Able to get up early in morning	Not much of excessive sleepiness. But, heavy uncontrollable sleepy feeling after taking lunch.	Increased sleepiness. Cannot get up easily in morning.
Effects on libido and sex	Neutral	Neutral	Neutral	Neutral to less
Effects on eye vision	Neutral	Neutral	Neutral	Neutral
Effects on driving	Neutral	Neutral	Neutral	Neutral
Effects on body temperature and sweating	No ‘heated body’ feeling and no increased sweating	No ‘heated body’ feeling and no increased sweating	No ‘heated body’ feeling and no increased sweating	Increased sweating
Other effects	Moderate right hand wrist pain and forearm pain was there due to excessive computer mouse usage, bad taste in mouth, mild skins rashes like an allergic reaction (red skin eruptions appear in line)	Mild right hand wrist pain and forearm pain was there due to excessive computer mouse usage, bad taste in mouth, mild skins rashes like an allergic reaction (red skin eruptions appear in line)	No hand pain or wrist pain, bad taste in mouth, bad breath, mild skins rashes like an allergic reaction (red skin eruptions appear in line)	Slight bad breath, mild skins rashes like an allergic reaction (red skin eruptions appear in line)
Diet during these time	Oats porridge in morning and night; lunch – rice with 200 g of chicken or fish with 200 g vegetables	Oats porridge in morning and night; lunch – rice with 200 g of chicken or fish with 200 g vegetables	Oats porridge in morning and night; lunch – rice with 200 g of chicken or fish with 200 g vegetables	Oats porridge in morning and night; lunch – rice with 200 g of chicken or fish with 200 g vegetables

Reasons of blurred vision and profuse sweating

After taking sertraline, I am getting blurred vision frequently. Sometimes cannot read the fine print and labels on the shopping items. Also cannot work long time seeing the laptop monitor. Also, I get muscle fasciculation or muscle twitch on my eyelids and sometimes on muscles around the eye.

From Wikipedia, I got the following information.

The iris contains two sets of muscles:

• a radial group for enlargement of the pupil (dilator pupillae)

• a circular group set to decrease pupil size on contraction (sphincter pupillae).

The muscles regulate the amount of light entering the eye. The sphincter pupillae is stimulated through muscarinic receptors by the parasympathetic nervous system. The dilator pupillae is stimulated through noradrenergic receptors by the sympathetic nervous system.

Alterations are produced by muscarinic antagonism in two muscles: inhibition of iris sphincter muscle causes mydriasis, while relaxation of ciliary muscle produces ciclopegia.

It may be possible that, sertraline might have decreased acetylcholine in the eye muscles possibly due to its increased dopaminergic activity. However, I did not observe this effect with bupropion. So, the another possibility is that sertraline might have decreased noradrenaline which might have caused the imbalance in eye accommodation. I also feel less sweating with sertraline which I did not observe with fluoxetine or bupropion. Hence, in my case, profuse sweating might be the due to increased noradrenaline levels and blurred vision is probably due to decreased noradrenaline levels. Further research is required on this.

Update on 6 October 2015:

Effect of folic acid and methylcobalamin

During the last few months, I was having blurred vision after lunch and even after mild exercises. I was not able to read fine print and medicine labels for most of the time. I was not able to see computer monitor for long time and work. I took folic acid 1.25 mg and methylcobalamin 250 microgram and vitamin C 500 mg for few days. This combination almost cured my blurred vision. Now, I am able to read fine print (but not very fine print in the medicine labels), see computer monitor for long time and work. No blurred vision. It appears that I may have some fault in the absorption or processing of folic acid or cobalamin. I need to explore it further. After taking methylcobalamin, my finger pain also reduced very much suggesting the fault in processing of cobalamin.

Brightness of vision and increased contrast detection

I really don't know how to call the effects I observed today. That's why I used the above title. Now, I could see more brightness in my house as well as on the roads. When I see my laptop monitor, I could see rich blues and rich rendition of colors and brightness. Previously I never used to see like this.

I used to feel this effect only when I was taking bupropion. At that time, I could see more clearly in my car's rear view as well as side view mirrors. Previously I could not see the distance between cars in those mirrors and cannot make any judgment about their relative location. I could only see bunch of headlights fashing in my car's mirrors. With rear view mirror, I could see something for the nearby cars but for the cars at little distance, I could not see clearly. The condition was worse with side view mirrors.

My diet today:

• Rice + 1 chicken drumstick for breakfast.
• Rice + 1 piece of fish + tea for lunch
• Rice + chicken egg omelet for dinner

My medicines today:

• Pharmaton vitality multivitamin capsules (contains ginseng) - 1 capsule at breakfast
• Folic acid 400 microgram - 1 tablet at breakfast
• Liv. 52 - 2 tablets at breakfast
• GTF chromium 200 microgram - 1 capsule at breakfast

Possible mechanisms:

It could be because of either folic acid or Liv. 52.

Folic acid, folinic acid and depression

Today I saw a research paper on folic acid accidently while searching for some literature on antidepressant experiment protocol in animals. The research paper [1] states that the folic acid exhibits antidepressant property through opioidergic mew and delta receptors. Delta opiod receptor agonists are reported to be potential antidepressant agents [2].

The dosage of folic acid mentioned in the clinical trials is between 500 microgram - 800 microgram per day [3].

On the basis of current data, we suggest that oral doses of both folic acid (800 µg daily) and vitamin B12 (1 mg daily) should be tried to improve treatment outcome in depression [3].

References:

[1]. Evidence for the involvement of the opioid system in the antidepressant-like effect of folic acid in the mouse forced swimming test. Behavioral Brain Research. 2009 Jun 8;200(1):122-7.
[2]. The Antidepressant - like Effects of Delta-Opioid Receptor Agonists. Molecular Interventions. June 2006, 6:162-169;doi:10.1124/mi.6.3
[3]. Treatment of depression: time to consider folic acid and vitamin B12. Journal of Psychopharmacology. January 2005 vol. 19 no. 1 59-65.