The recommended dosage of sildenafil is 50 mg/day, usually taken 1 hour before sexual activity. This dose may be increased to 100 mg or decreased to 25 mg based on side effects.6 PDE5 inhibitors also have a beneficial effect in the treatment of heart failure with reduced ejection fraction as well as pre- and post-capillary pulmonary hypertension. The use of PDE5 inhibitors in the treatment of right heart failure and left ventricular failure associated with combined pre- and post-capillary pulmonary hypertension has been well studied.71,72
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Second-generation cardioselective beta-blockers (atenolol, metoprolol, bisoprolol, etc.) can also lead to ED. Atenolol was shown to cause significant reduction of sexual activity compared with placebo in a double-blind, parallel-arm study.22 The same study also showed a significant reduction in testosterone levels with atenolol versus valsartan. An open, prospective study of hypertensive men treated with atenolol, metoprolol and bisoprolol for at least 6 months showed high prevalence of ED – approaching 66 % – in these patients.23
Avanafil has been demonstrated to be effective in treating ED in men of various ages and has been shown to be effective in men with ED related to diabetes mellitus.
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Erectile dysfunction (ED) is when a man cannot get or keep an erection. The condition prevents the man from having sex or finishing sex. This condition used to be called impotence. ED can occur at any age, but it is more common in men older than 75 years of age.
Citation: European Cardiology Review 2018;13(2):98–103.
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How much exercise does a man need? The answer depends on his individual health. Seeing a doctor is recommended before starting any exercise program. With a doctor’s guidance, a man can choose the types of exercise that are best for him. Men’s Sexual Health Erectile Dysfunction Public Prev Next What is the “normal” frequency of sex? What is the “normal” frequency of masturbation? What factors determine semen volume? Medical Editor: John P. Cunha, DO, FACOEP Pelvic Floor Muscles What Are the Pelvic Floor Muscles? Kegels for Men How Are Kegel Exercises Performed in Men? Guide Are Kegel Exercises Good For ED? Topic Guide Kegels are exercises used to strengthen the muscles of the pelvic floor, which can help prevent incontinence, prevent accidentally passing gas or stool, and improve orgasms. Kegel exercises can also help men with erectile dysfunction (ED) and enhance sexual performance.
Kasraeian Urology introduced this new ED treatment in 2021 for their patients in the Jacksonville, FL area.
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There's an excellent chance that your erections can be restored through one of the increasingly wide range of treatments now available but the psychological scars may take longer, and be more difficult, to heal.
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This is especially important for erections. When a man is sexually stimulated, his penis fills with blood. This blood gives him the firmness he needs for sexual activity. Once he ejaculates, the blood flows out of the penis and back into the rest of his body.
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- Natural ways to reverse erectile dysfunction without resorting to expensive pharmaceuticals.
The occasional inability to achieve a satisfactory erection doesn't normally constitute a problem. What's the risk? Most men will experience an erection problem at least once. This could be due to stress, exhaustion, too much alcohol or simply not feeling like sex. Persistent erectile dysfunction (ED) is estimated to affect about 10% of men at any one time. Although age itself isn't a cause of erectile dysfunction (ED), the risk nevertheless increases as you get older: 18% of 50—59 year olds have trouble with their erections compared with 7% of 18—29 year olds. What causes it?
Speedy, gentle, and enduring treatment is the ideal help for any problem. Physical activity can help you restore your sexual wellness.
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“ED (the inability to get or keep an erection firm enough to have sexual intercourse) in men can be caused due to a physical or psychological condition. It is becoming increasingly common due to our sedentary lifestyle, increased stress etc. Even men in their 20s can experience ED,” he said.
A GP might recommend sex therapy, either on its own or in combination with other psychotherapy.
If you can’t get or keep an erection that lasts long enough or is rigid enough for sex, you have erectile dysfunction.
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Therefore, men with these health conditions should not use tadalafil without having these conditions evaluated and stabilized first. For example, men with uncontrolled high blood pressure should have their blood pressure controlled; and men with potentially life-threatening abnormal heart rhythms should have these rhythms controlled.
