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The diagnosis of erectile dysfunction is made clinically, based on a patient’s symptoms. It therefore is important for patients to be evaluated by their GP in the first instance. At this appointment, a full history will be taken from the patient regarding the current symptoms and other medical issues. Regular medications will also be reviewed to ensure that there are no contributing factors. Questions regarding alcohol intake and smoking will also be asked. A general physical examination will be performed by the GP, which may include checking blood pressure and an examination of the genitals. Examination of the vascular system and peripheral nervous system may also be undertaken.
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Studies show about 5 percent of men who are 40 years old have full-blown ED, and that percentage jumps to 15 percent for men who are 70.
A number of medical treatment options exist for erectile dysfunction include the following:
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A penile prosthesis is a pair of malleable (bendable) rods that are surgically inserted into the penis. It allows erections to happen by a mechanism of compressing on a special part by the device. Men disappointed with other treatments might be fit for penile prosthesis. Medical Author: Stephen W Leslie, MD, FACS Medical Editor: Bradley Fields Schwartz, DO, FACS Medical Editor: Mary L Windle, PharmD Medical Editor: Martin I Resnick, MD What to Expect During Your Doctor Visit Sexual, Medical, and Psychosocial History to Diagnose Erectile Dysfunction Physical Examination to Diagnose Erectile Dysfunction Laboratory Testing to Diagnose Erectile Dysfunction Imaging Studies to Diagnose Erectile Dysfunction Further Testing to Diagnose Erectile Dysfunction Diagnostic Testing Results Diagnosing Erectile Dysfunction Pictures Diagnosing Erectile Dysfunction Topic Guide Men are frequently reluctant to discuss their sexual problems, particularly erectile dysfunction or ED, and often need to be specifically asked.You can assist and initiate this process just by telling your doctor directly that erectile dysfunction is a problem for you. Opening a dialogue allows your doctor to begin the investigation or refer you to a consultant.Scheduling enough time with your doctor to conduct a full interview and physical examination is important.After performing a full interview, physical examination, and laboratory testing, your doctor can then discuss your particular situation, the most likely cause, and reasonable treatment options.
Alprostadil is an FDA-approved erectile dysfunction drug that can be injected directly into the penis to trigger an automatic erection. "Penile injection is the most effective type of ED treatment for men who can't take oral treatment," says Nelson Bennett, MD, a urologist at the Lahey Clinic in Burlington, Mass. In fact, it has an 85 percent success rate. Possible side effects include a burning sensation and priapism, an erection that lasts more than four hours and requires medical treatment.
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The recommended starting dose is 100 mg taken as early as 15 minutes prior to sexual activity, no more than once a day. The maximum dose is 200 mg. Avanafil may be taken with or without food. As with the other PDE5 inhibitors, sexual stimulation is necessary for avanafil to work.
Alongside your doctor-prescribed treatment, you might also want to consider other holistic ways to manage your health, which in turn, help with the ED experience. One of these options is through various forms of exercise.
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Erectile dysfunction is a frustrating condition where your penis cannot get or maintain an erection firm enough for sex. There is no specific treatment to reverse damage to blood vessels caused by diabetes, there are several options to help you have erections.
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Mechanical malfunction is another risk of the prosthesis. However, advancements including lock-out valves and special covering over areas of the tubing have decreased the risk of mechanical malfunction.
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Despite the appeal of suppositories, their effectiveness is relatively poor and overall patient satisfaction is relatively low.
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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.
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If you’re wondering about these tests, please don’t be concerned. This testing is covered under OHIP at certified labs.
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Erectile Dysfunction Guidebook: The Complete Sexual Health Solution to Identifying, Working on and Curing ED and Impotence: Natural Remedies, ... Diet and More (The Sexual Help Project)
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Picture of device used to measure penile nerve sensation. The presence of normal skin sensation adequate to produce an erection is measured with this device.
The GAINSWave® therapy provides a non-invasive means of dealing with ED. It is already being used in the United States, which is an advantage over the other new treatments we discussed.
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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Your hormonal status for testosterone (the male hormone) is evaluated, particularly if one of your symptoms is low sexual desire (low libido).Blood tests for testosterone should ideally be taken early in the morning because that is when levels are usually at their highest.Blood may also be tested for other hormones that can affect sexual function (eg, luteinizing hormone, prolactin).Your blood may be checked for glucose (sugar), cholesterol, thyroid function, triglycerides, and prostate specific antigen (PSA).A urinalysis looking for blood cells, protein, and glucose (sugar) may also be done.
