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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.

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Most studies into the effect of beta-blockers on ED point to negative effects of first- and second-generation beta-blockers, while beta-blockers with vasodilating effects can improve erectile function. Alpha-blockers, calcium channel blockers, and angiotensin-converting enzyme inhibitors seem to have a neutral effect on erectile function. Multiple previous studies have demonstrated a beneficial effect of angiotensin receptor blockers on erectile function and they should probably be the favoured antihypertensive agents in patients with ED.29
These pilate exercises activate the right group of muscles and maintain pelvic floor strength while moving. Pilates are highly beneficial in keeping away issues like erectile dysfunction. But you must know that proper training is necessary to learn pilate properly to avoid any injuries or muscle pull. .

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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.

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GAINSWave® therapy does not involve drugs or invasive procedures. There are few to no side effects. The therapy is clinically proven to treat erectile dysfunction and enhance sexual performance. When a man improves blood flow in the penis, sexual performance benefits. GAINSWave® therapy uses extracorporeal shockwave therapy to increase blood flow. The sound waves help men grow new tissue, including blood vessels, in the penis, thereby increasing blood flow.
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Liver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause and may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.

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One of the most important causes for ED is vascular disease; examples include diabetes (Types I and II), high blood-pressure, high cholesterol/lipids, tobacco use, obesity, and lack of exercise. All of these conditions can lead to impaired response of the blood vessels responsible for controlling penile erection. There is evidence that men who have vascular disease and make healthy lifestyle changes (e.g. increasing exercise, losing weight, quitting smoking) may experience improvement in erectile function. It is important to remember that whatever is good for the heart is also good for the penis.

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    The first line of treatment for erectile dysfunction is usually non-invasive and can involve lifestyle changes such as losing weight or quitting smoking. Medications called phosphodiesterase type-5 inhibitors that increase penile blood flow may be prescribed:

    Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633-641. PMID: 29746858 pubmed.ncbi.nlm.nih.gov/29746858. Version Info
    With this self-test you can easily find out if there are any serious indications of pathological erectile dysfunction in your body. This test is based on the so-called IIEF-score. IIEF stands for «International Index of Erectile Function». In medicine, the IIEF-score is not only used for the diagnosis of erectile dysfunction, but also for success monitoring of therapies.

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    In some cases, ED can be a warning sign of a more serious disease. One study suggests it can predict heart attack, stroke, and even death from cardiovascular disease. If you’re diagnosed with ED, get checked for cardiovascular disease. This doesn’t mean every man with ED will develop heart disease, or that every man with heart disease has ED, but you should be aware of the link.

    The best plan is to see your doctor early on, so you can get an accurate diagnosis.
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  • erectile dysfunction exercises tutorial

    You probably already know that aerobic exercise is associated with a range of overall health benefits like weight loss, preventing vascular disease and improving mental health, but did you know that exercise is the lifestyle factor most strongly associated with erectile function and sexual health?

    Other medical therapies under evaluation include ROCK inhibitors and soluble guanyl cyclase activators. Melanocortin receptor agonists are a new set of medications being developed in the field of erectile dysfunction. Their action is on the nervous system rather than the vascular system. PT-141 is a nasal preparation that appears to be effective alone or in combination with PDE5 inhibitors. The main side effects include flushing and nausea. These drugs are currently not approved for commercial use.
    Despite the appeal of suppositories, their effectiveness is relatively poor and overall patient satisfaction is relatively low.

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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.

