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I'm 45 and have difficulty maintaining an erection. What can i do ?

There are a number of potential biological reasons for this, and a range of natural solutions you can explore. A look at how Viagra works can help. Viagra promotes a key chemical involved in erections called nitric oxide, which is produced by the amino acid arginine. So supplementing arginine may help you. It is recommended to take this supplement at 2 grams a day. This is quite common in men above the age of 40. You can get you level checked at your local clinic and it should be above 12nmol/L.

Also worth a good look are a handful of natural aphrodisiacs that, at least anecdotally, have been reported to help sustain erections. These are ginseng, damian, muira puama and maca. 

Ginseng is widely regarded as a 'sexual rejuvenator' and animal studies have shown it to increase testosterone levels, help the body adapt to stress and boost energy. You need about 1 gram a day of either Panax ginseng (standardised to 10 per cent ginsenosides) or Siberian ginseng (standerdised to 1 per cent eleutherosides).

Damian is a central American shrub that is said to stimulate production of testoterone, although the exact mechanism is not known. Try 400 to 800 mg twice daily.

Muira Puama is native to the Brazilian Amazon, and its workings, too, are shrouded in mystery. In a study in France, 62 per cent of men who took it claimed it had changed their lives. Try 1 gram a day.

Maca (Lepidium Meyenii) is native to Peru's central highlands, where it has been used in traditional Andean culture to awaken healthy passion. Experiments on animals showed increased sexual performance and improved erectile function even in rats with their testes removed! Try 3 to 5 grams of ground maca. You can find many herbal remedies containing combinations of these herbs.

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