It can be embarrassing to discuss sexual matters with your doctor. Yet a doctor’s appointment is neccessary if you want to get treatment for ED. Here’s how to prepare for your doctor visit.
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if you take medicine to treat pulmonary arterial hypertension, such as riociguat (Adempas).
To put it simply, feeling distressed or anxious in some way causes an erection to subside as the body is tricked into thinking that your attention is needed for a more important event (or threat).
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Seidman SN, Roose SP. The relationship between depression and erectile dysfunction. Curr Psychiatry Rep 2000; 2: 201–5. doi:10.1007/s11920-996-0008-0
“Alcohol is a depressant and can cause both temporary and long-term erectile dysfunction,” Mucher cautions.
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There is often a vicious cycle linking performance anxiety and erectile dysfunction. If you still have erections at times and the problem started rapidly (except after surgery), this usually means psychological reasons are involved.
The type of prescription medication that’s most commonly used in the treatment of erectile dysfunction is phosphodiesterase type 5 inhibitors (including sildenafil, vardenafil and tadalafil). They are used to relax and open the penile tissue, allowing for blood to enter the penis and cause an erection. Intracavernous (base of the penis) injections of vasoactive agents, such as prostaglandin E1, are also used for ED. (32)
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Your doctor may make suggestions to improve your overall health, including the health of your heart and circulatory system. Increasing your amount of exercise, eating well, and ensuring that you get sufficient vitamins and minerals can help with this overall wellbeing. Another recommendation may be reducing or eliminating your use of drugs, tobacco, or alcohol. Your doctor may also recommend losing weight.
Medications, such as treatment for high blood pressure, can also play a role. These drugs reduce blood pressure by reducing blood flow, which can affect erections. It is not recommended that men stop their blood pressure medications, of course. But some patients can eliminate their need for the treatment through changes in diet and exercise.
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But you'll have to have a consultation with the pharmacist to make sure it's safe for you to take it.
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.
Algorithm for evaluating and managing the patient with ED. CV, cardiovascular; CVD, cardiovascular disease; ED, erectile dysfunction.
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Mayo Clinic “Acupuncture: Definition,” “Acupuncture: Why it’s done,” “Drugs and Supplements: DHEA,” “Dietary supplements for erectile dysfunction: A natural treatment for ED?”
Grapefruit may interact with avanafil and lead to unwanted side effects. Avoid the use of grapefruit products.
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There are many unproven herbals, dietary supplements, and natural remedies for ED. These include panax, propionyl-L-carnitine, L-citrulline, pomegranate, rhodiola rosea, golden root, Indian ginseng, zinc supplements, and ashwagandha.
Testosterone replacement in patients with hypogonadism remains controversial. A double-blind placebo controlled study using long-acting testosterone undeconate and involving seven UK general practices showed small changes in glycated haemoglobin (HbA1c) (reduced from 7.61% to 7.52%) over 30 weeks but marked changes after a further 22 weeks (down from 8.3% to 7.3%). Mean weight loss was 2 kg with a 1.5 cm reduction in waist circumference.9 There was no significant increase in mean PSA and mean haematocrit was unchanged. Another meta-analysis showed significant reduction in fasting plasma glucose, HbA1c, fat mass and triglycerides, but no significant change in total and high-density lipoprotein cholesterol, blood pressure or BMI.10
Erectile dysfunction (ED) is a common medical condition that primarily affects men older than 40. Among other symptoms, ED can make it difficult to get and maintain erections during sexual activity, placing an unwanted burden on your intimate relationships as well as on your physical and emotional health. While you can’t get standard prescription ED pills over the counter, some supplementary treatments do not require a prescription.
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Young adult men who frequently turn to pornography for stimulation, or who may even be struggling with a porn addiction, are much more likely to experience sexual dysfunctions in their lifetime.
Horny Goat Weed: Extracts from the leaves of this herb have long been used as an ED remedy in traditional Chinese medicine. At least one study on rats showed promise, but it has yet to be tested on people.
You may already know most of the names: Cialis, Levitra, Staxyn, Stendra, Viagra. Learn more about these medications that can help men with erectile dysfunction.
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Supplements. A lot of over-the-counter products have been hailed as all-natural ways to treat ED. But it’s not clear if they’re effective or if they’re safe.
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If the tablets mentioned above don't work, then injecting a medicine called Caverject into the base of your penis is another option. It allows most men to get an erection, which may last beyond ejaculation. Some men may be put off by this method, but the injector devices are simple and convenient to use and the procedure is virtually painless. Your doctor or sexual health specialist needs to show you in person how to use it safely.
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Kegel exercises are an easy activity you can engage in to instantly begin to increase your sexual function and health. Normally used by women after giving birth, this exercise helps strengthen muscles that are responsible for holding in blood and maintaining your stamina. When not used, these muscles can become weakened and fail to help ...
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Banana contains potassium which helps to regulate the flow of blood by dilating arterioles and in turn enhancing erection.
