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.
Sexual intercourse itself involves an increase in physical exertion and a very small risk for heart attack for people with heart disease or heart disease risk factors. If you have heart disease or have recently had a heart attack, talk with your doctor about whether you can safely have sex. .
Erectile dysfunction may have a significant impact on both patients and their relationships. It therefore is important to seek appropriate help and support, both from GPs and from other organisations, such as Relate.
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What are truly the norms for testosterone levels in men and could we better determine which might actually benefit, and thus, should receive TRT?
AgingDiabetes High blood pressureAtherosclerosis (hardening of the arteries)Stress, anxiety, or depressionAlcohol or tobacco useSome prescription medicinesTirednessBrain or spinal cord damageLow testosteroneMultiple sclerosisParkinson’s diseaseRadiation therapy to the testiclesStrokeSome types of prostate or bladder surgery
Can over-the-counter (OTC) and/or natural or home remedies treat erectile dysfunction?
Kegel exercises, or pelvic exercises, have proven to be effective in addressing erectile dysfunction, and it should be used as the first-line of treatment. The ischiocavernosus and bulbocavernosus muscles in the pelvic area surround the penis and are active during an erection. The following exercises aim to strengthen these muscles.
Though you're the one with ED, your partner is also affected. Talking openly about ED will help your partner understand the diagnosis and treatment options. This can reassure them that you haven't lost interest.
Unlike the other PDE5 inhibitors, sildenafil (Viagra) may affect another phosphodiesterase enzyme in the eye, causing transient abnormal vision (a bluish hue or brightness).
Such exercises are common among women, with them recommended for mothers-to-be to lower their risk of incontinence.
If your test indicates low testosterone, the doctor should retest to confirm the results. Other tests that measure hormone level involved in the brain and body's production of testosterone may be needed if testosterone levels are low. A diagnosis of hypogonadism requires clinical signs and symptoms associated with the condition in addition to low testosterone levels in the blood.
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.
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:
Even when ED has a physical cause, psychotherapy can help. A therapist can teach the man and their partner techniques to reduce performance anxiety and improve intimacy. Therapy can also help couples adjust to the use of vacuum devices and implants.
There can also be drug-drug interactions with other medications you take, potentially including anti-HIV drugs. When taken with ritonavir or cobicistat (boosting agents included in some HIV treatment regimens), levels of the erectile dysfunction medication may be increased, potentially adding to side-effects. On the other hand, when taken with non-nucleoside reverse transcriptase inhibitors (NNRTIs), levels of the erectile dysfunction drug may be lowered.
Manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Such products can be sold without any proof of efficacy or safety. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce harmful side effects. There have been a number of reported cases of serious and even lethal side effects from these products. You should always check with your doctor before using any herbal remedies or dietary supplements.