Multiple sclerosis (MS) can be thought of as an immune-mediated inflammatory process involving different areas of the central nervous system (CNS) at various points in time. Early warning signs and symptoms of MS in children, teens, and adults are similar; however, children and teens with pediatric also may have seizures and a complete lack of energy. Adults with MS do not have these signs and symptoms. Other signs and symptoms of MS include inflammation of the optic nerve (optic neuritis), changes in vision, Wiping or having tissues around the eye and moving the eye may be painful, and double vision. There are four types of MS, relapsing remitting MS (RRMS), secondary progressive MS (SPMS), primary progressive MS (PPMS), and progressive relapsing MD (PRMS).
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Continuing Professional Development (CPD) Education Committee E-Learning Revalidation
Quit smoking.Cut back on alcohol (no more than 2 drinks per day).DO NOT use illegal drugs.Get plenty of sleep and take time to relax.Stay at a healthy weight for your height.Exercise and eat a healthy diet to keep good blood circulation.If you have diabetes, keep blood sugar well-controlled.Talk openly with your partner about your relationship and sex life. Seek counseling if you and your partner have trouble communicating. References
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American Urological Association website. What is erectile dysfunction? www.urologyhealth.org/urologic-conditions/erectile-dysfunction(ed). Updated June 2018. Accessed October 15, 2019.
Yes, urologists treat erectile dysfunction (ED). They are specialized doctors who treat disorders of the urinary tract and male reproductive system. Since ED is an inability to get or maintain an erection for penetrative sex, that would fall under the urology category.
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Cancer and cancer treatments that involve the pelvic area including colon cancer surgery, prostate cancer surgery or radiation treatments may cause neurological as well as vascular damage which may lead to sexual dysfunction as well.
You can consult the sexologist/ andrologist or specialist doctor for Erectile Dysfunction in the case of severity.
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Kegel exercises, or pelvic exercises, have proven to be effective in addressing erectile dysfunction, and it should be used as the first-line of treatment. The ischiocavernosus and bulbocavernosus muscles in the pelvic area surround the penis and are active during an erection. The following exercises aim to strengthen these muscles.
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However, it can be a sign of an underlying medical condition such as high blood pressure or cholesterol, side effects of medication, or hormonal issues.
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Depression, High Blood Pressure, Severe Anxiety and that’s why many people face erectile dysfunction at 17 or 20. The symptoms of ED at 20 are
If unsuccessful, interferes with other treatmentsFully Inflatable ImplantsMimics natural process of rigidity-flaccidity
Professor of Urology and Epidemiology & Biostatistics, Frank Hinman, Jr. MD Endowed Professor in Urologic Education, Associate Chair for Education and Residency Program Director, Chief of Urology, Zuckerberg San Francisco General Hospital and Trauma Center, Chief of Genitourinary Reconstructive Surgery at UCSF Health, Program Director, Genitourinary Reconstructive Surgery Fellowship
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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.
ED pills you take by mouth can have side effects. These can range from muscle pain and flushing to heart attack. DO NOT use these drugs with nitroglycerin. The combination can cause your blood pressure to drop.
“Erectile Dysfunction (ED).” UW Health. Retrieved from: http://www.uwhealth.org/urology/erectile-dysfunction-ed/20537
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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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Nearly every primary care physician, internist and geriatrician will be treating men with ED.
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Aetna considers exogenous testosterone replacement therapy, including transdermal preparations, experimental and investigational for the treatment of non-hypogonadal impotence because its effectiveness in non-hypogonadal impotence has not been established. (See CPB 0345 - Implantable Hormone Pellets.)
Our team of clinicians and health experts can support you along every step of your treatment journey. Getting a health check-up from home is easier than ever. Take a look at our home blood tests to find the perfect test for you.
This section offers general information about treatment options and situations can vary in different countries.
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Combination therapy for the treatment of erectile dysfunction has been under investigation. Most of these studies have been small trials, and long-term data regarding their effectiveness and safety are lacking. However, with thorough evaluation and counseling, there may be a use for combination therapy for certain individuals with ED.
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Vidyut Jammwal is an action hero in Hindi cinema who advocates fitness not only for films, but as a way of life. Having gone to a sports school and been trained in India’s ancient martial art form Kalaripayattu, his strength and stamina know no bounds. In the hope to share his knowledge with thousands of his fans who were struggling to stay fit during the lockdown, he decided to start a YouTube channel last year. So far, he's posted crazy workout challenges, movements to improve balance and alignment and country boy exercises among other informative and inspiring videos.
