Nearly every primary care physician, internist and geriatrician will be treating men with ED.
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ED can be related to mental or emotional distress which may require other types of treatment such as counseling, but in most cases it is a matter of poor blood flow that could be related to diabetes, heart disease, hypertension, or metabolic syndrome.
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Rose essential oil works to fight stress and anxiety, two causes of erectile dysfunction. It’s also known to help balance sex hormones and improve libido. A 2015 double-blind, randomized and placebo-controlled clinical trial that was published in Neuropsychiatric Disease and Treatment found that rose essential oil was able to improve sexual function in males with SSRI-induced sexual dysfunction and major depressive disorder. Using rose oil improved the participant’s self-rated symptoms of depression and helped to improve sexual dysfunction that was caused by medication use. (30)
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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.
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First-line treatment is typically with the use of phosphodiesterase inhibitors, such as sildenafil (also known as Viagra). In the UK, Viagra is now available without a prescription, and can be obtained over the counter from pharmacists, once suitability has been assessed. A vacuum device, or pump, can also be useful especially if medications are not suitable. Vacuum pumps work by encouraging blood flow to the penis, resulting in an erection.
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The diagnosis of erectile dysfunction is made clinically, based on a patient’s symptoms. It therefore is important for patients to be evaluated by their GP in the first instance. At this appointment, a full history will be taken from the patient regarding the current symptoms and other medical issues. Regular medications will also be reviewed to ensure that there are no contributing factors. Questions regarding alcohol intake and smoking will also be asked. A general physical examination will be performed by the GP, which may include checking blood pressure and an examination of the genitals. Examination of the vascular system and peripheral nervous system may also be undertaken.
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Erectile dysfunction can be a warning sign of current or future heart disease sometimes. In fact, ED can precede coronary artery disease in almost 70 percent of cases.
A vacuum device (VED) is an external device (not a drug) that goes over the penis. When pumped, it pulls blood into the penis then a special ring is placed over the base of the penis to keep it erect.
If counseling alone does not help treat the psychological issue, medications through a qualified psychiatrist may be prescribed.
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Sometimes, the cause of erectile dysfunction may be related to lifestyle choices. Poor diet, sedentary lifestyle, excessive alcohol intake, smoking, and using illegal drugs are some health-related behaviors that may cause erectile dysfunction. It is advisable to start forming healthy habits to avoid or lessen the possibility of experiencing erectile dysfunction.
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Feeling embarrassed about ED may prevent many men from getting the medical care they need. This can delay diagnosis and treatment of more serious underlying conditions. ED itself is often linked to an underlying problem such as heart disease, diabetes, liver disease, or other health conditions. Talk with your healthcare provider if you have problems with ED. Help is available.
Home Archive Volume 93, Issue 1105 Recent advances in the treatment of erectile dysfunction
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It's best to see a doctor before buying medicines online. They know your medical history and can discuss whether you might benefit from treatment.
ED can be embarrassing to talk about. However, if it is affecting your relationship, you need to discuss it. Find tips for talking to your partner and getting successful treatment.
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We understand your concerns and can answer your questions about male sexual issues. We’ve heard it all before, and we can find the answers—and the treatment—that is personally best for you.
Many men are uncomfortable speaking with their physician about erectile dysfunction symptoms; however, it is important to treat your symptoms as ED can be a warning sign of current or future heart disease.
You can also inject drugs directly by inserting a tiny needle into the penis. Several drugs and drug combinations are available, including alprostadil (Edex, Caverject), phentolamine, and papavarine (usually given in combination as Bimix or Trimix).
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Men being treated for prostate cancer with treatments such as radical prostatectomy, radiation therapy or the use of Lutenizing hormone-releasing hormone (LHRH) agonists and antagonists can expect that ED may accompany these treatments.12
Obesity is a major risk factor for ED and research shows that the treatment of obesity and a sedentary lifestyle improves this condition. According to a 2004 study published in JAMA, approximately 30 percent of men who lost 10 percent or more of their body weight demonstrated improvements in erectile function. To lose weight, the 55 men in the intervention group reduced their caloric intake and increased their level of physical activity, while the men in the control group only received general information about healthy food choices and exercise. (16)
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It’s true that sexual function declines with age, but recent research shows that many aging men and women engage in sexual activity, and 50 percent of older adults indicate that sex is an important part of their lives. (3) In addition to these findings, researchers indicate that there has been a sharp rise in erectile dysfunction, delayed ejaculation, reduced libido and decreased sexual satisfaction in men under the age of 40. This may be caused by porn-induced erectile dysfunction, a growing problem that’s caused by the ease and accessibility of internet pornography.
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Phosphodiesterase inhibitor medications, such as sildenafil (Viagra) can cause a reduction in blood pressure, and so should not be taken by patients known to have low blood pressure (hypotension), or in those who have recently had a stroke or heart attack. Similarly, they should not be used in patients who take nitrate medication (such as glyceryl trinitrate, GTN, or isosorbide mononitrate) for chest pain. Phosphodiesterase inhibitor medications are associated with some side-effects, which include headaches, hot flushes, and dizziness. More serious side-effects may occur less commonly, including chest pains, prolonged and painful erections (priapism) or a change in vision. If patients experience any of these symptoms, they should seek immediate medical attention.
Individuals at higher risk for priapism (painful erection lasting longer than six hours), including men with sickle cell anemia, thrombocytopenia (low platelet count), polycythemia (increased red blood cell count), multiple myeloma (a cancer of the white blood cells), and history of blood clots (for example, deep venous thrombosis [DVT]) or hyperviscosity (thick blood) syndrome are at increased risk for priapism with MUSE.
