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Treatment options for ED have evolved considerably over the past decade to encompass psychological counseling; oral, topical, intraurethral, and intracavernosal vasoactive therapy; oral therapies with other or unknown mechanisms; hormone replacement; vacuum constriction devices; and surgery, including vascular bypass procedures and penile implants. The goal of treatment is to restore satisfactory erections with minimal adverse effects. Men have demonstrated a strong preference for oral treatments even if they have low efficacy.
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Not only this but under the guidance of the best sexologist in India and a team of the best sexual health experts, we offer Special Relationship Counselling Sessions and Couple Therapies to treat all the psychological causes of ED.
Erectile dysfunction is common and becomes increasingly more so with age. Complete impotence occurs in 5% of men aged 40 years and 15% of men aged 70 years old. Milder forms of impotence can affect 50% of men aged 50 years old, increasing to 70% of men over 70 years old.
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Risk of ED is higher if you have high blood pressure, diabetes, vascular disease, low testosterone, history of prostate surgery, or take certain medications. Stress and other psychological aspects can sometimes play a role.
Patients with ED at high risk of cardiovascular events should refrain from sexual activity until they are stable from a cardiovascular point of view. Their management should be under close supervision from a cardiologist.58
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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.
Additionally, it’s a good idea to share any life changes or stressors that could be affecting your mental health, such as the death of a loved one, a job change, the birth of a child, or trouble in your relationship.
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Despite conflicting findings in clinical studies, men should monitor the effects of alcohol use on erectile function. Alcohol can lower testosterone levels, decrease blood flow into the penis, and cause fatigue. At least in some men, alcohol can exacerbate symptoms of E.D.
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• Repeated feelings of doubt and failure or negative communication that reinforce the erection problems
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• Conditions such as diabetes, high blood pressure, heart or thyroid conditions, poor blood flow, depression, or neurologic disorders (such as multiple sclerosis or Parkinson's disease)
PDE5i medications do not work like an aphrodisiac and will not increase desire or libido.
An injection test is also called an intracavernosal test. Your doctor injects a medicine into the base of your penis that should give you an erection. If you don’t get one, you may have a problem with blood flow to your penis.
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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
DiabetesAny type of Heart DiseasesKidney Related issuesHormonal issues like low testosterone level and others.
The third and final exercise which may be of benefit if you have erectile dysfunction is pelvic floor exercise (Kegels).
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The ACP did not recommend for or against routine use of hormonal blood tests or hormonal treatment in the management of patients with ED.
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.
Kasraeian Urology introduced this new ED treatment in 2021 for their patients in the Jacksonville, FL area.
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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.
By asking about your sexual history -- your relationships, sex drive, if you ever get erections -- they can begin to figure out whether the problem is more likely to be physical or mental. Be honest with your doctor; they can’t help you if you withhold information.
Exercise that results in losing weight, particularly around the waistline, can cut a man’s risk of ED. A man with a 32-inch waistline has only half the likelihood of erectile dysfunction as a man with a 42-inch waistline. Losing excess weight is one of many factors that can affect penile dysfunction.
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In 2018, the Journal of performance Medicine published a review of 42 studies on ED and depression. Together, the studies included over 192,000 men. The authors reported that men with depression had a 39% increased risk for ED. And men with ED were almost three times more likely to have depression than men who had no trouble with erections.
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Did you know that diabetes can contribute to erectile dysfunction and other men’s health conditions? Find out more about why treating your diabetes is important. Get more education on diabetes awareness.
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Learn More About Treatment for Erectile Dysfunction: Medication, Alternative and Complementary Therapies, Surgery Options, and More
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Stability ball is one of the most versatile exercise equipment out there. You can use it to stretch and strengthen any part of your body. Vidyut, for instance, has incorporated it into his kalari sutra workout. He has placed his feet atop it while being in a plank position and pushed his hips upward and downward in an alternate motion, so as to stretch and strengthen the joints. When you do this exercise, make sure you maintain proper balance and stop your legs from falling off the stability ball. Go down on all fours. Place your palms on the floor in line with your shoulders. Lift your legs off the floor and place them on a stability ball. Keep your elbows and knees straight. Raise your hips to make a mountain with your body. Lower your hips and bring them as close to the floor as possible without touching it. Repeat in a seamless motion.
