If you’re like most middle-aged and older men, you want better erections—erections that are reliable and hard. But better sex is only one of the benefits of better erections…

Surprising fact: A man’s erection is an important barometer of his health. Erectile dysfunction (ED)—when a man can’t get or keep an erection firm enough for sexual intercourse—often is an early warning sign of heart disease. An erection requires healthy blood vessels, nerves and hormones.

Important scientific evidence: A seven-year study of more than 4,000 middle-aged and older men, published in The Journal of the American Medical Association, showed that those who had ED at the beginning of the study or developed it during the study had a 45% higher risk of developing heart disease.

Unfortunately, ED affects roughly half of American men over age 60 (and many younger men)—most of whom have cardiovascular disease or one or more risk factors for developing it, such as high cholesterol, high blood pressure, insulin resistance, diabetes or obesity.

Of course, you can take an ED drug (such as Viagra, Cialis or Levitra) for the problem. But that won’t take care of the underlying health issues. Plus, no man wants to be dependent on ED drugs…they’re not without risk (blindness is a rare but possible side effect)…and they don’t always work.

Here’s what you need to know to preserve or restore your erections—and the health of your body—naturally…


Erections owe most of their hardness to nitric oxide, a molecule that signals blood vessels to relax, allowing blood to enter and pool in the penis. The body’s most effective way of stimulating nitric oxide formation is exercise—even mild exercise, such as walking.

Scientific evidence: In a study of 180 men ages 40 to 70, published in International Journal of Impotence Research, those who were sedentary were 10 times more likely to develop ED than those who were physically active.

My recommendation: 10,000 steps a day, which you can achieve through everyday physical activity (typically 4,000 to 5,000 steps) and a brisk walk of 4,000 to 6,000 steps (about two to three miles, or 30 to 45 minutes).

Start with 5,000 steps daily for one week. Increase to 6,000 steps daily the second week…and to 7,000 the third week…until you reach 10,000. Maintain that level. You can find an accurate pedometer—typically at a cost of $20 to $30—at your local sporting-goods store or on the Internet at DigiWalker.com.


Your sexual performance is greatly impacted by the foods you eat. My recommendations…

Reduce the fats in your diet. Fatty foods lead to clogged arteries, which prevent blood flow from reaching the penis. Cut back on saturated fats such as egg yolks, butter, cream, fatty red meats and palm oil.

Eat more fruits and vegetables. They reduce cholesterol and improve blood flow to the penis.

Eat whole grains, nuts and seeds. They provide an important basis for cardiovascular and penile health.

Spice up your foods. Chili peppers stimulate the nervous system, helping with sexual arousal. Ginger has long been considered a sexual stimulant and an overall tonic for general health.


Several supplements can help restore erections…

L-arginine and Pycnogenol. The amino acid L-arginine (found in meat, whole grains, fish, nuts and milk) is converted to nitric oxide in the body. But most men don’t get enough in their diets, so I often recommend an L-arginine supplement Caution: Talk to your doctor before you take L-arginine, especially if you have low blood pressure, herpes, gastric ulcer, liver disease or kidney disease.

L-arginine works best when combined with Pycnogenol, a patented amalgam of more than three dozen antioxidants extracted from the bark of the French pine tree. Together, the supplement allows for better nitric oxide production and utilization.

Scientific research: In a study of men with mild-to-moderate ED, published in Phytotherapy Research, taking a supplement with L-arginine and Pycnogenol for eight weeks improved erections and satisfaction with sex.

Typical dose: A daily dose of the supplement Prelox Blue, which contains a blend of Pycnogenol and L-arginine.

Omega-3 fatty acids (fish oil). Found in oily fish such as salmon and sardines, omega-3s can reduce plaque inside artery walls…decrease blood clotting…lower triglyceride (blood fat) levels…and decrease both blood pressure and blood vessel inflammation. Omega-3s are the nutritional building blocks of heart and penis health.

Typical dose: 2,000 milligrams (mg) daily, taken with a meal.

Horny goat weed (Epimedium sagittatum). This Chinese herb perks up sexual desire.

Scientific evidence: I conducted two studies on Exotica H-G-W, a brand of horny goat weed. The first study showed that the supplement enhanced sexual satisfaction in three out of five men. The second study—in which men took horny goat weed capsules one hour before sexual activity—resulted in a significant increase in hardness in two-thirds of the participants.

Typical dose: Two capsules daily, totaling 500 mg of horny goat weed. My patients take it for six weeks and then start to taper off. You can use it intermittently after that.


Testosterone—the predominantly male hormone that helps drive sexual desire and performance—declines with age. But most of that decline is caused by lifestyle—poor sleep, relentless stress and belly fat. My recommendations…

Sleep seven to eight hours a night. Going to bed at the same time every night (say, 11:00 pm) and getting up at the same time every morning (say, 6:30 am) is one of the best habits for deep, refreshing sleep.

Add strength-training to your routine. Whether it’s in the gym or at home with resistance bands, building and maintaining muscle are key to producing plenty of testosterone.

Breathe. Take a few slow, deep breaths a few times a day every single day—it does wonders for relieving tension and anxiety.


How do you prepare for an upcoming sexual encounter, especially if you didn’t do so well in a previous effort and don’t feel confident?

Sex is a physical act—and just as athletes practice visualization techniques so they can perform optimally, you can use the same techniques to build confidence in your bedroom “performance.”

First, relax—lie on your back on a mat or a rug with your arms at your sides and take a deep breath. Hold it for a moment, then exhale. Lie still, and continue breathing slowly.

Once you are relaxed, picture yourself about to have sex. Patiently go through the step-by-step sequence of events. Imagine every aspect of the session, including the sights, sounds and smells associated with sex. Try to rehearse the action in your mind just as you would actually perform it. It’s all about mental practice. When the time comes for the actual moment, your confidence will be higher.

No Guts, No Glory