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A healthy sex life can increase your confidence, reduce stress, and help you sleep better at night. But problems with stamina, premature ejaculation, or other sexual performance issues can be both frustrating and embarrassing.

Prescription drugs can help improve erection quality and sexual performance by increasing blood flow to the penis. Prescription erectile dysfunction drugs include:

But as with all prescription drugs, they come with some risks. Erectile dysfunction drugs can lead to numerous side effects. For a quick rundown on what you might experience depending on the drug, check out this article.

But, generally speaking, flushing, headaches, visual changes, upset stomach, and nasal congestion are associated with ED drugs. In some cases, these medications can have dangerous effects for people taking nitrate drugs or blood thinners, or those with heart problems and diabetes.

Natural solutions may not present the same risks or drug interactions, and some may actually improve overall health. Read on to learn more.

There are a number of reasons you might not be lasting long in bed, but experts believe there are both emotional and physical reasons. You can either be experiencing premature ejaculation (PE), which is when ejaculation happens sooner than you or your partner would like, or you may have trouble keeping an erection long enough to have penetrative sex.

Sometimes, PE and ED are connected — and PE is most certainly a problem for people with ED. Since an erection goes away after ejaculation, it can be tough to know if the problem is PE or ED. ED should be treated first. Once ED is treated, premature ejaculation may no longer be a problem.

Stress, anxiety, and depression can contribute to ED, according to Dr. Puja Uppal, a board-certified family medicine physician and the chief medical officer at Think Healthy. A number of underlying health conditions like sleep apnea, diabetes, and heart disease, as well as ADHD and other mental health conditions, can also be culprits. You may not even know you have one of these conditions.

Age may also be a factor. The likelihood of ED increases with age, but experts are now seeing it more in younger people. Unfortunately, ED in young people is often ignored, but it can be an indicator of future cardiovascular conditions.

1. Quit smoking

Smoking could be to blame for sexual dysfunction, among other conditions. Smoking can impair circulation, increase your risk of erectile dysfunction, and decrease your sperm count and viability.

2. Exercise

Being overweight and failing to exercise can both impact your sexual performance, so get moving and get healthy. By fine-tuning your cardiovascular health, you could be building bedroom endurance as well.

3. Acupuncture

Acupuncture is a treatment method of traditional Chinese medicine (TCM) that’s been practiced for more than 2,500 years. The practice of inserting small needles into certain points across the body is said to stimulate the nervous system and affect natural opioids and hormones.

Research into the use of acupuncture to treat ED is limited, and only small studies are currently available, but some results seem promising.

In one older study from 2003, participants were tested in two groups. One group had acupuncture in the specific acupressure spots for ED. (For ED treatment, acupuncture needles are placed along the abdomen, hands, and legs.) The control group was given acupuncture in other areas of the body.

About two-thirds of those in the group getting the ED treatment showed signs of improvement of their ED symptoms compared to the control group.

4. Increase zinc intake

Zinc is found in many herbal male enhancement supplements — and with good reason. Zinc deficiency can lead to sexual dysfunction and decreased testosterone levels. But too much zinc isn’t good for you either.

Rather than supplementing, you may find your zinc levels are best regulated by eating foods rich in the important mineral, like:

  • oysters
  • meat
  • fortified breakfast cereals

5. Boost L-arginine consumption

Amino acids are the building blocks of protein. L-arginine is an essential amino acid that can be converted to nitric oxide, which can help relax the blood vessels of the penis and increase blood flow and erection quality. It acts much in the same way current prescription drugs do. Soy and vegetables are good sources of L-arginine.

That being said, the research into L-arginine and its effectiveness in treating ED is mixed.

Some study results on L-arginine for ED have been promising, like one 2019 study where researchers found that dosages between 1500–5000 milligrams offered significant improvements in ED over placebo, with improved self-reported scores of sexual satisfaction and erectile function submitted by the participants.

But L-arginine is often combined with other supplements, which have different, more successful results. This article goes into more detail about L-arginine in combination with other supplements to treat ED.

