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Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.

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One of the best things men can do to reduce ED is to quit smoking. Smoking leads to cardiovascular disease, which can cause erectile dysfunction. In addition to affecting a man’s blood vessels, smoking itself increases his risk of ED.
Erythrocytosis has been noted in men on TRT, and should be monitored every 6–12 months depending upon the patients’ response to changes in haematocrit levels. For mild elevations, the dosage of testosterone can be decreased or the interval of using the medication can be increased. With the haematocrit greater than 50%, decisions to temporarily discontinue the medication or periodic phlebotomy may be indicated.38 .

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American Association of Genitourinary Surgeons American Urological Association European Association of Urology Punch Club Société Internationale d’Urologie Urological Club of Great Britain & Ireland
The major breakthrough occurred in 1998 when sildenafil became the first oral drug to be approved to treat ED.4 This was followed by the use of tadalafil and vardenafil as similar phosphodiesterase-5 inhibitor oral medications for treating ED in 2003.4

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Patients could seek help from a physiotherapist who understands the disease, or sign up for a team sport such as football, which has also been shown to be particularly beneficial for health.
These results do not necessarily mean that depression and ED cause each other directly.

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Exercises have helped many with erectile problems. For a normal erection to happen,

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    A very rare but more serious visual complication is shared by all PDE5 inhibitors. This would be non-arteritic anterior ischemic optic neuropathy (NAION). A number of cases have been reported and generally risk factors for this very rare form of blindness are severe cardiovascular conditions. In summary, men at high-risk for cardiovascular disease with congestive heart failure or unstable angina should not receive treatment for sexual dysfunction until their cardiac condition has stabilized. The FDA advises patients to stop taking these medicines and call a doctor immediately, if they experience sudden or decrease vision loss in one or both eyes. Furthermore, patients taking or considering taking these products should inform their healthcare professionals if they have ever had severe loss of vision, which may reflect a prior episode of NAION. Such patients are at an increased risk of developing NAION again.

    The recommended starting dose is 100 mg taken as early as 15 minutes prior to sexual activity, no more than once a day. The maximum dose is 200 mg. Avanafil may be taken with or without food. As with the other PDE5 inhibitors, sexual stimulation is necessary for avanafil to work.
    - What your pelvic floor muscles are and why strengthening them will turn you into a stud.

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    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.

    ED not only affects the sex life of men in a committed relationship. Single men with ED often avoid dating because of the condition.
    To get specific, mild to moderate aerobic exercise can be defined as the kind of movement that warms you up, makes you sweat a little, and gets your heart rate and blood vessels pumping. So less of a leisurely stroll, and more of a jog.

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    A common misconception is that erectile dysfunction only occurs in older men. While that is mostly true, it doesn’t mean that ED isn’t common among younger men. Lifestyle choices among younger men has led to a sharp increase in the number of young men suffering from erectile dysfunction. A 2013 study published by the Journal of Sexual Medicine found that 1 in every 4 men who were newly diagnosed with ED were below the age of 40, and roughly 50% of them were suffering from severe ED. Causes of Erectile Dysfunction Obesity Fatigue Excessive smokingAlcoholism Substance abuse Diabetes Prostate cancer Cardiovascular disease Treatment for Erectile Dysfunction

    Viagra was introduced in 1998 (the others in 2003) and revolutionized the way that men and their partners looked at ED.
    PDE5 inhibitors are commonly prescribed to treat ED. The second Princeton Consensus Conference reviewed their appropriate use and recent studies of placebo-controlled and post-marketing surveillance data have confirmed their safety regarding cardiovascular events.61–63

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    Monitoring erections that occur during sleep (nocturnal penile tumescence) can help you and your doctor to understand if the erectile dysfunction is due to psychological or physical causes. The nocturnal penile tumescence test is a study to evaluate erections at night. Normally men have three to five erections per eight hours of sleep. The test can be performed at home or in a sleep lab. The most accurate way to perform the test involves a special device that is connected to two rings. The rings are placed around the penis, one at the tip of the penis and the other at the bottom (base) of the penis. The device records how many erections occur, how long they last, and how rigid they are. The test is limited in that it does not assess the ability to penetrate.

    The primary cause of the problem is considered to be a psychological problem. Any person suffering from anxiety, depression, stress, fear may find it hard to enjoy intimate moments. In some cases, smoking, drugs have also been considered a common cause of erectile Dysfunction.
    This section lists the different tests your doctor may need to assess your situation. It offers general information about the diagnosis of ED. Keep in mind that situations can vary in different countries.

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Usually, men have 3 to 5 erections during the night as they sleep. Your doctor may use an overnight erection test to see whether you’re able to get an erection.

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Did you know that around 5% of men aged 40, and 15% of men aged 70 have complete erectile dysfunction?

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Nearly 95% of men with erectile dysfunction can obtain an erection sufficient for sexual satisfaction with a vacuum constriction device. Only vacuum constriction devices containing a vacuum limiter should be used. All FDA approved devices have such a limiter. Vacuum constriction devices can be a useful second-line treatment option especially in the patient with a supportive partner in a stable relationship. Virtually all men of all ages and with all types of erectile dysfunction can have successful intercourse with a vacuum constriction device.

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