It is important for clinicians prescribing these drugs to make the patient aware of the action of the drugs especially the fact that they do not result in an immediate erection, and that they do not cause an erection without sexual stimulation. There is frequently a great expectation when men begin using these drugs and it is wise to temper their enthusiasm and explain they do not work immediately, and may not work every time, but also let the patient know that if these drugs do not work, there are other options.
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ED can have a negative effect on quality of life. Quality of life involves both physical and psychological health. It is important not only to feel healthy but also to feel free of the psychological discomfort of living with ED. Another important issue is that different people can experience the same symptoms differently. Therefore both your personal experience and your quality of life should not be underestimated: they are as important as diagnostic tests and treatment results.
When psychological factors are believed to be the principle cause of ED– particularly in men who are experiencing anxiety or depression – psychological counseling is mandatory. Consultation with a mental health professional with expertise in sexuality should be considered in all cases as this consultation is seldom harmful and the majority of patients will have some psychogenic or relational component to their sexual symptoms.
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Kasraeian Urology introduced this new ED treatment in 2021 for their patients in the Jacksonville, FL area.
All four of the PDE5 inhibitors (Viagra, Cialis, Levitra, and Stendra) are approved by the Food and Drug Administration for on-demand use for erectile dysfunction.
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Learn More About Treatment for Erectile Dysfunction: Medication, Alternative and Complementary Therapies, Surgery Options, and More
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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What are symptoms of low testosterone (low T)? Take this quiz to learn more about causes of low testosterone and how to treat it.
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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
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Depending on the symptoms elicited, further investigations including blood tests will be performed. These blood tests will include a check of testosterone (which is best checked first thing in the morning, preferably after fasting), as well checking other hormones, including thyroid function and blood sugar (or glycosylated haemoglobin, HbA1c, which may be used to check for diabetes).
Limit the intake of added salt, fat, and sugar which will help to reduce the risk of having erectile dysfunction. Increase the intake of dietary fiber, vitamin E, and lycopene-rich foods such as avocados, tomatoes, etc.
The EAU Annual Congress 2019 achieved the Patients Included™ status. Patients Included™ status is self-assessed. Read more.
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Monitoring erections that occur during sleep (nocturnal penile tumescence) can help you and your doctor to understand if the erectile dysfunction is due to psychological or physical causes. The nocturnal penile tumescence test is a study to evaluate erections at night. Normally men have three to five erections per eight hours of sleep. The test can be performed at home or in a sleep lab. The most accurate way to perform the test involves a special device that is connected to two rings. The rings are placed around the penis, one at the tip of the penis and the other at the bottom (base) of the penis. The device records how many erections occur, how long they last, and how rigid they are. The test is limited in that it does not assess the ability to penetrate.
Writing in the journal Physiotherapy, Mr Myers said 30 per cent of men suffer from premature ejaculation.
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Talk to your provider if your erection problems have to do with a fear of heart problems. Sexual intercourse is usually safe for men with heart problems.
National Comprehensive Cancer Network (NCCN). Clinical practice guidelines in oncology: Survivorship [Version 2.2019]. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf on January 31, 2020.
Blood levels of testosterone, prolactin, FSH (follicle-stimulating hormone), LH (luteinising hormone) and thyroid hormones will normally be measured.
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The Erectile Dysfunction Test Kit is a specialised blood test that checks your testosterone, sex hormone binding globulin (SHBG), free androgen index, and lipid profile (including cholesterol) because these biomarkers are particularly relevant when looking at the potential causes of ED. If you would prefer a more general health check up, the At-Home Health MOT or At-Home Health MOT (One-Off) would be a more appropriate choice for you. The At-Home Health MOT is a general health check up that measures a broader range of health indicators than the Erectile Dysfunction Test Kit. It’s a home blood test kit (just like the ED Test Kit) that can be used to give you a clearer insight into your health without needing to see a doctor in person. Like the ED Test Kit, it includes a free test result review from a clinician who can give you health and lifestyle advice based on the outcome of your blood test.
Both products belong to the same class of drugs and the way they act on the body is essentially the same. If you think the medicine you are using is too weak, contact us to discuss the change to your treatment plan. Our doctors will assess and decide if a higher dose of medicine may be appropriate.
