Erectile dysfunction, also known as ED or impotence, is defined as the inability to maintain a penile erection sufficient for successful sexual intercourse. Achieving an erection is a complex process involving the brain, hormones, nerves, muscles, and blood circulation. If something interferes with this process, the result can be erectile dysfunction. SLIDESHOW Sex-Drive Killers: The Causes of Low Libido See Slideshow Being able to achieve an erection sometimes but not every time you want to have sex Being able to achieve an erection that doesn’t last long enough for intercourse Being unable to achieve an erection at all
Being able to enjoy sex without worrying about losing my erection has been mindblowing. But sometimes I question whether getting an implant was the right decision. It’s not reversible, so if a cure for ED comes out in 20 years’ time, I’m stuck with it.
Much of the research was conducted at a McMaster University lab that typically studies human bone injuries, not animal penises.
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Did you receive surgical intervention for your erectile dysfunction? Were you satisfied with the results?
Understanding the signs and causes of ED is the first step toward achieving a better sex life.
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Thomas said he recognizes that studies like these often become highly politicized and weaponized on news and social media feeds by people for and against the oilsands. He added that the industry listens to reputable science and has responded in proactive ways in the past when their practices have been shown to be harmful.
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Risk of infection, scar tissue formation with distortion of the penis, and painful erections SLIDESHOW Erectile Dysfunction (ED) Causes and Treatment See Slideshow
U.S. Food and Drug Administration. FDA Drug Safety Communication: fda cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. www.fda.gov/Drugs/DrugSafety/ucm436259.htm. Bassil N , Alkaade S , Morley JE . The benefits and risks of testosterone replacement therapy: a review. Ther Clin Risk Manag 2009;5:427–48. Søe KL , Søe M , Gluud C . Liver pathology associated with the use of anabolic-androgenic steroids. Liver 1992;12:73–9. doi:10.1111/j.1600-0676.1992.tb00560.x Randrup E , Baum N , Feibus A . Erectile dysfunction and cardiovascular disease. Postgrad Med 2015;127:166–72. doi:10.1080/00325481.2015.992722 Wrishko R , Sorsaburu S , Wong D , et al . Safety, efficacy, and pharmacokinetic overview of low-dose daily administration of tadalafil. J Sex Med 2009;6:2039–48. doi:10.1111/j.1743-6109.2009.01301.x Seftel AD , Sun P , Swindle R . The prevalence of hypertension, Hyperlipidemia, diabetes mellitus and depression in men with erectile dysfunction. J Urol 2004;171:2341–5. doi:10.1097/01.ju.0000125198.32936.38
The surgery for placement of a penile prosthesis is typically an outpatient surgery. Doctors often perform a penile prosthesis through a single incision, and all of the components are hidden under the skin. Health care professionals often give patients antibiotics at the time of surgery and often after the surgery to decrease the risk of developing an infection. Depending on your health history, a health care provider may leave a catheter in your penis to drain your bladder overnight.
The doctor or nurse will ask about your lifestyle and relationships, and any problems you might be having.
While its true medications can help improve blood flow and hormone levels, dietary changes and simple exercises can also help improve erectile function by supporting overall cardiovascular health. That being said, your first step should be to contact your doctor in order to determine the cause of your E.D. symptoms. In some men, E.D. is an early warning sign of cardiovascular disease.
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Given that erectile dysfunction can be a sensitive marker of vascular pathology, it is also recommended that all patients with erectile dysfunction undergo an assessment of cardiovascular risk, including assessing risk factors for cardiovascular disease.
Inadequate production of testosterone is not a common cause of erectile dysfunction. But, when ED does occur due to decreased testosterone production, testosterone replacement therapy may improve the problem.
Hormonal therapy is not used as a primary therapy for the treatment of ED. Testosterone therapy is used if there is ED and symptoms of low testosterone, as well a low blood level of testosterone.
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To see an improvement in erectile dysfunction, one research paper recommended that those experiencing ED engage in aerobic exercise “of moderate to vigorous intensity 4 times per week for 40 minutes”.
The same concerns regarding the use of sildenafil with nitrates and alpha-blockers apply to vardenafil.
In rare cases, men who take these drugs develop vision problems that include seeing a blue haze, temporary increased brightness, and even temporary vision loss in a few cases. The effect is usually temporary, lasting a few minutes to several hours. Men at risk for eye problems who take PDE5 inhibitors should have regular eye examinations with an ophthalmologist. Men should also see an eye doctor if visual problems last more than a few hours.
