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Folic acid, also known as folate, can decrease high levels of homocysteine. Homocysteine is an amino acid. At high concentrations, it can damage the lining of your blood vessels. High levels of homocysteine have been linked to heart disease and stroke.

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My friends know too. I broke it to them by calling myself a ‘robot man’. I was working on a building site at the time and everyone kept asking me to show them how it worked. It was like showing off a new gadget.
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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At Yale Medicine, we take a multidisciplinary approach to determine the underlying causes of your erectile dysfunction. We understand the relationship between erectile dysfunction and other health issues which inspires us to use an interdisciplinary approach to caring for our patients. We regularly collaborate with colleagues across different areas of medicine to help patients who we treat.
Several studies support the conclusion that following a Mediterranean-style diet can decrease the risk of E.D. The link between diet and improved erectile function was stronger in men under the age of 60, but it was found in all age groups (Bauer et al., 2020).

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GAINSWave therapy is effective and safe for men who cannot take oral ED medicine, such as those with heart disease, diabetes, or high blood pressure. GAINSWave can be used to treat Peyronie’s Disease, which Viagra and other oral ED drugs cannot. Here is How Those With Erectile Dysfunction Can Still Provide and Achieve Sexual Pleasure 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
Some men find that the treatment options listed above are not suitable for them due to medical conditions, lifestyles, personal preference, or the treatment option may be ineffective. In this case, a penile implant may be an appropriate option.

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Unstable angina (chest pain due to coronary artery disease that occurs at rest or with minimal physical exertion)Low blood pressure (a resting systolic blood pressure less than 90 mm Hg)Uncontrolled high blood pressure (greater than 170/110 mm Hg)Recent stroke or heart attack (within six months)Uncontrolled, potentially life-threatening abnormal heart rhythmsSevere liver diseaseSevere heart failure or disease of the heart valves (for example, aortic stenosis)Retinitis pigmentosa

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• The inability to achieve or maintain an erection sufficient for sexual intercourse •Symptoms include erection problems, decreased desire, and psychological distress •Treatments include medications, injection therapy, a vacuum erection device, and penile implant•Involves urology

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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.

    © NAM Publications 2022, all rights reserved. NAM is not responsible for the content of external websites.
    What is Erectile Dysfunction or Impotence?Erectile dysfunction (ED) or impotence is an erection problem of men. A man is not able to get or maintain a proper erection that is hard enough to have intercourse with a woman.

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    Evaluation should include a breast examination, rectal examination of the prostate, and a PSA level (prostate specific antigen) blood test. Patients who have breast and prostate cancers should not use testosterone.

    How can one tell the difference between ED that is psychological or stress-related, and ED that is a heart disease risk? Dr. Walker said he can usually tell from an initial conversation.
    A plastic cylinder, in which the individual places his penisA pump, which draws air out of the cylinderAn elastic band, which is placed around the base of the penis, to maintain the erection after the cylinder is removed and during intercourse by preventing blood from flowing back into the body (see figure 2).The vacuum device may be operated by hand or be battery operated.

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    What causes ED? There are many causes of impotence both medical and psychological. Often, age is a predominant factor in erectile dysfunction; however, your chronological age is not solely responsible for ED’s development. Men over the age of 40 typically experience ED as the result of inadequate blood flow to the penis, most often due to the narrowing of blood vessels. This can arise due to many causes including:

    Men with new onset ED and no signs or symptoms of CVD are at increased risk for experiencing a CV event in the subsequent 3–5 years.24
    Yes, there is a blood test to diagnose this disease. The blood is tested for glucose, and if it is greater than 125 fasting, or more than 200 when randomly tested, the diagnosis is diabetes. If the fasting blood sugar is between 100-125, the person has a diagnosis of prediabetes.

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    “This is not an uncommon problem with other viral infections,” Berglund said. “It’s just that the scale of this viral infection and the severity of it have probably led to a higher incidence of vascular-related disease and vascular inflammatory disease than other viral infections.”

    The doctor will take the person’s complete medical history and look for the causes of erectile dysfunction. They will examine the penis and testicles to look for signs of injury and check the person’s nerves for sensation. Depending on the cause, they can recommend various treatment options. Every treatment carries some risks and benefits, which will be explained by the doctor.
    The doctor will perform a physical exam, including examination of the genitals and a digital rectal examination (the doctor inserts a gloved and lubricated finger into the person's rectum) to check for prostate abnormalities. The doctor will also examine your breasts and thyroid gland. The doctor should check your blood pressure and evaluate your blood circulation by checking the pulses in your legs.

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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.

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American Urological Association website. What is erectile dysfunction? www.urologyhealth.org/urologic-conditions/erectile-dysfunction(ed). Updated June 2018. Accessed October 15, 2019.

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When sexually stimulated/aroused, the nerves supplying the penis release a chemical, nitric oxide (NO). Nitric oxide is important because it stimulates the production of a chemical called cyclic guanosine monophosphate (cGMP). cGMP causes the muscle in arteries of the penis to relax and increase blood flow into the penis. NO is broken down in the body by phosphodiesterase enzymes. PDE5 inhibitors thus prevent the breakdown of NO and thus promote increased blood flow into the penis.

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