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PDE5 inhibitors are also sometimes used in combination with testosterone replacement therapy for men with hypogonadism (low testosterone levels). Some research indicates that the addition of testosterone provides little benefit.

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All men receiving testosterone replacement need to have periodic measurement of haemoglobin and haematocrit to monitor for erythrocytosis. Feldman HA , Goldstein I , Hatzichristou DG , et al . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994;151:54–61. Araujo AB , Esche GR , Kupelian V , et al . Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab 2007;92:4241–7. doi:10.1210/jc.2007-1245 Lindau ST , Schumm LP , Laumann EO , et al . A study of sexuality and health among older adults in the United States. N Engl J Med 2007;357:762–74. doi:10.1056/NEJMoa067423 Shah J . Erectile dysfunction through the ages. BJU Int 2002;90:433–41. doi:10.1046/j.1464-410X.2002.02911.x Mobley D . Early history of inflatable penile prosthesis surgery. Asian J Androl 2015;17:225–9. Roumeguère T , Wespes E , Carpentier Y , et al . Erectile Dysfunction is associated with a high prevalence of hyperlipidemia and coronary Heart Disease Risk European Urology.44:355–9. Klein R , Klein BE , Lee KE , et al . Prevalence of self-reported erectile dysfunction in people with long-term IDDM. Diabetes Care 1996;19:135–41. doi:10.2337/diacare.19.2.135 Larsen SH , Wagner G , Heitmann BL . Sexual function and obesity. Int J Obes 2007;31:1189–98. doi:10.1038/sj.ijo.0803604 McWaine DE , Procci WR . Drug-induced sexual dysfunction. Med Toxicol Adverse Drug Exp 1988;3:289–306. doi:10.1007/BF03259941 Croft H , Settle E , Houser T , et al . A placebo-controlled comparison of the antidepressant efficacy and effects on sexual functioning of sustained-release bupropion and sertraline. Clin Ther 1999;21(4):643–58. doi:10.1016/S0149-2918(00)88317-4 Janeway M , Baum N . Managing the enlarged prostate gland in elderly men. Clinical Geriatrics http://www.consultant360.com/articles/managing-enlarged-prostate-gland-elderly-men. Kumar RJ , Barqawi A , Crawford ED . Adverse events associated with hormonal therapy for prostate Cancer. Rev Urol 2005;7 Suppl 5:S37–S43. Aksam A , Yassin A , Saad F . Testosterone and erectile dysfunction. J Andrology 2008;29. Gades NM , Nehra A , Jacobson DJ , et al . Association between smoking and erectile dysfunction: a population-based study. Am J Epidemiol 2005;161:346–51. doi:10.1093/aje/kwi052 Mobley D , Baum N . Smoking: it’s impact on urologic conditions. Rev Urology 17 2015. Stein RA . Endothelial dysfunction, erectile dysfunction, and coronary heart disease: the pathophysiologic and clinical linkage. Rev Urol 2003;5(Suppl 7):S21–S27. Andersson K , Stief C . Penile erection and cardiac risk: pathophysiologic and pharmacologic mechanisms. Am J Cardiol 2000;86:23–6. doi:10.1016/S0002-9149(00)00887-0 Feldman HA , Johannes CB , Derby CA , et al . Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med 2000;30:328–38. doi:10.1006/pmed.2000.0643 Vlachopoulos C , Ioakeimidis N , Terentes-Printzios D , et al . The triad: erectile dysfunction-endothelial dysfunction-cardiovascular disease Curr Pharm Des. 2008;14:3700–14. Watts GF , Chew KK , Stuckey BG et al . The erectile-endothelial dysfunction nexus: new opportunities for cardiovascular risk prevention. Nat Clin Pract Cardiovasc Med 2007;4:263–73. doi:10.1038/ncpcardio0861 Montorsi F , Briganti A , Salonia A , et al . Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003;44:360–5. doi:10.1016/S0302-2838(03)00305-1 Vlachopoulos C , Rokkas K , Ioakeimidis N , et al . Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study. Eur Urol 2005;48:996–1003. doi:10.1016/j.eururo.2005.08.002 Mulhall J , Teloken P , Barnas J et al . Vasculogenic erectile dysfunction is a predictor of abnormal stress echocardiography. J Sex Med 2009;6:820–5. doi:10.1111/j.1743-6109.2008.01087.x Hodges LD , Kirby M , Solanki J , et al . The temporal relationship between erectile dysfunction and cardiovascular disease. Int J Clin Pract 2007;61:2019–25. doi:10.1111/j.1742-1241.2007.01629.x Inman BA , Sauver JL , Jacobson DJ , et al . A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc 2009;84:108–13. doi:10.4065/84.2.108 Ponholzer A , Temml C , Obermayr R , et al . Is erectile dysfunction an indicator for increased risk of coronary heart disease and stroke? Eur Urol 2005;48:512–8. doi:10.1016/j.eururo.2005.05.014 Thompson IM , Tangen CM , Goodman PJ , et al . Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005;294:2996–3002. doi:10.1001/jama.294.23.2996 Banks E , Joshy G , Abhayaratna WP , et al . Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: a prospective cohort study. PLoS Med 2013;10:e1001372. doi:10.1371/journal.pmed.1001372 Lewis RW , Fugl-Meyer KS , Corona G , et al . Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med 2010;7:1598–607. doi:10.1111/j.1743-6109.2010.01778.x Yaman O , Gulpinar O , Hasan T , et al . Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity. Int Urol Nephrol 2008;40:117–23. doi:10.1007/s11255-007-9293-8 Montorsi P , Ravagnani PM , Galli S , et al . Association between erectile dysfunction and coronary artery disease. role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J 2006;27:2632–9. doi:10.1093/eurheartj/ehl142 Montorsi P , Ravagnani PM , Galli S , et al . Association between erectile dysfunction and coronary artery disease:matching the right target with the right test in the right patient. Eur Urol 2006;50:721–31. doi:10.1016/j.eururo.2006.07.015 Yassin AA , Saad F . Testosterone and erectile dysfunction. J Androl 2008;29:593–604. doi:10.2164/jandrol.107.004630 Khera M . Androgens and erectile function: a case for early androgen use in postprostatectomy hypogonadal men. J Sex Med 2009;6:234–8. doi:10.1111/j.1743-6109.2008.01159.x Aversa A , Isidori AM , De Martino MU , et al . Androgens and penile erection: evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction. Clin Endocrinol 2000;53:517–22. doi:10.1046/j.1365-2265.2000.01118.x Wespes E , Amar E , Hatzichristou D , et al . EAU guidelines on erectile dysfunction: an update. Eur Urol 2006;49:806–15. doi:10.1016/j.eururo.2006.01.028
For people who want to avoid drugs, taking an aggressive approach to healthy eating plan and lifestyle change is an option. It isn't easy, but if someone is very committed and motivated, lifestyle changes can be enough to maintain a healthy blood sugar level and to lose weight. Learning about a healthy diabetes diet (a low-glycemic load diet) can be a good place to start. .

