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Eradicate erectile dysfunction and premature ejaculation, and become the stud you were born to be.
Our urologists have access to state-of-the-art technology and provide the latest, safest erectile dysfunction treatments. .

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To see an improvement in erectile dysfunction, one research paper recommended that those experiencing ED engage in aerobic exercise “of moderate to vigorous intensity 4 times per week for 40 minutes”.
erectile dysfunctionendothelial dysfunctiontestosteronetestosterone deficiencyandrogen deficiencytestosterone replacementcardiovascular diseasestem cellsgene therapy

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Let's talk about erections, or lack thereof. If you are a man and you are having difficulty with erections, know that you are not alone. There are about 18 million men in the US suffering from ED. The rate of ED triples between the ages of 40 and 65.
Of the 90% of men who have an underlying physical cause, the main abnormalities found are: Cardiovascular disease in 40%; Diabetes in 33%; Hormone problems (e.g. high prolactin or low testosterone levels) & drugs (e.g. antihypertensives, antipsychotics, antidepressants, antihistamines, heroin, cocaine, methadone) in 11%; click here to watch a short video about testosterone deficiency from the NHS Health & Care Video Library. Neurological disorders in 10%; Pelvic surgery or trauma in 3-5%; and Anatomical abnormalities in 1-3% (e.g. tight foreskin, short penile frenulum, Peyronie's disease, inflammation, penile curvature). What treatments are available for this problem?

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Diuretics (pills that increase urine flow)High blood pressure medsAntihistaminesAntidepressantsParkinson's disease drugsAntiarrhythmics (drugs for irregular heartbeat)Tranquilizers and sedativesMuscle relaxantsNonsteroidal anti-inflammatory drugs (NSAIDs)Histamine H2-receptor antagonistsHormonesChemotherapy medicationsProstate cancer drugsAnti-seizure medications

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    There is reliable evidence that oral phosphodiesterase-5 (PDE-5) inhibitors (e.g., sildenafil, vardenafil, tadalafil, mirodenafil, and udenafil) improve erectile functioning in men with ED. However, there is a lack of reliable evidence of the efficacy of hormonal treatments and the value of hormone testing for ED. The American College of Physicians (ACP) developed guidelines on hormonal testing and pharmacological treatments of ED (Qaseem et al, 2009). Current drug therapies include PDE-5 inhibitors as well as hormonal treatment. The ACP recommended clinicians initiate therapy with a PDE-5 inhibitor in men who seek treatment for erectile dysfunction and who do not have a contra-indication to PDE-5 inhibitor use, and clinicians base the choice of a specific PDE-5 inhibitor on the individual preferences of men with erectile dysfunction, including ease of use, cost of medication, and adverse effects profile.

