The next chart depicts how the most reputable Viagra Alternatives rate concerning the quality of their ingredients (the herbs Urologists or physicians that deal with the diagnosis and the treatment of diseases of the urinary tract and/or urogenital system look for in a supplement prior to prescribing the Viagra Alternative to their patients):
Positive Effects
	Physicians Select Viagra Alternative	Enzyte Viagra Alternative	Vipra Viagra Alternative	Vig Rx Viagra Alternative
*Yohimbe	Yes	Yes	No	No
*L-Arginine	Yes	Yes	Yes	No
*Avena Sativa	Yes	No	No	Yes
*Epimedium	Yes	Yes	No	Yes
*Tribulus Terrestris	Yes	Yes	Yes	No
*Maca	Yes	Yes	No	Yes
*Saw Palmetto	Yes	Yes	Yes	No
*Schiznadra	Yes	No	No	Yes
*Guarana	Yes	No	No	No
*Please see below for a complete description of these ingredients:

Description of herbs for enhancing male sexual performance and male libido.

The following represents a brief description of the herbs that Urologists recommend for improving male performance and sexual desire. The herbs are listed in the order of relevance for the enhancement of male sexual performance, as well as, the improvement of libido (manifestation of the sexual drive).

Yohimbe and L-Aginine are important for the dilation of the corposa cavernosa and the corpus spongiosum or the parallel cylinders that transverse the length of the penis. During the male sexual response the corposa cavernosa and the corpus spongiosum become engorge with blood and provide the erection.

While Avena sativa, Epimedium, and Tribulus terrestris naturally increase the levels of Testosterone (the most important representative of the male sex hormones collectively called androgens)

*Yohimbe (Pausinystalia yohimbe) - Used for centuries in Africa to enhance performance and virility, clinical studies indicate that Yohimbe is effective in some 80% of men with impotence. Yohimbe bark has traditionally been used in western Africa as a sexual aphrodisiac, especially in male erectile disorders. Yohimbe is very unique in that the herb has a dual aphrodisiac function: First Yohimbe improves sexual function by displacing hormonal epinephrine from the alpha-2 adrenergic receptors in the pelvic area and increasing blood flow to the male erectile organs. Second, the herb increases the levels of free norepinephrine which subsequently results in an increase sense of alertness and sexual arousal. The active ingredient in Yohimbe was the only product approved by the Federal Drug Administration (FDA) for the treatment of impotence prior to the introduction of Viagra.

*L -Arginine - Play a significant role in the erection process through its oxidation to nitric oxide, L- Arginine. Research has shown that increased levels of nitric oxide can correct up to 90% of the clinical cases of erectile dysfunction. The role of nitric oxide in controlling blood flow was only recently discovered in 1998 resulting in a Nobel Prize for scientific discovery. The increase release of nitric oxide further allows additional blood into the penis, increasing both the length and girth of the penis.

*Avena sativa (Wild oat) - Modern studies at the Institute for Advanced Study of Human Sexuality have shown that Avena sativa helps to improve libido dramatically. Clinical studies have shown that Avena sativa exerts its action by freeing up testosterone. Bound testosterone is not as effective as free testosterone in promoting sexual desire. Free testosterone also increases stamina and promotes muscle growth. The studies also revealed that both males and females have reported positive results including better stamina and an overall feeling of well being.

*Epimedium (Yin yang huo) - This herb has been shown to increase the pituitary gland's production of androgens thus increasing testosterone production and release, promote erectile response, stimulates the sensory nerves and supports muscular growth and health.

*Tribulus terrestris (Puncture vine) - has been used for centuries for the treatment of the following conditions: enhances erections and overall muscle mass by increasing levels of testosterone. diseases of genito urinary tract including dysuria chronic cystitis, phosphaturia, incontinence, spermatorrhoea (involuntary discharge of semen without orgasm) impotence, cardiovascular disorders, and immune system deficiencies.

*Maca (Lepidium peruvianum chacon) - Cultivated in the Andes Mountains in Peru in heights over 3400 up to 4800 meters, the herb as become very popular due to its energizing effects, aphrodisiac qualities, and fertility enhancement. Other traditional uses include increasing stamina, energy and endurance in athletes and promoting mental clarity.

*Saw Palmetto (Serenoa repens) - The North American natives for hundreds of years have used the palmetto berries as a cure for various aliments that include impotence, atrophy of the testes, urinary tract inflammation of the prostate, decreased libido, infertility, dysmennorhea, and an expectorant for mucous membranes.

*Schizandra (Schizandra chinensis) - Seems to have been made into a famous tonic consumed by Chinese royalty and Daoist masters. The herb acts as a anti-hepatotoxic , antioxidant, and decreases impotence symptoms, which is secondary to its ability to dilate blood vessels improving erections.

*Guarana (Paullinia cupana) - The supplemental benefits of Guarana include: acts as an aphrodisiac, used for weight control as an appetite suppressant, central nervous system stimulant to increase alertness and decrease fatigue, relief of mild anxiety stress and nervous tension.

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