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About Contact Events News Search Menu Students Teachers Patients Browse About Contact Events News Topical issues Practical Information You and Your Hormones Search Home Topical issues Erectile dysfunction Erectile dysfunction (ED) is the inability to have or maintain an erection for sexual intercourse. Hormones and fetal growth In vitro fertilisation treatment (IVF) Glossary All Topical issues Resources for Topical issues

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Prior to starting with treatment of erectile dysfunction, it is important to make sure that it is safe from a medical standpoint to participate in sexual activity. Sexual activity is physical exertion, and in some men with significant heart disease, this increase in physical exertion can increase the risk of a heart attack. Thus, it is very important to discuss your cardiovascular risks with your doctor prior to trying any medication or treatment for erectile dysfunction.
Since endothelial dysfunction, CVD and ED are closely associated in epidemiological studies, the question for clinicians is whether to recommend the man presenting with ED undergo a cardiovascular (CV) evaluation. Clearly, based on numerous studies, ED can be considered at least a ‘marker’ for possible further vascular disease or CVD.15 In their report, Vlachopoulos and coworkers make the point that the man presenting with ED, the clinician, is offered an opportunity to attempt to improve the health of the man by addressing lifestyle modification, and consider further vascular evaluation owing to the clear relationship between endothelial dysfunction, ED and CVD.19 .

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The role of the endothelium in erectile function became clearer with the observation that the phosphodiesterase type 5 (PDE5) inhibitor, sildenafil, enhanced erectile function. Erection occurs with the release of nitric oxide (NO) from the vascular endothelial cells.17 The reduction in endothelial cell production of NO results in the negative impact on the smooth muscles in the corporal bodies and results in less relaxation of the smooth muscle cells with decrease in blood supply and resulting ED. A similar phenomenon is well known to impact the coronary arterial system resulting in CVD.
But Performer 8 can reverse the slow down process effectively and assist you in improving your sex performances. In addition to enhancing your libido and stamina it also increases the girth as well as hardness of your penis.

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First line treatment will be medication with a phosphodiesterase inhibitor such as sildenafil (Viagra), tadalafil (Cialis) or avanafil (Spedra). These drugs only work when used together with sexual stimulation and will have no effect on your sex drive. There is no evidence that these drugs are dangerous if you have underlying heart disease. However, they should not be used if you are taking nitrates (e.g. GTN, isosorbide) for angina
Yes, the vacuum device is effective. In fact, with the use of the vacuum device, 88% of men will have an erection that is satisfactory for the completion of sexual activity. The vacuum device may be the only therapy that is effective after the removal of a penile prosthesis. Patients also use vacuum devices as part of penile rehabilitation after radical prostatectomy to help preserve the tissue of the penis and prevent scarring within the penis and loss of penile length. Its use, however, is limited by its mechanical nature of it and the time taken to pump the device and apply the band. Sex partners may complain about the penis being cool to touch.

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Your GP should work through a recommended scheme of assessment for men with erectile dysfunction (impotence). This will normally include some or all of the following:

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A study published in the January 2016 edition of the American Journal of Clinical Nutrition suggests a diet rich in flavonoid-rich foods can reduce the risk of ED. The study reviewed data from more 25,000 men who were middle-aged and older, and who participated in routine health survey since 1986. Researchers compared responses about having and maintaining an erection sufficient for intercourse with the number of flavonoid-rich foods each man reported consuming. Men who ate more fruit had a 14 percent reduced risk of ED. Men who consumed a high volume of flavonoid-rich fruits and exercised regularly experienced a 21 percent reduction of risk. Foods such as blueberries, cherries, blackberries, radishes, citrus fruits, and red wine offered the flavonoid profile with the greatest benefits. L-arginine is an amino acid that naturally occurs in the body and helps synthesize proteins. It is also the precursor to the compound nitric oxide (NO). NO is vital for achieving and maintaining an erection, as it helps the blood vessels relax to support blood flow throughout the body, including into the penis. Supplementing arginine in conjunction with a balanced lifestyle can offer men added support for a healthy erection. Added pounds can have a significant impact on blood flow, as well as put men at risk for diseases that may exacerbate ED. A study published in the January 2005 issue of the journal Canadian Family Physician found 30 percent of men who participated in a weight loss program and lost an average of 15 percent of their total body weight saw sexual function restored compared to only 5 percent of the control group.