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Side effects of intraurethral alprostadil include pain in the penis and sometimes in the testicles, mild urethral bleeding, dizziness, and vaginal itching in the sex partner. Patients rarely report syncopal (fainting) episodes with initial use, and thus the first trial of this medication should be performed in the physician's office.
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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
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“Kegel exercises for men: understand the benefits.” Mayo Clinic. Retrieved from: http://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074
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The link between chronic disease and ED is most striking for diabetes. Men with diabetes are two to three times more likely to have erectile dysfunction. And it could start 10 to 15 years earlier. But blood sugar control can lower this risk. Any condition that affects the way blood flows through your body could lead to ED. This includes cardiovascular disease, atherosclerosis (hardening of the arteries), kidney disease, and multiple sclerosis.
Erectile dysfunction is an inability to maintain an erection. The fastest way to cure erectile dysfunction is to attend to heart and vascular health, psychological health and to use other treatments.
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This penile tumescence monitor is placed on the penis. It is connected to a monitor that records a continuous graph depicting the force and duration of erections that occur during sleep. The monitor is strapped to the leg. The nocturnal penile tumescence or NPT test is conducted on several nights to obtain an accurate indication of erections that normally occur during sleep. Click to view larger image.
American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Male Sexual Dysfunction: A couple’s problem – 2003. Update Endocr Pract. 2003;9(No. 1). Accessed at https://www.aace.com/sites/default/files/2019-06/sexdysguid.pdf on January 31, 2020.
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Pelvic Floor Rehabilitation(PFR) is a therapy to reinforce your pelvic floor muscles which play a significant role in sustaining an erection. The experienced pelvic floor therapist, with the help of specialized equipment, ensures stronger muscles especially ischiocavernosus and bulbospongiosus. These muscles lead to stronger erections and better ejaculations with the increase in Ejaculatory time.
Studies have shown that for men with stress-related ED, when the partner is involved in the therapy, the problem is resolved 50%–70% of the time. When the man must go through counselling alone, the results are less successful. Psychosexual counselling is unlikely to be effective if a man drops out of treatment after just one or two sessions.44
There are two main causes of ED: physical and psychological. Most doctors agree that the majority of cases are physical but it's also clear that many men with ED also quickly start to feel anxious, stressed or depressed. These feelings can easily make the symptoms of ED worse. Relationship conflicts Stress and anxiety Depression (90% of men affected by depression also have complete or moderate ED) Unresolved sexual orientation Sexual boredom
Some men with early-stage prostate cancer have a choice between radiation and surgery to treat their cancer. When looking at how men’s erections are affected by prostate cancer treatment, there does not seem to be much long-term difference between the two. Men who have had radiation may see a general decrease in the firmness of their erections over time (up to several years after radiation). In contrast, after surgery most men have erection problems right away and then have a chance to recover erections in the first 2 years following the surgery. About 4 years after either treatment, the percentage of men reporting ED is about the same. Treatments can often help these men get their erections back whether they’ve had surgery or radiation.
Picture of urethral suppository. The Medicated Urethral System for Erections (MUSE) is a small suppository that is placed into the urethra with this device. The suppository is very small, and users often question whether anything is in the device.
Other risks of penile prosthesis include over- or undersizing of the prosthesis, which can cause an abnormal appearance to the erect penis or reservoir or pump migration into abnormal locations.
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Pills are an easy way to treat ED, but you might get a stronger erection from injecting medication directly into your penis. That’s because these drugs widen your blood vessels so your penis fills with blood. Another option: A medicated pellet you put into the opening at the end of your penis. The pellet can trigger an erection within 10 minutes.
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Traditional treatments for erectile dysfunction have centered on medications given orally. The brand names of these drugs include Cialis, Levitra, Stendra, Staxyn, and Viagra®.
If you have a neurological disorder or spinal cord injury and other erectile dysfunction treatments aren’t effective, two types of surgical implants could offer solutions to your ED. “An implantable pump can be used to manually create an erection by pumping fluid into cylinders placed inside the penis,” explains Feloney. “The other option is a malleable prosthesis that works like a gooseneck lamp to direct the penis into position for intercourse." Risks for these ED treatments include infection and mechanical breakdown.
