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Some men should not take PDE5 inhibitors. They can cause hypotension (abnormally low blood pressure that can lead to fainting and even shock) when given to patients who are taking nitrates (medications taken for heart disease). Therefore, patients taking nitrates daily should not take any of the PDE5 inhibitors. Nitrates relieve angina (chest pain due to insufficient blood supply to the heart muscle because of narrowing of the coronary arteries); these include nitroglycerine tablets, patches, ointments, sprays, and pastes, as well as isosorbide dinitrate and isosorbide mononitrate. Other nitrates such as amyl nitrate and butyl nitrate also are in some recreational drugs called "poppers."

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The At-Home Health MOT (One-Off) is a blood test that measures important biomarkers (such as your testosterone, cholesterol, and vitamin D levels) to give you an accurate insight into your health. It also tests the function of your thyroid, kidneys, and liver to tell you if they’re working as they should. Each At-Home Health MOT comes with a free review from a UK clinician who can offer personalised health advice based on the outcome of your test.
Aetna considers surgical correction of Peyronie’s disease (e.g., plaque excisions and venous graft patching, tunica plication, Nesbit tuck procedure) medically necessary for the treatment of members with Peyronie's disease for 12 or more months with significant morbidity who have failed conservative medical treatment. Surgical correction of Peyronie's disease is considered experimental and investigational when criteria are not met. .

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Several medications can interfere with the chemical processing of PDE5i medications by the liver. These can include ketoconazole (an antifungal medication known by the brand name Nizoral), erythromycin (an antibiotic), and cimetidine (also known as Tagamet, for reducing stomach acid). A lower dose of PDE5i medications should be used if one is taking any of these medications.

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Some men find that the treatment options listed above are not suitable for them due to medical conditions, lifestyles, personal preference, or the treatment option may be ineffective. In this case, a penile implant may be an appropriate option.
They reported that 160 minutes of exercise a week for 6 months “contributes to a decrease of ED” for men experiencing ED due to physical inactivity, obesity, and cardiovascular disease.

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Problems faced by urologists at all stages when returning to surgery after a prolonged absence

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Erectile dysfunction is a potential complication following prostate cancer treatments. The nerves that control an erection lie very close to the prostate and may be injured during treatment. However, some men may regain their previous level of erectile function with nerve-sparing procedures. But it may take up to a year while some men may never recover their ability to have a natural erection.

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    Even when the nerves are spared, research has shown that the healing process takes up to 2 years for most men. We don’t know all the reasons some men regain full erections and others do not. We do know that men are more likely to recover erections when nerves on both the left and right sides of the prostate are spared.

    Click here to watch a short video about erectilel dysfunction from the NHS Health & Care Video Library.
    These are not common tests for initial diagnosis of ED and are only necessary if your doctor needs additional information to assess your personal situation.

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    Did you receive surgical intervention for your erectile dysfunction? Were you satisfied with the results?

    Other treatments also have possible side effects and complications. Ask your provider to explain the risks and benefits of each treatment.
    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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    As with most other organ system in the human body, changes and loss of function is normal consequence of the ageing process. This is also true of the endocrine system, specifically the levels of testosterone production from the Leydig cells of the testicle. Accompanying the decrease in testosterone is a decrease in erections which also has a component in decrease in the blood supply to the penis making erection not as frequent and not as rigid compared with a young man’s erectile function. Although these changes are in itself not life threatening, they can impact a man’s relationship with his partner, and also ED may be a harbinger of other undiagnosed conditions such as coronary artery disease (CAD), hypercholesterolaemia or diabetes mellitus.6

    6. Mix it up. Along with the longer pelvic floor exercises, try practising short contractions (two to three seconds) as well, to ensure pelvic muscles are regularly activated.
    “Street” drugs can dampen a man’s feelings of arousal as well as other sensations. Illicit drugs can take away the pleasure of sex and make a man impotent. Some men use drugs to cope with other issues that could be the root of their penile dysfunction. Using drugs only compounds a man’s difficulty in achieving and maintaining erections.

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    • The inability to achieve or maintain an erection sufficient for sexual intercourse •Symptoms include erection problems, decreased desire, and psychological distress •Treatments include medications, injection therapy, a vacuum erection device, and penile implant•Involves urology

    "Pelvic floor exercises and biofeedback are an effective treatment for men with erectile dysfunction" – The British Journal of General Practice.
    Tobacco use restricts blood flow to veins and arteries. Over time this can cause chronic health conditions that lead to erectile dysfunction. Medical treatments, such as prostate surgery or radiation treatment for cancer, are also risk factors for erectile dysfunction.

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Most effective form (Trimix) not covered by most insurance plans and may be quite expensive

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Avid cyclists suffer more erectile dysfunction than other athletes because the shape of some bicycle seats causes pressure on the nerves that are vital to sexual arousal. Cyclists who ride for many hours each week may benefit from seats designed to protect the perineum.

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If you have a regular sexual partner, your doctor may ask to talk to the two of you together. This can help them learn more about your relationship and how it might affect your ability to get and keep erections.

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