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Stimulation of growth of the prostate (benign prostatic hypertrophy) and possible growth of existing prostate cancerSkin reactionsLimiting sperm production and shrinkage of testiclesOverproduction of red blood cells (which can contribute to a heart attack)Some studies have implicated testosterone in an increase in cardiovascular events.

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Vacuum constriction devices, or penis pumps, may be useful in the treatment of erectile dysfunction (impotence). A penis pump is an acrylic cylinder with a pump that can be attached to the end of the penis. The pump then creates a vacuum to help the penis become erect, while a constriction ring maintains the erection.
Past and present medical conditions, surgeries, and medicationsAny history of psychological problems, including stress, anxiety, or depressionLifestyle factors, such as alcohol, drug, and dietary supplement use .

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Thankfully, if you’re experiencing these issues, you don’t have to rely solely on expensive medications or complicated and extensive therapies. There are several exercises, specifically Kegel exercises, that can strengthen the core and pelvic area of the body.
Despite the appeal of suppositories, their effectiveness is relatively poor and overall patient satisfaction is relatively low.

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If you are using Viagra, Cialis or other drugs in this way – especially if you are buying the pills online, at sex shops or in clubs – there are some risks to be aware of:
To summarize, there are many different factors that can cause or contribute to ED. Some of the strongest contributors, such as comorbid conditions, can be modified and controlled with lifestyle changes. Most common however, ED causes are multifactorial and complex. Our urology team is here to work with you to resolve your ED and improve your sexual function.

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Doing a few of these exercises every day, if not all, can prevent erectile dysfunction. Considering the sedentary and stressful lives of youngsters today, Vidyut recommends men even as young as 20 years old to practise these exercises to protect themselves from this crippling condition. AskMen India shares 6 exercises from Vidyut Jammwal’s kalari sutra workout that improve sexual health:

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There is no clear proof that testosterone therapy is helpful in reversing any aspects of natural aging in males. Vogiatzi, MG, MD. Hypogonadism Treatment & Management. Medscape. Updated: April 3, 2019.

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    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.

    Although testosterone therapy helps with hypogonadism, whether it helps in the reversal or slowing of normal effects of aging and lower testosterone levels is unclear. Several published research articles have conflicting results and more research is needed to make a final determination about the use of testosterone for healthy aging males.
    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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    Pelvic floor exercises tighten the muscles around the base of the penis. These muscles exert pressure on the blood vessels that drain the penis. Tightening these muscles can help keep blood in the penis longer and therefore help maintain an erection. Pelvic floor exercises (also called Kegel exercises) can tighten the muscles that sag and weaken as we age (Meldrum et al., 2014).

    Medications inserted or injected into the penisVacuum devicesSurgery (limited to rare cases)
    Forty-three percent of women and 31% of men have some form of sexual dysfunction, with obesity and a lack of exercise often being factors, according to the National Institutes of Health. A study published in The Journal of Sexual Medicine found men with either a high waist circumference or elevated BMI were 50% more likely to have erectile dysfunction, while approximately half of obese women reported problems with sexual activity, desire and performance, at least some of the time, in a study published in Obesity.

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    Pneumonia from COVID-19 can cause blood vessels to become inflamed, leading to restricted blood flow, which can contribute to erectile dysfunction, Jannini said.

    Perhaps the most well-known treatment for erectile dysfunction is the oral medication Viagra (Sildenafil). While Viagra can certainly be a fantastic option for improving the quality of erections, many men are interested in more natural, convenient, affordable, or reliable alternatives to Viagra. Some of the most popular treatments for ED in the Jacksonville Beach area include: Oral medication (Viagra, Cialis®, Stendra®, etc.) TriMix injection Penile implant/pump Vacuum constrictor device Psychotherapy/counseling Behavioral modification Hormone replacement therapy Shockwave therapy
    Men do not have to begin a more active lifestyle with drastic measures. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends that men slowly incorporate more activity into their lives. A man can begin by taking short walks at a normal speed and gradually increasing the pace and length of his walks.