Caffeine and nicotine both narrow blood vessels, reducing blood flow into the penis and increasing the risk of E.D. when it is secondary to vascular problems. Several studies have found that smoking is the leading modifiable cause of E.D., particularly in younger men.
Exercises should not cause any pain whatsoever. If you do experience pain, stop the exercises immediately, and seek medical help.
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Unfortunately, some men may not recover their ability to have a natural erection.
ED is most commonly caused by medical conditions such as diabetes and high blood pressure or pelvic surgeries. Age related decline in erectile function is also thought to occur. An injury A disease (e.g. diabetes, high blood pressure, or high cholesterol) Various studies have estimated that between 20% – 71% of individuals with diabetes suffer from erectile dysfunction. An operation (e.g. prostate gland removal) Substance use (e.g. tobacco, drugs, alcohol or medications) Stress, anxiety, depression, psychological trauma Approximately 30 million American men suffer from erectile dysfunction. Most men with erectile dysfunction still have the ability to have an orgasm and father a child, but often have difficulty doing these things because they can’t get or sustain an erection. Erectile dysfunction is not normal, and is by no means an inevitable consequence of aging. Most men at one time or another during their sexual lives are unable to get or keep an erection. This is normal and does not indicate a problem. However, millions of men of all ages experience this inability as a continuing problem. In most cases, erectile dysfunction can be overcome using medical or surgical options. We typically start with questionnaires such as the International Index of Erectile Function (IIEF) to determine the severity. Penile injections such as Trimix may be used to assess the quality of your erection and to differentiate among the many causes. Occasionally a penile duplex ultrasound is indicated if there is concern for disease in the blood vessels or penile scarring. Treatment Options for Erectile Dysfunction
Pelvic surgeries are a common cause of sexual dysfunction. Erectile dysfunction is a potential complication following prostate cancer surgery.
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It can be embarrassing to discuss sexual matters with your doctor. Yet a doctor’s appointment is neccessary if you want to get treatment for ED. Here’s how to prepare for your doctor visit.
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You may not be able to use these drugs if you have any of the following conditions:
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Recent stroke or heart attackSevere heart disease, such as unstable angina or irregular heartbeat (arrhythmia)Severe heart failureUncontrolled high blood pressureUncontrolled diabetesVery low blood pressure
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Vascular reconstructive surgery is one way to improve blood flow to the penis to help a man with erectile dysfunction get and keep an erection.
Research in stem cell therapy and gene therapy for erectile dysfunction is also ongoing. Cuzin, B. "Alprostadil cream in the treatment of erectile dysfunction: clinical evidence and experience." Ther Adv Urol 8.4 Aug. 2016: 249-256. Diamond, L.E., et al. "Co-administration of Low Doses of Intranasal PT-141, a Melanocortin Receptor Agonist, and Sildenafil to Men With Erectile Dysfunction Results in an Enhanced Erectile Response." Urology 65 (2005): 755. Jackson G., et al. "The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine." Journal of Sexual Medicine 3 (2006): 28. Kim, E.D. "Erectile Dysfunction Treatment & Management." Medscape.com. Oct. 12, 2015. Matz, E.L., et al. "Stem cell therapy for erectile dysfunction." Sex Med Rev 2018 April 6 epub ahead of print. United States. Food and Drug Administration. "Hidden Risks of Erectile Dysfunction 'Treatments' Sold Online." Mar. 23, 2015. Yafi, F.A., et al. "Erectile dysfunction." Nat Rev Dis Primers 2 (2016): 16003.
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.
Men can increase the blood flow throughout their bodies by engaging in regular physical activity. Increased blood flow to the penis decreases the risk of ED and enhances sexual performance.
As many as 30 million men in the U.S. experience erectile dysfunction (ED). Often, ED stems from an underlying physical disorder, such as vascular disease, high blood pressure (hypertension), or diabetes, or from side effects of medication or urological procedures.
