Nebivolol seems to have an advantage over other beta-blockers when used to treat men with hypertension and ED. It has additional vasodilating effects because it stimulates endothelial release of nitric oxide (NO), resulting in relaxation of smooth muscle in the corpus cavernosum, allowing penile erection.25 Despite limited studies, nebivolol does not seem to worsen erectile function and some studies have demonstrated significant improvement in erectile function with nebivolol compared with second-generation cardioselective beta-blockers.23,26–28
While conducting a full interview, specific questions like these will probably be asked: .
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.
Erectile Dysfunction Peyronie’s Disease Penile Implants About Penile Implants Penile Implant Revision Surgery Penile Implants And Prostate Cancer
NOTE: Some of the information provided contains graphic, medical images which individuals may find upsetting
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.
Some men may be able to gain an erection by self-injecting drugs into the penis, causing it to become engorged with blood. The advantage of injection therapy that it can easily be self-administered and in most patients leads to a strong erection when given the right dose. Potential side effects of injection therapy include: fibrosis (scarring) and long-lasting painful erections. Injections are shown to have a long-term dropout rate of about 37% – 76%. Reasons for dropping out of drug therapy include: Desire for a permanent treatment alternative Inadequate response Return of spontaneous erections Fear of needles Concern over side effects
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Bullet point: The relationship between the risk factors for CVD and ED are intimately interwoven, one with the other. Clinicians need to factor this in when counselling the man with ED.
The most likely explanation for men developing ED prior to developing CVD is that the penile arteries are much smaller than the coronary arteries and the smaller penile arteries are likely to be occluded before the coronary arteries are significantly narrowed and become symptomatic.
In one study, 55 men with E.D. were either taught pelvic floor exercises with biofeedback and lifestyle changes (treatment group) or advised on lifestyle changes (control group). After six months, 40 percent of men who performed pelvic floor exercises regained normal erectile function (Dorey et al., 2005). Concentrate on lifting and pulling in your genitals for a count of 5. Slowly relax your muscles. Don’t hold your breath while performing this exercise. Repeat 10 times, aim for two to three times per day. Be sure you are not contracting your stomach, legs, or buttocks.If you are unsure whether you are contracting the correct muscles. Try stopping your stream of urine periodically to feel these muscles tighten. Pilates
When sexually stimulated/aroused, the nerves supplying the penis release a chemical, nitric oxide (NO). Nitric oxide is important because it stimulates the production of a chemical called cyclic guanosine monophosphate (cGMP). cGMP causes the muscle in arteries of the penis to relax and increase blood flow into the penis. NO is broken down in the body by phosphodiesterase enzymes. PDE5 inhibitors thus prevent the breakdown of NO and thus promote increased blood flow into the penis.
Poor communication with your partner.Feelings of doubt and failure.Stress, fear, anxiety, or anger.Expecting too much from sex. This can make sex a task instead of a pleasure.
Psychosexual counselling, or sex therapy, is an appropriate recommendation especially for men who are experiencing discord with their partner especially if the conflict is related to the man’s ED. Counselling usually consists of 5–20 sessions with counsellor. It is our recommendation that referral doctors treating men with ED make a referral to a psychotherapist or sex therapist who is certified by AASECT (American Association of Sexuality Educators, Counselors and Therapists) of certified sexuality educator.43
You may be able to improve your sex life with a few lifestyle changes. Giving up smoking, losing weight, and exercising more often can improve your blood flow. If you suspect a medication could be to blame, talk to your doctor about adjusting the dosage or switching to another drug.