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Hormonal therapy is not used as a primary therapy for the treatment of ED. Testosterone therapy is used if there is ED and symptoms of low testosterone, as well a low blood level of testosterone.
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Certain feelings can interfere with normal sexual function, including feeling nervous about or self-conscious about sex, feeling stressed either at home or at work, or feeling troubled in your current sexual relationship. In these cases, treatment incorporating psychological counseling with you and your sexual partner may be successful. One episode of failure, regardless of cause, may propagate further psychological distress, leading to further erectile failure. Los of desire or interest in sexual activity can be psychological or due to low testosterone levels.
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Men with new onset ED and no signs or symptoms of CVD are at increased risk for experiencing a CV event in the subsequent 3–5 years.24
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.
While medications are a common first therapy, they tend to only work in about 50 percent of men with diabetes. Good blood sugar control can help slow the progression of ED and sexual dysfunction in men. Men with diabetes are more likely to move on to other treatment options, such as the: vacuum erection pump, penile injection therapy, and penile implants. ED and Medications
1. Identify the pelvic floor muscles: To find the pelvic floor muscles, you can either stop urination midstream or squeeze the muscles that stop you from passing gas.
ED can have a negative effect on your sex life. It is difficult to feel attractive and confident or be intimate with your partner when you do not feel able to give him or her pleasure. This can have an effect on trust, intimacy, and closeness. Your intimacy as well as your daily interaction may be affected.
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Phosphodiesterase inhibitor medications, such as sildenafil (Viagra) can cause a reduction in blood pressure, and so should not be taken by patients known to have low blood pressure (hypotension), or in those who have recently had a stroke or heart attack. Similarly, they should not be used in patients who take nitrate medication (such as glyceryl trinitrate, GTN, or isosorbide mononitrate) for chest pain. Phosphodiesterase inhibitor medications are associated with some side-effects, which include headaches, hot flushes, and dizziness. More serious side-effects may occur less commonly, including chest pains, prolonged and painful erections (priapism) or a change in vision. If patients experience any of these symptoms, they should seek immediate medical attention.
Conclusions The present study suggests that physical activity and exercise interventions improve patient-reported erectile dysfunction, particularly aerobic exercise with moderate-to-vigorous intensity.
Risk factors for ED and cardiovascular disease (CVD) are similar. The most cases of ED result from a vascular disturbance of the endothelium. Risk factors are such as: Diabetes Dyslipidemia Hypertension Low levels of testosterone Neurologic diseases (e.g. Parkinson’s disease, spinal cord injury) Nerve damage to the penis or the pelvic area Obesity Pelvic surgery Radiation therapy to the pelvic area Smoking
Your doctor will take a full medical history and perform a complete physical exam. Although it can be awkward to discuss ED with your doctor, it is important to be open and honest about all your symptoms, because they could indicate a serious medical problem.
Lifestyle factors than can affect the condition include obesity, smoking, cycling too much, drinking too much, and stress.
The primary cause of the problem is considered to be a psychological problem. Any person suffering from anxiety, depression, stress, fear may find it hard to enjoy intimate moments. In some cases, smoking, drugs have also been considered a common cause of erectile Dysfunction.
Erectile Dysfunction is the consistent inability to sustain an erection sufficient for sexual intercourse. A total inability to achieve an erection – You can never get an erection. An inconsistent ability to do so – You can only occasionally get an erection. A tendency to sustain only brief erections – You can get an erection, but can’t keep it long enough for satisfying sex.
As your body becomes more familiar and used to these exercises, consider increasing the length of time you squeeze and hold the different pelvic muscles. You can also increase the number of repetitions or sets of exercises you do.
First-line treatment is typically with the use of phosphodiesterase inhibitors, such as sildenafil (also known as Viagra). In the UK, Viagra is now available without a prescription, and can be obtained over the counter from pharmacists, once suitability has been assessed. A vacuum device, or pump, can also be useful especially if medications are not suitable. Vacuum pumps work by encouraging blood flow to the penis, resulting in an erection.
For people who cannot take medications, a vacuum device, or “penis pump,” can help maintain an erection. In extreme cases, surgery may be required.
Several treatment options are available to help ED. Sometimes, resolving underlying medical conditions will also improve your ED symptoms.
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A range of physical and psychological factors contribute to erectile dysfunction and this can occur at any age in men. However, the problem is more common in older men due to the aging process and the effect this process has on our circulatory systems, blood pressure and natural elasticity of our blood vessels.