The U.S. FDA (Food and Drug Administration) has a list of 29 OTC products that claim to treat erectile dysfunction. Patients should avoid these because many contain harmful ingredients. Other natural or herbal remedies such as DHEA, L-arginine, ginseng, and yohimbe are supplements that have been used but have not been proven safe and effective according to some researchers. Before using such compounds, individuals should consult their doctor. According to some experts, acupuncture does not effectively treat erectile dysfunction. Other home remedies for reducing ED symptoms include diet changes such as eating blueberries and citrus fruits and drinking red wine.
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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
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In some cases, more extensive exams might be necessary to see if you have other conditions that could be causing your ED symptoms.
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We don't currently post comments online but are always keen to hear your feedback. References Map of Medicine - Erectile Dysfunction Pathways NHS - Erectile Dysfunction British Society for Sexual Medicine - Management Guidelines fo Erectile Dysfunction Patient UK - Erectile Dysfunction
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Dr Gautam Banga, consultant and andrologist at the Sunrise Hospital New Delhi previously told indianexpress.com that in India, ED is a taboo because people don’t see it as a medical disorder but as sexual incompetence. “It does not happen because the man is not interested in or is incapable of having sex, but there are medical reasons like diabetes, high cholesterol, high blood pressure and ischemic heart disease (IHD), depression etc., that leads to ED,” he said.
If lifestyle changes and medications do not work, other treatments for ED include:
Research suggests that avid bikers are more likely to get ED than other athletes. Some bicycle seats put pressure on the perineum, an area between the anus and scrotum full of arteries and nerves vital to sexual arousal. If you bike for many hours each week, get a seat designed to protect this area.
An inflatable penile implant can be implemented in the case of erectile dysfunction, Peyronie’s disease, or other medical conditions in which a man can no longer maintain an erection or sexual function.
FDA: "Hidden Risks of Erectile Dysfunction 'Treatments' Sold Online," "FDA Approves Stendra for Erectile Dysfunction."
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Lifestyle choices can contribute to ED. Smoking, heavy drinking, and drug use disorder can damage the blood vessels and reduce blood flow to your penis. Being overweight and getting too little exercise also raise your odds. Studies show that men who exercise regularly have a lower risk of ED.
We are talking about pelvic floor muscle exercises for men. Within just three weeks of doing these exercises, which take less than ten minutes per session and can be done anywhere, you will start noticing a reversal in erectile dysfunction, and you will regain control over your penis so that you get to decide on your own, exactly when to ejaculate. All you need to do is learn to follow a series of precisely outlined instructions, and you will be free to perform these exercises as often as you want and condition your penis until it regains its maximum strength and then some.
Copyright @ 2022 IASH India: Institute of Andrology & Sexual Health India. All Rights Reserved.
Youtube: “Kegel Exercises for Men - Beginners Pelvic Floor Strengthening Guide.” Michelle Kenway.
Finally, penile implants or surgery to bypass penile artery damage in younger men with a history of severe pelvic trauma may be performed.
Simple lifestyle changes, such as smoking cessation, weight loss, and even modest but regular exercise very often improve ED symptoms. In mild cases of ED this change alone may be sufficient to resolve the issue. In more severe cases these changes may improve the efficacy of available medical options. In any case these changes are good for the heart and overall longevity/health so should be considered by all men with ED.
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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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3. Keep everything else relaxed. Make sure you aren't inadvertently tensing your glutes, abs or leg muscles — it's only the pelvic muscles we want to engage. And remember to breathe!
Tadalafil (Cialis) is the third oral medicine approved by the U.S. FDA for the treatment of erectile dysfunction. Like sildenafil (Viagra) and vardenafil (Levitra), tadalafil inhibits PDE5 (as described earlier). Unlike the other PDE 5 inhibitors, patients should take tadalafil once daily and is approved for the treatment of BPH (benign enlargement of the prostate).
Exercises are supposed to be good for a person but that’s not true. Too much exercise or exertion can cause serious aftereffects on a person’s body. Not only your body but your brain as well can get an adverse impact as well. Plank exercises for Erectile Dysfunction taken in excess can harm your body.
Besides PDE5 inhibitors and among second-line therapies are VCDs which are clear plastic chambers placed over the penis, tightened against the lower abdomen with a mechanism to create a vacuum inside the chamber. This directs blood into the penis. If an adequate erection occurs inside the chamber, the patient slips a small constriction band off the end of the VCD and onto the base of the penis. An erection beyond 30 min is not recommended. These devices can be a bit cumbersome, but are very safe.40
Nearly every primary care physician, internist and geriatrician will be treating men with ED.
