Aetna considers Xiaflex as experimental and investigational for all other indications except for Dupuytren's contracture, see CPB 0800 - Dupuytren's Contracture Treatments.
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You’re taking the first important step by researching ED online. But every man’s situation is unique, and a specialist is the best way for you to be diagnosed accurately.
Erectile dysfunction (ED) happens when a man has ongoing problems getting and keeping an erection. Without treatment, ED can make sex difficult. The problem is reported by 1 in 5 men, and that number gets bigger with age.
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Your doctor will do a physical exam and ask you questions about your symptoms. He or she may do a blood or urine test. Your doctor may consider other tests to rule out other conditions.
It is a myth to assume that erection dysfunction is inevitable while aging. The major reason why anyone suffers from erection problems is uneven or improper blood flow in the penis.
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Aspartate Aminotransferase (AST or SGOT) an enzyme found in skeletal and heart muscle, liver and other organs. Abnormalities may represent liver disease.
The pathogenesis of organic ED is related to dysfunction of the endothelium. Endothelial cells can become injured through a variety of mechanisms, most of which cause oxidative stress on the tissues. Many of these causes of oxidative stress are related to lifestyle issues which lead to hypertension, diabetes and dyslipidaemia (figure 1). Endothelial cell dysfunction results in reduction of endothelium-dependent vasorelaxation as well as increased adhesion of leukocytes to the endothelium. Endothelial cell injury then leads to a variety of sequelae, including ED, other types of vasoconstriction, atherosclerosis and thrombus formation.18
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to reconstruct arteries in order to increase the flow of blood to the penis; andto block veins that drain blood from the penis (currently not recommended).Currently, placement of a penile prosthesis is the most common surgical procedure performed for erectile dysfunction. Penile prosthesis placement is typically reserved for men who have tried and failed (either from efficacy or tolerability) or have contraindications to other forms of therapy including PDE5 inhibitors, intraurethral alprostadil, and injection therapy.Penile prosthesis
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Exercises should not cause any pain whatsoever. If you do experience pain, stop the exercises immediately, and seek medical help.
Male infertility is caused by abnormal sperm production, blockage of sperm delivery or low sperm production. Treatments are available that work.
Erectile dysfunction affects almost one in every ten men at some point in their lives. So, it is not surprising that many men, and their partners, are asking if diet and exercise can affect erectile dysfunction. Researchers have been evaluating the best foods and diets to support erectile function as well as exercises that may help.
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Low self-esteemStressAnxietyRelationship issuesA lack of intimacyAn unfulfilling sex lifeInability to get your partner pregnant
ED may be a side effect of medication, including certain blood pressure drugs and antidepressants. Talk to your doctor if you think a prescription or over-the-counter drug may be causing erectile problems. But never stop taking any medicine before you discuss it with your doctor.
Objective To conduct a systematic review and meta-analysis evaluating the effects of physical activity modalities and exercise on erectile function in erectile dysfunction trials.
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It is estimated that ED occurs in 10% of healthy men without any apparent physical cause. This is known as idiopathic ED. the blood supply to the penis, hormonal abnormalities, interruption of normal nerve supply, certain medications, psychogenic factors weak or tight pelvic floor muscles.
It may come as no surprise that many men are embarrassed to come forward for treatment and may also suffer from low self-esteem and depression and experience difficulties in establishing and maintaining a relationship.
Khera M, Snyder PJ, Martin KA. Treatment of male sexual dysfunction. UpToDate. 2019. Accessed at https://www.uptodate.com/contents/treatment-of-male-sexual-dysfunction on January 31, 2020.
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Erectile dysfunction (ED) can occur at any age and can severely impact on the quality of life of men and their partners.
Avanafil shares the common PDE5 inhibitor side effects, contraindications, and cautions. No changes in dose are need for men with mild or moderate kidney disease. Individuals with severe kidney disease, severe liver disease, or those on kidney dialysis should not use avanafil.
This section lists the different tests your doctor may need to assess your situation. It offers general information about the diagnosis of ED. Keep in mind that situations can vary in different countries.