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Combination therapy for the treatment of erectile dysfunction has been under investigation. Most of these studies have been small trials, and long-term data regarding their effectiveness and safety are lacking. However, with thorough evaluation and counseling, there may be a use for combination therapy for certain individuals with ED.
Besides PDE5 inhibitors and among second-line therapies are VCDs which are clear plastic chambers placed over the penis, tightened against the lower abdomen with a mechanism to create a vacuum inside the chamber. This directs blood into the penis. If an adequate erection occurs inside the chamber, the patient slips a small constriction band off the end of the VCD and onto the base of the penis. An erection beyond 30 min is not recommended. These devices can be a bit cumbersome, but are very safe.40
With regular pelvic floor exercises, your pelvic floor muscles will strengthen, and your sexual health can improve.
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Contributors DFM and NB wrote the majority of the manuscript. MK wrote the section on testosterone and made review comments and approved the final manuscript along with the attached figure.
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Noticing a lack of intimacy with your partner? Here we explore how stress, lack of sleep, weight gain, depression and low T can...
But, the odds of ED increased with age across all racial and ethnic groups when health, relationship, lifestyle, psychological, and sociodemographic factors were controlled for.
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Lay down on the floor, stand or sit as per your like to start the exercises. After you decide your position, clench your bulbocavernosus muscles and take a pause for 2 to 3 minutes. Release your hands to complete the set. Repeat this exercise more than five times a day to see better results.
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Berookhim BM, Mulhall JP. Erectile dysfunction. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 191.
Medications inserted or injected into the penisVacuum devicesSurgery (limited to rare cases)
ED from organic or medical causes occurs gradually over time and progressively becomes worse. ED is present with most or all sexual interactions and these men either lack an erection upon awakening, or have poor erections.
Exercises should not cause any pain whatsoever. If you do experience pain, stop the exercises immediately, and seek medical help.
In much the same way inflammation of the heart muscle, or myocarditis, can occur as a consequence of COVID-19, it is plausible that erectile dysfunction could occur from the disease.
For an algorithm to facilitate evaluation and treatment of patients with ED, see figure 2.
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This book dives into a subject it may even be considered a taboo, so I believe the first step is admitting this problem is real, common and it can be tackled and solved. “Curing Erectile Dysfunction” by Jason Brown is a book that broadly and intelligibly covers a taboo topic.
Brittle penis bones could impair the species' ability to reproduce, affecting other species up and down the food chain.
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Youtube: “Kegel Exercises for Men - Beginners Pelvic Floor Strengthening Guide.” Michelle Kenway.
In a few cases, these drugs have been associated with partial vision loss. The vision loss is caused by non-arteritic anterior ischemic optic neuropathy (NAION), a condition that occurs from poor blood flow to optic nerves. However, ED is itself linked to the same vascular problems that cause NAION. Men who have diabetes, high blood pressure, and heart disease are at higher risk for ED as well as other vascular problems such as NAION. Although the risk of blindness appears small, men who experience a sudden loss of vision should immediately stop taking the drug and contact their doctor.
Erectile dysfunction (ED) is when you can’t get and maintain a satisfying erection for sex. ED affects more than 30 million men in the United States. It is a topic that several men still find hard to talk about.
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Once, a girlfriend found my pills and asked what they were. It was so awkward, I just pretended not to hear her. The secret put a strain on our relationship and we eventually broke up. I wish I had talked to her about it but I just felt so ashamed.
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Treatment depends on what is causing it. If it is caused by uncontrolled blood sugar and high blood pressure, take your medicine and follow your doctor’s instructions.
Infection is a concern after placement of a penile prosthesis and is reported as a complication in up to 20% of men undergoing placement of a penile prosthesis. If the device becomes infected more commonly, it needs to be removed. Another prosthesis can be placed after the infection is treated and the penile tissues have healed, but it is a difficult surgery. Erosion of the prosthesis, whereby it compresses through the corporal tissue, into the urethra may occur. Symptoms include pain, blood in the urine, discharge, abnormal stream, and malfunction of the prosthesis. If the prosthesis erodes, it will need to be removed. A catheter is placed to allow the urethra to heal.
