All PDE5i medication does not improve erections in normal men, only in those with difficulty in achieving or maintaining erections sufficient for sexual intercourse due to a true medical problem.
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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
You will also be asked a detailed past medical and surgical history as you may have other medical conditions which may be contributing to your erectile dysfunction. It is important to tell your GP about other symptoms such as pain, premature ejaculation (uncontrolled ejaculation before or immediately after penetration) or symptoms of prostatic obstruction because they are often associated with erectile dsyfunction.
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HDL Cholesterol High-density lipoproteins are believed to take cholesterol away from cells and transport it back to the liver for removal or processing. They are known as the "good" cholesterol as people with high levels of HDL may have less heart disease. Low HDL could be the result of lack of exercise and smoking.
The phrase “penis exercise” actually refers to exercises known as pelvic floor or Kegel exercises, in which a man focuses on strengthening the muscles that control the flow of urine and ejaculation. These exercises are often recommended to men who are recovering from prostate cancer treatment, have problems with ejaculation, or have a hard time holding their urine, but they do not appear to help erectile dysfunction.
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There have been rare reports of priapism (prolonged and painful erections lasting more than six hours) with the use of PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil. Patients with blood cell diseases such as sickle cell anemia, leukemia, and multiple myeloma have higher than normal risks of developing priapism. Untreated priapism can cause injury to the penis and lead to permanent impotence. Therefore, if your erection lasts four hours, you should seek emergency medical care.
Many men are uncomfortable speaking with their physician about erectile dysfunction symptoms; however, it is important to treat your symptoms as ED can be a warning sign of current or future heart disease.
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AtherosclerosisDiabetes High blood pressureChronic kidney diseaseHeart diseaseMultiple sclerosisPeyronie’s diseaseProstate cancerInjury to the penis or surrounding organs
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This patient education application provides patients and Health Care Practitioners with easy to access information on Erectile Dysfunction management. The developer, BuiltByDoctors, has not provided details about its privacy practices and handling of data to Apple.
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Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain a hard enough erection for satisfactory completion of sexual activity. Erectile dysfunction is different from other health conditions that interfere with male sexual function, such as lack of sexual desire (decreased libido) and problems with ejaculation release of the fluid from the penis (ejaculatory dysfunction) and orgasm/climax (orgasmic dysfunction), and penile curvature (Peyronie's disease), although these problems may also be present. ED affects about 50% of men age 40 and over. This article focuses on the evaluation and treatment of erectile dysfunction.
Various studies have shown that around 11 percent of men experience mild symptoms of ED in their early 30s. And by doing proper exercises and yogas, one can overcome those symptoms to get over their problem before touching their 40s.
Strengthening the muscles that surround and support the genital area can assist the penis in obtaining and maintaining an erection and address issues that cause premature ejaculation.
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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
If you have a problem getting or keeping an erection hard enough for you to have sex with your partner, you may have erectile dysfunction. The condition is common in men over 40 years of age, although it can affect men of all ages. Symptoms may differ from person to person. Some men do not get an erection at all, others may be able to get an erection but can’t maintain it long enough for sex and some men get an erection, but it is not hard enough for sex. Lose weight if you are overweight Stop smoking, as it damages blood vessels Don’t drink more than 14 units of alcohol per week Eat a healthy, balanced diet Exercise regularly Try to reduce your stress levels
Based on your physical exam as well as your medical and sexual history, your doctor may want to order certain blood or urine tests. They’ll use these to check for problems that can lead to ED, such as:
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Men who want to treat their ED have another option. The GAINSWave® treatment is a safe, non-surgical therapy that can restore sexual function and help to prevent erectile dysfunction in men who don’t have ED.
Your doctor might perform a combination of different exams to determine if you have erectile dysfunction (ED).
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The dose of PDE5 inhibitor that you start with may vary with underlying medical conditions and medications that you are taking. Thus, it is important to review all medications (even over the counter medications) with your physician. Typically, one starts with a lower dose and increases as needed. Some medical conditions prevent going up to higher doses. You can review the drug prescribing information or consult with your doctor regarding the dose(s) that are appropriate for you.
Checking the penis for sensitivity determines any nervous system origins. Inspection of penile appearance helps rule out Peyronie's disease. A blood pressure check rules out circulation problems by checking wrist and ankle pulse.
Journal of Sexual Medicine: “Prevalence and correlates of erectile dysfunction by race and ethnicity among men aged 40 or older in the United States: from the male attitudes regarding sexual health survey.
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How Common is ED?Did know out of 10 men 1 man is suffering from erectile dysfunctionDid you know only 33%men seek advice from sex experts.Did you know Ed is responsible for 20% of divorce casesDid You know Ed Is also responsible for male infertility
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Currently, penile implants are the closest thing to a natural erection that we can do through through treatment. Implants are clearly the winner for overall satisfaction rates with around 95 percent satisfaction (compared to 50 percent for pills, 40 percent for injections, and 20 percent for vacuum devices). *McCabe MP, et al. (2016) Incidence and prevalence of sexual dysfunction in women
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Erectile dysfunction, also known as impotence, is when a man is unable to get or maintain an erection.
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Some information provided may not be valid for residents of other countries due to variations in medical practice and drug approval and indications.
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When resistance training was combined with aerobic exercise in a series of trials, men who responded positively to the physical exercise regimen experienced a 15% improvement in erectile function.
