Sildenafil treats erectile dysfunction of either physical or psychological cause. It is effective in treating erectile dysfunction in men with coronary artery disease, diabetes mellitus, hypertension, depression, coronary artery bypass grafting (CABG), and men who are taking antidepressants and several classes of antihypertensives.
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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.
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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
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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.
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ED is more than a quality of life issue; numerous studies have indicated that men with ED are at increased risk of developing cardiovascular disease and even dying form cardiac disease.
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Hackensack University Medical Center has been ranked the #1 Urology Department in New Jersey for eight years in a row by U.S. News & World Report and is the only urology department in New Jersey that is nationally ranked.
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Many sexologists or sex doctors recommend exercise guides and charts to the young generation to overcome their fear for first-time sex and enjoy it with a healthy body and mind.
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.
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Ultrasound (and ultrasonography) is imaging of the body used in the medical diagnosis and screening of diseases and conditions such as: TIAs, stroke, aneurysm's, heart valve irregularities, carotid artery disease, heart disease, gallstones, kidney stones, liver disease, diseases of the female reproductive, and diseases of the male reproductive organs.
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.
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All of this is available to ensure a proper diagnosis of your ED. It allows your ED specialist to customize a treatment specifically for you!
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.
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Check your pulse at your wrists and ankles to see whether your blood flow is normalListen to your heartbeat to make sure it sounds rightTake your blood pressure
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.
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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.
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As you seek solutions to impotence, you will undoubtedly run into male enhancement recommendations, possibly suggesting penis exercise to improve your erections.
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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. . Andersson, K.E., and G. Wagner. "Physiology of Penile Erection." Physiol Rev 75.1 January 1995: 191-236. Cheitlin, M.D., A.M. Hutter Jr., R.G. Brindis, et al. "ACC/AHA Expert Consensus Document. Use of Sildenafil (Viagra) in Patients With Cardiovascular Disease. American College of Cardiology/American Heart Association." J Am Coll Cardiol 33.1 January 1999: 273-282. The European Alprostadil Study Group. "The Long-Term Safety of Alprostadil (Prostaglandin-E1) in Patients With Erectile Dysfunction. Br J Urol 82.4 October 1998: 538-543. Feldman, H.A., I. Goldstein, D.G. Hatzichristou, et al. "Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study." J Urol 151.1 January 1994: 54-61. Laumann, E.O., A. Paik, and R.C. Rosen. "Sexual Dysfunction in the United States: Prevalence and Predictors." JAMA 281.6 Feb. 10, 1999: 537-544. National Kidney and Urologic Diseases Clearinghouse. National Kidney and Urologic Diseases Clearinghouse. Available at http://kidney.niddk.nih.gov/. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 270.1 July 7, 1993: 83-90. The Process of Care Consensus Panel. "The Process of Care Model for Evaluation and Treatment of Erectile Dysfunction." Int J Impot Res 11.2 April 1999: 59-70; discussion 70-74. Segraves, R.T., M. Bari, K. Segraves, and P. Spirnak. "Effect of Apomorphine on Penile Tumescence in Men With Psychogenic Impotence." J Urol 145.6 June 1991: 1174-1175. United States. FDA Center for Drug Evaluation and Research. FDA Center for Drug Evaluation and Research. Available at http://www.fda.gov/cder/.
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Stress, anxiety, depression and other mental health conditions can also lead to or worsen erectile dysfunction.
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Erectile dysfunction is more likely to be related to an emotional problem if you experience symptoms only occasionally. For example, when you get an erection in the mornings but not during sexual activity.
The placement of a penile prosthesis is typically an outpatient procedure and is typically performed through a single incision. All of the parts of the prosthesis are hidden under the skin. Antibiotics are given to decrease the risk of an infection. A catheter may be left in the penis in some men for a short period. After placement, there will be a time period of healing prior to the ability to use the prosthesis.
We can strengthen our pelvis bone and muscles through some basic pelvic floor exercises like kegels. Kegel exercise is also known as pelvic floor exercises are the best way to strengthen pelvic bones and overcome ED problems. There are some basic pelvic floor exercises or other variations like sitting pelvic floor activation or standing pelvic floor activation.
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The NHS says PE falls into two categories - primary or secondary, based on whether men have always had the issue or it recently developed.
Erectile dysfunction (E.D.) is often caused by blood vessel damage or suboptimal hormone levels; however, it can also be caused by stress or poor lifestyle choices such as smoking, an unhealthy diet, or not making time for physical activity.
Penile rejuvenation has the highest success of getting rid of ED and there have been various successful transplants to date all over the world. Any day-by-day doctors are learning more and more to make these methods safer and more effective. Penile Shockwave therapy is the most effective and painless treatment done for curing Erectile Dysfunction in a body. It involves passing the low-intensity sound-waves through the erectile tissues in a body. By doing this, the blood functioning is improved and new blood vessels are grown to improve the erection issues.
For many of the 30 million Americans affected by erectile dysfunction, Viagra, Levitra, and Cialis are the first line of ED treatment — and they’re successful for about 80 percent of men. These drugs, called phosphodiesterase-5 inhibitors, are approved by the U.S. Food and Drug Administration (FDA) and work by increasing blood flow to an erection. Common side effects include nasal congestion and headache. Note: If you take nitroglycerin pills for heart disease, you won’t be able to take ED pills, as they can cause a dangerous drop in blood pressure.
