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Exercise can help reverse some of the risk factors for E.D., such as being overweight or obese, having high blood pressure, being stressed, or having weak pelvic floor muscles.

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Plus, it’s notoriously difficult to assess sexuality simply by asking people to fill out a questionnaire. Men who have whopping amounts of sex (or at least report doing so) might also be more inclined to gloss over the details of their erection shortcomings.
Counseling. If stress, depression, or relationship problems contribute to your ED, talking to a counselor could help. .

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Exercise that results in losing weight, particularly around the waistline, can cut a man’s risk of ED. A man with a 32-inch waistline has only half the likelihood of erectile dysfunction as a man with a 42-inch waistline. Losing excess weight is one of many factors that can affect penile dysfunction.
It is important to distinguish between a normal decline of testosterone levels and hypogonadism.

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Men should be wary of advertising that pushes testosterone replacement therapy for "low T," an informal term for low testosterone that many doctors regard with skepticism. Testosterone levels decrease with aging and there is no scientific consensus on what testosterone levels constitute "low T". Furthermore, male hypogonadism is a condition that involves more than simply low testosterone levels.
If your doctor doesn't take your problem seriously, ask to be referred to a specialist. Don't let yourself be fobbed off with comments like "What do you expect at your age?"

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Erectile dysfunction (or impotence) is when you cannot get or keep an erection that enables you to have sex.

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    ©2022 WebMD, Inc. All rights reserved. eMedicineHealth does not provide medical advice, diagnosis or treatment. See Additional Information.

    Prostaglandin E1 (intraurethral alprostadil or MUSE) can be inserted in a pellet (suppository) form into the urethra to attain erections. It is available in four dosage strengths: 125 mcg, 250 mcg, 500 mcg, and 1,000 mcg. Most individuals need 500 mcg to 1,000 mcg for a satisfactory response.
    Moreover, there is no evidence to suggest that patients will maintain an exercise regime based solely on the recommendation of their doctor.

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    Currently, penile implants are the closest thing to a natural erection that we can do through through treatment. Implants are clearly the winner for overall satisfaction rates with around 95 percent satisfaction (compared to 50 percent for pills, 40 percent for injections, and 20 percent for vacuum devices). *McCabe MP, et al. (2016) Incidence and prevalence of sexual dysfunction in women

    Physicians make a diagnosis of erectile dysfunction in men who complain of troubles having a hard enough erection or a hard erection that does not last long enough. It is important as you talk with your doctor that you be candid in terms of when your troubles started, how bothersome your erectile dysfunction is, how severe it is, and discuss all your medical conditions along with all prescribed and nonprescribed medications that you are taking. Your doctor will ask several questions to determine if your symptoms are suggestive of erectile dysfunction and to assess its severity and possible causes. Your doctor will try to get information to answer the following questions:
    As men age, the amount of testosterone in their bodies gradually declines. Although a direct cause and effect relationship between testosterone deficiency and erectile dysfunction has not been proven, decreased testosterone levels in patients with erectile dysfunction have been observed in clinical settings.

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    Patients should start with a low dose and increase in small doses until the dose that results in a rigid enough erection for completion of sexual activity is achieved. If one injects and there is an inadequate response, one should not reinject another dose of the medication at that time, due to the risk of priapism.

    It would not be surprising if COVID-19 harmed male sexual health, said Dr. Emmanuele Jannini, professor of endocrinology and medical sexology at the University of Rome Tor Vergata, who has written extensively on the subject.
    Energy Wave Therapy is an exciting new, non-invasive approach to treating erectile dysfunction that uses low-frequency sound waves to increase blood flow to the penis to optimize erections, sensitivity, and sexual performance. With energy wave therapy men can achieve natural, spontaneous erections without ED medications.

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    Erectile Dysfunction can sometimes be the first sign of underlying health problems such as diabetes, high blood pressure or cardiovascular disease. The most common precipitating factor for such a problem in younger men includes stress and anxiety, and this can have an impact on their relationships.

    Erectile dysfunction is common and becomes increasingly more so with age. Complete impotence occurs in 5% of men aged 40 years and 15% of men aged 70 years old. Milder forms of impotence can affect 50% of men aged 50 years old, increasing to 70% of men over 70 years old.
    A small study has shown that Kegels might be an effective treatment for erectile dysfunction.

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Once you feel comfortable with this feeling, you can incorporate this into a daily routine of performing pelvic floor exercises. It won't take long, and will soon feel like second nature.

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In randomized placebo-controlled trials, an estimated 60% of men with diabetes, and 80% of men without diabetes experienced improved erections with sildenafil.

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Diabetic eye diseaseHeart diseaseFoot problems such as wounds that don't heal, loss of feeling, or pins and needles sensationsNeuropathy or nerve pain especially in the legs and feetSexual issues such as erectile dysfunction, inability to orgasm or feel full sensationUrinary frequencyUnusual odor to urine

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Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet) belongs to a class of drugs called biguanides. Metformin is first-line therapy for most type 2 diabetics. It works to stop the liver from making excess glucose, and has a low risk of hypoglycemia. Hypoglycemia, or very low blood sugar can cause symptoms such as sweating, nervousness, heart palpitations, weakness, intense hunger, trembling, and problems speaking. Many patients lose some weight taking metformin, which is also helpful for blood sugar control.

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