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Hackett G. Long-acting testosterone undecanoate improved diabetes control vs. placebo in a hypogonadal population with type 2 diabetes. J Sex Med 2011; 8: 1743–6095.

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Though it can be difficult to discuss this intimate subject with someone, the more your doctor knows about your health, lifestyle, and history, the more likely they can help determine the cause of your ED and the right course of treatment.
Conditions like vascular disease, surgery, diabetes, and medications are some of the top causes of erectile dysfunction. If you suffer from ED, schedule an evaluation with your doctor and get the help you need

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benign prostatic enlargement – take it as soon as you remember and then continue as usualpulmonary hypertension – take it within 8 hours if you can. If you remember after 8 hours, skip the missed dose and take the next dose as usual.
Besides PDE5 inhibitors and among second-line therapies are VCDs which are clear plastic chambers placed over the penis, tightened against the lower abdomen with a mechanism to create a vacuum inside the chamber. This directs blood into the penis. If an adequate erection occurs inside the chamber, the patient slips a small constriction band off the end of the VCD and onto the base of the penis. An erection beyond 30 min is not recommended. These devices can be a bit cumbersome, but are very safe.40

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The Massachusetts Male Aging Study linked a healthier lifestyle, including a healthy diet, to a reduced risk for ED as well as diseases that can contribute to ED such as type 2 diabetes and obesity. A diet rich in whole grains, fruits, vegetables, nuts, and legumes, and low in processed foods, sugar, and red meat may be particularly healthful.

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Erythrocytosis has been noted in men on TRT, and should be monitored every 6–12 months depending upon the patients’ response to changes in haematocrit levels. For mild elevations, the dosage of testosterone can be decreased or the interval of using the medication can be increased. With the haematocrit greater than 50%, decisions to temporarily discontinue the medication or periodic phlebotomy may be indicated.38

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    Ginkgo biloba. Known primarily as an herbal treatment for cognitive decline, ginkgo has also been used to treat erectile dysfunction -- especially cases caused by the use of certain antidepressant medications. But the evidence isn't very convincing. One 1998 study published in the Journal of Sex & Marital Therapy found that it did work. But a more rigorous study, published in Human Pharmacology in 2002, failed to replicate this finding. "Ginkgo has come out of fashion in the past few years," says Ronald Tamler, MD, assistant professor of medicine and codirector of the men's health program at Mount Sinai Medical Center in New York City. "That's because it doesn't do much. I can say that in my practice, I have not seen ginkgo work -- ever."

    Hackett G. Long-acting testosterone undecanoate improved diabetes control vs. placebo in a hypogonadal population with type 2 diabetes. J Sex Med 2011; 8: 1743–6095.
    Ginseng. Korean red ginseng has long been used to stimulate male sexual function, but few studies have tried systematically to confirm its benefits. In one 2002 study involving 45 men with significant ED, the herb helped alleviate symptoms of erectile dysfunction and brought "enhanced penile tip rigidity." Experts aren't sure how red ginseng might work, though it's thought to promote nitric oxide synthesis. "I would recommend ginseng [for men with ED]," says Espinosa. Discuss with your doctor before taking it since ginseng can interact with drugs you may already be taking and cause allergic reactions.

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    Acupuncture. Though acupuncture has been used to treat male sexual problems for centuries, the scientific evidence to support its use for erectile dysfunction is equivocal at best. In 2009, South Korean scientists conducted a systematic review of studies on acupuncture for ED. They found major design flaws in all of the studies, concluding that "the evidence is insufficient to suggest that acupuncture is an effective intervention for treating ED." QUESTION Erectile dysfunction (ED) is… See Answer

    Don’t spend another day with the sexual disappointment and frustration that comes with ED. Contact one of our Oakdale Erectile Dysfunction Clinics to schedule a fast and friendly consultation with a trusted ED specialist. Related Procedures Platelet Rich Plasma (PRP) Treatment Peyronie's Disease Treatment Erectile Dysfunction Treatment About What is GAINSWave? What to expect? How it works? Comparing treatments Frequently asked questions Medical advisory board Clinical research Find a provider near you → Locations New York Texas Florida California Colorado Arizona Washington See all locations → Quick Links Men’s Health Guide GW Magazine As Seen On For Providers Provider Resources For Affiliates For Press Partnership
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    When other treatment options are not successful, penile implant surgery can provide excellent patient and partner satisfaction. Both malleable (bendable) and inflatable devices can be implanted to allow penile rigidity and satisfactory sexual intercourse.