The good news is that there’s a cure for ED. Depending on the underlying cause of the problem, your doctor can opt for one of these treatment options;
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If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.
Penile implant surgery can be very effective, provided that precautions are taken to avoid infection. Prosthesis surgery is contraindicated if systemic cutaneous or urinary infection is present. Antibiotics should be provided pre-operatively, and the surgical site should be shaved immediately prior to surgery. We use both Mentor and AMS penile implants with specialized antibiotic coats. Patients are hospitalized overnight for closed suction drainage, and sent home on seven days of post-operative antibiotics. Using these and other precautions, our implant infection rate is comparable to national averages (2-4%, 1-2% for antibiotic coated implants). Vascular surgery is recommended only in healthy individuals with recently acquired erectile dysfunction due to a focal arterial narrowing (usually related to trauma) and in the absence of generalized vascular disease. Sign up for Email Updates Click here Support Urology
A man’s psychological state is clearly an essential consideration when addressing issues of sexual function. While ED that is purely psychological is not common, many men who experience difficulty with erections may develop anxiety or fear about being able to get an erection the next time they try. This anxiety may lead to a stress response involving activation of the sympathetic nervous system and release of adrenaline, which will tend to make it even more difficult to get an erection. Conflict with a partner (or the absence of a partner) will also tend to increase stress and potentially interfere with erectile function.
Erectile dysfunction can be a warning sign of serious underlying disease. Research has found that erectile dysfunction is a strong predictor of heart attack, stroke, and even death from cardiovascular disease. All men with erectile dysfunction should be evaluated for cardiovascular disease. Notably, this does not mean every man with erectile dysfunction will develop heart disease, or that every man with heart disease has erectile dysfunction; however, erectile dysfunction patients should be aware of the link.
You need at least three healthy things for an erection: a penis, blood vessels, and nerves. The most simplistic explanation of an erection is that nerves send signals to the blood vessels to deliver more blood to the penis. Then, spongy (erectile) tissue of the penis (corpus cavernosum) gets filled with blood and an erection occurs. If any of the above components are not functioning well, erection may not happen.
Normal penile erection is controlled by two mechanisms: reflex erection and psychogenic erection. Reflex erection occurs by directly touching the shaft of the penis, while psychogenic erection occurs by erotic or emotional stimuli. ED is a condition where erection does not take place by either mechanism. ED can occur because of hormonal imbalance, neural disorders or lack of adequate blood supply to the penis.54 Lack of blood supply can be a result of impaired endothelial function associated with CAD.54
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MUSE offers an alternative route for administration of prostaglandin using a small pellet inserted using an applicator into the tip of the urethra (water pipe opening). Once massaged the prostaglandin is released and helps the blood to flow into the penis to gain an erection. Some men experience a mild burning sensation afterwards in the water pipe but this is a good alternative option for men who do not like the idea of using injection therapy.
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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
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
Erectile dysfunction often has more than one cause. Many diseases can cause blood flow problems, damage nerves, arteries and muscles, which can impair erectile function.
“Perhaps some men will be more motivated to know that they can improve their erectile function, sexual health, and quality of life, rather than just being told that they can live longer,” says Gerbild.
Book a free consultation with us at Oakwood Health Network, our specialists will evaluate your case and build a custom plan for diagnosis and treatment if needed. Previous Post Men’s Mental Health Month 2021 Next Post COVID-19 and Erectile Dysfunction: 6 Factors August 13, 2021 Dr. Manisha Sharma Dr. Manisha Sharma attended medical school at Queens University in Kingston, Ontario in 2007 before returning to her roots in Toronto to complete her residency in Family Medicine at the University of Toronto. Categories ED Diagnosis ED Prevention ED Treatment ED Treatment Specials Men's Health Mental Health Peyronie's Disease Prostate Cancer Tags
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DiabetesHigh blood pressureHeart or thyroid conditionsClogged arteries (atherosclerosis)DepressionNervous system disorders, such as multiple sclerosis or Parkinson disease
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If nothing else works (or if these other options don't fit into the patient's lifestyle), there is always a penile implant. A penile implant (or Inflatable Penile Prosthesis – IPP, as most urologists call it) is a hydraulic device that gets implanted into the penis and replaces the erectile tissue with two cylinders. There is a little pump that gets placed into the scrotum, next to the testicles (not into the testicles) to inflate and deflate the device.