Oral drugs or pills are often prescribed for ED (Viagra, Cialis, Levitra, Stendra)Testosterone Therapy (if blood tests indicate low testosterone)Penile Injections (ICI, intracavernosal Alprostadil)Intraurethral medication (IU, Alprostadil)Vacuum Erection DevicesPenile ImplantsSurgery to bypass penile artery damage for some younger men with a history of severe pelvic trauma (this procedure is not recommended for older men with hardened arteries)
Due to the fact that ED and CVD share many of the same risk factors, it is not surprising that there is a high incidence of ED in men who present with CVD. A study by Montorsi et al found that ED was present in roughly 50% of patients with acute chest pain and confirmed CAD on angiography.21
Side effects may include acne, breast enlargement or soreness, high blood pressure, and mood swings. Testosterone therapy can also increase cholesterol levels, prostate specific antigen (PSA) levels, red blood cell count. If you take testosterone therapy, your doctor should monitor your cholesterol, PSA, and hematocrit (red blood cell) levels, and liver function.
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“Street” drugs can dampen a man’s feelings of arousal as well as other sensations. Illicit drugs can take away the pleasure of sex and make a man impotent. Some men use drugs to cope with other issues that could be the root of their penile dysfunction. Using drugs only compounds a man’s difficulty in achieving and maintaining erections.
Heart disease, atherosclerosis, high blood pressure, and high cholesterol levels are major risk factors for ED. Peripheral artery disease (PAD), a form of atherosclerosis, is very common in men who have ED. In fact, erectile problems may be a warning sign of these conditions in men at risk for atherosclerosis. Men who experience ED due to vascular causes have a greater risk for angina, (chest pain due to low oxygen levels in the blood), heart attack, and stroke.
Tadalafil shares the common side effects of the PDE5 inhibitors, however, due to its effect on PDE11, another phosphodiesterase located in muscle, tadalafil has been associated with muscle aches. Back pain and muscle aches occur in less than 7% of men taking tadalafil and in most patients will go away without treatment within 48 hours. When treatment was necessary, acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil) or naproxen (Aleve) were effective. Rarely do the muscle aches and back pain cause men to stop using tadalafil.
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Other potential biological causes of ED include injury to nerves, certain medications, and low levels of testosterone.
Like any other issue, Erectile Dysfunction is also treated at IASH with the methodologies and treatments. Under the guidance of professional sexual health experts and doctors, they also offer special exercise guides and plans for the patients to help them overcome Erectile Dysfunction symptoms. Institute of Andrology and Sexual Health is a well-renowned and Jaipur’s best male reproductive health and wellness clinic that offers treatments and guidance for all types of sexual health issues at a single roof. Dr. Chirag Bhandari is the best sexologist in Jaipur and director of IASH, Jaipur that offers the world’s best treatments with the latest technology and methods.
A new study has found that hydrocarbon contaminants typically associated with oilsands operations are contributing to decreased penis bone strength among river otters.
Diabetes: Diabetes and sexual problems go hand-in-hand. In fact people suffering from type II diabetes are more at risk of facing performance issues in bed due to erectile dysfunction as there is less blood flowing to the organ [2].
A German study found that 69% of men involved in a sleep apnea study also suffered from ED. Disruptions to breathing during sleep affect oxygen levels in the blood, which can cause problems generating an erection. Lack of sleep also disrupts hormone production.
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.
Sildenafil is available as oral tablets at doses of 25 mg, 50 mg, and 100 mg. Patients should take sildenafil approximately one hour before sexual activity. In some men, the onset of action of the drug may be as early as 11-20 minutes. It's best for men to take sildenafil on an empty stomach for best results since absorption and effectiveness of sildenafil can be diminished if it is taken shortly after a meal, particularly a meal that is high in fat. Sildenafil and the other PDE5 inhibitors don't cause an immediate erection. Sexual stimulation is necessary for these medications to work.
The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater.
Some preliminary research suggested that men who take sildenafil may be at increased risk for developing skin cancer (melanoma). A more recent review of data does not support sildenafil as a cause for melanoma. Men who have had melanoma or are at risk for it should discuss this issue with their doctors. Injections and Topical Treatments
The bottom line is that taking steps to keep your endothelium healthy will help you prevent or reduce your erectile dysfunction risk. Being more physically active is important to the health of your endothelium and, therefore, to the health of your heart and your penis.
Sometimes, ED happens when your hormones are out of balance. Your doctor can perform a blood test to check your hormones.
Did you know that certain medical condition may be responsible for ED? Some causes of impotence are medically treatable and reversible. Learn more about what can be done about erectile dysfunction with the Impotence Quiz.
The doctor may also test for thyroid and adrenal gland dysfunction. For more sophisticated tests, the doctor may refer you to specialist such as an urologist or endocrinologist.
Anxiety has both emotional and physical consequences that can affect erectile function. It is among the most frequently cited contributors to psychological ED.
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