Psychosexual counselling, or sex therapy, is an appropriate recommendation especially for men who are experiencing discord with their partner especially if the conflict is related to the man’s ED. Counselling usually consists of 5–20 sessions with counsellor. It is our recommendation that referral doctors treating men with ED make a referral to a psychotherapist or sex therapist who is certified by AASECT (American Association of Sexuality Educators, Counselors and Therapists) of certified sexuality educator.43
Patients should continue testosterone therapy only if there is improvement in the symptoms of hypogonadism and should be monitored regularly. You will need periodic blood tests for testosterone levels and blood tests to monitor your blood count and PSA. Testosterone therapy has health risks, and thus doctors should closely monitor its use. Testosterone therapy can worsen sleep apnea and congestive heart failure.
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Penile prostheses are very effective, and most patients who have a penile prosthesis placed are satisfied with the prosthesis. Different than a normal erection, the prosthesis does not elongate, in fact, some men notice that after the prosthesis is placed their penis appears a little shorter.
Currently, there are no therapies that cure erectile dysfunction. However, a number of effective therapies are available that allow an individual to have an erection when desired. Depending on the cause of the erectile dysfunction, certain therapies may be more effective than others. Although there is limited data on lifestyle modification, intuitively, decreasing risk factors for erectile dysfunction may help prevent progression of disease.
An enlarged prostate, or benign prostatic hyperplasia, is a common condition affecting men over 50. While uncomfortable, BPH is not life threatening.
DiabetesHigh blood pressureHeart or thyroid conditionsClogged arteries (atherosclerosis)DepressionNervous system disorders, such as multiple sclerosis or Parkinson disease
Algorithm for evaluating and managing the patient with ED. CV, cardiovascular; CVD, cardiovascular disease; ED, erectile dysfunction.
Whilst erectile dysfunction may be related to both mental and physical disorders, in approximately 80% of cases, medical conditions may play a contributory role. It is therefore important for all patients experiencing erectile dysfunction to be reviewed by their GP.
Since endothelial dysfunction, CVD and ED are closely associated in epidemiological studies, the question for clinicians is whether to recommend the man presenting with ED undergo a cardiovascular (CV) evaluation. Clearly, based on numerous studies, ED can be considered at least a ‘marker’ for possible further vascular disease or CVD.15 In their report, Vlachopoulos and coworkers make the point that the man presenting with ED, the clinician, is offered an opportunity to attempt to improve the health of the man by addressing lifestyle modification, and consider further vascular evaluation owing to the clear relationship between endothelial dysfunction, ED and CVD.19
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.
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The following guide should help you learn how to use your blood test kit effectively, and give you some important information before you start. Taking the at-home test is easy and convenient. Just follow the simple steps below. Full instructions will be included in your test kit. You should set aside around 20 minutes to complete the whole process, especially if it’s your first time using a home blood test kit. It’s also important to stay well hydrated before taking a finger prick test to avoid any fainting or dizziness. We recommend having a normal evening meal the night before you complete the test, and then sips of water in the morning. This will ensure the most accurate results. If you think you might feel faint at the sight of blood, we advise taking the test in a comfortable, safe environment and asking someone to help you take your sample. Check the details on the labels are correct and place the transport containers, any used or unused lancets and completed forms in the prepaid coloured return envelope. Do not return the box. Remove the seal protection strip and close the coloured envelope. The sample can now be posted for free via any UK post box. In case of an urgent medical problem, please contact NHS 111 via 111.nhs.uk or by calling 111. NHS 111 is available 24 hours a day, 7 days a week.
There are various ways to treat erectile dysfunction. The treatment options range from home remedies to medications and therapies.
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.
Bullet point: The relationship between the risk factors for CVD and ED are intimately interwoven, one with the other. Clinicians need to factor this in when counselling the man with ED.
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