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For most men it is only temporary and an erection occurs most times when

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However, some men have persistent, or recurring problems with sexual function.

It can occur at any age but becomes more common with increasing age. About half of men between the ages of 40 and 70 have ED.

There are several causes which tend to be grouped into those that are mainly physical and those that are mainly due to mental health issues. Book a consultation with a local pharmacist today via Patient Access and discuss treatment options. About 8 in 10 cases of ED are due to a physical cause. Causes of ED include: Reduced blood flow to the penis . This is, by far, the most common cause of ED in men over the age of 40.

Like in other parts of the body, the arteries which take blood to the penis can become narrowed.

The blood flow may then not be enough to cause an erection. Risk factors can increase your chance of narrowing of the arteries. These include getting older, high blood pressure, high cholesterol and smoking.

For example, multiple sclerosis, a stroke, Parkinson's disease, etc. For example, a lack of a hormone called testosterone which is made in the testicles (testes).

However, one cause of a lack of testosterone that is worth highlighting is a previous head injury.

A head injury can sometimes affect the function of the pituitary gland in the brain. The pituitary gland makes a hormone that stimulates the testicle to make testosterone.

So, although it may not at first seem connected, a previous head injury can in fact lead to ED. Other symptoms of a low testosterone level include a reduced sex drive (libido) and changes in mood. For example, spinal injury, following surgery to nearby structures, fractured pelvis, radiotherapy to the genital area, etc. The most common are some antidepressants; beta-blockers such as propranolol, atenolol, etc; some 'water tablets' (diuretics); cimetidine.

Many other less commonly used tablets buy generic sildenafil citrate sometimes cause ED.

ED after long-distance cycling is thought to be common. It is probably due to pressure on the nerves going to the penis, from sitting on the saddle for long periods. This may affect the function of the nerve after the ride. Excessive outflow of blood from the penis through the veins (venous leak) . This is rare but can be caused by various conditions of the penis.

In most cases due to physical causes (apart from injury or after surgery), the ED tends to develop slowly.

So, you may have intermittent or partial ED for a while, which may gradually become worse. If the ED is due to a physical cause, you are likely still to have a normal sex drive apart from if the cause is due to a hormonal problem. In some cases, ED causes poor self-esteem, anxiety and even depression.

For instance, many men have occasional times when they cannot get, or maintain, an erection.

If you have one episode where you can't have sexual intercourse as a result, you may get anxious that it will happen again.

This anxiety can be enough to stop you getting an erection next time, leading to more anxiety.

Various mental health conditions may cause you to develop ED.

They include: Stress - for example, due to a difficult work or home situation.

Typically, the ED develops quite suddenly if it is a symptom of a mental health problem. The ED may resolve when your mental state improves - for example, if your anxiety or depression eases.

However, some people become even more anxious or

depressed

They do not realise it is a reaction to their mental health problem. This can make matters worse and lead to a vicious circle of worsening anxiety and persisting ED. As a rule, a psychological cause for the ED is more likely than a physical cause if there are times when you can get a good erection, even though most of the time you cannot.

(For example, if you can get an erection by masturbating, or wake up in the morning with an erection.) What you need to know before you take erectile dysfunction medication.

You can now buy erectile dysfunction (ED) medication over the counter at pharmacies.

Erectile Dysfunction (ED) Urology Associates provides various treatment options for erectile dysfunction (ED).

Our urology team will help treat your ED safely and effectively. About ED: Erectile dysfunction (ED), also known as impotence , is the most common sexual problem amongst men. ED is defined as the inability to achieve or sustain an erection for sexual intercourse. At least 25% of men over the age of 50 are diagnosed with ED.

Roughly 8-10% of men between 20-30 years old suffer from ED.

Normal erections are dependent upon complex interactions between the vascular, hormonal, neurologic, and physiological systems.

A disruption within any of these systems can compromise a man’s ability to achieve an erection. Risk Factors of ED: Comorbid Conditions: One of the strongest predictors of ED in men revolves around comorbid conditions.