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Most of the people ignore these issues as they think that there is no such way that they can treat their sexual problems. And going for any surgery and operation is not an option for them.
Some men with erectile dysfunction report having either a partial erection that is unable to sustain sexual intercourse, or the total absence of swelling of the penis. The severity of erectile dysfunction can be assessed using the International Index of Erectile Function (IIEF-5), which uses a questionnaire to grade ED as either mild, moderate or severe.

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4. A mixture of powdered walnuts and honey are a natural remedy that proves to be an effective decoction to tide over erectile problems. Take equal measure of powdered walnuts and honey and mix it well. Take a spoonful of this mixture thrice a day followed by a cup of milk.
Rew KT, Heidelbaugh JJ. Erectile dysfunction. Am Fam Physician. 2016;94(10):820-827. PMID: 27929275 pubmed.ncbi.nlm.nih.gov/27929275/.

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Erectile dysfunction often affects men as they get older. It is also more common in men with HIV than in the general population, although it has been difficult to estimate how many men with HIV are affected. Research suggests that around 40 to 60% of men with HIV may have some degree of erectile dysfunction.

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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

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    Exercise does more than improve penile blood flow, however. Staying fit keeps a man’s weight under control, may increase his testosterone levels, and boosts his confidence. It can also reduce depression and anxiety. These factors can affect erections as well as other aspects of sexual health.

    If pills don't work for you or the side effects bother you severely, we can use alternative treatments. These include: injections, suppositories, vacuum devices, shockwave therapy, or surgery. ED Vacuums
    Pneumonia can lead to lung damage that can reduce a person’s ability to get enough oxygen in the blood, Jannini said. That can reduce the ability to maintain an erection.

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    Vardenafil shares the same side effects as sildenafil but is not associated with the abnormal vision that may occur with sildenafil.

    With the increasing interest in more natural and holistic therapies for erectile dysfunction, many men are choosing nonsurgical shockwave therapy. This breakthrough treatment delivers virtually painless ultrasonic waves to the penis in order to remodel tissues, strengthen blood vessels, and increase blood flow to the penis. In the days and weeks following a quick shockwave ED treatment, which typically lasts 30 minutes or less and requires no downtime, patients will begin to develop stronger, firmer, longer-lasting erections.
    While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice. General News Erectile Dysfunction Anti-Aging Lifestyle Hair Loss Sexual Health Weight Loss Performance Nutrition

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    This maxim springs more from anecdotal observations than from scientific studies: Men who have erection problems tend not to have much sex, urologists noticed. And those who don’t, have plenty. Then again, anyone with a passing knowledge of the birds and the bees might have guessed as much.

    Dynamic infusion cavernosometry and cavernosography (DICC)Intracavernous injection pharmacotesting (ICI)Color duplex ultrasoundNocturnal penile tumescence and rigidity (NPTR)Bulbocavernosus reflex latencyMeasurement of calculated bioavailable testosterone (free testosterone and albumin-bound testosterone)Psychologic evaluation and possible interview with partner
    According to Professor Bente Klarlund Pedersen from the University of Copenhagen and Ellids Kristensen, doctor and research scientist at the Sexological Clinic in Copenhagen, these conclusions are supported by known mechanisms that can explain the link to erectile dysfunction: Physical activity makes the blood vessels more elastic, allowing more blood to flow to the sex organs. Physical activity stimulates the body’s production of nitrogen oxide, allowing the blood vessels to expand. This is essentially just what the popular medicine, Viagra, does.

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    For Immediate Beneficial Results1. Regular intake of a glass of milk at night before going to bed is another healthy option.

    Surgery provides the only true cure, but men typically want to explore other, less invasive options first.
    If you use sildenafil, tadalfil, or vardenafil and get chest pains, be sure to tell the paramedics, nurses or doctors at the hospital that you use it and when you used it last.

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OverviewWhat is erectile dysfunction?What are the risk factors for erectile dysfunction?How is erectile dysfunction treated?What else should you know about ED?What makes Yale Medicine’s approach to treating erectile dysfunction unique?

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The good news is that there’s a cure for ED. Depending on the underlying cause of the problem, your doctor can opt for one of these treatment options;

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Alprostadil is derived from a natural substance, prostaglandin E1, which opens (relaxes) blood vessels. This medicine is an effective treatment for many men with ED. It can be administered by:

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While the discovery of weaker otter penises may stand out, the study also found that the presence of some contaminants — strontium, iron and the hydrocarbon retene — was associated with stronger penis bones among some otters. The former two elements are naturally occurring and retene is a byproduct of forest fires.

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