If it looks more likely that a mental or emotional issue is the source of the problem, your doctor will ask you standard questions about your mental well-being. They help them check for depression, anxiety, and other common causes of erectile dysfunction.
As is true in so many medical conditions, lifestyle modifications, considered first-line therapy, can have a salutary effect in ED management, and men should be encouraged to make the necessary changes to the benefit of their sexual function and to their overall health as well. Despite the benefits of behaviour modification, men presenting with ED want the physician to help with measures that can have an immediate impact.
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If necessary, your doctor may refer you to a neurologist, a psychiatrist, an andrologist, or an endocrinologist for further tests.
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.
Once you feel comfortable with this feeling, you can incorporate this into a daily routine of performing pelvic floor exercises. It won't take long, and will soon feel like second nature.
If these fail to improve symptoms, second-line treatments include a topical cream (alprostadil, prostaglandin E1) which works by relaxing the blood vessels, improving blood supply to the penis, and so causing an erection. Alternatively, alprostadil (prostaglandin E1) may also be injected into the penis, to relax blood vessels
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."
Spinal cord traumaMultiple sclerosisDiabetic neuropathyPelvic surgery (prostate, bowel)Parkinson’s diseaseAlzheimer’s diseasePoor Blood Flow
Your free consultation with our doctors can ensure you find the right ED meds for your needs.
Knee fallouts. Start by lying down, knees bent and feet flat on the floor. Clench your lower pelvic muscles, and lower one knee sideways towards the floor. Repeat five times on each knee.Supine foot raises. These might not sound like a penis-related exercise, because they're not, but it helps with pelvic floor activation. Start in the knee fallout pose, then slowly raise one foot, keeping your torso still. Slowly lower, and repeat with the other leg.Pelvic curl. You might know these as bridges, and this one also starts with the same technique of lying on your back, legs hip-width apart. Squeeze and lift your buttocks in the air, keeping your hip width stable, tensing the pelvic floor muscles. Slowly lower, and repeat.Tips for maximising the sexual benefits of Kegel exercises
If this small selection of benefits from walking, running, or swimming, were not enough, then you can add improved erectile function among men who live a sedentary lifestyle, are overweight, suffer from atherosclerosis, or have high blood pressure.
Dr. Chirag Bhandari and the team of male sexual health experts treat all aspects of sexual dysfunction at the Institute of Andrology and Sexual Health with well-advanced technologies and methodologies.
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Your partner may suffer without saying much, so it is very important that you openly discuss the best way to cope with this condition.
While popularized in the media, Viagra is not the only erectile dysfunction drug. Other erectile dysfunction drugs include:
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The Prostate Cancer Prevention Trial was a landmark study by Thompson et al that prospectively assessed the time to developing CVD after the diagnosis of ED. There were 4247 men with no ED at study entry; 2420 developed incident ED (defined as the first report of ED of any grade) over 5 years. Those men that developed ED had a 1.45-fold higher probability of experiencing a CV event compared with men who did not develop ED.27