This condition is characterized by the bending or curvature of the penis, or narrowing of the penile shaft. Scarring related to Peyronie’s disease can cause circulation problems in the penis.
This therapy has been shown to produce results for up to two years and over time has been proven to increase overall blood flow to the penis, and it also has been shown to be safe for diabetics and patients with cardiac problems.
https://www.koreascience.or.kr/article/JAKO200311922122275.page Randomised Controlled Trial of Pelvic Floor Muscle Exercises and Manometric Biofeedback for Erectile Dysfunction. (2004).
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.
Each treatment option for ED varies in cost depending on your specific needs. The cost is based on your symptoms, sexual history, and medical evaluation. A consultation with a Oakdale ED specialist is the best way to get a quote for the costs of treatment.
Several FDA-approved phosphodiesterase-5 (PDE5) inhibitor medications exist to treat ED in men. These medications work by enhancing the effects of nitric oxide to relax the penile muscles, expand blood vessels that go into the penis, and improve penile blood flow. This helps improve the ability to get and maintain erections.
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Impotence treatments were discussed in the oldest Chinese text, The Yellow Emperor’s Classic of Internal Medicine, which describes traditional Chinese medicine during the time of the Yellow Emperor’s rule which ended around 2600 BC. One of the treatments for impotence discussed is a potion with 22 ingredients.4
With self-injection, a medication is injected directly into the penis to increase blood flow. It is very effective (about 75 percent to 85 percent) and works whether the nerve that controls erections is intact or not. It can be more costly than oral therapies and results in scarring in 5 percent to 30 percent of users (depending on the drug used). To ensure proper dosing, the first dose is generally administered in the doctor’s office.
Often, erectile dysfunction can be a symptom of a heart condition, diabetes, or high blood pressure. To address this, Yale Medicine established the Male Reproductive Health/Sexual Medicine Program, a collaboration between the specialties of cardiovascular medicine and urology.
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
While some studies back up acupuncture’s claim to work for ED, the evidence is rather scant.
Relaxation exercises can aid relieve stress related to erectile dysfunction and level exercises can help to strengthen the muscles of the pelvic floor and this improves erectile function.
Some of these products have been found to contain sildenafil (the active ingredient in Viagra) or a substance similar to vardenafil (the active ingredient in Levitra and Staxyn). These products can be dangerous for people who take nitrates to treat chest pain or heart disease.
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The causes of erectile dysfunction are many, including physical problems like diabetes, heart disease, obesity, high blood pressure, high cholesterol, and even sleep disorders. Medication taken for health conditions can result in erectile dysfunction, as can alcohol and smoking.
Kegel exercises are an easy activity you can engage in to instantly begin to increase your sexual function and health. Normally used by women after giving birth, this exercise helps strengthen muscles that are responsible for holding in blood and maintaining your stamina. When not used, these muscles can become weakened and fail to help ...
Medication therapy is effective, especially in older men. Additional treatment may include self-injected medication, vacuum erection devices, or urethral suppositories. Surgical interventions include vascular reconstruction for improved penile blood flow. Penile implants are considered for some cases.
If anxiety or stress is causing your ED, it may help to talk to a professional therapist.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427191/ Effect of Lifestyle Changes on Erectile Dysfunction in Obese Men: A Randomized Controlled Trial. (2004).
Erectile dysfunction (ED, impotence) is the failure to achieve or maintain an erection. There are many potential underlying causes of erectile dysfunction, including stress and emotional problems, brain dysfunction, problems with blood supply to the penis, and structural problems with the penis.
To improve sexual function with rose oil, diffuse 5 drops at home or rub 2 drops on your neck before you are planning to engage in sexual activity.
Benign Prostatic Hyperplasia/BPH, Erectile Dysfunction, General Urology, Male Incontinence, Male Sexual Dysfunction, Peyronie's Disease, Urethral Stricture Disease, UroLift
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.
Avanafil is for use only in men. It is not known whether this medicine would be harmful if used by a woman during pregnancy or while breast-feeding.
Acupuncture is also known to help improve health conditions that are associated with erectile dysfunction, including anxiety, depression, fatigue and inflammation.
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Even when there is an initial physical reason, when this has passed you may still feel anxious about having sex and this can add to the problem.
Your doctor will do a physical exam and ask you questions about your symptoms. He or she may do a blood or urine test. Your doctor may consider other tests to rule out other conditions.
Vacuum erection device, also called vacuum constriction devices, are made of three parts:
The role of the endothelium in erectile function became clearer with the observation that the phosphodiesterase type 5 (PDE5) inhibitor, sildenafil, enhanced erectile function. Erection occurs with the release of nitric oxide (NO) from the vascular endothelial cells.17 The reduction in endothelial cell production of NO results in the negative impact on the smooth muscles in the corporal bodies and results in less relaxation of the smooth muscle cells with decrease in blood supply and resulting ED. A similar phenomenon is well known to impact the coronary arterial system resulting in CVD.
18. Caverject (Alprostadil) [Prescribing Information]. New York, NY: Pfizer Inc; December 2017.
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