Erectile dysfunction isn’t caused only by unhealthy eating or nights on the lash. In fact, it’s been estimated that 10-20% of all cases of erectile dysfunction are caused by psychological problems. Issues like stress, PTSD, poor body image, relationship issues and depression can all impact your ability to enjoy a fulfilling, satisfying sex life.
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It is recommended that prior to proceeding with other therapies, patients reporting failure of their PDE5 inhibitors should be evaluated to determine whether the trial was adequate. This would include discussion of fatty food ingestion, which is important with sildenafil, and specific patient population such as prostatectomy and diabetes. Furthermore, patients should be encouraged to continue attempts at intercourse up to the eighth to tenth dose of PDE5 inhibitor as improvements in success rate are seen up to the eighth to tenth dose.
In addition to the FDA-approved ED medications and other standard treatment options listed above, the following OTC treatments might help mitigate the symptoms of ED. Always seek medical advice from a healthcare provider before trying any of these, as not everything is effective or safe.
The Sexual Advice Association has factsheets on medicines and other treatments for erectile dysfunction.
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The options for management beyond behaviour modification include TRT, PDE5 inhibitors, intracavernosal injection therapy, vacuum constriction devices (VCDs), intraurethral prostaglandin suppositories and surgical placement of a penile prosthesis.40
If you are taking a medicine and are worried about its effects, don't stop taking it suddenly. Instead discuss this with your doctor or pharmacist. There might be a different medicine you can take that is less likely to cause sexual problems. Read more about medicines and sexual problems. existing values or attitudes towards sex stress, guilt, depression or fatigue performance-related anxiety about your performance during sex traumatic past experiences including sexual abuse poor body image relationship problems (possible anger, power or control issues with your partner) problems with intimacy and communication intercourse less than once per week (twice the risk of developing erectile dysfunction).
It helps reduce symptoms of an enlarged prostate gland, such as difficulty peeing or needing to pee urgently, by relaxing the muscles in the prostate and bladder.
If counseling alone does not help treat the psychological issue, medications through a qualified psychiatrist may be prescribed.
In their extensive review, Bassil and coworkers summarise the benefits and risks, with benefits such as improvement of sexual function, bone density, muscle strength, cognition and overall improvement in quality of life. Among the risks that have been suggested include erythrocytosis, liver toxicity, worsening of sleep apnoea and cardiac function, possibly increasing symptoms of benign prostatic hyperplasia (BPH). They also note that although a possibility of stimulation of prostate cancer has been hypothesised, no scientific or clinical evidence exists to this possible risk.38
11. Levitra (Vardenafil) [Prescribing Information]. Research Triangle Park, NC: GlaxoSmithKline; November 2018.
For some men, vacuum pump devices, rigid or inflatable surgical penile implants or testosterone replacement (only for men with unequivocally low levels of this hormone) may also be options. Constriction bands at the base of the penis can be a treatment option for men with non-sustained erections. Discuss these options with your doctor.
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Erection problems (impotence) are very common, particularly in men over 40. It's usually nothing to worry about, but you should see a GP if it keeps happening. It could be the sign of a more serious problem. Causes of erection problems
Acupuncture. This ancient Chinese practice involves placing very fine needles at certain spots on your body. It’s thought to boost your body's ability to heal itself. It has helped some men. But more research is needed to prove that it works.Aromatherapy. Some scents, like lemon, may improve your mood. And that may put you in the mood.Not Recommended for ED
A 2017 systematic review and meta-analysis published in the British Journal of Sports Medicine found that physical activity and exercise, particularly aerobic exercise with moderate-to-vigorous intensity, improves erectile function. (17)