    A general physical examination will be performed to assess the development of your male sexual characteristics and to detect any abnormality of your penis or testicles. Your blood pressure, height and weight will normally be measured as part of this examination.
    ED is a common disease affecting men with IHD. Endothelial dysfunction is the link between ED and IHD and both diseases share the same aetiology, risk factors and pathogenesis. Aggressive control of these risk factors – along with lifestyle modification – is recommended to improve symptoms of ED and reduce cardiovascular risk. PDE5 inhibitors remain the first-choice treatment for ED in IHD patients and they have been shown to be safe and effective. However, PDE5 inhibitors can potentiate the hypotensive effect of nitrates so concomitant administration of sildenafil and nitrates is contraindicated. Gene and stem cell therapy are being investigated as a future therapies for ED. Hatzimouratidis K, Amar E, Eardley I, et al. European Association of Urology. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol 2010;57:804–14. Crossref | PubMed Solomon H, Man JW, Jackson G. Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator. Heart 2003;89:251–3. PubMed Meller SM, Stilp E, Walker CN, Mena-Hurtado C. The link between vasculogenic erectile dysfunction, coronary artery disease, and peripheral artery disease: role of metabolic factors and endovascular therapy. J Invasive Cardiol 2013;25:313–9. PubMed Fung MM, Bettencourt R, Barrett-Connor E. Heart disease risk factors predict erectile dysfunction 25 years later: The Rancho Bernardo Study. J Am Coll Cardiol 2004;43:1405–11. Crossref | PubMed Giuliano F. New horizons in erectile and endothelial dysfunction research and therapies. Int J Imp Res 2008;20:S2–S8. Crossref | PubMed Rodriguez JJ, Al Dashti R, Schwarz ER. Linking erectile dysfunction and coronary artery disease. Int J Imp Res 2005;17:S12–S18. Crossref | PubMed Kula K, Slowikowska-Hilczer J, Kula W. Pathophysiology of erectile dysfunction – an organisation/activation concept. J Repr Med Endocrinol 2005;2:246–50. Sai Ravi Shanker A, Phanikrishna B, BhakthaVatsala Reddy C. Association between erectile dysfunction and coronary artery disease and its severity. Indian Heart J 2013;65:180–6. Crossref | PubMed Montorsi P, Ravagnani PM, Galli S, et al. Common grounds for erectile dysfunction and coronary artery disease. Curr Opinion Urol 2004;14:361–5. PubMed Dong JY, Zhang YH, Qin LQ. Erectile dysfunction and risk of cardiovascular Disease. J Am Coll Cardiol 2011;58:1378–85. Crossref | PubMed Inman BA, St. 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. Crossref | PubMed 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. Crossref | PubMed Batty GD, Li Q, Czernichow S, et al. Erectile dysfunction and later cardiovascular disease in men with type 2 diabetes: prospective cohort study based on the ADVANCE trial. J Am Coll Cardiol 2010;56:1908–13. Crossref | PubMed Thompson IM, Tangen CM, Goodman PJ, et al. Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005;294:2996–3002. Crossref | PubMed Greenstein A, Chen J, Miller H, et al. Does severity of ischemic coronary disease correlate with erectile function? Int J Impot Res 1997;9:123–6; PubMed 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;44:360–4. Crossref | PubMed Jackson G. Erectile dysfunction and cardiovascular disease. Arab J Urology 2013;11:212–6. Crossref | PubMed Simonsen U. Interactions between drugs for erectile dysfunction and drugs for cardiovascular disease. Int J Impot Res 2002;14:178–88. Crossref | PubMed Chang SW, Fine R, Siegel D, et al. The impact of diuretic therapy on reported sexual function. Arch Intern Med 1991;151:2402–8. Crossref | PubMed Grimm RH Jr, Grandits GA, Prineas RJ, et al. Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS). Hypertension 1997;29:8–14. Crossref | PubMed Adverse reactions to bendrofluazide and propranolol for the treatment of mild hypertension. Report of Medical Research Council Working Party on Mild to Moderate Hypertension. Lancet 1981;2:539–43. Crossref | PubMed Fogari R, Preti P, Derosa G, et al. Effect of antihypertensive treatment with valsartan or atenolol on sexual activity and plasma testosterone in hypertensive men. Eur J Clin Pharmacol 2002;58:177–80. Crossref | PubMed Doumas M, Tsakiris A, Douma S, et al. Beneficial effects of switching from B-blockers to nebivolol on the erectile function of hypertensive patients. Asian J Androl 2006,8:177–82. Crossref | PubMed Fogari R, Zoppi A, Poletti L, et al. Sexual activity in hypertensive men treated with valsartan or carvedilol: a crossover study. Am J Hypertens 2001;14:27–31. Crossref | PubMed Sharp RP, Gales BJ. Nebivolol versus other beta blockers in patients with hypertension and erectile dysfunction. Ther Adv Urol 2017;9:59–63. Crossref | PubMed Boydak B, Nalbantgil S, Fici F, et al. A randomized comparison of the effects of nebivolol and atenolol with and without chlorthalidone on the sexual function of hypertensive men. Clin Drug Invest 2005;25:409–16. PubMed Cordero A, Bertomeu-Martinez V, Mazon P, et al. Erectile dysfunction in high-risk hypertensive