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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Many men have micro-plaque in their penises without realizing it. Contact sports, other athletic activity, and vigorous sex can cause the formation of micro-plaque. As a man accumulates micro-plaque over time, he can develop conditions like Peyronie’s disease, which can cause erectile dysfunction. Peyronie’s disease leads to painful curvature of the penis that can make sex impossible or unenjoyable. GAINSWave® therapy breaks down micro-plaque to treat or prevent Peyronie’s disease.
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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Pilates are another great group of erectile dysfunction exercises because hey challenge you to use your pelvic floor strength while moving. Prostate experts recommend men take advantage of pilates exercises for a wide range of benefits, including, among other things, improved erectile dysfunction. Lying on the floor with your knees bent and your arms at your side. You will see that, in this position, your lower back does not quite touch the ground. Next, flex your hips so that your back does make contact with the floor, so that your pelvic muscles rotate upward and contract. Hold this position for 3-5 seconds and then release, repeating for sets of 10-12. Pelvic Rock This erectile dysfunction exercises starts from the same position as the pelvic tilt. Next: Flatten your lower back against the groundAs you do this, position your legs slightly to one side. Make sure your legs are together, and your feet firmly on the floor as you do this.Return to your starting position and then lower your back again, this time moving your legs to the other side. The Zip and Hollow Place a mat or a blanket on the floor, lie down, and fully extend your legs on the ground.Place your hands on your lower abdomen with your thumbs pointing towards your belly button, your fingers towards your feet, and your hands on your pelvic bone Inhale and contract your abdominal muscles so that your navel drops down towards your spinal cord
So, what are the options for a man with ED? Well, there are a few. Usually the first option we (urologists and primary care doctors) will try are medications like Viagra, Cialis, Levitra, etc. All those medications function by bringing more blood flow to the penis. They are all pretty similar in their action, and if one of them works for you, chances are the others will, too. Some men will experience side effects, most common being facial flushing.
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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.
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
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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).
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Alternative treatments, such as nutritional supplements, herbal remedies, and acupuncture, are options to consider. However, evidence supporting many of these treatments is spare and due to the lack of FDA regulation the quality of any given supplement is unclear. In several high profile cases allegedly “natural” ED treatments were found to contain erection medications; as these medications have certain side effects and drug interactions (specifically PDE5I and nitrates) there is potential for very serious reactions even with “natural”, non-prescription medications.
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The study also concludes that training should be supervised, since the men involved all received professional help to adapt their exercise regimes into their daily lives and to keep their motivation up.
You’ll need to take these pills at least four times before deciding if they work for you or not. headache, facial flushing, upset stomach, back pain (Cialis), sensitivity to light, or blurry vision.
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Erectile dysfunction (ED), also known as impotence, is the most common sexual problem amongst men. ED is defined as the inability to achieve or sustain an erection for sexual intercourse. At least 25% of men over the age of 50 are diagnosed with ED. The numbers continue to increase as age increases. Young males can suffer from ED as well. Roughly 8-10% of men between 20-30 years old suffer from ED.
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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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The medical treatments for erectile dysfunction may provide satisfying erections, but they do not give you a long-term cure for your problem. If anything, they are band-aids for the symptoms but not a total solution. An erection that is rigid and satisfying for sexual activity, The ability to be spontaneous in their sex lives, The ability to predict and control how long the erection lasts and how often they can use it, and An erection that naturally occurs without devices or other impediments.
Sometimes, blood flow problems develop because of damage to the endothelium or penile smooth muscle – tissues in the penis that are important for normal erections. This damage may be the result of high blood pressure or smoking. It can also happen if a man has high cholesterol, triglyceride, or blood sugar levels.
Many supplements and alternative therapies are marketed to help men with ED. The U.S. Food and Drug Administration (FDA) warns that these products may contain potentially harmful drugs, contaminated formulations, or unknown dosages of pharmacologically active medications. They can also interact with other medications you take.
Erectile dysfunction, also known as impotence, is when a man is unable to get or maintain an erection.
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If your doctor thinks there’s a psychological cause, he might refer you to a mental health professional.
