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Rare side effects of all PDE5 inhibitors include a sudden loss of vision in one or both eyes, NAION (nonarteritic anterior ischemic optic neuropathy), and sudden loss of hearing. These rare side effects have been reported with all of the PDE5 inhibitors, and should you develop loss of vision or hearing, you should seek immediate medical care.

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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.
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 .

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If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.
A 2004 Harvard Study found that walking for at least 30 minutes every day reduces the risk of ED by about 40%.

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Because ED is often caused by other medical conditions, your doctor will want to know about your medical history.
Furthermore, certain medications can lead to erectile dysfunction including antiandrogens (testosterone blockers) used in conjunction with prostate cancer therapy, certain antidepressants, blood pressure medications, sedatives or tranquilizers, some ulcer medications, and appetite suppressants.

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Talk to your provider if your erection problems have to do with a fear of heart problems. Sexual intercourse is usually safe for men with heart problems.

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Erectile dysfunction can occur if any of these requirements are damaged. The following are causes of erectile dysfunction in men, and many men may have more than one cause. SLIDESHOW Erectile Dysfunction (ED) Causes and Treatment See Slideshow Bad Bugs and Their Bites Sex Drive Killers Cancerous Tumors Multiple Sclerosis Adult Skin Problems Habits That Wreck Your Teeth Manage Diabetes in 10 Minutes Erectile Dysfunction Type 2 Diabetes Warning Signs Health Benefits of Sex Scalp, Hair and Nails ADHD Symptoms in Children? Readers Comments 2 Share Your Story

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    The pathogenesis of organic ED is related to dysfunction of the endothelium. Endothelial cells can become injured through a variety of mechanisms, most of which cause oxidative stress on the tissues. Many of these causes of oxidative stress are related to lifestyle issues which lead to hypertension, diabetes and dyslipidaemia (figure 1). Endothelial cell dysfunction results in reduction of endothelium-dependent vasorelaxation as well as increased adhesion of leukocytes to the endothelium. Endothelial cell injury then leads to a variety of sequelae, including ED, other types of vasoconstriction, atherosclerosis and thrombus formation.18

    Several medications are not recommended for the treatment of erectile dysfunction. These include trazadone, yohimbine, and herbal therapies, as there is no evidence to support their safe use for the treatment of erectile dysfunction. It is important to note that testosterone therapy is not indicated for the treatment of erectile dysfunction in the patient with a normal serum testosterone level.
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    2. Strengthen the pelvic floor muscles: Once you have located your pelvic floor muscles, try squeezing them for three seconds, then relax for three seconds. Try it in your seat now.
    Tell your physician about any health problems you’ve had in the past and all the medications you take, both prescribed and over-the-counter. It’s also important to let your doctor know if you use recreational or illegal drugs, drink alcohol, or use tobacco products.

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    Blood test A blood sample may help your doctor look for signs of diabetes, heart disease, low testosterone, or other issues such as liver or kidney disease.Urine test A urine test can look for markers of diabetes.Ultrasound/Doppler exam This test can let your doctor see if you have problems with penile blood flow.Psychological exam Your doctor might screen you for depression or another mental health disorder that could be linked to ED symptoms.What Should You Tell Your Doctor About Symptoms?

    L-citrulline can be converted to L-arginine in the body. L-arginine widens blood vessels, increasing blood flow.
    One type of blood test can check your thyroid function. A butterfly-shaped gland in your neck, it has a lot of jobs to do. One of them is to help with the flow of sex hormones. This test can check whether it’s working right.

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    There are hundreds of medications that have the side effect of ED and/or decreased libido. Examples of drugs implicated as a cause of ED include hydrochlorothiazides and beta-blocking agents. Medications used to treat depression, particularly the SSRIs such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Prozac Weekly, Sarafem), fluvoxamine (Luvox, Luvox CR), paroxetine (Paxil, Paxil CR, Pexeva) and sertraline (Zoloft), may also contribute to ED.9 Bupropion (Wellbutrin) which has a predominant effect on blocking the reuptake of dopamine is an antidepressant with lower incidence of ED.10 The side effects of 5ARIs occurring in fewer than 5% of patients can include gynaecomastia, ED, loss of libido and ejaculatory dysfunction.11

    You shouldn’t use these medicines if you take nitroglycerin or any other nitrates for chest pain. If you have heart problems, tell your doctor before taking any ED medicines. These medicines can have serious side effects in people who have heart problems.
    Some men should not take PDE5 inhibitors. They can cause hypotension (abnormally low blood pressure that can lead to fainting and even shock) when given to patients who are taking nitrates (medications taken for heart disease). Therefore, patients taking nitrates daily should not take any of the PDE5 inhibitors. Nitrates relieve angina (chest pain due to insufficient blood supply to the heart muscle because of narrowing of the coronary arteries); these include nitroglycerine tablets, patches, ointments, sprays, and pastes, as well as isosorbide dinitrate and isosorbide mononitrate. Other nitrates such as amyl nitrate and butyl nitrate also are in some recreational drugs called "poppers."

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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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ED is a common condition in men of all ages and ethnicities. The risk of having ED increases with age.

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The third and final exercise which may be of benefit if you have erectile dysfunction is pelvic floor exercise (Kegels).

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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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