    When talking to your doctor, be as open and honest about your symptoms as possible. Tell your healthcare provider how often you have symptoms and how long you’ve had them.
    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. Int J Impot Res 2002;14:178–88. Crossref | PubMed Chang SW, Fine R, Siegel D, et al. The impact of diuretic therapy on reported sexual function. Arch Intern Med 1991;151:2402–8. Crossref | PubMed Grimm RH Jr, Grandits GA, Prineas RJ, et al. Long-term effects on sexual function of five antihypertensive drugs and nutritional hygienic treatment in hypertensive men and women. Treatment of Mild Hypertension Study (TOMHS). Hypertension 1997;29:8–14. Crossref | PubMed Adverse reactions to bendrofluazide and propranolol for the treatment of mild hypertension. Report of Medical Research Council Working Party on Mild to Moderate Hypertension. Lancet 1981;2:539–43. Crossref | PubMed Fogari R, Preti P, Derosa G, et al. Effect of antihypertensive treatment with valsartan or atenolol on sexual activity and plasma testosterone in hypertensive men. Eur J Clin Pharmacol 2002;58:177–80. Crossref | PubMed Doumas M, Tsakiris A, Douma S, et al. 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. A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension. J Hypertens 2005;23:233–46. Crossref | PubMed Andersson K, Stief C. Penile erection and cardiac risk: pathophysiologic and pharmacologic mechanisms. Am J Cardiol 2000;86:23f–6. Crossref | PubMed Kloner RA, Zusman RM. Cardiovascular effects of sildenafil citrate and recommendations for its use. Am J Cardiol 1999;84:11n–7. Crossref | PubMed Jeremy JY, Ballard SA, Naylor AM, et al. Effects of sildenafil, a type-5 cGMP phosphodiesterase inhibitor, and papaverine on cGMP and cAMP levels in the rabbit corpus cavernosum in vitro. Br J Urol 1997;79:958–63. Crossref | PubMed Yavuzgil O, Altay B, Zoghi M, et al. Endothelial function in patients with vasculogenic erectile dysfunction. Int J Cardiol 2005;103:19–26. Crossref | PubMed Kaiser DR, Billups K, Mason C, et al. 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. Erectile dysfunction. N Engl J Med 2000;342:1802–13. Crossref | PubMed Traish AM, Galoosian A. Androgens modulate endothelial function and endothelial progenitor cells in erectile physiology. Korean J Urology 2013;54:721–31. Crossref | PubMed Crossman DC. The pathophysiology of myocardial ischaemia. Heart 2004;90:576–80. Crossref | PubMed Nehra A, Jackson G, Miner M, et al. The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease. Mayo Clin Proc 2012;87:766–78. Crossref | PubMed Gupta BP, Murad MH, Clifton MM, et al. The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Arch Intern Med 2011;171:1797–803. Crossref | PubMed Kling J. From hypertension to angina to Viagra. Mod Drug Discov 1998;1:31–8. Schwarz ER, Rastogi S, Kapur V, et al. Erectile dysfunction in heart failure patients. J Am Coll Cardiol 2006;48:1111–9. 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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Clinical trials of sildenafil citrate demonstrate no increase in risk of myocardial infarction and cardiovascular death compared with placebo. Int J Clin Pract 2003;57:597−600. PubMed De Vecchis R, Cesaro A, Ariano C, et al. Phosphodiesterase-5 inhibitors improve clinical outcomes, exercise capacity and pulmonary hemodynamics in patients with heart failure with reduced left ventricular ejection fraction: a meta-analysis. J Clin Med Res 2017;9:488–98. Crossref | PubMed Assad TR, Hemnes AR, Larkin EK, et al. Clinical and biological insights into combined post- and pre-capillary pulmonary hypertension. J Am Coll Cardiol 2016;68:2525–36. Crossref | PubMed Hackett G, Kirby M, Wylie K, et al. British Society for Sexual Medicine guidelines on the management of erectile dysfunction in men – 2017. J Sex Med 2018;15:430–57. Crossref | PubMed Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine guidelines on adult testosterone deficiency, with statements for UK practice. J Sex Med 2017;14:1504–23. Crossref | PubMed Anaissie J, Hellstrom WJ. Clinical use of alprostadil topical cream in patients with erectile dysfunction: a review. Res Rep Urol 2016;8:123–31. Crossref | PubMed Bivalacqua TJ, Deng W, Champion HC, et al. Gene therapy techniques for the delivery of endothelial nitric oxide synthase to the corpa cavernosa for erectile dysfunction. Methods Mol Biol 2004;279:173–85. Crossref | PubMed Bivalacqua TJ, Usta MF, Champion HC, et al. Effect of combination endothelial nitric oxide synthase gene therapy and sildenafil on erectile function in diabetic rats. Int J Impot Res 2004;16:21–9. Crossref | PubMed Bivalacqua TJ, Usta MF, Champion HC, et al. Gene transfer of endothelial nitric oxide synthase partially restores nitric oxide synthesis and erectile function in streptozotocin diabetic rats. J Urol 2003;169:1911–7. Crossref | PubMed Harraz A, Shindel AW, Lue TF. Emerging gene and stem cell therapies for the treatment of erectile dysfunction. 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Here are some diet tips to follow while doing these exercises for erectile dysfunction for maximum results. Diet and weight loss are important aspects of erectile dysfunction treatment. People suffering are more likely to be overweight and inactive. Consumption of alcohol also plays a vital role in erectile dysfunction.

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Your doctor can provide you with specific details about the pros and cons of each of the following treatments: Lifestyle changes like stopping smoking, losing weight and eating healthier Vacuum Erection Devices

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“We listen to the patient and partner, understand the cause of the problem and work with the couple to start treatment that works best for the patient,” says Dr. Honig. PDE-5 inhibitors (phosphodiesterase type 5 inhibitors): These are medicines which relax muscle cells in the penis and increase blood flow. Vacuum erection device: This pulls blood into the penis, causing an erection. The erection is maintained by placing an elastic ring at the base of the penis. Injection therapy: Doctors use a very small needle to inject medication directly into the side of the penis. This relaxes the muscle allowing for blood flow and is a highly successful. Minimally invasive penile implant surgery: which our experienced physicians routinely perform. Most patients recover full sexual function in six to eight weeks. Yale Medicine Urology has extensive experience in standard and complicated penile implant surgery.

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