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There are contraindications for each drug (i.e., reasons why a person should not try to use it). Men with certain liver, kidney, or cardiovascular conditions may not be able to take ED medications safely. Men taking nitrates and alpha-blockers to treat hypertension may need to find other ways to treat their ED. Other health conditions could make PDE-5 medications unsafe for men. .
Erection problems (impotence) are very common, particularly in men over 40. It's usually nothing to worry about, but you should see a GP if it keeps happening. It could be the sign of a more serious problem. Causes of erection problems
Men with mild to moderate kidney or liver disease will need to use lower doses of the PDE5 inhibitors. None of the PDE5 inhibitors are recommended for men with severe kidney disease, those on dialysis, and those with severe liver disease.
Blood essentially gets “trapped” inside the penis. This leads to it becoming erect. In order for this to all happen properly, and for the man to maintain his erection, there has to be no problem starting with the thought in the brain, the message sent to the blood vessels and penis, and blood flow.
Finally, Dr Montorsi et al found that severe ED was more common in patients with multivessel coronary involvement as compared with those with single-vessel disease (31% vs 12.5%; p<0.01). They also found a significant inverse relationship between the extent of CVD and IIEF scores.31
ED is defined as the inability to achieve a full erection or the inability to maintain an erection adequate for sexual intimacy. Other types of sexual dysfunction such as premature ejaculation and low libido may occur; however, the most common and disruptive problem in men is ED. Although most men will experience periodic episodes of ED, these episodes tend to become more frequent with advancing age.
Certain street drugs such as "poppers" also can cause serious problems if taken with PDE5i medications. These poppers are often types of nitrates and can cause severe drops in blood pressure. Ecstasy is another street drug that may increase sexual desire but interferes with performance. This has prompted some men to combine ecstasy with PDE5i medications. This mixture (a combination sometimes called "sextasy") can improve erection ability but also causes severe headache and priapism. (Priapism is an abnormally prolonged erection that becomes extremely painful and may result in permanent damage to the erection mechanism.) There are also potentially dangerous effects to your heart from mixing PDE5i medications with various other street drugs.
It affects approximately half of all men over age 40 While erectile dysfunction is usually a physical problem, it can also have psychological roots. More often than not, it is a combination of both. And help is available. “We have a treatment for everyone,” says Stanton Honig, MD, a director of the Yale Medicine Male Reproductive Health Program. “It's just a matter of what option you choose.”
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May have attributed this to inflammation as an immune response to the virus, which is the cause of many 'long Covid' symptoms - often placed under the umbrella of MIS-C.
National Comprehensive Cancer Network (NCCN). Clinical practice guidelines in oncology: Survivorship [Version 2.2019]. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf on January 31, 2020.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause and may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
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However, while shockwave therapy alone is effective for many, it may not be enough for those with severe ED.
Currently, there are several different types of penile prostheses. The simplest is the malleable penile prosthesis and the most complex, the three-piece inflatable penile prosthesis.