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    A study published in May 2014 in The Journal of Sexual Medicine found that some men can reverse erectile dysfunction with healthy lifestyle changes, such as exercise, weight loss, a varied diet, and good sleep. The Australian researchers also showed that even if erectile dysfunction medication is required, it's likely to be more effective if you implement these healthy lifestyle changes.

    Lifestyle changes. Your doctor might suggest that you lose weight or start an exercise routine to improve your ED symptoms. They might also recommend that you stop smoking, drinking alcohol, or using marijuana or other drugs.
    To help you decide, we’ve tested and reviewed the major providers and treatments and analyzed all of the scientific research. Here, we’ll break down all of your best options. Best overall: BlueChew tadalafil Best if money’s no object: Hims Stendra Best for newbies: BlueChew free trial Best for flexible dosage: Roman sildenafil Best for convenience: BlueChew tadalafil Best for morning sex: Hims Stendra Best for men who believe Viagra is the only option for them: Hims Viagra

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    But do any of these things really work? Eric Laborde, MD, a spokesman for the American Urological Association, is skeptical.

    Urethral suppositories (MUSE) have the same ingredient as ED injections (alprostadil) only they are in pellet form. You will insert the pellet into your urethra (urinary channel), where it will dissolve.
    Tadalafil is effective in treating erectile dysfunction in men of all ages and is effective in men with diabetes mellitus and erectile dysfunction after prostate cancer surgery. Studies demonstrated that tadalafil improved the ability to get a hard erection and to have the hard erection last long enough.

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    Erectile dysfunction is a common condition and its frequency increases with age. Whilst for some men it may only occur occasionally, being related to fatigue, stress or alcohol intake, for others, it can occur more frequently. The male erection is the culmination of two aspects of sexual function – a reflex aspect, controlled by the nerves in the body, and a psychogenic aspect, which is the result of emotional or erotic stimuli, and involving the brain’s limbic system (which controls emotions and feelings).

    Research shows that saw palmetto extract has been used extensively in the treatment of lower urinary tract symptoms and improves prostate health. And although the results are mixed, studies have shown that saw palmetto is also effective in improving erectile dysfunction. An animal study, for instance, evaluated the erectile functions of rats and rabbits that received saw palmetto extract. Researchers found that saw palmetto caused a relaxant response within the erectile tissue of the animals, allowing for increased blood flow. (22, 23).
    Your urine will normally be tested to see whether it contains sugar (which might indicate diabetes), or blood (which may be a sign of infection or require further investigation).

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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.

    Other research has shown Black men may be less likely to report symptoms of moderate to severe ED.
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A meta-analysis of 36 744 men with ED in 12 prospective cohort studies found that the presence of ED significantly increased the risk of CVD, CAD, stroke and all-cause mortality, and the presence of ED was an independent risk factor for CVD. Ponholzer et al found that men with moderate to severe ED had a 65% increased relative risk for developing symptomatic CAD compared with men who did not have ED.26

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“If your testosterone is low, then that might be playing a role” in your erectile dysfunction, Laborde says. “But if it’s normal, making more testosterone is not going to help you.”

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As already mentioned, taking certain medications, using tobacco, and drinking heavily can cause or contribute to problems with ED.

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Oral drugs Popular medicines like sildenafil (Viagra), tadalafil (Adcirca, Cialis), vardenafil (Levitra, Staxyn), and avanafil (Stendra) work by boosting the effects of nitric oxide — a chemical that relaxes muscles in the penis. Note that drugs in this class (PDE-5 inhibitors) are contraindicated in patients who take nitrates in any form, because the combination can lead to severe hypotension.

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