If you are interested in purchasing a prescription product from our website, FROM MARS will assist you with obtaining an independent doctor who will determine if the treatment is appropriate for you and consider writing a prescription for you which can be used at your pharmacy of choice. What Can You Do for Severe Erectile Dysfunction? Medical Author: John P. Cunha, DO, FACOEP Medical Author: Pamela I. Ellsworth, MD Ask a Doctor Doctor’s Response What Can You Do for Severe Erectile Dysfunction? Topic Guide
ED is a common complication of diabetes and people with diabetes are also prone to developing cardiovascular complications.48 The risk of ED is relatively high in patients with known CVD. This was supported by a study of men with known CVD, in which ED was substantially predictive of all-cause mortality and the composite of CVD death, admission for heart failure, MI and stroke.17 Macroangiopathy, microangiopathy and endothelial dysfunction are among the mechanisms by which diabetes causes ED.
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VEDs provide a simple way of obtaining an erection for 30-45 minutes by sucking blood into the penis and holding it in place with a constriction (pictured). Ejaculation may be restricted by the ring but this technique is simple, safe and has no known side-effects. Unfortunately, most patients have to purchase VEDs themselves.
Lifestyle factors than can affect the condition include obesity, smoking, cycling too much, drinking too much, and stress.
But, the odds of ED increased with age across all racial and ethnic groups when health, relationship, lifestyle, psychological, and sociodemographic factors were controlled for.
Your doctor may order laboratory tests to identify metabolic disorders underlying the ED.
If unsuccessful, interferes with other treatmentsVascular Reconstructive SurgeryRestores natural erections when successful
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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.
When sexually stimulated/aroused, the nerves supplying the penis release a chemical, nitric oxide (NO). Nitric oxide is important because it stimulates the production of a chemical called cyclic guanosine monophosphate (cGMP). cGMP causes the muscle in arteries of the penis to relax and increase blood flow into the penis. NO is broken down in the body by phosphodiesterase enzymes. PDE5 inhibitors thus prevent the breakdown of NO and thus promote increased blood flow into the penis.
If ED comes from a blocked artery leading to the penis, surgery can restore blood flow. The procedure usually works best on men under 30. Doctors don’t recommend it for older men with widespread narrowing of the arteries.
Your doctor will ask you to describe the firmness and duration of your morning erections and sexually stimulated ones. The doctor will also ask if you have problems with arousal, ejaculation, and orgasm.
As with all content on Greater Boston Urology's blog, the following information is educational in nature, not medical advice. Always talk to your physician about your specific questions concerning erectile dysfunction.
You’ve probably heard of sildenafil (Viagra), but it isn’t the only pill for ED. This class of drugs also includes avanafil (Stendra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn). All work by improving blood flow to the penis during arousal. They're generally taken 30-60 minutes before sexual activity and should not be used more than once a day. You can take tadalafil up to 36 hours before sexual activity. It also comes in a lower, daily dose. All require an OK from your doctor first for safety.
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Because flavonoids improve circulation, foods high in this nutrient may increase blood flow into the penis. Flavonoids are naturally occurring antioxidants.
These erectile dysfunction treatments should not be used in patients with high blood pressure. If you do not know your blood pressure you can have it tested at a number of places, including:
The evaluation of a man who presents to our office includes an open, honest and absolutely confidential discussion about the current sexual function and overall medical health. A thorough physical exam and generalized, as well as specialized, bloodwork are often done. We also offer patients blood circulation studies of the penis to further delineate the cause of ED. At Broward Urology Center, we focus on a goal-oriented approach to erectile dysfunction treatment. The treatment options for ED include: The Priapus Shot Or P-Shot® PRP (Platelet Rich Plasma) Penile Injection
Even if you take the medicine, you still need physical and mental stimulation and desire to have an erection. If your first dose doesn’t help, call your doctor. Your doctor may want to change your tablet strength.
In diagnosing the cause of erectile dysfunction, an ultrasound may be done on the lower abdomen, the pelvis, and the testicles, or it may be restricted to just the penis.
S.NoTestosterone LevelImpact on the body1.<300 ng/dLIt becomes hard for a person to maintain an erection.2.>900Excess of the hormone can create high sexual desires that are hard to please.
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It's more likely to be an emotional problem if you only have erection problems some of the time. For example, you get an erection when waking up in the morning, but not during sexual activity.
In one study, 55 men with E.D. were either taught pelvic floor exercises with biofeedback and lifestyle changes (treatment group) or advised on lifestyle changes (control group). After six months, 40 percent of men who performed pelvic floor exercises regained normal erectile function (Dorey et al., 2005). Concentrate on lifting and pulling in your genitals for a count of 5. Slowly relax your muscles. Don’t hold your breath while performing this exercise. Repeat 10 times, aim for two to three times per day. Be sure you are not contracting your stomach, legs, or buttocks.If you are unsure whether you are contracting the correct muscles. Try stopping your stream of urine periodically to feel these muscles tighten. Pilates
Your free consultation with our doctors can ensure you find the right ED meds for your needs.
MedicineNet does not provide medical advice, diagnosis or treatment. See additional information. sexual health center/sexual health a-z list/erectile dysfunction ed impotence center /erectile dysfunction (ed, impotence) article Erectile Dysfunction (ED, Impotence) Medical Author: Pamela I. Ellsworth, MD Medical Editor: Melissa Conrad Stöppler, MD
S.noFood that can help in curing sexual dysfunctionBenefits1.SpinachHelps in boosting testosterone level.2.CoffeeHelps in improving sex-life3.AppleRemoving prostate cancer4.AvocadosHelps in boosting libido5.OatsFor getting better orgasm6.TomatoesHelps in maintaining sperm quality and motility7.Pepper and chiliEaten for getting high testosterone levels in a male body. Yoga helps to relax all the body parts and encourage proper blood flow and optimal oxygen level in the body. Performing these 12 yoga poses especially for ED daily for 30-40 minutes has helped to eliminate impotency issues among men.
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