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You might need other tests to check for underlying issues or to further assess your condition. These might include the following:
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Pilates is a group of exercises designed to strengthen your body core. Although there are many potential exercises, here are two sample ones that focus on the pelvic floor. Lie down with your knees bent and your feet flat on the floor. Rest your arms at your side. Attempt to flex your hips to press your lower back into the ground. Hold this position for 3 to 5 seconds. Repeat the exercise slowly, 10 times, or as able. Be in the same position as for the pelvic tilt. Press your lower back on the floor. Slowly rotate one knee to one side while keeping your feet flat. Return your knees to the midline. Repeat this exercise slowly 10 times. Aerobics
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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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Other drugs may be used to treat erectile dysfunctions such as self-injections of medication at the base of the penis, hormone replacement for low testosterone, or suppositories.
If you would like some information about some of the latest treatments for erectile dysfunction, contact a GAINSWave® therapy provider today. We can give you all of the information you need about our therapy, which may be helpful for men who cannot take oral ED medication. We can recommend a doctor in your area who works with our treatment method. Dr. Ocampo is an expert physician specializing in anti-aging, hormone therapy, pathology and environmental medicine. He received his medical degree from Columbia State Medical School in Montreal, Canada. Dr. Ocampo’s comprehensive medical experience includes working as medical officer for the U.S. Public Health Service and C.D.C, National Institute for Occupational Health, medical director for the U.S. Public Health Service, and as a Principal Investigator for American Pharmaceutical Companies. What is GAINSWave? What to expect? How it works? Comparing treatments Frequently asked questions Medical advisory board Clinical research Find a provider near you → New York Texas Florida California Colorado Arizona Washington See all locations → Men’s Health Guide GW Magazine As Seen On For Providers Provider Resources For Affiliates For Press Partnership Facebook Instagram Twitter Youtube Linkedin Tiktok
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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Metabolism (breakdown) of vardenafil can be slowed by aging, liver disease, and concurrent use of certain medications (such as erythromycin [an antibiotic], ketoconazole [Nizoral, a medication for fungal/yeast infections], and protease inhibitors [medications used to treat AIDS]). Slowed breakdown allows vardenafil to accumulate in the body and potentially increase the risk for side effects. Therefore, in men over 65 years of age with liver disease, or who are also taking medication(s) that can slow the breakdown of vardenafil, the doctor will initiate vardenafil at low doses to avoid its accumulation. For example,
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Ultrasound (and ultrasonography) is imaging of the body used in the medical diagnosis and screening of diseases and conditions such as: TIAs, stroke, aneurysm's, heart valve irregularities, carotid artery disease, heart disease, gallstones, kidney stones, liver disease, diseases of the female reproductive, and diseases of the male reproductive organs.
Avanafil is the most recently FDA-approved PDE5 inhibitor to treat erectile dysfunction.
If you are looking for a urologist with many years of experience, contact Kasraeian Urology's office in Jacksonville, FL.
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.
A web-based project by the Society for Endocrinology that aims to give patients and the general public access to reliable online information on endocrine science. Privacy Disclaimer Browse Search Cookie settings Facebook Twitter Male Urology > Erectile Dysfunction Erectile dysfunction is a challenging and embarrassing problem for men.
