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Our patients often undergo a full body exam to determine whether they have early cardiovascular disease, vascular disease or a metabolic condition such as diabetes. Treatment is addressed with a multi-disciplinary approach.

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The link between cycling and erectile dysfunction (ED) has been hotly debated for a number of years. Aside from ED, concerns...
29. Andersson DP, Landucci L, Lagerros YT, et al. Association of phosphodiesterase-5 inhibitors versus alprostadil with survival in men with coronary artery disease. J Am Coll Cardiol. 2021;77(12):1535-1550. .

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Erectile dysfunction is a frustrating condition where your penis cannot get or maintain an erection firm enough for sex. There is no specific treatment to reverse damage to blood vessels caused by diabetes, there are several options to help you have erections.
Adhering to a set sleep schedule is a natural erectile dysfunction remedy, and can help ensure that those signals are clear and consistent.

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https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis Does Vitamin D Deficiency Contribute to Erectile Dysfunction? (2012).
Erectile dysfunction occurs when sexual stimulation or arousal does not result in enough blood flow to your penis, even though you may still have the urge. For some men there is a physical or medical reason for this. For others the problem is related to thoughts or emotions.

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“We listen to the patient and partner, understand the cause of the problem and work with the couple to start treatment that works best for the patient,” says Dr. Honig. PDE-5 inhibitors (phosphodiesterase type 5 inhibitors): These are medicines which relax muscle cells in the penis and increase blood flow. Vacuum erection device: This pulls blood into the penis, causing an erection. The erection is maintained by placing an elastic ring at the base of the penis. Injection therapy: Doctors use a very small needle to inject medication directly into the side of the penis. This relaxes the muscle allowing for blood flow and is a highly successful. Minimally invasive penile implant surgery: which our experienced physicians routinely perform. Most patients recover full sexual function in six to eight weeks. Yale Medicine Urology has extensive experience in standard and complicated penile implant surgery.

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Routine use of drugs like Viagra is associated with an increased risk of developing several types of eye problems that can lead to sudden vision loss ...

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    If stress, anxiety, or other emotional issues are causing the condition, counseling may help. Some men experience erectile dysfunction because of past experiences that cause a lack of self-esteem, fear, or guilt, and counseling can help you overcome those negative feelings. Couple counseling can also help improve mutual understanding and acceptance in a relationship, allowing you to feel more comfortable during intimacy.

    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.
    And if you need support in the process of reducing stress and anxiety, try cognitive behavioral therapy that will help you to work through tough situations that would normally leave you in a state of stress.

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    Medications may include drugs to manage underlying health conditions such as diabetes, high blood cholesterol, or kidney diseases in addition to medications that specifically target erectile dysfunction. Sildenafil Tadalafil Vardenafil Avanafil Alprostadil (injectable drug or a suppository)

    As of yet, there are no clinically proven home remedies for ED. For this reason, many people tend to choose ED medications (such as sildenafil or tadalafil) to treat their symptoms because they have been clinically proven to promote harder, longer-lasting erections. However, although ED can be effectively treated with erectile dysfunction tablets, it’s still advisable to foster healthy habits at home to reduce the likelihood of experiencing ED. Maintaining a healthy diet, exercising regularly, and avoiding excessive porn consumption can all help to keep erectile dysfunction at bay.
    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.

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    Pomegranate juice. Drinking antioxidant-rich pomegranate juice has been shown to have numerous health benefits, including a reduced risk for heart disease and high blood pressure. Does pomegranate juice also protect against ED? No proof exists, but results of a study published in 2007 were promising. The authors of this small-scale pilot study called for additional research, saying that larger-scale studies might prove pomegranate juice's effectiveness against erectile dysfunction. "I tell my patients to drink it," says Espinosa. "It could help ED, and even if it doesn't, it has other health benefits."

    Panax ginseng (red ginseng) is sometimes called “herbal Viagra”. There have been more than a handful of studies providing evidence that Panax ginseng can help with ED. However, the studies leave a fair bit to be desired in their methodologies and size. The evidence thus far points to the need for more research and the alluring potential of red ginseng as an effective treatment.
    Some over-the-counter (OTC) supplements may help increase blood flow to the penis and mitigate the symptoms of ED. Keep in mind that because the FDA doesn’t monitor or approve these supplements, you may not get a consistent dose. Additionally, the supplements may not always contain the ingredient advertised, or they may contain other unlisted ingredients. Ginseng: A small number of studies suggests that red ginseng, or Korean red ginseng, may increase penile blood flow and help treat ED. L-arginine: Some men with ED appear to have low levels of this amino acid. When combined with tadalafil (Cialis) or pycnogenol (a compound found in pine bark), it may help improve ED, but more research is necessary because the studies have been small.Horny goat weed: This herb has long been used in traditional Chinese medicine in the treatment of ED and sexual dysfunction. However, one study from 2017 found that while there is some evidence that it helps increase sexual activity in castrated rats, there is little to no direct evidence it increases penile blood flow in human males. Stretches

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    https://pubmed.ncbi.nlm.nih.gov/26391406/ Biological Activities of Ginseng and Its Application to Human Health. (2011).

    Bohm M, Baumhakel M, Teo K, et al. Erectile dysfunction predicts cardiovascular events in high-risk patients receiving telmisartan, ramipril, or both: The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (ONTARGET/TRANSCEND) Trials. Circulation 2010; 121: 1439–46. doi:10.1161/CIRCULATIONAHA.109.864199
    (Orchis mascula) The commonest of the British native orchids. The tubers (and those of most of the Orchis species of Europe and Northern Asia), when prepared, yield salep, which had, at least according to the doctrine of signatures (the word orchid means testicle) a reputation for curing impotence (Pliny gemina radice, testiculus simili), a reputation flourishing in eastern countries particularly, though it is represented too in north-east Scotland, where the root was used as an aphrodisiac, the old tuber being discarded, and the new one used. It would be dried, ground, and secretly administered as a potion (Anson). John Moncrieff of Tippermalloch (in the 18th century) went further How to Cure ED Last Updated on Mon, 04 Jul 2022 | Natural Health About Contact Advertise Privacy Policy Resources

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Erectile dysfunction can be a difficult problem to discuss with your partner or even your doctor. However, it needn't be because erectile dysfunction, which causes sexual performance issues for men, is a very common and highly treatable condition.

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usesWhat is Viagra (Sildenafil (Injection)) used for?Pulmonary HypertensionHeart DiseasePulmonary ImpairmentErectile DysfunctionPulmonary Heart or Vascular DiseaseThromboembolic Pulmonary Hypertension

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https://www.jsm.jsexmed.org/article/S1743-6095(19)31115-4/fulltext Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study. (1994).

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Coronary Artery DiseaseCoronary artery disease (CAD) and ED frequently occur concomitantly due to mutual risk factors such as diabetes, hypertension, and hyperlipidemia. In men with CAD, the incidence of ED is estimated to be 42% to 57%. Because the primary cause of ED is vasculogenic, ED can precede CAD, stroke, and peripheral artery disease by an average of 3 years.27,28 The package insert for PDE5Is cautions providers about using these agents in patients with uncontrolled hypertension (>170/100 mmHg), CAD with unstable angina, or a history of myocardial infarction (MI), stroke, or life-threatening arrhythmia within the past 6 months.8-11 The primary concern with using PDE5Is in these patients is that the physical demands of intercourse could provoke a CV event.

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