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Dr. Chirag Bhandari and a team of sexual health experts have now made it possible to cure ED with only medication. Dr. Chirag and other experts are making every possible effort to make people aware of sexual problems in men like Erectile dysfunction and its early signs to alert the young generation from getting into big trouble too soon.
Some men may be able to gain an erection by self-injecting drugs into the penis, causing it to become engorged with blood. The advantage of injection therapy that it can easily be self-administered and in most patients leads to a strong erection when given the right dose. Potential side effects of injection therapy include: fibrosis (scarring) and long-lasting painful erections. Injections are shown to have a long-term dropout rate of about 37% – 76%. Reasons for dropping out of drug therapy include: Desire for a permanent treatment alternative Inadequate response Return of spontaneous erections Fear of needles Concern over side effects
Erectile dysfunction is the ongoing inability to achieve or maintain an erect penis, and men experience these erectile dysfunction symptoms:
The National Institute of Diabetes and Digestive and Kidney Diseases: “Erectile Dysfunction.”
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Penile re-vascularization is considered experimental and investigational for other indications because its effectiveness for indications other than the one listed above has not been established. Consistent with clinical guidelines of the American Urological Association, Aetna considers arterial reconstructive procedures, dorsal vein arterialization procedures, or penile venous occlusive surgery (e.g., venous ligation, dorsal vein ligation) in men with erectile dysfunction secondary to arteriosclerotic occlusive disease experimental and investigational because such procedures have not been proven to be effective.
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Your doctor may order laboratory tests to identify metabolic disorders underlying the ED.
Erectile dysfunction can be treated at any age. Treatment depends on your overall health and the underlying cause of the problem.
Blood in the semen (haematospermia) Blood in the urine (haematuria) Erectile dysfunction (impotence) Fertility problems Incontinence of urine Kidney stones Male menopause (androgen deficiency in the ageing male) Premature ejaculation Prostate symptoms (bladder outlet obstruction) Raised PSA Testicle missing Testicular lump Tight foreskin (phimosis) Urinary infection (adult) Urinary infection (child)
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To diagnose ED, the doctor will ask about your symptoms and medical history. They’ll do a complete physical exam to look for signs like poor circulation or nerve trouble. They’ll also check for problems in your genital area that could cause trouble with erections.
DiabetesHigh blood pressureHeart or thyroid conditionsClogged arteries (atherosclerosis)DepressionNervous system disorders, such as multiple sclerosis or Parkinson disease
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Alprostadil should not be used in men with urethral stricture (scarring and narrowing of the tube that urine and the ejaculate pass through), balanitis (inflammation/infection of the glans [tip] of the penis, severe hypospadias (a condition where the opening of the urethra is not at the tip of the penis, rather on the underside of the penis), penile curvature (abnormal bend to the penis), and urethritis (inflammation/infection of the urethra).
A common misconception is that erectile dysfunction only occurs in older men. While that is mostly true, it doesn’t mean that ED isn’t common among younger men. Lifestyle choices among younger men has led to a sharp increase in the number of young men suffering from erectile dysfunction. A 2013 study published by the Journal of Sexual Medicine found that 1 in every 4 men who were newly diagnosed with ED were below the age of 40, and roughly 50% of them were suffering from severe ED. Causes of Erectile Dysfunction Obesity Fatigue Excessive smokingAlcoholism Substance abuse Diabetes Prostate cancer Cardiovascular disease Treatment for Erectile Dysfunction
If you are experiencing symptoms of erectile dysfunction, know that you aren’t alone. ED is common, especially as people age, and it is treatable. Don’t let your self-esteem and sex life continue to suffer because you’re too embarrassed to talk to a doctor. MultiCare urologists have the experience, knowledge and compassion to ensure you get the correct diagnosis and a treatment that works for your lifestyle. Learn more about erectile dysfunction and the treatment options available at MultiCare from Jack Walter, MD, of MultiCare Urology of Tacoma.
Other physical activities that can help you in getting rid of erectile dysfunction are aerobic excerises, and yoga asanas. You can perform simple yoga exercises such as Dhanurasana, Paschimottanasana, Siddasana, Shavasana, etc (Also Read: Yoga poses and aerobic exercises for erectile dysfunction)
This book dives into a subject it may even be considered a taboo, so I believe the first step is admitting this problem is real, common and it can be tackled and solved. “Curing Erectile Dysfunction” by Jason Brown is a book that broadly and intelligibly covers a taboo topic.
“Erectile Dysfunction (ED).” UW Health. Retrieved from: http://www.uwhealth.org/urology/erectile-dysfunction-ed/20537
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