If you experience erectile dysfunction (ED) for more than 6 months you should seek professional help. Your doctor can help you find the causes by performing physical and psychological tests. Read more about them in the section Diagnosis of ED.
Can over-the-counter (OTC) and/or natural or home remedies treat erectile dysfunction?
Of course, the test cannot and will not replace a medical examination and diagnosis. For each form of erectile dysfunction a medical examination is advisable. This is all the more true as even mild erectile dysfunctions can be an early warning sign for circulatory disorders such as coronary heart disease or peripheral arterial occlusive disease. Please answer the following 15 questions completely, otherwise an appraisal is not possible. You receive the test result at the end. It is only visible to you. 1. How often have you managed to get an erection during sexual activity in the last month? no sexual activity almost always or always most times (much more than half the time) sometimes (about half the time) a few times (much less than half the time) almost never or never 2. When you had erections with sexual stimulation in the last month, how often were your erections hard enough for penetration? no sexual activity almost always or always most times (much more than half the time) sometimes (about half the time) a few times (much less than half the time) almost never or never 3. When you attempted sexual intercourse in the last month, how often were you able to penetrate your partner? no attempt almost always or always most times (much more than half the time) sometimes (about half the time) a few times (much less than half the time) almost never or never 4. During sexual intercourse in the last month, how often were you able to maintain your erection after you had penetrated your partner? no attempt almost always or always most times (much more than half the time) sometimes (about half the time) a few times (much less than half the time) almost never or never 5. During sexual intercourse in the last month, how difficult was it to maintain your erection to completion of intercourse? no attempt extremely difficult very difficult difficult slightly difficult not difficult 6. How often have you attempted sexual intercourse in the last month? no attempts 1-2 attempts 2-3 attempts 5-6 attempts 7-10 attempts 11-20 attempts 7. When you attempted sexual intercourse, how often was it satisfactory for you? no attempt almost always or always most times (much more than half the time) sometimes (about half the time) a few times (much less than half the time) almost never or never 8. How much did you like your sexual intercourse in the last month? no sexual intercourse very well liked well liked it was all right. not much liked not liked 9. When you have had sexual stimulation or intercourse during the last month, how often have you ejaculated? no sexual stimulation or intercourse almost always or always most times (much more than half the time) sometimes (about half the time) a few times (much less than half the time) almost never or never 10. When you have had sexual stimulation or intercourse during the last month, how often have you had the feeling of orgasm (with or without ejaculation)? 11. How often did you feel sexual desire during the last month? almost always or always most times (much more than half the time) sometimes (about half the time) a few times (much less than half the time) almost never or never 12. How high would you rate your sexual desire during the last month? very high high moderate low very low to no desire 13. How satisfied have you been with your overall sex life during the last month? very satisfied quite satisfied about equally satisfied quite unsatisfied very unsatisfied 14. How satisfied have you been with your sexual relationship with your partner during the last month? very satisfied quite satisfied about equally satisfied quite unsatisfied very unsatisfied 15. How do you rate your confidence with regard to the last month that you could get and keep an erection? very high high moderate low very low
Certain diseases or conditionsPsychological or emotional issuesObesity or a history of smoking
A physician typically asks a series of questions to determine family and sexual history, the male's ability and frequency of erections and sexual relations, levels of satisfaction, any diminished desire for sex, surgeries or injuries near the penis, prescription medication use, and history of using tobacco, alcohol, or illegal drugs.
Atherosclerosis (narrowing of the arteries)DiabetesHigh blood pressureSmokingUrological problemsPeyronie’s diseasePelvic traumaPelvic floor dysfunctionIncontinence
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