    Erectile dysfunction is an extremely important problem, with implications far beyond sexual activity. ED can be both a herald marker and a consequence of several chronic disease states. Early recognition is important because of the opportunities relating to cardiovascular risk modification.
    More than two drinks a day is considered a risk factor for ED. Alcohol can lower testosterone levels, decrease flowing blood to the penis, and cause nerve and hormonal imbalances. Low testosterone from alcohol or drug abuse can also affect your libido and performance, potentially leading to further psychological ED complications.

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    In a double-blind, randomized, placebo-controlled study, researchers found that oral administration of l-arginine in high doses (5 grams per day for a six-week period) significantly improved sexual function in men with erectile dysfunction, but only if the dysfunction was caused by decreased nitric oxide excretion. (26)

    Jones TH, Arver S, Behre HM, et al. Testosterone replacement in hypogonadal men with type 2 diabetes and or metabolic syndrome (TIMES2 Study). Diabetes care 2011, 34: 828–37. doi:10.2337/dc10-1233
    Hypertension (high blood pressure) is associated with ED and is seen more commonly among aging men. In addition, medications prescribed for hypertension, such as beta blockers and thiazide diuretics, have been shown to have detrimental effects on erectile function.

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If your doctor suspects that you may have an underlying condition, however, you might need further tests or a consultation with a specialist. Tests for underlying conditions can include: A physical exam: Your doctor will examine your penis and testicles for signs of abnormalities and will test sensation. Blood tests: Blood tests can show if you may have heart disease, diabetes, low testosterone levels, or other issues. Urine tests: Urinalysis is used to look for signs of diabetes and other health conditions. An ultrasound: A specially trained technician will use a wand-like device (transducer) over the blood vessels that supply the penis to analyze for blood flow issues. A psychological exam: Your doctor may want to evaluate you for depression or other mental illnesses that may cause erectile dysfunction. Why Do Men Often Die Before Women Groan-Up Humor of 'Dad Jokes' No Sign Testosterone Supplements Cause Heart Issue Men Think They're Healthier Than They Are Frozen Testes Tissue in Mice Viable After Decades Daily Health News Why Are Men More Prone to Cancer? TPOXX: The Only Monkeypox Treatment Toxic Burn Pit Bill Remove Little Kidney Stones, Too Opioid Prescriptions Decline More Health News » Trending on MedicineNet Triple-Negative Breast Cancer Causes of Stool Color Changes Good Heart Rate By Age Laminectomy Recovery Time Normal Blood Pressure By Age

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“Ginseng is thought to increase nitric oxide production, leading to improved blood flow," he says. "Pomegranate juice is a potent antioxidant and can help prevent atherosclerosis." Always talk to your doctor before taking any supplements, as they might interfere with other medication you're taking.

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The most compelling new treatments being researched are acoustic wave and low-intensity shockwave therapies (LI-SWT). These treatments both use soundwaves, but the much faster-moving shockwaves appear to be more effective at stimulating blood flow and improving vascular performance in penile tissue.

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The Prostate Cancer Prevention Trial was a landmark study by Thompson et al that prospectively assessed the time to developing CVD after the diagnosis of ED. There were 4247 men with no ED at study entry; 2420 developed incident ED (defined as the first report of ED of any grade) over 5 years. Those men that developed ED had a 1.45-fold higher probability of experiencing a CV event compared with men who did not develop ED.27

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