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I have severe erectile dysfunction, and it’s really affecting my self-esteem and marriage. I’ve been too embarrassed to seek help, but my wife has put her foot down and demanded I seek treatment for impotence. What is the treatment for severe ED?

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Mayo Clinic: Erectile Dysfunction: Diagnosis and Treatment.UCSF Medical Center: Erectile Dysfunction Diagnosis.Urology Care Foundation: How is ED Diagnosed?National Institute of Diabetes and Digestive and Kidney Diseases (NIH): Diagnosis of Erectile Dysfunction.Cleveland Clinic: Erectile Dysfunction (ED): Diagnosing.
Extra weight can make a man more likely to develop diabetes or cardiovascular disease, which are both associated with erectile dysfunction. Also, carrying fat around the middle can affect a man’s hormones, which can contribute to penile dysfunction.

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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.
The main causes could be due to stress, tiredness, anxiety or drinking too much alcohol. If it happens often, it could be due to physical or emotional problems.

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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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Erectile dysfunction (ED) is a common condition. Although it is not life-threatening, it can negatively affect your quality of life. Because it can be related to other conditions, such as heart disease, it is important that you get the right treatment. There are various treatment options for ED, discuss with your doctor which option is best for your individual situation.

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    In patients with low testosterone, testosterone treatment can improve libido and erectile dysfunction, but many men still may need additional oral medications such as sildenafil, vardenafil, or tadalafil. Some studies suggest that men with ED and low testosterone may respond better to PDE5 inhibitors when given testosterone therapy; however, this is controversial.

    Cardiovascular diseasesDiabetesObesityIncreased ageRelationship issuesHigh blood pressureDamage in the pelvic zone due to surgery
    Our urological specialists at University of Utah Health understand your sensitivities related to ED. We develop treatment plans customized for your needs to help you get your sexual function back. Causes of ED

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    If the above steps don’t solve your issues with ED, you should see a medical provider to determine the cause and potential treatment solutions. Erectile dysfunction can be a sign of a larger health issue, including cardiovascular conditions, diabetes, hormone deficiencies, and more. If you’re dealing with persistent ED symptoms, a comprehensive health assessment can help our providers find and treat underlying conditions that may be contributing to ED. Our providers offer customized treatment plans to help with ED and your overall health.

    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.
    In a small study, L-citrulline and trans-resveratrol were added to phosphodiesterase 5 inhibitors. According to the study, the addition of L-citrulline and trans-resveratrol improved erectile function in men who were dissatisfied with the results of using phosphodiesterase 5 inhibitors alone (Shirai et al., 2018). Watermelon is an excellent source of L-citrulline.

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    Moderate exercise can help reduce a man’s risk of erectile dysfunction (ED) and improve his sexual function. Also, specific exercises can help him to build a strong pelvic floor to enhance his sexual performance.

    Often, erectile dysfunction can be a symptom of a heart condition, diabetes, or high blood pressure. To address this, Yale Medicine established the Male Reproductive Health/Sexual Medicine Program, a collaboration between the specialties of cardiovascular medicine and urology.
    He added: 'Pelvic floor exercises to prevent ED and PE are a non-invasive and a cheaper option than traditional methods.

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    - Natural ways to reverse erectile dysfunction without resorting to expensive pharmaceuticals.

    You should speak to your doctor if it keeps happening, so they can investigate further.
    Erectile dysfunction (ED) is generally defined as the persistent (at least 6 months) inability to achieve and maintain penile erection sufficient to allow satisfactory sexual performance.1 It is a common condition, and recent studies predict a higher prevalence of ED in the future.2 It is estimated that ED has affected more than 150 million men worldwide and this number will reach approximately 322 million by 2025.2,3 It has affected 30 million men in the US alone.4

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PDE 5 inhibitors are broken down primarily by enzyme, cytochrome P450enzyme CYP3A4. Medications that decrease or increase the activity of CYP3A4 may affect levels and effectiveness of PDE 5 inhibitors. Such drugs include medications for the treatment of HIV (protease inhibitors) and the antifungal medications ketoconazole and itraconazole. Thus caution is recommended.

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Erection problems (impotence) are very common, particularly in men over 40. It's usually nothing to worry about, but you should see a GP if it keeps happening. It could be the sign of a more serious problem. Causes of erection problems

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Erectile dysfunction can be treated at any age. Treatment depends on your overall health and the underlying cause of the problem.

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