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Erection problems can affect men at any age, but are more common as you get older. Physical causes are more common in older men. Emotional causes are more common in younger men.
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice. General News Erectile Dysfunction Anti-Aging Lifestyle Hair Loss Sexual Health Weight Loss Performance Nutrition
If we think more broadly about blood flow, aerobic exercises improve circulation in the entire body, including the penis. This is backed up by a whole heap of medically reviewed research.
Aging and ED can slow men's sexual health, but pleasure is not only possible, it can also improve quality of life in men 60 and older.
Pilates is another best way to fight against ED as they increase the blood flow and energy level in the body that ultimately helps in fighting with ED.
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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It may come as no surprise that many men are embarrassed to come forward for treatment and may also suffer from low self-esteem and depression and experience difficulties in establishing and maintaining a relationship.
Prostaglandin E1 (intraurethral alprostadil or MUSE) can be inserted in a pellet (suppository) form into the urethra to attain erections. It is available in four dosage strengths: 125 mcg, 250 mcg, 500 mcg, and 1,000 mcg. Most individuals need 500 mcg to 1,000 mcg for a satisfactory response.
There are many potential causes for erectile dysfunction, such as these conditions/circumstances: Vascular conditions: High blood pressure Elevated cholesterol Cardiovascular disease Diabetes Trauma: Spinal cord injury Pelvis injury Neurologic disease: Stroke Parkinson’s disease Alzheimer’s disease Radiation to the pelvis for cancer Endocrine: Hypogonadism (low testosterone) Hyperprolactinemia (high prolactin levels) Pelvis surgery: Radical prostatectomy (a surgical procedure for the partial or complete removal of the prostate) Surgeries for rectal cancer or bladder cancer Medication side effects: Antidepressants Antihypertensives (high blood pressure medicine) Antiandrogens (testosterone blockers) Antiarrhythmics (heart rhythm medicine) Alcohol Cigarette smoking Cocaine and marijuana Diabetes & ED View full infographic.
A small study has shown that Kegels might be an effective treatment for erectile dysfunction.
Did you guess C multiple sclerosis? If you did, you are incorrect. The actual answer is hepatitis C. That disease can be spread through the penis, but it doesn’t harm the penis’ capability to function normally.
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You usually need to take a pill about one to three hours before planned sexual activity. Sexual stimulation is also necessary to provide an erection. Drug treatments have been found to be successful for 70 percent to 80 percent of men. Select Find a Doctor Request an Appointment First Avenue at 16th Street New York, NY 10003 First Avenue at 16th Street New York, NY 10003 Phone: 212-420-2000212-420-2000 212-857-9980212-857-9980 1111 Amsterdam Ave New York, NY 10025 1111 Amsterdam Ave New York, NY 10025 Phone: 212-523-4000212-523-4000 5 East 98th Street, 6th Floor New York, NY 10029 5 East 98th Street, 6th Floor New York, NY 10029 Phone: 212-241-4812212-241-4812 Fax: 212-987-4675 425 West 59th Street, 4th Floor New York, NY 10019 425 West 59th Street, 4th Floor New York, NY 10019 Phone: 212-523-7756212-523-7756
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Pilates is a group of exercises designed to strengthen your body core. Although there are many potential exercises, here are two sample ones that focus on the pelvic floor. Lie down with your knees bent and your feet flat on the floor. Rest your arms at your side. Attempt to flex your hips to press your lower back into the ground. Hold this position for 3 to 5 seconds. Repeat the exercise slowly, 10 times, or as able. Be in the same position as for the pelvic tilt. Press your lower back on the floor. Slowly rotate one knee to one side while keeping your feet flat. Return your knees to the midline. Repeat this exercise slowly 10 times. Aerobics
Pelvic surgeries are a common cause of sexual dysfunction. Erectile dysfunction is a potential complication following prostate cancer surgery.