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    Certain feelings can interfere with normal sexual function, including feeling nervous about or self-conscious about sex, feeling stressed either at home or at work, or feeling troubled in your current sexual relationship. In these cases, treatment incorporating psychological counseling with you and your sexual partner may be successful. One episode of failure, regardless of cause, may propagate further psychological distress, leading to further erectile failure. Individuals suffering from psychogenic ED may benefit from psychotherapy, treatment of the ED, or a combination of the two. Also, medications used to treat psychologic troubles may cause ED; however, it is best to consult with your physician prior to stopping any medications that you are taking. Althof, S.E., E.W. Corty, S.B. Levine, et al. "EDITS: development of questionnaires for evaluating satisfaction with treatments for erectile dysfunction." Urology 53.4 April 1999: 793-799. American Foundation for Urologic Disease. American Foundation for Urologic Disease. American Urological Association. "Erectile Dysfunction." 2011. . Andersson, K.E., and G. Wagner. "Physiology of Penile Erection." Physiol Rev 75.1 January 1995: 191-236. Cheitlin, M.D., A.M. Hutter Jr., R.G. Brindis, et al. "ACC/AHA Expert Consensus Document. Use of Sildenafil (Viagra) in Patients With Cardiovascular Disease. American College of Cardiology/American Heart Association." J Am Coll Cardiol 33.1 January 1999: 273-282. The European Alprostadil Study Group. "The Long-Term Safety of Alprostadil (Prostaglandin-E1) in Patients With Erectile Dysfunction. Br J Urol 82.4 October 1998: 538-543. Feldman, H.A., I. Goldstein, D.G. Hatzichristou, et al. "Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study." J Urol 151.1 January 1994: 54-61. Laumann, E.O., A. Paik, and R.C. Rosen. "Sexual Dysfunction in the United States: Prevalence and Predictors." JAMA 281.6 Feb. 10, 1999: 537-544. National Kidney and Urologic Diseases Clearinghouse. National Kidney and Urologic Diseases Clearinghouse. Available at http://kidney.niddk.nih.gov/. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 270.1 July 7, 1993: 83-90. The Process of Care Consensus Panel. "The Process of Care Model for Evaluation and Treatment of Erectile Dysfunction." Int J Impot Res 11.2 April 1999: 59-70; discussion 70-74. Segraves, R.T., M. Bari, K. Segraves, and P. Spirnak. "Effect of Apomorphine on Penile Tumescence in Men With Psychogenic Impotence." J Urol 145.6 June 1991: 1174-1175. United States. FDA Center for Drug Evaluation and Research. FDA Center for Drug Evaluation and Research. Available at http://www.fda.gov/cder/.

    He left with a prescription for the drug Cialis to treat his ED, a clearer picture of his health in general and new motivation to make lifestyle changes.
    Among men not receiving antihypertensive medication, penile blood flow velocity progressively decreased with rising blood pressure – i.e. blood flow was fastest in those with normal blood pressure, slower in those with high-normal blood pressure, and slowest in those with hypertension (see Figure). In contrast, among men taking antihypertension therapy, there was no difference in penile blood flow velocity between the three blood pressure categories.

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Scar tissue (the protein collagen) also can build up in the fibrous sheathe that surrounds the chambers in the penis involved in erections. Blockages within these chambers can result in smaller erections. Being overweight is another reason for shrinkage due to accumulation of fat in the lower abdomen which makes the flow of blood into the penis poor hence the brevity of your erection. Closely related to age induced cause of two-minute erection and shrinkage has to do with medical condition and your lifestyle.

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Education of patient and partner, if available.Evaluation of possible lifestyle factors such as smoking, alcohol, or other substance use.Management of comorbid illnesses, such as diabetes, obesity, or heart and vascular disease.Review of potential changes in medications - always consult with your physician.If appropriate, trial of various psychosexual therapies and interpersonal therapies may be tried. Treatments can be provided along with these therapies.

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With this alternative ED treatment, there are no expensive prescriptions to remember to take or refill, and no penile implants or surgery. There are none of the harmful side effects with this ED treatment as with oral drugs.

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