Psychoteraphy is often the first form of treatment recommended for depression. Psychotherapy helps depression by helping people understand the behaviors, emotions and ideas that contribute to their depression, regain a sense of control and pleasure in life, and learn coping techniques as well as problem solving skills.
Journal of Sexual Medicine: “Prevalence and correlates of erectile dysfunction by race and ethnicity among men aged 40 or older in the United States: from the male attitudes regarding sexual health survey.
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High cholesterol levels can contribute to ED. Using a home blood test can give you an accurate health assessment and show...
Vacuum devices for erectile dysfunction, also called pumps, offer an alternative to medication. To use a pump, the penis is placed inside a cylinder. Then the pump draws air out of the cylinder to create a partial vacuum around the penis causing it to fill with blood, leading to an erection. An elastic band worn around the base of the penis is used to maintain the erection during intercourse. Individuals should discuss the use of this device with their doctor, and especially the elastic band use to avoid potential penile damage.
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Tadalafil shares the common side effects of the PDE5 inhibitors, however, due to its effect on PDE11, another phosphodiesterase located in muscle, tadalafil has been associated with muscle aches. Back pain and muscle aches occur in less than 7% of men taking tadalafil and in most patients will go away without treatment within 48 hours. When treatment was necessary, acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) or naproxen (Aleve) were effective. Rarely do the muscle aches and back pain cause men to stop using tadalafil.
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S.NOWhat to eat to eliminate EDHow is it helpful?1.Leafy Green and BeatsHelps in relaxing the effect of nitrates on the blood vessels2.Dark ChocolatesLowers the blood pressure and cholesterol in the body.3.PistachiosKeeps the blood vessels relaxed for better blood flow.4.Oysters and ShellfishProduction of the male hormone5.WatermelonsHelps in increasing the sexual desires6.TomatoesFor better circulation and sexual desires.7.CoffeeBetter arousal and desires.
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The physical examination will confirm the information you gave the doctor in your medical history and may help reveal unsuspected disorders, such as diabetes, vascular disease, penile plaques (scar tissue or firm lumps under the skin of the penis), testicular problems, low male hormone production, injury or disease to the nerves of the penis, and various prostate disorders.
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A meta-analysis of 36 744 men with ED in 12 prospective cohort studies found that the presence of ED significantly increased the risk of CVD, CAD, stroke and all-cause mortality, and the presence of ED was an independent risk factor for CVD. Ponholzer et al found that men with moderate to severe ED had a 65% increased relative risk for developing symptomatic CAD compared with men who did not have ED.26
Because PDE-5 medications sometimes cause significant problems for men, researchers continue to develop new methods for helping men overcome ED.
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If you think any medicine you are taking may be causing erection problems, talk with your provider. You may need to lower the dose or change to another drug. DO NOT change or stop taking any medicine without first talking to your provider.
The lab testing obtained for the evaluation of erectile dysfunction may vary with the information obtained on the health history, physical examination, and recent lab testing. A testosterone level is not necessary in all men; however, a physician will order labs to determine a patient's testosterone level if other signs and symptoms of hypogonadism (low testosterone) such as decreased libido, loss of body hair, muscle loss, breast enlargement, osteoporosis, infertility, and decreased penile/testicular size are present.
The pulses in your legs will normally be assessed and the nerve reflexes involving your legs, and your penis or anus (back passage). Rectal examination (pictured) may be performed to assess the tone of your anal muscles and to feel your prostate gland.
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
The prostate gland is located just below the bladder and is surrounded by nerves and blood vessels. These nerves and blood vessels are needed to achieve a normal erection. Much research has been done to understand where these nerves are located and how to prevent them from getting damaged during surgery or other treatments.
Bladder Procedures Fertility & Infertility Procedures Kidney & Adrenal Procedures Miscellaneous Procedures Penis Procedures Prostate Procedures Retroperitoneum Procedures Stone Procedures Testis & Scrotal Procedures Transplantation & Dialysis Procedures Ureter Procedures Urethra Procedures
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Adjustment of medications that adversely affect erectile function should be considered whenever possible.
Recent studies have found that even if medication is used as part of treating erectile dysfunction, it's way more likely to be effective if lifestyle changes are also addressed.
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?
Writing in the journal Physiotherapy, Mr Myers said 30 per cent of men suffer from premature ejaculation. Figures suggest more than half of men over the age of 50 have erectile dysfunction, which gets more common with age
All of this is available to ensure a proper diagnosis of your ED. It allows your ED specialist to customize a treatment specifically for you!
Men with a known hypersensitivity to alprostadil should not use intraurethral prostaglandin E1.
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It is recommend that the first trial of intraurethral prostaglandin be performed in the doctor's office due to the risk of hypotension with this medication.
In diagnosing the cause of erectile dysfunction, an ultrasound may be done on the lower abdomen, the pelvis, and the testicles, or it may be restricted to just the penis.
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.
Impotence treatments were discussed in the oldest Chinese text, The Yellow Emperor’s Classic of Internal Medicine, which describes traditional Chinese medicine during the time of the Yellow Emperor’s rule which ended around 2600 BC. One of the treatments for impotence discussed is a potion with 22 ingredients.4
Cholesterol, Total A sterol in the blood. Knowing your cholesterol level may be as important as knowing your blood pressure. Elevated cholesterol levels are associated with an increasing risk of coronary heart disease.
Penile erection occurs, but the penis does not remain hard enough for completion of sex.Penile erections are not hard enough for penetration.There is an inability to obtain a penile erection.One can still achieve an orgasm and ejaculate with erectile dysfunction.
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