ED is an extremely common issue and it doesn't have to be the end of your sex life. It can be treated, and even reversed, with a little help.
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.
Men typically have 3 – 5 erections per 8 hours of sleep, usually at night. This is called nocturnal penile tumescence (NPT). The NPT test shows whether these erections have occurred.
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The International Society of Sexual Medicine (ISSM) defines premature ejaculation as occurring within one minute of penetration.
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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.
It is still a rough guide at this stage, but it will be refined by future research, says Gerbild. For example, future research should consider whether exercise is particularly beneficial to certain groups of patients, and whether the stage of the disease has any effect on the benefits of exercise, she says. For now the results only apply to a general picture of men suffering from erectile dysfunction.
Exercise can help reverse some of the risk factors for E.D., such as being overweight or obese, having high blood pressure, being stressed, or having weak pelvic floor muscles.
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
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Erectile dysfunction occurs when a man is not able to maintain or get an erection. It’s common in men of all ages. Facing erectile dysfunction once in 2-3 months is fine. But if it becomes an ongoing problem, it needs medical intervention in time.
When a man is at the age of 40, he might face diabetes problems or bp problems, which may also affect the proper blood flow and can also lead to an erection problem.
The same concerns regarding the use of sildenafil with nitrates and alpha-blockers apply to vardenafil.
The healthy foods on this list are expected to improve cardiovascular health and, therefore, erectile function. However, it is important to investigate the underlying cause of E.D. Your doctor can discuss your symptoms and develop a comprehensive plan that emphasizes a healthy diet while also considering the many potential medical interventions such as Trimix that have helped many men with E.D. regain normal erectile function.
DiabetesHigh blood pressureHeart or thyroid conditionsClogged arteries (atherosclerosis)DepressionNervous system disorders, such as multiple sclerosis or Parkinson disease
Vidyut Jammwal is an action hero in Hindi cinema who advocates fitness not only for films, but as a way of life. Having gone to a sports school and been trained in India’s ancient martial art form Kalaripayattu, his strength and stamina know no bounds. In the hope to share his knowledge with thousands of his fans who were struggling to stay fit during the lockdown, he decided to start a YouTube channel last year. So far, he's posted crazy workout challenges, movements to improve balance and alignment and country boy exercises among other informative and inspiring videos.
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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. 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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. 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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. 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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. 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Nat Rev Urol 2010;7:143–52. Hypertension in Women: Should There be a Sex-specific Threshold? Drug Eluting Stents and Late Stent Thrombosis: Technical Considerations for Interventional Cardiologists Improving Prevention of Strokes: New Developments in the Field of Early Detection of Afib Footer Menu 1 About Us Our Team Privacy Terms & Conditions Contact Us Footer Menu 2 Authors A-Z Image Gallery Media Partners Industry Partners Services Arrhythmia Academy Education by Breas Register for FREE
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?
A vacuum constriction device (VCD) is an external pump with a band on it that a man with erectile dysfunction can use to get and maintain an erection.
Ischaemic heart disease (IHD), also known as coronary artery disease (CAD), is a predominant manifestation of cardiovascular disease (CVD). CVD is the leading cause of morbidity and mortality, accounting for 17.3 million deaths globally every year; this figure is expected to grow to 23.6 million by the year 2030. Eighty per cent of these deaths occur in lower- and middle-income countries.5 ED and IHD are highly prevalent and occur concomitantly because they share the same risk factors, including diabetes, hypertension, hyperlipidaemia, obesity and smoking.
Sexual health and function are important determinants of quality of life. As males age, erectile dysfunction (ED) or impotence is more common. Erectile dysfunction often has a negative impact on sex life and overall quality of life for both the male experiencing the erectile troubles and his partner.
On the mental and emotional side of things, anxiety, depression, and stress all play a role. Relationship issues can also be a factor.
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