patients treated with beta-blockade agents. Cardiovasc Ther 2010;28:15–22. Crossref | PubMed Brixius K, Middeke M, Lichtenthal A, et al. Nitric oxide, erectile dysfunction and beta blocker treatment (MR NOED study): benefit of nebivolol versus metoprolol in hypertensive men. Clin Exper Pharmacol Phys 2007;34:327–31. Crossref | PubMed Nicolai MP, Liem SS, Both S, et al. A review of the positive and negative effects of cardiovascular drugs on sexual function: a proposed table for use in clinical practice. Neth Heart J 2014;22:11–9. Crossref | PubMed Bacon CG, Mittleman MA, Kawachi I, et al. A prospective study of risk factors for erectile dysfunction. J Urol 2006;176:217–21. Crossref | PubMed Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature 1993;362:801–9. Crossref | PubMed Schachinger V, Zeiher AM. Prognostic implications of endothelial dysfunction: does it mean anything? Coronary Artery Dis 2001;12:435–43. PubMed Brunner H, Cockcroft JR, Deanfield J, et al. Endothelial function and dysfunction. Part II: Association with cardiovascular risk factors and diseases. A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension. J Hypertens 2005;23:233–46. Crossref | PubMed Andersson K, Stief C. Penile erection and cardiac risk: pathophysiologic and pharmacologic mechanisms. Am J Cardiol 2000;86:23f–6. Crossref | PubMed Kloner RA, Zusman RM. Cardiovascular effects of sildenafil citrate and recommendations for its use. Am J Cardiol 1999;84:11n–7. Crossref | PubMed Jeremy JY, Ballard SA, Naylor AM, et al. Effects of sildenafil, a type-5 cGMP phosphodiesterase inhibitor, and papaverine on cGMP and cAMP levels in the rabbit corpus cavernosum in vitro. Br J Urol 1997;79:958–63. Crossref | PubMed Yavuzgil O, Altay B, Zoghi M, et al. Endothelial function in patients with vasculogenic erectile dysfunction. Int J Cardiol 2005;103:19–26. Crossref | PubMed Kaiser DR, Billups K, Mason C, et al. Impaired brachial artery endothelium dependent and independent vasodilation in men with erectile dysfunction and no other clinical cardiovascular disease. J Am Coll Cardiol 2004;43:179–84. Crossref | PubMed Kinsey AC, Pomeroy WR, Martin CE. Sexual behavior in the human male. Am J Pub Health 2003;93:894–8. Crossref | PubMed 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. Crossref | PubMed Panza JA, Quyyumi AA, Brush Jr JE, et al. Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension. N Engl J Med 1990;323:22–7. Crossref | PubMed Koga T, Takata Y, Kobayashi K, et al. Age and hypertension promote endothelium dependent contractions to acetylcholine in the aorta of the rat. Hypertension 1989;14:542–8. Crossref | PubMed Kung CF, Luscher TF. Different mechanisms of endothelial dysfunction with aging and hypertension in the rabbit aorta. Hypertension 1995;25:194–200. PubMed Taddei S, Virdis A, Ghiadoni L, et al. Cyclooxygenase inhibition restores nitric oxide activity in essential hypertension. Hypertension 1997;29:274–9. PubMed Behr-Roussel D, Chamiot-Clerc P, Bernabe J, et al. Erectile dysfunction in spontaneously hypertensive rats: pathophysiological mechanisms. Am J Physiol Regul Integr Comp Physiol 2003;284:R682–8. Crossref | PubMed Chowienczyk PJ, Brett SE, Gopaul NK, et al. Oral treatment with an antioxidant (raxofelast) reduces oxidative stress and improves endothelial function in men with type 2 diabetes. Diabetologia 2000;43:974–7. Crossref | PubMed Seftel AD, Sun P, Swindle R. The prevalence of hypertension, hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J Urol 2004;171:2341–5. Crossref | PubMed Nehra A. Erectile dysfunction and cardiovascular disease: efficacy and safety of phosphodiesterase type 5 inhibitors in men with both conditions. Mayo Clin Proc 2009;84:139–48. Crossref | PubMed Tengs TO, Osgood ND. The link between smoking and impotence: two decades of evidence. Prev Med 2001;32:447–52. Crossref | PubMed Eriksson J, Haring R, Grarup N, et al. Causal relationship between obesity and serum testosterone status in men: A bi-directional mendelian randomization analysis. PLoS One 2017;12:e0176277. Crossref | PubMed Tan RS, Pu SJ. The interlinked depression, erectile dysfunction, and coronary heart disease syndrome in older men: a triad often underdiagnosed. J Gend Specif Med 2003;6:31–6. PubMed Rosen RC. Psychogenic erectile dysfunction. Classification and management. Urol Clin North Am 2001;28:269–78. Crossref | PubMed Maiorino MI, Bellastella G, Esposito K. Diabetes and sexual dysfunction: current perspectives. Diabetes Metab Syndr Obes 2014;7:95–105. Crossref | PubMed Lue TF. Erectile dysfunction. N Engl J Med 2000;342:1802–13. Crossref | PubMed Traish AM, Galoosian A. Androgens modulate endothelial function and endothelial progenitor cells in erectile physiology. Korean J Urology 2013;54:721–31. Crossref | PubMed Crossman DC. The pathophysiology of myocardial ischaemia. Heart 2004;90:576–80. Crossref | PubMed Nehra A, Jackson G, Miner M, et al. The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease. Mayo Clin Proc 2012;87:766–78. Crossref | PubMed Gupta BP, Murad MH, Clifton MM, et al. