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David F Mobley1, Mohit Khera2, Neil Baum3 1 Department of Urology, Weill-Cornell Medicine, Houston, Texas, USA 2 Department of Urology, Baylor College of Medicine, Houston, Texas, USA 3 Department of Urology, Tulane Medical School, New Orleans, Louisiana, USA Correspondence to Dr David F Mobley, Department of Urology, Weill-Cornell Medicine, 18300 Katy Fwy, Ste 325, Houston 77094, TX, USA; mobleyresearch{at}gmail.com

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Certain street drugs such as "poppers" also can cause serious problems if taken with PDE5i medications. These poppers are often types of nitrates and can cause severe drops in blood pressure. Ecstasy is another street drug that may increase sexual desire but interferes with performance. This has prompted some men to combine ecstasy with PDE5i medications. This mixture (a combination sometimes called "sextasy") can improve erection ability but also causes severe headache and priapism. (Priapism is an abnormally prolonged erection that becomes extremely painful and may result in permanent damage to the erection mechanism.) There are also potentially dangerous effects to your heart from mixing PDE5i medications with various other street drugs.
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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Many sexual health clinics offer a walk-in service, where you do not need an appointment. What happens at your appointment
All treatments are medically proven to assist in getting and maintaining an erection – but each one of them are unique in their abilities and effectiveness.

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Your private physical examination happens with an ED specialist in a confidential men’s health clinic. Your blood pressure will be checked. Your testicles and penis will be examined, and a brief rectal exam may be recommended to check your prostate health.
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.

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A safe and non-drug treatment in which a cylinder-shaped device is placed on the penis and with the magic of negative pressure, the device pulls the blood in to the shaft of the penis to produce an erection.

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In sum, ED is a troubling condition that may be a sign of serious underlying health problems. It is appropriate to discuss ED with your physician. A variety of management options exist; men and their partners may decide which if any of these are appropriate for their specific circumstances.

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    Yale Medicine Urology offers many advanced medical and surgical options to address erectile dysfunction. The department is guided by personalized care to treat the patient.

    Dr. Chirag Bhandari promotes sex education in the urge to cultivate sexual awareness among youth and even among the blocked mindset of Indian people. Subscribe to his interactive youtube chat show, “Mans are from mars and women are from venus“, to earn some amazing facts about the sexual problem and natural treatments.
    The idea of using low-energy shock waves to treat erectile dysfunction comes from studies that show that these types of shocks help heart blood vessels regrow, a process called revascularization. Shock wave therapy may also work on the penis, and there have been some promising results, but it’s not currently an approved ED treatment. "It’s similar to the type of shock waves used to break up kidney stones, and it may cause revascularization,” says Bennett. “However, there are not yet any good controlled studies to recommend it to patients."

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    • Medications, most commonly blood pressure medications (especially beta-blockers or thizides), anti-depressants (such as SSRI), anti-androgens, and a variety of other medications

    But the BIG QUESTION is, which exercises are most effective? According to this study, pelvic floor exercises, also known as kegel, can help men suffering from ED. The study goes ahead to recommend these exercises as a first line approach for those seeking long term relief from ED.
    You can consult the sexologist/ andrologist or specialist doctor for Erectile Dysfunction in the case of severity.

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    Premature ejaculation is the unwanted or uncontrollable early release of semen during sexual intercourse. While premature ejaculation is not considered a medical condition, it can have negative effects on a male’s self-confidence and can affect his sexual relationships.

    Couples can learn new ways to please one another and to show affection. This can reduce anxiety about having erections. Feeling nervous about sex. This could be because of a bad experience or a previous episode of ED. Feeling stressed, including work and family stress. Feeling depressed. Feeling self-conscious about your body or performance. Thinking your partner is reacting negatively toward you.
    The recommended starting dose of tadalafil for use as needed for most patients is 10 mg taken orally approximately one hour before sexual activity. A doctor may adjust the dose higher to 20 mg or lower to 5 mg depending on efficacy and side effects. Doctors recommended that patients take tadalafil no more frequently than once per day. Some patients can take tadalafil less frequently since the improvement in erectile function may last 36 hours. Patients may take tadalafil with or without food. Tadalafil is currently the only PDE5 inhibitor that is FDA-approved for daily use for erectile dysfunction and is available in 2.5 mg or 5 mg dosages for daily use.

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    Alprostadil is an FDA-approved erectile dysfunction drug that can be injected directly into the penis to trigger an automatic erection. "Penile injection is the most effective type of ED treatment for men who can't take oral treatment," says Nelson Bennett, MD, a urologist at the Lahey Clinic in Burlington, Mass. In fact, it has an 85 percent success rate. Possible side effects include a burning sensation and priapism, an erection that lasts more than four hours and requires medical treatment.

    It is recommended that prior to proceeding with other therapies, patients reporting failure of their PDE5 inhibitors should be evaluated to determine whether the trial was adequate. This would include discussion of fatty food ingestion, which is important with sildenafil, and specific patient population such as prostatectomy and diabetes. Furthermore, patients should be encouraged to continue attempts at intercourse up to the eighth to tenth dose of PDE5 inhibitor as improvements in success rate are seen up to the eighth to tenth dose.
    The patient considering prosthesis implantation, should be aware of the different types of prosthesis, risks of infection and erosion, mechanical failure and resulting re-operations, differences from the normal flaccid and erect penis including the possibility of penile shortening, and the potential reduction in the effectiveness of other therapies if the device is subsequently removed.

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Diet rich in vitamins and minerals is essential. Also, you must cut down on junk, caffeine, alcohol, and cigarettes.

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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.

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Diuretics (pills that increase urine flow)High blood pressure medsAntihistaminesAntidepressantsParkinson's disease drugsAntiarrhythmics (drugs for irregular heartbeat)Tranquilizers and sedativesMuscle relaxantsNonsteroidal anti-inflammatory drugs (NSAIDs)Histamine H2-receptor antagonistsHormonesChemotherapy medicationsProstate cancer drugsAnti-seizure medications

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I like this book because it is informative, educational and clearly written. We've all seen those late night erectile dysfunction advertisements on TV, and you've probably heard them on the radio too. ED is something that many men deal with, but immediately turning to a blue pill may not always be the answer. This book outlines natural remedies for ED through diet and exercise. These methods are for men who want to take initiative to gain a better understanding of their bodies and how they function. This book is easy to follow and easy to read. It is written in laymen terms and seems pretty down to earth. The information is educational and the techniques make sense but are so easily overlooked. I'm glad that I read this to gain more insight on a common issue many don't feel comfortable talking about. Very informative and explains ways to improve Erectile Dysfunction with diet and exercise. As always still see your doctor because you still should know if it maybe related to health issues.

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