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ED has the same risk factors as both coronary artery disease (CAD) and generalised vascular disease.14 These include hypertension, diabetes, hyperlipidaemia, obesity, lack of physical exercise, excess alcohol intake, poor diet and psychological stress, in particular depression. As mentioned earlier, ED is now recognised as an marker of increased cardiovascular disease (CVD) that is independent of conventional risk factors.15

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However, speak to a pharmacist or doctor before taking it if you're trying to get pregnant.
We understand your concerns and can answer your questions about male sexual issues. We’ve heard it all before, and we can find the answers—and the treatment—that is personally best for you. .

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All men receiving testosterone replacement need to have periodic measurement of haemoglobin and haematocrit to monitor for erythrocytosis. Feldman HA , Goldstein I , Hatzichristou DG , et al . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994;151:54–61. Araujo AB , Esche GR , Kupelian V , et al . Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab 2007;92:4241–7. doi:10.1210/jc.2007-1245 Lindau ST , Schumm LP , Laumann EO , et al . A study of sexuality and health among older adults in the United States. N Engl J Med 2007;357:762–74. doi:10.1056/NEJMoa067423 Shah J . Erectile dysfunction through the ages. BJU Int 2002;90:433–41. doi:10.1046/j.1464-410X.2002.02911.x Mobley D . Early history of inflatable penile prosthesis surgery. Asian J Androl 2015;17:225–9. Roumeguère T , Wespes E , Carpentier Y , et al . Erectile Dysfunction is associated with a high prevalence of hyperlipidemia and coronary Heart Disease Risk European Urology.44:355–9. Klein R , Klein BE , Lee KE , et al . Prevalence of self-reported erectile dysfunction in people with long-term IDDM. Diabetes Care 1996;19:135–41. doi:10.2337/diacare.19.2.135 Larsen SH , Wagner G , Heitmann BL . Sexual function and obesity. Int J Obes 2007;31:1189–98. doi:10.1038/sj.ijo.0803604 McWaine DE , Procci WR . Drug-induced sexual dysfunction. Med Toxicol Adverse Drug Exp 1988;3:289–306. doi:10.1007/BF03259941 Croft H , Settle E , Houser T , et al . A placebo-controlled comparison of the antidepressant efficacy and effects on sexual functioning of sustained-release bupropion and sertraline. Clin Ther 1999;21(4):643–58. doi:10.1016/S0149-2918(00)88317-4 Janeway M , Baum N . Managing the enlarged prostate gland in elderly men. Clinical Geriatrics http://www.consultant360.com/articles/managing-enlarged-prostate-gland-elderly-men. Kumar RJ , Barqawi A , Crawford ED . Adverse events associated with hormonal therapy for prostate Cancer. Rev Urol 2005;7 Suppl 5:S37–S43. Aksam A , Yassin A , Saad F . Testosterone and erectile dysfunction. J Andrology 2008;29. Gades NM , Nehra A , Jacobson DJ , et al . Association between smoking and erectile dysfunction: a population-based study. Am J Epidemiol 2005;161:346–51. doi:10.1093/aje/kwi052 Mobley D , Baum N . Smoking: it’s impact on urologic conditions. Rev Urology 17 2015. Stein RA . Endothelial dysfunction, erectile dysfunction, and coronary heart disease: the pathophysiologic and clinical linkage. Rev Urol 2003;5(Suppl 7):S21–S27. Andersson K , Stief C . Penile erection and cardiac risk: pathophysiologic and pharmacologic mechanisms. Am J Cardiol 2000;86:23–6. doi:10.1016/S0002-9149(00)00887-0 Feldman HA , Johannes CB , Derby CA , et al . Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med 2000;30:328–38. doi:10.1006/pmed.2000.0643 Vlachopoulos C , Ioakeimidis N , Terentes-Printzios D , et al . The triad: erectile dysfunction-endothelial dysfunction-cardiovascular disease Curr Pharm Des. 2008;14:3700–14. Watts GF , Chew KK , Stuckey BG et al . The erectile-endothelial dysfunction nexus: new opportunities for cardiovascular risk prevention. Nat Clin Pract Cardiovasc Med 2007;4:263–73. doi:10.1038/ncpcardio0861 Montorsi F , Briganti A , Salonia A , et al . Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003;44:360–5. doi:10.1016/S0302-2838(03)00305-1 Vlachopoulos C , Rokkas K , Ioakeimidis N , et al . Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study. Eur Urol 2005;48:996–1003. doi:10.1016/j.eururo.2005.08.002 Mulhall J , Teloken P , Barnas J et al . Vasculogenic erectile dysfunction is a predictor of abnormal stress echocardiography. J Sex Med 2009;6:820–5. doi:10.1111/j.1743-6109.2008.01087.x Hodges LD , Kirby M , Solanki J , et al . The temporal relationship between erectile dysfunction and cardiovascular disease. Int J Clin Pract 2007;61:2019–25. doi:10.1111/j.1742-1241.2007.01629.x Inman BA , Sauver JL , Jacobson DJ , et al . A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc 2009;84:108–13. doi:10.4065/84.2.108 Ponholzer A , Temml C , Obermayr R , et al . Is erectile dysfunction an indicator for increased risk of coronary heart disease and stroke? Eur Urol 2005;48:512–8. doi:10.1016/j.eururo.2005.05.014 Thompson IM , Tangen CM , Goodman PJ , et al . Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005;294:2996–3002. doi:10.1001/jama.294.23.2996 Banks E , Joshy G , Abhayaratna WP , et al . Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: a prospective cohort study. PLoS Med 2013;10:e1001372. doi:10.1371/journal.pmed.1001372 Lewis RW , Fugl-Meyer KS , Corona G , et al . Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med 2010;7:1598–607. doi:10.1111/j.1743-6109.2010.01778.x Yaman O , Gulpinar O , Hasan T , et al . Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity. Int Urol Nephrol 2008;40:117–23. doi:10.1007/s11255-007-9293-8 Montorsi P , Ravagnani PM , Galli S , et al . Association between erectile dysfunction and coronary artery disease. role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J 2006;27:2632–9. doi:10.1093/eurheartj/ehl142 Montorsi P , Ravagnani PM , Galli S , et al . Association between erectile dysfunction and coronary artery disease:matching the right target with the right test in the right patient. Eur Urol 2006;50:721–31. doi:10.1016/j.eururo.2006.07.015 Yassin AA , Saad F . Testosterone and erectile dysfunction. J Androl 2008;29:593–604. doi:10.2164/jandrol.107.004630 Khera M . Androgens and erectile function: a case for early androgen use in postprostatectomy hypogonadal men. J Sex Med 2009;6:234–8. doi:10.1111/j.1743-6109.2008.01159.x Aversa A , Isidori AM , De Martino MU , et al . Androgens and penile erection: evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction. Clin Endocrinol 2000;53:517–22. doi:10.1046/j.1365-2265.2000.01118.x Wespes E , Amar E , Hatzichristou D , et al . EAU guidelines on erectile dysfunction: an update. Eur Urol 2006;49:806–15. doi:10.1016/j.eururo.2006.01.028
17. Muse (Alprostadil) [Prescribing Information]. Somerset, NJ: Meda Pharmaceuticals Inc; April 2018.

