Erectile dysfunction, aka ED, creeps up on men slowly. Most guys brush off the one-time occurrences until it becomes a regular thing and erectile dysfunction treatment can no longer be avoided. (Erectile dysfunction is found in women, as well, but we’ll focus on men here.)
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Nearly every primary care physician, internist and geriatrician will be treating men with ED.
Lifestyle changes are one of the most effective treatments. Weight loss, increased physical activity, cutting out smoking, getting enough sleep and reducing alcohol can all have a big effect on erectile dysfunction. If you have obstructive sleep apnoea, make sure you are using your CPAP machine.
It is recommended that prior to proceeding with other therapies, patients reporting failure of their PDE5 inhibitors should be evaluated to determine whether the trial was adequate. This would include discussion of fatty food ingestion, which is important with sildenafil, and specific patient population such as prostatectomy and diabetes. Furthermore, patients should be encouraged to continue attempts at intercourse up to the eighth to tenth dose of PDE5 inhibitor as improvements in success rate are seen up to the eighth to tenth dose.
Picture of penile tourniquet. This is one of many types of constricting devices placed at the base of the penis to diminish blood outflow and improve the quality and duration of the erection. These may be used in conjunction with oral drugs, injection therapy, and with vacuum devices.
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Exercises or engaging in physical activities help with ED by improving blood vessel health, lowering stress, and raising testosterone levels.
Only a small subset of men with ED benefit from vascular testing, which can identify specific arterial or venous dysfunction amenable to surgical reconstruction. For the vast majority, such testing is unlikely to change management strategy. Thus, specialized testing is now limited to PDE-I non-responders, young men with post-traumatic or primary ED, men with Peyronie’s Disease, and legal investigations.
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There are quite a few erectile dysfunction drugs on the market. The condition also often responds to natural remedies and even surgery is not excluded. A good option is to first start with the basics: try to determine the cause of the condition and implement the lifestyle changes mentioned below.
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If you want to avoid medications, devices, or surgery, there are other, more natural ways to help erectile dysfunction.
It’s no surprise that all our patients have concerns about aftercare. Some common questions: Will it hurt? Will there be bruising? When can I start using it? When will I see results?
Some men with early-stage prostate cancer have a choice between radiation and surgery to treat their cancer. When looking at how men’s erections are affected by prostate cancer treatment, there does not seem to be much long-term difference between the two. Men who have had radiation may see a general decrease in the firmness of their erections over time (up to several years after radiation). In contrast, after surgery most men have erection problems right away and then have a chance to recover erections in the first 2 years following the surgery. About 4 years after either treatment, the percentage of men reporting ED is about the same. Treatments can often help these men get their erections back whether they’ve had surgery or radiation.