Algorithm for evaluating and managing the patient with ED. CV, cardiovascular; CVD, cardiovascular disease; ED, erectile dysfunction.
The butterfly pose is well known for strengthening the pelvic floor and restoring sexual energy back into its muscles. Diamond hip thrusts are a variation of that exercise. Instead of flapping your legs, they involve thrusting your hips forward and backward in an alternate motion. This increases the flexibility and mobility of your hip joints and prevents sexual conditions like erectile dysfunction. Sit down on the floor. Bend your knees at 90 degrees. Join your feet to make a diamond shape with your legs on the floor. Keep your back straight and shoulders relaxed. Place your palms firmly on the floor behind your back. Lift your seat muscles off the floor. Thrust your pelvis forward and backward in this position. Swing your pelvis from side to side. Repeat in a seamless motion. Stability ball stretch
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Erectile dysfunction can be a difficult problem to discuss with your partner or even your doctor. However, it needn't be because erectile dysfunction, which causes sexual performance issues for men, is a very common and highly treatable condition.
In men, Kegel exercises can help with erectile dysfunction (ED) and enhance sexual performance. One study of men with ED found that after 6 months of performing Kegel exercises, 40% of men regained normal erectile function. Helping prevent incontinence (which can be important after prostate surgery) Longer time between bathroom visits Fewer “accidents” and leaking Drier underwear Preventing accidental passage of gas or stool Bulbocavernosus (BC) muscle Squeezes semen or urine out of the urethra Squeezes more blood into the end of the penis This is the main muscle used when performing Kegels Pubococcygeus (PC) muscle Plays a role in urination and bowel movements Forms a large part of the pelvic floor, supporting lower organs Contracts during orgasm Iliococcygeus (IC) muscle Forms part of the strength of the pelvic floor Pulls the anus back up after a bowel movement
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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.
Given that erectile dysfunction can be a sensitive marker of vascular pathology, it is also recommended that all patients with erectile dysfunction undergo an assessment of cardiovascular risk, including assessing risk factors for cardiovascular disease.
1. Identify the pelvic floor muscles: To find the pelvic floor muscles, you can either stop urination midstream or squeeze the muscles that stop you from passing gas.
Penile erection is a complex process in which the brain, nerves, muscles and blood vessels play a major role. The main causes of erectile dysfunction include psychological and health conditions, medications, trauma and lifestyle factors. What Can You Do for Severe Erectile Dysfunction? Medical Author: John P. Cunha, DO, FACOEP Medical Author: Pamela I. Ellsworth, MD Ask a Doctor Doctor’s Response What Can You Do for Severe Erectile Dysfunction? Topic Guide
An ultrasound examination of your penis and testicles may be performed. The principle of ultrasound is similar to the sonar used on submarines. Sound waves are reflected back when they contact relatively dense structures, such as fibrous tissue or blood vessel walls. These reflected sound waves are then converted into pictures of the internal structures being studied.
Vardenafil (Levitra) was the second oral medicine approved by the U.S. FDA for the treatment of erectile dysfunction. Like sildenafil (Viagra), vardenafil (Levitra) inhibits PDE5, which destroys cGMP (as discussed earlier). It is the only PDE 5 inhibitor that has a generic form available.
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When you talk about past surgeries, medicine you take, injuries, and lifestyle choices, your doctor can learn about diseases or other issues you might have that might lead to ED.
Aetna considers the following laboratory tests medically necessary for the diagnosis of erectile dysfunction: Biothesiometry (Note: Biothesiometry is considered an integral part of the comprehensive history and physical examination.) Blood glucose Complete blood count Creatinine Hepatic panel Lipid profile Prostate specific antigen Serum testosterone
Tools & Resources How an Erection Occurs Lifestyle Changes to Improve ED ED Myths and Facts Why Can't I Get an Erection? Erections: Use It or Lose It? Protect Your Erection: 11 Tips
Erectile dysfunction essentially refers to not being able to obtain or keep an erection and is often coupled with a reduced desire for sex. ED can have a range of causes, both physical and psychological. Certain risk factors for developing erectile dysfunction can include:
The various PDE5 inhibitors for the treatment of ED share several common side effects, including headache, flushing, nasal congestion, nausea, dyspepsia (stomach discomfort), and diarrhea. Differences exist in side effects of the different PDE5 inhibitors, and thus it is important to be familiar with the prescribing information of the PDE5 inhibitor you are prescribed.
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
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