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Vardenafil is effective in men of all ages, different nationalities, and in men with such medical conditions as diabetes mellitus and erectile dysfunction after prostate surgery.

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The role of the endothelium in erectile function became clearer with the observation that the phosphodiesterase type 5 (PDE5) inhibitor, sildenafil, enhanced erectile function. Erection occurs with the release of nitric oxide (NO) from the vascular endothelial cells.17 The reduction in endothelial cell production of NO results in the negative impact on the smooth muscles in the corporal bodies and results in less relaxation of the smooth muscle cells with decrease in blood supply and resulting ED. A similar phenomenon is well known to impact the coronary arterial system resulting in CVD.
A man’s psychological state is clearly an essential consideration when addressing issues of sexual function. While ED that is purely psychological is not common, many men who experience difficulty with erections may develop anxiety or fear about being able to get an erection the next time they try. This anxiety may lead to a stress response involving activation of the sympathetic nervous system and release of adrenaline, which will tend to make it even more difficult to get an erection. Conflict with a partner (or the absence of a partner) will also tend to increase stress and potentially interfere with erectile function. .

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Unlike other treatments for erectile dysfunction, PDE5i medications requires sexual stimulation to function. Without stimulation, these medications will not provide any effect.
An ultrasound to examine the blood vessels in the penis and blood flowNocturnal penile tumescence (NPT) test to evaluate the quality of your nocturnal erectionsAn injection test during which medication is injected into your penis to stimulate an erection so that your doctor can see how long it lastsUrine tests to check for diabetes or other underlying health conditions

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Kegels or pelvic floor exercises are most suitable for erectile dysfunction. These exercises target the muscles which are at the bottom side of the pelvis. The muscle which gets targeted by this exercise is pubococcygeus. So, performing pelvic floor exercises will definitely strengthen the pubococcygeus. Thus, prove to be very effective in coping up with erectile dysfunction.
In general, there are three main pelvic floor muscles that are used when performing a kegel:

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Many factors can contribute to sexual dysfunction in older men, including physical and psychological conditions, comorbidities and the medications used to treat them. Aspects of an ageing man’s lifestyle and behaviour and androgen deficiency, most often decreasing testosterone levels, may affect sexual function as well. A study of men between the ages of 30 and 79 years showed that 24% had testosterone levels below 300 ng/dL and 5.6% had symptomatic androgen deficiency.2

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MedicineNet does not provide medical advice, diagnosis or treatment. See additional information. sexual health center/sexual health a-z list/erectile dysfunction ed impotence center /erectile dysfunction (ed, impotence) article Erectile Dysfunction (ED, Impotence) Medical Author: Pamela I. Ellsworth, MD Medical Editor: Melissa Conrad Stöppler, MD

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    Other research has shown Black men may be less likely to report symptoms of moderate to severe ED.

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    Picture of penile tourniquet. This is one of many types of constricting devices placed at the base of the penis to diminish blood outflow and improve the quality and duration of the erection. These may be used in conjunction with oral drugs, injection therapy, and with vacuum devices.

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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

    ED can be embarrassing to talk about. However, if it is affecting your relationship, you need to discuss it. Find tips for talking to your partner and getting successful treatment.
    Low testosterone is linked to ED. One of the only ways to know your testosterone level is by having a blood test to see...

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    As its name suggests, this exercise targets the muscles of the pelvis, strengthening them and increasing their range of motion as they’re rotated clockwise and anticlockwise. However, given that you have to be in a plank while doing this, your core power also improves. The abdominals, chest and back together help you maintain that position. The arms and shoulders are also toned. Go into a plank position. Place your palms firmly on the floor in line with your shoulders. Extend your legs at the back. Keep your elbows and knees straight. Bring your body in one straight line from head to toe. Swing your hips from side to side. Thrust your hips upwards and downwards. Rotate your hips. Repeat in a seamless motion. Cat and cow

    Journal of Sexual Medicine: “Prevalence and correlates of erectile dysfunction by race and ethnicity among men aged 40 or older in the United States: from the male attitudes regarding sexual health survey.
    If you’re older, there’s probably a physical reason for your ED. But the causes can be in your head, too. Experts say stress, depression, low self-esteem, and performance anxiety can short-circuit the process that leads to an erection. These factors can also make the problem worse if your ED stems from a physical problem.

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    An intimate relationship between two people is complex and involves many aspects. ED may affect or change your relationship with yourself and your partner. You may be embarrassed and feel guilty, making it difficult to talk to your partner about this issue. ED could have a direct impact on a committed relationship.

    The treatment of erectile dysfunction depends on the underlying cause. If an underlying physical cause is found (such as diabetes), treatments will be needed to manage these. Other treatments, such as cognitive behavioural therapy (CBT), may be offered for any related mental health disorders including anxiety and depression. Irrespective of the contributing causes, psychosexual counselling may be recommended to help with the effects of impotence on sexual relationships.
    ED that’s caused by psychological factors, hormone issues, or injuries to the penis can usually be effectively treated.

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If you have symptoms of ED, your doctor will probably start with a physical exam to check your overall health.

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Bullet point: Ageing and comorbidities as well as polypharmacy factor greatly influence the development of ED.

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Similar to injections, studies show that about half of men discontinue use of this treatment within six to eight months. Side effects can include pain, bleeding at the injection site, urethral pain or burning, low blood pressure, and dizziness.

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