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A general physical examination will be performed to assess the development of your male sexual characteristics and to detect any abnormality of your penis or testicles. Your blood pressure, height and weight will normally be measured as part of this examination.
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• Medications, most commonly blood pressure medications (especially beta-blockers or thizides), anti-depressants (such as SSRI), anti-androgens, and a variety of other medications
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Not only physical activity but erection dysfunction can also be solved by taking a natural food diet.
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Rarely, a doctor may perform an angiogram (injecting a dye into the arteries that supply the penis and taking X-rays to look for areas of narrowing of the arteries) in cases in which possible vascular surgery could be beneficial.
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When 3724 men were questioned about their dietary habits, men who reported a higher caffeine intake were less likely to report E.D. However, this study was based on self-reported data and was not a prospective study (Lopez et al., 2015). Caffeine is a vasoconstrictor, which means that it can reduce blood flow into the penis. Further study is needed to determine whether caffeine improves or worsens E.D. symptoms.
Are you taking any medicines, including over-the counter medicines and supplements?Do you drink, smoke, or use recreational drugs?What is your state of mind? Are you stressed, depressed, or anxious?Are you having relationship problems?
Get the most from your doctor’s visit Cancer survivorship An improved approach to prostate cancer Anxiety and Depression Sexual health European Code Against Cancer PRESS RELEASE: Alarmingly Low Awareness of Urology Across Europe
We talked to five health care providers about what might put men at higher risk for COVID-19 and what they need to do about it. Men's Health Antidepressants and Sexual Side Effects: 5 Things Men Should Know
Kasraeian Urology introduced this new ED treatment in 2021 for their patients in the Jacksonville, FL area.
Risk exposure is important to consider in the PDE5 inhibitors. Cardiovascular diseases may be a contraindication to treatment, as severely impaired patients may run the risk of a cardiac complication related to vigorous sexual activity. Likewise, patients actively taking nitrates, including nitroglycerine and other agents, are contraindicated from receiving prescriptions for PDE5 inhibitor. Relative contraindications to the use of PDE5 inhibitor include alpha-adrenergic antagonists. Visual disturbances can be seen with sildenafil (blue haze to the visual field) as a result of inhibition of the PDE6 enzyme.
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Tests for evaluation of pituitary dysfunction (e.g., measurement of luteinizing hormone, follicle-stimulating hormone, and prolactin levels) if serum testosterone level is below normal
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!
Surgery, including treatments for prostate cancer, bladder cancer, or BPH, can sometimes damage nerves and blood vessels near your penis. If the nerve damage is permanent, you’ll need treatment to get an erection. But sometimes surgery causes temporary ED that gets better on its own after 6 to 18 months.
If you have a regular sexual partner, your doctor may ask to talk to the two of you together. This can help them learn more about your relationship and how it might affect your ability to get and keep erections.
Taking a home blood test properly is the key to getting accurate blood test results. To ensure your health check-up goes...
The link between underlying chronic disease and erectile dysfunction is most striking with diabetes. Approximately half of the men with diabetes experience erectile dysfunction. Nevertheless, good blood sugar control can minimize this risk.
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If your doctor rules out other causes, he or she may prescribe Sildenafil (brand name: Viagra), tadalfil (brand name Cialis), and vardenafil (brand name Levitra). These medicines are taken by mouth to help you maintain an erection.
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Many people with ED are also prescribed oral medications to help them get and maintain an erection. Injectable or suppository use of alprostadil can also help some people. Testosterone therapy may be another option.
Many men report disappointment, fear, and distress when they have trouble with erections. They report they feel that something important is missing. Men may report a general unhappiness with life and depression when they have problems with erections. These feelings are a natural part of coping with erection problems. And most men, if they are able find effective treatments to help with their erections, will start to feel better. If these feelings are severe or persist, most men find it very helpful to see a mental health professional who specializes in sexual issues or a psychiatrist who can help address these feelings.
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Expect your doctor to ask questions about your overall health, check your heart and blood pressure, and gather information about your erectile dysfunction. They may also draw blood for lab tests or refer you to an urologist.
