The role of endothelial dysfunction in CAD is well known.32,33 Also, endothelial-derived NO induces vasodilatation, which in turn is an important event to achieve normal erectile function.34–36 Moreover, systemic endothelial-dependent vasodilatation has been shown to be reduced in men with ED.37,38
Prior to starting testosterone therapy, it is important for a doctor to perform a thorough evaluation on the patient. .
Not everyone can use these medicines. Your doctor may talk to you about alprostadil if oral medicines aren’t an option for you. Alprostadil is a synthetic version of prostaglandin E. It can be injected into the penis or inserted as a tiny suppository into the urethra (the hole at the end of the penis). Your doctor will help you decide which treatment is best for you.
It is recommended that testosterone be measured in patients with ED because low levels are a reliable measure of hypogonadism. Hypogonadism is not only a treatable cause of ED, but can also lead to reduced or lack of response to PDE5 inhibitors.73 Testosterone deficiency is also associated with increased cardiovascular and all-cause mortality.74 Levels >350 ng/dl do not usually require replacement, but in patients with testosterone <230 ng/dl, replacement can usually be beneficial.57 In patients with congestive heart failure, testosterone replacement can lead to fluid retention, so caution is advised. In these patients, the aim should be to keep testosterone levels in the middle range, i.e. 350–600 ng/dl.57
Oakwood Health Network specialists commonly send patients a requisition form for: A blood test to check the patient’s testosterone levelsAn ultrasound to diagnose a relatively common condition called Peyronie’s disease
If you’re battling ED, you’ll want to arm yourself with credible information. Here are some of Everyday Health’s top resources.
Kegel exercises, also called pelvic muscle exercises, are performed to strengthen the muscles of the pelvic floor, which can help prevent incontinence, prevent accidentally passing gas or stool, and improve orgasms.
Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure.
These changes can be very difficult to deal with because for most men sexuality and erection remain important throughout their whole life. You may even go into denial or suffer from depression. That is why the effect of ED on your quality of life should not be underestimated.
Many men are uncomfortable speaking with their physician about erectile dysfunction symptoms; however, it is important to treat your symptoms as ED can be a warning sign of current or future heart disease.
This is especially important for erections. When a man is sexually stimulated, his penis fills with blood. This blood gives him the firmness he needs for sexual activity. Once he ejaculates, the blood flows out of the penis and back into the rest of his body.
Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.
Your healthcare provider may recommend a vacuum device, also called a “penis pump,” to help you get an erection. The pump helps pull blood into your penis, so you can achieve an erection that lasts long enough for sexual intercourse. It’s paired with an elastic ring that helps you maintain an erection.
To summarize, there are many different factors that can cause or contribute to ED. Some of the strongest contributors, such as comorbid conditions, can be modified and controlled with lifestyle changes. Most common however, ED causes are multifactorial and complex. Our urology team is here to work with you to resolve your ED and improve your sexual function.
Yes, urologists treat erectile dysfunction (ED). They are specialized doctors who treat disorders of the urinary tract and male reproductive system. Since ED is an inability to get or maintain an erection for penetrative sex, that would fall under the urology category.
As you seek solutions to impotence, you will undoubtedly run into male enhancement recommendations, possibly suggesting penis exercise to improve your erections.
Certain feelings can interfere with normal sexual function, including feeling nervous about or self-conscious about sex, feeling stressed either at home or at work, or feeling troubled in your current sexual relationship. In these cases, treatment incorporating psychological counseling with you and your sexual partner may be successful. One episode of failure, regardless of cause, may propagate further psychological distress, leading to further erectile failure. Individuals suffering from psychogenic ED may benefit from psychotherapy, treatment of the ED, or a combination of the two. Also, medications used to treat psychologic troubles may cause ED; however, it is best to consult with your physician prior to stopping any medications that you are taking. Althof, S.E., E.W. Corty, S.B. Levine, et al. "EDITS: development of questionnaires for evaluating satisfaction with treatments for erectile dysfunction." Urology 53.4 April 1999: 793-799. American Foundation for Urologic Disease. American Foundation for Urologic Disease. American Urological Association. "Erectile Dysfunction." 2011.