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med 2011;171:1797–803. Crossref | PubMed Kling J. From hypertension to angina to Viagra. Mod Drug Discov 1998;1:31–8. Schwarz ER, Rastogi S, Kapur V, et al. Erectile dysfunction in heart failure patients. J Am Coll Cardiol 2006;48:1111–9. Crossref | PubMed Kostis JB, Jackson G, Rosen R. Sexual dysfunction and cardiac risk (the Second Princeton Consensus Conference) Am J Cardiol 2005;96:313–21. Crossref | PubMed Giuliano F, Jackson G, Montorsi F, et al. Safety of sildenafil citrate: review of 67 double-blind placebo-controlled trials and the postmarketing safety database. Int J Clin Pract 2010;64:240–55. Crossref | PubMed Kloner RA, Jackson G, Hutter AM. Cardiovascular safety update of tadalafil: retrospective analysis of data from placebo-controlled and open-label clinical trials of tadalafil with as needed, three times-per-week or once-a-day dosing. Am J Cardiol 2006;97:1778–84. Crossref | PubMed Olsson AM, Persson CA; Swedish Sildenafil Investigators Group. Efficacy and safety of sildenafil citrate for the treatment of erectile dysfunction in men with cardiovascular disease. Int J Clin Pract 2001;55:171–6. PubMed Kloner R, Padma-Nathan H. Erectile dysfunction in patients with coronary artery disease. Int J Impot Res 2005;17:209–15. Crossref | PubMed Conti CR, Pepine CJ, Sweeney M. Efficacy and safety of sildenafil citrate in the treatment of erectile dysfunction in patients with ischemic heart disease. Am J Cardiol 1999;83:29C−34. Crossref | PubMed DeBusk RF, Pepine CJ, Glasser DB, et al. Efficacy and safety of sildenafil citrate in men with erectile dysfunction and stable coronary artery disease. Am J Cardiol 2004;93:147−53. Crossref | PubMed Kloner RA, Goggin P, Goldstein I, et al. A new perspective on the nitrate-phosphodiesterase type 5 inhibitor interaction. J Cardiovasc Pharmacol Ther 2018;23:375−86. Crossref Arruda-Olson AM, Mahoney DW, Nehra A, et al. Cardiovascular effects of sildenafil during exercise in men with known or probable coronary artery disease. A randomized crossover trial. JAMA 2002;287:719−25. Crossref | PubMed Mittleman MA, Glasser DB, Orazem J. Clinical trials of sildenafil citrate demonstrate no increase in risk of myocardial infarction and cardiovascular death compared with placebo. Int J Clin Pract 2003;57:597−600. PubMed De Vecchis R, Cesaro A, Ariano C, et al. Phosphodiesterase-5 inhibitors improve clinical outcomes, exercise capacity and pulmonary hemodynamics in patients with heart failure with reduced left ventricular ejection fraction: a meta-analysis. J Clin Med Res 2017;9:488–98. Crossref | PubMed Assad TR, Hemnes AR, Larkin EK, et al. Clinical and biological insights into combined post- and pre-capillary pulmonary hypertension. J Am Coll Cardiol 2016;68:2525–36. Crossref | PubMed Hackett G, Kirby M, Wylie K, et al. British Society for Sexual Medicine guidelines on the management of erectile dysfunction in men – 2017. J Sex Med 2018;15:430–57. Crossref | PubMed Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine guidelines on adult testosterone deficiency, with statements for UK practice. J Sex Med 2017;14:1504–23. Crossref | PubMed Anaissie J, Hellstrom WJ. Clinical use of alprostadil topical cream in patients with erectile dysfunction: a review. Res Rep Urol 2016;8:123–31. Crossref | PubMed Bivalacqua TJ, Deng W, Champion HC, et al. Gene therapy techniques for the delivery of endothelial nitric oxide synthase to the corpa cavernosa for erectile dysfunction. Methods Mol Biol 2004;279:173–85. Crossref | PubMed Bivalacqua TJ, Usta MF, Champion HC, et al. Effect of combination endothelial nitric oxide synthase gene therapy and sildenafil on erectile function in diabetic rats. Int J Impot Res 2004;16:21–9. Crossref | PubMed Bivalacqua TJ, Usta MF, Champion HC, et al. Gene transfer of endothelial nitric oxide synthase partially restores nitric oxide synthesis and erectile function in streptozotocin diabetic rats. J Urol 2003;169:1911–7. Crossref | PubMed Harraz A, Shindel AW, Lue TF. Emerging gene and stem cell therapies for the treatment of erectile dysfunction. 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    What Are the Best Three Exercises for Erectile Dysfunction? Learn whether exercises can help and what other treatments can help to relieve your symptoms. Health News Latest Facts on COVID-19 Vaccine Boosters Study Finds COVID Vaccine Protection Dropped Over 6 Months 28 Million Years of Life Lost to COVID COVID Expert Q&A: 'This Pandemic Still Has Legs' High Humidity + Heat Magnifies Climate Threat Featured Topics WebMD Exclusive How Breast Cancer Changed My Life ... and Me Get Our Newsletters Health News and Information, Delivered to Your Inbox Erectile Dysfunction Home News Reference Slideshows Quizzes Questions & Answers Medications Find a Doctor Erectile Dysfunction Guide Overview Symptoms & Risk Factors Testing &Treatment Living & Managing Related to Erectile Dysfunction Diabetes Drug Interaction Checker Heart Disease Hypertension Living Healthy Low T Assessment Smoking Cessation If you think you have ED, a good first step is to talk with your doctor. The treatment you need – ranging from lifestyle changes to medication to surgery - will depend on what’s causing it.