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Doctors must be consulted before resorting to herbs or supplements to avoid side effects and complications as a result of a herb or supplement.
Side effects will usually go away when you stop taking the tablets. Talk to a doctor if you have taken too much tadalafil and you're worried about these side effects.

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This is why a healthy circulatory system is key to maintaining penile health. In addition, stress causes nerve endings to be less receptive to incoming signals, making erection difficult.

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Although ED is commonly seen in older men, it is not a natural part of aging. Older men may need more sexual stimulation, such as touching or stroking, to achieve an erection, or they may need longer periods between two erections. Older men in good health, however, should be able to get an erection sufficient for intercourse.

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    Exercise is probably the most effective natural remedy for Erectile Dysfunction.
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    The major cause of erectile dysfunction is restricted blood flow to the penis because of narrowed blood vessels. In fact, because the vessels in the penis are very small compared to other parts of the body, problems with erectile dysfunction can be a warning sign that other vessels, such as those leading to the heart, may eventually be affected. Diabetes, which also can affect the blood vessels, also is linked to erectile dysfunction.

    Chesapeake Urology is home to leading urology specialists in Maryland. With fellowship-trained urologists, 25 convenient locations, and comprehensive telehealth services, we’re here as a knowledgeable and caring source of trusted advice, treatment, and support.
    If someone collapses or isn't breathing after taking Viagra (Sildenafil (Injection)), call 911

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    Stendra is also our top choice for couples who enjoy morning sex. Why? Tadalafil taken in the morning can sometimes require about an hour before it is fully effective. This experience with tadalafil varies — some men find tadalafil to be effective for a full 36 hours (which would make the prior morning’s dose still effective), while others find its effects wear off in closer to 18 hours. If you are in the latter camp, Stendra will be better for your morning rituals because you can take a dose as you wake up and then be ready for fun in as little as 15 minutes.

    For men searching for ED medication, there are many newer erectile dysfunction treatments (all prescription drugs) that help you get an erection firm enough to have sex, and most have few side effects.
    Dehydroepiandrosterone (DHEA) is an important hormone for sexual function that’s naturally produced in the body. Generally DHEA levels peak when a person is in their 20s and gradually decrease thereafter.

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    Research shows that saw palmetto extract has been used extensively in the treatment of lower urinary tract symptoms and improves prostate health. And although the results are mixed, studies have shown that saw palmetto is also effective in improving erectile dysfunction. An animal study, for instance, evaluated the erectile functions of rats and rabbits that received saw palmetto extract. Researchers found that saw palmetto caused a relaxant response within the erectile tissue of the animals, allowing for increased blood flow. (22, 23).

    Benign Prostatic Hyperplasia/BPH, Erectile Dysfunction, General Urology, Kidney Stones, Penile Prosthesis, UroLift, Urologic Cancers, Vasectomy
    19. Staxyn (Vardenafil) [Prescribing Information]. Research Triangle Park, NC: GlaxoSmithKline; August 2017.

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The pulsating waves also trigger a healing response that “wakes-up” dormant stem cells and growth factors in the penis for an overall rejuvenation of male erectile tissue.

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Karelis AD, St-Pierre DH, Conus F, et al. Metabolic and body composition factors in subgroups of obesity: what do we know? J Clin Endocrinol Metab 2004; 89: 2569–75. doi:10.1210/jc.2004-0165

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Thejuice extracted from ginger is a valuable aphrodisiac and beneficial in thetreatment of sexual weaknesses.

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Many men prefer to take an ED medication only when they need it, rather than at the start of a day when they may or may not have sex. These men also understandably want that drug to take effect as quickly as possible and with the lowest chance of side effects.

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