Associate Professor of Urology, Director of Newport Beach Urology, Director of Men's Health, Chief, Division of Men's Health and Reconstructive Urology
Erectile dysfunction (ED) indicates something physical or psychological is preventing a man from achieving and sustaining an erection. The most common reasons for ED involve inadequate blood flow to the penis, damaged erectile tissue and problems with the brain sending sexual arousal signals to the penis. Conditions causing ED include high blood pressure, diabetes, low testosterone, heart disease, neurological disorders (Alzheimer’s, Parkinson’s) or undergoing radiation treatments for prostate cancer. Men who suffer anxiety, depression or other mental health issues may also experience erectile dysfunction.1 .
Answer: If you go to your physician for your sex related issues he may suggest testosterone therapy or intake of steroids. Though such advice may give you results but they have many side effects. The side effects can be quite serious and some may cause long term ailments.
BHRT provided by Renew Health and Wellness increases low testosterone levels in men without causing side effects attributed to synthetic hormone replacements. Nearly identical in molecule structure to hormones produced by the body, plant-based bioidentical hormones also provide a wide variety of health benefits to men with ED and testosterone loss due to aging or medical conditions.
https://www.jsm.jsexmed.org/article/S1743-6095(19)31115-4/fulltext Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study. (1994).
Psychosexual counselling, or sex therapy, is an appropriate recommendation especially for men who are experiencing discord with their partner especially if the conflict is related to the man’s ED. Counselling usually consists of 5–20 sessions with counsellor. It is our recommendation that referral doctors treating men with ED make a referral to a psychotherapist or sex therapist who is certified by AASECT (American Association of Sexuality Educators, Counselors and Therapists) of certified sexuality educator.43
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According to a Harvard Medical School study, a man with a 32-inch waist is 50% less likely to have ED than a man with a 42-inch waistline. The implication here is that heavier men are likely to have clogged arteries, diabetes, or other health conditions that impede sexual performance. Exercising can promote blood flow throughout the body, and eating better can improve heart health.
Overall, the drug was well tolerated, with the most common adverse event being headache, and fewer than 2% of patients discontinued due to an adverse event. There were no serious adverse events, Mulhall added.
Erectile function was also assessed using a standard scoring system. The researchers took factors such as height, weight, blood pressure, hand grip strength, amount of body fat, age, education, marital status, occupation and smoking behavior into account. Depression, the probability of obstructive sleep apnea, medication usage, diet and alcohol consumption, and physical activity were also assessed, as were blood levels of glucose, triglycerides (an unhealthy blood fat) and cholesterol.
Nearly 95% of men with erectile dysfunction can obtain an erection sufficient for sexual satisfaction with a vacuum constriction device. Only vacuum constriction devices containing a vacuum limiter should be used. All FDA approved devices have such a limiter. Vacuum constriction devices can be a useful second-line treatment option especially in the patient with a supportive partner in a stable relationship. Virtually all men of all ages and with all types of erectile dysfunction can have successful intercourse with a vacuum constriction device.
Due to the fact that ED and CVD share many of the same risk factors, it is not surprising that there is a high incidence of ED in men who present with CVD. A study by Montorsi et al found that ED was present in roughly 50% of patients with acute chest pain and confirmed CAD on angiography.21
Physical disorders associated with erectile dysfunction can sometimes be related to hormones in the body. Non-hormonal causes include conditions that affect the blood supply to the penis (such as high blood pressure, type 1 or type 2 diabetes and smoking) and those that affect the nerves supplying the penis (such as Parkinson’s disease and damage to the nerves in the body e.g. due to both type 1 or type 2 diabetes). Erectile dysfunction can also be a side-effect of a medical intervention or treatment. Potential treatments that may be implicated in the cause of erectile dysfunction include certain antidepressants and treatment for high blood pressure (antihypertensives).
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https://pubmed.ncbi.nlm.nih.gov/8254833/ Modifying Risk Factors in the Management of Erectile Dysfunction: A Review. (2016).
But Stendra will cost you significantly more than sildenafil or tadalafil — that’s the tradeoff. Hims — our top choice for convenient access to Stendra — offers a monthly subscription for Stendra at $116 per month, billed quarterly. If you can afford the cost, this may be the best choice for you.
He also noted that there are data on sexual attempts within 15 minutes of dosing tadalafil (Viagra) and sildenafil (Cialis) but he did not have that available.