6. Herbs and supplements

There are countless male enhancement products on the market. Some that are used in traditional medicine include:

Makers of these products know that people take great pride in their bedroom performance and are willing to spend accordingly. Do your research before breaking the bank on an herbal “cure.”

None of these supplements have gone through rigorous testing to prove their benefits or their risks. Also, some testing has revealed these supplements don’t contain as much of the active ingredients as reported. Be sure to check with your doctor before taking supplements or herbs.

If you’re looking to avoid the potential risks of prescription drugs, the lifestyle changes above may provide the best risk-free results. Plus, losing weight and quitting smoking can only stand to improve your sexual prowess.

7. Consider therapy

Though this may not be your first choice, the connection between ED and psychological conditions has been well established. But it’s usually a case of “chicken or the egg,” according to a 2018 meta-analysis on the subject. Depression can ignite ED, and ED can ignite depression.

In this 2017 study that focused on people assigned male at birth, 28 participants under 40 and who had ED symptoms showed a significant improvement after they underwent cognitive behavioral therapy.

8. Find out if you have underlying health conditions

As mentioned before, ED can be a symptom of a number of serious health conditions, like sleep apnea, diabetes, and cardiovascular problems. Book an appointment with your doctor for a physical because ED can be a sign of something more serious.

Dehydroepiandrosterone (DHEA)

DHEA helps create sex hormones, including testosterone and estrogen. Natural DHEA levels decrease as a person gets older. While some studies suggest that DHEA supplements could help ED, others have found no evidence to support this claim.

Side effects of DHEA can include:

  • fatigue
  • headaches
  • acne
  • irregular heartbeat

Yohimbine

Yohimbine is the main component of an African tree’s bark. It’s known to be an aphrodisiac.

The National Center for Complementary and Integrative Health reports that there’s not enough evidence to show that yohimbine from tree bark can treat ED.

Plus, studies have linked yohimbine with serious side effects, including heart attacks and seizures. Other side effects include stomach problems, anxiety, and high blood pressure.

Yohimbine hydrochloride, a different form of yohimbine, is available as a prescription drug for ED. This is a different product than dietary supplements made from tree bark.

Horny goat weed

Epimedium grandiflorum, also known as horny goat weed, is a traditional remedy for increasing fertility.

One study reports that it could improve sexual performance in people with renal failure on hemodialysis. But there’s not enough evidence to support its use.

This supplement is often well-tolerated. Side effects can include nausea, vomiting, irregular heartbeat, and dry mouth.

If you start noticing regular symptoms of ED or a loss of desire, book an appointment with your doctor.

Talk with a urologist about premature ejaculation if you almost always ejaculate within 1 minute of beginning intercourse or if you’re almost always unable to delay ejaculation when you want to.

As mentioned above, ED can be caused by underlying health conditions that may need to be treated before your sex life can resume as normal.

How long does the average person last during sex?

The duration of sex varies. One older 2005 survey showed the median time for some 500 couples, conducted over a 4-week period, was anywhere from 5.4 minutes, and interestingly did not vary based on circumcision status. (The range was from 30 seconds to 44 minutes).

These couples in this study were all heterosexual and had been involved in stable relationships for at least 6 months.

Why can’t I last longer in bed?

ED is multifactorial, meaning it can have roots in your emotional and physical worlds. Stress, anxiety, depression play a factor, as do diet, weight, and various health concerns.

Are there pills that can help me stay hard longer?

There are a number of FDA-approved pills that treat ED. These include sildenafil (Viagra), avanafil (Stendra), tadalafil (Cialis), and vardenafil (Levitra). They all assist with blood supply to the penis. There are herbal supplements, too, but scientific data on their efficacy is mixed.

Many people will experience concerns in the bedroom at some point in their lives. The good news is that this is a highly treatable condition.

The first step is to contact a doctor to help you troubleshoot the root cause. There are a number of FDA-approved medications to treat erectile dysfunction. There are also many herbal supplements to help you last longer in bed, but certain lifestyle changes can often yield positive results.