Other alternative therapies that may help reduce stress, and in turn, ease ED symptoms, include:
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This is the preliminary exercise to master before attempting other kegel-based exercises. To do it: Lie down with your knees bent, your feet flat on the ground, and your arms stationary at your sidesAs you exhale, squeeze the pelvic floor muscles and count to three as you do so.Follow it up by inhaling and exhaling while you count out three seconds.Be careful to make sure you are identifying and targeting the right muscles (and not the abdomen or buttocks). Pelvic Floor Activation While Sitting Sit with your arms flat against your sides and your feet flat on the floor.Make sure your feet are roughly hip-width apart. Utilizing the same technique you used above, activate your pelvic floor muscles while counting out three seconds, and release them doing the same. Again it is imperative that you are targeting your pelvic floor muscles and not your abdomen and/or buttocks. Pelvic Floor Activation While Standing Upright You must stand straight with your arms resting at your sides, and again with your feet hip-width apart.Using the same 1-2-3 counting method activate and then relax your pelvic floor muscles, again while ensuring you are isolating the correct muscles. Pilates Exercises
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However, a number of side effects, as well as some potentially dangerous health conditions, can occur through regular use of PDE inhibitor oral medications. Minor side effects include: Interaction with nitrate drugs: where the PDE-5 and nitrate may cause a dangerous drop in blood pressure. Interaction with alpha blockers: which can cause problems with hypertension and dizziness. Interactions with other drugs and supplements: which can cause significant side effects, even with certain herbs, drugs, and supplements that are mild enough to be sold over the counter. Vision problems: where users may notice a blue-ish shade in their vision that is usually temporary, or a complete vision loss that lasts a long time. Hearing problems: where users may lose their hearing temporarily or for a long period of time. Erections that do not subside: where some users have an erection that lasts for four hours or more, requiring a doctor or hospital visit. New Treatments for ED
Quitting smoking, exercising regularly, losing excess weight, curtailing excessive alcohol consumption, controlling hypertension, and optimizing blood glucose levels in patients with diabetes are not only important for maintaining good health but also may improve or even prevent progression of erectile dysfunction. It is unclear if such lifestyle changes can reverse erectile dysfunction. However, lifestyle improvements may prevent progression of the erectile dysfunction. Some studies suggest that men who have made lifestyle improvements experience increased rates of success with oral medications.
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Metabolism (breakdown) of vardenafil can be slowed by aging, liver disease, and concurrent use of certain medications (such as erythromycin [an antibiotic], ketoconazole [Nizoral, a medication for fungal/yeast infections], and protease inhibitors [medications used to treat AIDS]). Slowed breakdown allows vardenafil to accumulate in the body and potentially increase the risk for side effects. Therefore, in men over 65 years of age with liver disease, or who are also taking medication(s) that can slow the breakdown of vardenafil, the doctor will initiate vardenafil at low doses to avoid its accumulation. For example,
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.
Having erection problems? What is erectile dysfunction (ED)? Learn about erectile dysfunction causes and treatments such as drugs...
Dr. Honig is an internationally recognized speaker on issues related to sexual health and conducts research into experimental treatments of erectile dysfunction. Our researchers are studying the links between erectile dysfunction and cardiovascular disease.
High blood sugar levels can damage the nerves that control sexual stimulation. They can also damage blood vessels that provide blood flow to the penis to achieve and maintain an erection.
Finally, there are NO-releasing polymers that are capable of delivering NO in a pharmacologically useful way. Such compounds include compounds that release NO upon being metabolised and compounds that release NO spontaneously in aqueous solution. Initial animal studies suggest that cavernosal injections of NO polymers can significantly improve erectile function.48
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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
Since the release of NO is dependent on sexual stimulation/arousal, PDE5 inhibitors only work if there is sexual stimulation. Simply taking the pill will not produce an erection. This is important because this is different than other treatments for erectile dysfunction.
In their extensive review, Bassil and coworkers summarise the benefits and risks, with benefits such as improvement of sexual function, bone density, muscle strength, cognition and overall improvement in quality of life. Among the risks that have been suggested include erythrocytosis, liver toxicity, worsening of sleep apnoea and cardiac function, possibly increasing symptoms of benign prostatic hyperplasia (BPH). They also note that although a possibility of stimulation of prostate cancer has been hypothesised, no scientific or clinical evidence exists to this possible risk.38
Erectile dysfunction is a condition that makes it difficult to achieve or maintain an erection that is firm enough for satisfactory sexual intercourse. There are many causes of erectile dysfunction...
Wave therapy is a non-invasive procedure that has been shown to improve certain types of erectile dysfunction. However, not all wave therapy machines are equal. Urologist Dr. John Smith explains how the use of waves can ...
Surgery provides the only true cure, but men typically want to explore other, less invasive options first.
Patients may take tadalafil as needed as with sildenafil, vardenafil, and avanafil or once a day. It is the only ED oral medication that patients can take on a daily basis.
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