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.
Compared to aerobic exercise like jumping on a treadmill, performing pelvic floor muscle exercises are super discreet. In fact, the pelvic floor muscles aren't visible — but you'll feel them!
ED can have physical or psychological causes, and occasionally a combination of both. The causes of ED may include: Health conditions: Diabetes, heart disease, obesity, high cholesterol and other conditions can affect blood flow to the penis and contribute to ED. Medications: Drugs prescribed for high blood pressure, heart disease, depression and other mental health problems can cause erectile dysfunction. Lifestyle: Smoking, excessive drinking, drug use and diet can also contribute to ED. Psychological conditions: Stress, anxiety, depression and relationship problems can all cause or worsen ED.
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Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633-641. PMID: 29746858 pubmed.ncbi.nlm.nih.gov/29746858. Version Info
A quick web search will reveal dozens of "dietary supplements" that claim to treat ED. But the FDA warns that many of these are not what they seem. These pills often contain prescription drugs not listed on the label, including the active ingredient in sildenafil (Viagra). This can cause problems if the medication interacts with something else you take.
Have you been able to get and keep erections in the past?Are you having trouble getting an erection or keeping erections?Do you have erections during sleep or in the morning?How long have you had trouble with erections?
There are a number of significant benefits to energy wave therapy. For men who are candidates for this treatment option, a future without erectile dysfunction is perhaps the biggest benefit. The restoration of a man’s vitality and spontaneous active sex life are also major benefits of this exciting new treatment.
Eat a healthy dietStop smokingLose excess weightExercise dailyMaintain normal blood pressure and cholesterol levelsGet help for alcohol or drug addiction problemsLearn about the side effects of medicines you takeConsider couples counseling if you and your partner are having trouble communicating
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VEDs provide a simple way of obtaining an erection for 30-45 minutes by sucking blood into the penis and holding it in place with a constriction (pictured). Ejaculation may be restricted by the ring but this technique is simple, safe and has no known side-effects. Unfortunately, most patients have to purchase VEDs themselves.
Sildenafil is available as oral tablets at doses of 25 mg, 50 mg, and 100 mg. Patients should take sildenafil approximately one hour before sexual activity. In some men, the onset of action of the drug may be as early as 11-20 minutes. It's best for men to take sildenafil on an empty stomach for best results since absorption and effectiveness of sildenafil can be diminished if it is taken shortly after a meal, particularly a meal that is high in fat. Sildenafil and the other PDE5 inhibitors don't cause an immediate erection. Sexual stimulation is necessary for these medications to work.
The causes of primary premature ejaculation are often psychological, such as having a traumatic sexual experience at an early age.
The symptoms of Erectile Dysfunction are diagnosed through detailed medical, sexual, and social history. There may be a very low sex drive in men. Some laboratory evaluations are done to screen the unrecognized systemic diseases and test the hormonal causes if any, like change in testosterone and prolactin level. If reports show low testosterone level: The sexologist in Jaipur we check follicle-stimulating hormone and then prescribe
ED is sometimes the cause and sometimes the result of unsatisfying or dysfunctional relationships. It is often difficult to find out which started first.
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“We knew that physical activity reduces the risk of erectile dysfunction, but here we see clearly that it could also be a form of treatment. This makes sense because when you create better flow through the blood vessels, you are actually treating the very cause of erectile dysfunction. So I think that this study could very well lead to a treatment,” she says.
Removal of a penile implant is considered medically necessary for infected prosthesis, intractable pain, mechanical failure, or urinary obstruction.
The tests for sexual problems like Erectile Dysfunction include a blood test, urine test, and self-evaluation tests that can help you in analyzing and determining the state and extent of ED in your body. By taking the ED test yourself, you can enhance the chances of treating ED with better treatments and methods.
In a study of 120 men with varying degrees of E.D., the men with the most severe E.D. had the lowest folic acid levels, despite having normal testosterone levels (Karabakan et al., 2015). Folic acid is abundant in many fruits and vegetables.
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.)
The National Institute of Diabetes and Digestive and Kidney Diseases: “Erectile Dysfunction.”
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