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Even when the nerves are spared, research has shown that the healing process takes up to 2 years for most men. We don’t know all the reasons some men regain full erections and others do not. We do know that men are more likely to recover erections when nerves on both the left and right sides of the prostate are spared.
Avanafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil (Viagra) or other drugs similar to avanafil. Most of these people also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old. It is not clear whether avanafil is the actual cause of vision loss.
Pills are an easy way to treat ED, but you might get a stronger erection from injecting medication directly into your penis. That’s because these drugs widen your blood vessels so your penis fills with blood. Another option: A medicated pellet you put into the opening at the end of your penis. The pellet can trigger an erection within 10 minutes.
Keep in mind that these medications are amplifiers, not magic pills; you must have sexual stimulation for them to work. These pills also typically do not work the first few times. Here are instructions for how to properly take Viagra, Levitra, or Cialis: Take your medication one hour before sexual activity. Take the pills prior to a meal or after a light snack, especially for Viagra. They do not absorb well if you have a full stomach.
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.
Even when the nerves are spared, research has shown that the healing process takes up to 2 years for most men. We don’t know all the reasons some men regain full erections and others do not. We do know that men are more likely to recover erections when nerves on both the left and right sides of the prostate are spared.
Atherosclerosis (narrowing of the arteries)DiabetesHigh blood pressureSmokingUrological problemsPeyronie’s diseasePelvic traumaPelvic floor dysfunctionIncontinence
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Horny goat weed. Horny goat weed (Epimedium) and related herbs have purportedly been treatments for sexual dysfunction for years. Italian researchers found that the main compound in horny goat weed, called icariin, acted in a similar way as drugs like sildenafil.
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Because erectile dysfunction is strongly linked to cardiovascular disease, researchers suggest that men with ED should always be screened for cardiovascular disease. Studies show that there’s a two- to five-year interval between the development of erectile dysfunction symptoms and the onset of cardiovascular problems. ED is also a risk factor for peripheral arterial disease and stroke.
It’s clearly an alien conspiracy to depopulate the earth of humans before they take over…. 😉 I contracted Covid in Feb. 2020, began experiencing ED problems — no libido. I received the Pfizer jabs in spring 2021: after the first shot, began feeling tingling and shooting pains in the area of the pericardial sac, and in the penis. Then developed Peyronie’s disease and intercourse became impossible even though libido had returned. [Vitamins C and E, coupled with an antioxidant (anthocyanimids from bilberries), seems to be helping restore function, but very slowly.]
4. People suffering from elevated blood pressure, diabetes, and increased cholesterol levels:
Finding a good support system is key for overcoming ED. Talking to your partner may be a good place to start.
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In general, PDE5i works successfully in about 65%-70% of all men with erectile dysfunction (impotence). The greater the degree of damage to the normal erection mechanism and severity of the ED, the lower the overall success rate. Men with diabetes and those with spinal cord injury reported between 50%-60% responding successfully to treatment with oral PDE5i medications. The lowest success rate has been in men who developed ED (impotence) after prostate cancer surgery (radical prostatectomy) for more advanced prostate cancer that required removal of both sets of nerves around the prostate. In men who did not have the nerves removed/damage, there is a better chance of response to PDE5 inhibitors.
Low intensity shockwave therapy(LiST) is a groundbreaking “drug and surgery-free” procedure that uses acoustic waves to stimulate a cascade of biological actions that lead to the healing and regeneration of the sexual organs. Simply…LiST helps your body heal itself! Learn more about Low Intensity Shockwave Therapy. Oral medications for ED are called PDE-5 inhibitors. The drugs in this class include medications like Viagra, Levitra, Cialis, Stendra and more. This class of drugs is considered first line therapy for those men presenting with ED. Learn More About Oral Medications for ED. Penile injection therapy involves an injection of a medication into the shaft of the penis on an as needed basis to produce a rapid erection. It is commonly used by patients who have failed oral medications. Learn more about this very effective treatment. The same medicine used for penile injection may be used as a very small suppository placed into the tip of the penis to provoke an erection.
Erectile Dysfunction can happen because of many reasons. Chronic illness like diabetes, elevated blood pressure, increased cholesterol levels, etc.is one of the primary causes of ED. Apart from it, excess consumption of alcohol, poor lifestyle habits, high-stress levels, genital injuries, etc. also lead to a yielding erection.
As an alternative, try taking ashwagandha or a standardized extract of Asian ginseng. Ashwagandha, from the roots of a plant in the nightshade family called Withania somnifera, is reputed to be a mild aphrodisiac and has long been popular in India. Asian ginseng, or Panax ginseng, is a good general stimulant and sexual energizer. For either, follow the dosage on the package, and give it a six or eight week trial to have an effect. Both ashwagandha and Asian ginseng are generally safe (but Asian ginseng can raise blood pressure and cause irritability and insomnia in some people). Read more tips, recipes, and insights on a wide variety of topics from Dr. Weil here.
There is some evidence that acupuncture can be helpful in treating erectile dysfunction. Although studies show mixed results, one study found that after 4–10 acupuncture sessions, 13 of the 19 patients in the intervention group were able to obtain a full erection without further therapy and their symptom scores improved by 41.9 percent. This study suggests that acupuncture can be helpful for some men in improving erectile function. (31)
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As is true in so many medical conditions, lifestyle modifications, considered first-line therapy, can have a salutary effect in ED management, and men should be encouraged to make the necessary changes to the benefit of their sexual function and to their overall health as well. Despite the benefits of behaviour modification, men presenting with ED want the physician to help with measures that can have an immediate impact.
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