Energy wave therapy is a safe and effective treatment. Gentle high frequency, low-intensity sound waves are delivered to the penile tissue through a special treatment wand to stimulate the erectile tissue and improve blood flow in the penis so men can achieve natural, spontaneous erections. The application of energy waves triggers revascularization, a process in which new blood vessels form. The formation of new blood vessels, coupled with the restoration of blood flow in the penis, help restore erectile function in men with ED.
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To avoid ED problems before they start, regular exercise is essential. Find out what you need to add to your routine.
and men: A consensus statement from the fourth international consultation on sexual Our Doctors on the Radio When to Seek Treatment for Erectile Dysfunction: Jim Hotaling, MD, ESPN 700 Video: Erectile Dysfunction Explained, Past Seminar Hear From Our Patients Gene Miluk
A problem in a person’s mental health is one of the most common contributing factors of erectile dysfunction.
An erection problem is usually not "all in your head." In fact, most erection problems have a physical cause. Below are some common physical causes.
Picture of erection-measuring snap gauge. A number of devices have been developed to determine if an erection occurs during sleep. This snap gauge is fastened around the penis but opens when an erection occurs.
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According to Professor Bente Klarlund Pedersen from the University of Copenhagen and Ellids Kristensen, doctor and research scientist at the Sexological Clinic in Copenhagen, these conclusions are supported by known mechanisms that can explain the link to erectile dysfunction: Physical activity makes the blood vessels more elastic, allowing more blood to flow to the sex organs. Physical activity stimulates the body’s production of nitrogen oxide, allowing the blood vessels to expand. This is essentially just what the popular medicine, Viagra, does.
Medication therapy is effective, especially in older men. Additional treatment may include self-injected medication, vacuum erection devices, or urethral suppositories. Surgical interventions include vascular reconstruction for improved penile blood flow. Penile implants are considered for some cases.
In patients with low testosterone, testosterone treatment can improve libido and erectile dysfunction, but many men still may need additional oral medications such as sildenafil, vardenafil, or tadalafil. Some studies suggest that men with ED and low testosterone may respond better to PDE5 inhibitors when given testosterone therapy; however, this is controversial.
Total Cholesterol/HDL Ratio calculated by dividing the total cholesterol by the HDL cholesterol. This is the ratio used by physicians in determining your relative risk for developing cardiovascular disease. Thyroid Panel with Thyroid-Stimulating Hormone (TSH) - Thyroid function is critical to your metabolism and affects your energy level, weight control, heart rate, and more. The thyroid-stimulating hormone is produced in the pituitary gland and stimulates the production of thyroid hormones. The TSH helps to identify an overactive or underachieve thyroid state. This comprehensive evaluation of your thyroid hormone levels includes: T-3 Uptake, T4, T7, and Thyroid-Stimulating Hormone (TSH)
Zhou ES, Bober SL. Sexual problems. In DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2019:2220-2229.
A doctor can help decide what medication(s) may be the best for the patient. This is an important step to do so the doctor can help choose the best and safest drug(s) and other treatments so that men with other medical problems can get individualized care appropriate for their medical conditions. Read Doctor's View Readers Comments 12 Share Your Story
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While oral medications are a common first step for therapy, they only tend to work in about 50 percent of men with diabetes. Diabetic men are more likely to move on to other treatment options, such as the pump, penile injection therapy, and penile implants. However, the penile implant has the highest satisfaction rate of all treatment options.
L-citrulline can be converted to L-arginine in the body. L-arginine widens blood vessels, increasing blood flow.
Arizona Institute of Urology Arizona Urology Specialists Chesapeake Urology Tennessee Urology Urological Associates of Southern Arizona United Urology Group
Men being treated for prostate cancer with treatments such as radical prostatectomy, radiation therapy or the use of Lutenizing hormone-releasing hormone (LHRH) agonists and antagonists can expect that ED may accompany these treatments.12
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.
Not only this but under the guidance of the best sexologist in India and a team of the best sexual health experts, we offer Special Relationship Counselling Sessions and Couple Therapies to treat all the psychological causes of ED.
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