    Learn More About Diagnosing Erectile Dysfunction: Tests and Screenings, Early Diagnosis, and Your Doctors
    Experts often treat psychologically based impotence using techniques that decrease anxiety associated with intercourse. The patient's partner can help apply the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety during treatment of physical impotence. If these simple behavioral methods at home are ineffective, a doctor may refer an individual to a sex counselor. Readers Comments 2 Share Your Story

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    Liver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause and may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.

    When did you first notice symptoms of ED?What are your main symptoms?How often do you have erections?If you have erections, how firm are they?Do you have erections at night or in the morning?What sexual techniques do you use?Do you notice that your ability to get an erection changes at different times during sex?Are there problems in your current relationship?How has ED affected your current relationship?Do you have problems with sex drive or arousal?
    PDE5i medications are absolutely not to be taken by men with heart conditions who are taking nitrates such as nitroglycerine or isosorbide (Isordil, Ismo, Imdur). Those with serious heart disease, exertional angina (chest pain), and those taking multiple drugs for high blood pressure are advised to seek the advice of a heart specialist before beginning therapy with sildenafil.

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    If you want to find out whether you are suffering from symptoms of erectile dysfunction then we have an interesting test for you to be done at your home.

    One way to test whether you’re doing the squeezing correctly is to try and stop urine flow for a few seconds. If you are able to do so, you are doing it correctly.
    Erectile dysfunction can be a warning sign of serious underlying disease. Research has found that erectile dysfunction is a strong predictor of heart attack, stroke, and even death from cardiovascular disease. All men with erectile dysfunction should be evaluated for cardiovascular disease. Notably, this does not mean every man with erectile dysfunction will develop heart disease, or that every man with heart disease has erectile dysfunction; however, erectile dysfunction patients should be aware of the link.

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Treatment depends on what is causing it. If it is caused by uncontrolled blood sugar and high blood pressure, take your medicine and follow your doctor’s instructions.

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Since the release of NO is dependent on sexual stimulation/arousal, PDE5 inhibitors only work if there is sexual stimulation. Simply taking the pill will not produce an erection. This is important because this is different than other treatments for erectile dysfunction.

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Doing a few of these exercises every day, if not all, can prevent erectile dysfunction. Considering the sedentary and stressful lives of youngsters today, Vidyut recommends men even as young as 20 years old to practise these exercises to protect themselves from this crippling condition. AskMen India shares 6 exercises from Vidyut Jammwal’s kalari sutra workout that improve sexual health:

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Vacuum Erection Device is one such external device that is FDA approved and is easy and safe to use. At IASH, we explain step by step procedure for the safe and competent use of this device.

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