These conditions include, but are not limited to: obesity, cardiovascular disease, diabetes, high blood pressure, high cholesterol , and neurological conditions. 70-80% of ED is related to poor arterial blood flow to the penis which all these comorbid conditions above may contribute to in some degree.

Anatomical

Psychosocial factors including depression or anxiety can also cause ED and seems especially more prominent in younger men.

Lifestyle choices: Additionally, there are strong associations between certain lifestyle choices and ED. Smoking and a sedentary life style increases ED prevalence dramatically.

Luckily, lifestyle modifications can dramatically decrease a man’s chances of developing ED or progressing their existing symptoms.

Sufficient exercise has been shown to decrease ED occurence. In fact, a well-supported study demonstrated that weight loss and increased activity can actually reverse ED in obese men without the help of medications. Sexual Activity: The amount of sexual activity also appears to impact ED prevalence rates. In one study, men having decreased sexual intercourse (average of less than once per week) had twice the rates of ED compared to men having more frequent sexual intercourse (at least once a week).

Sleep Apnea/RLS: Interestingly, sleep apnea appears to be a risk factor for ED. Treatment with CPAP (continuous positive airway pressure) may improve ED symptoms.

Although not fully investigated, restless leg syndrome (RLS) appears also to increase the rates of ED in men.

It is still unclear how treatment for RLS impacts ED. Medications: Certain medications may increase ED rates in men.

It is estimated that medications may be at least partially responsible for 25% of ED cases in men.

Some of the most common medications that can cause ED include: antidepressants, sympathetic blockers (clonidine, methyldopa), certain diuretics (water pills), ketoconazole, H2 antagonists (cimetidine, ranitidine), anticholinergics. A variety of other medications are also associated with ED.

Alcohol, cocaine, marijuana, and other

drugs

Bicycling places pressure on the perineal nerves, which in excessive amounts, can cause numbness of the penis and impotence.

Others: Other potential causes of ED include systemic sclerosis (scleroderma), Peyronie’s disease (excessive curvature of the penis), past trauma to the penis or pelvis, past surgeries, and prostate cancer treatment. To summarize, there are many different factors that can cause or contribute to ED.

Some of the strongest contributors, such as comorbid conditions, can be modified and controlled with lifestyle changes.

Most common however, ED causes are multifactorial and complex. Our urology team is here to work with you to

resolve

How We Diagnose ED: As described above, there are many risk factors and causes for ED.

Therefore, our team investigates the potential causes for each patient thoroughly and independently to ensure the best possible outcome.

Our work up for ED may include: Medical and sexual history Physical exam Psychological assessment Basic labs.

Treatment Options: Treatment options may vary depending on the presumed cause of your ED. Our team will work with and may suggest the following treatments: Oral medications, such as Viagra, Cialis, or Levitra Vacuum devices Penile self-injection therapy Lifestyle modifications Surgical procedures. Erectile dysfunction (also known as impotence, or ED) is the inability to get and keep an erection firm enough for sex.

A practical approach to treating ED —similar to the strategy for most medical issues — starts with a medical history, physical examination and basic lab tests. More extensive testing may be suggested depending on the individual. If the evaluation indicates that the ED buy viagra for female online is psychological or emotional in origin, referral to a qualified psychologist, psychiatrist or sexual counselor will be the next step.

If the lab results indicate low testosterone, additional hormone tests will be done to determine the precise cause of the low testosterone, then a treatment aimed at normalizing the levels will be suggested.

If testing shows undiagnosed or poorly controlled diabetes or a risky lipid and cholesterol profile, a referral to another medical professional will be necessary.

Although ED treatment is tailored to the individual patient, there are four general paths of treatment for ED: 1. A healthy lifestyle can “reverse” ED naturally, as opposed to “managing” it. Since ED can often be considered a “chronic disease,” healthy lifestyle choices can reverse it, prevent it from getting worse, or even prevent it altogether. Since sexual function is based on many body parts working together, this approach is to nurture every cell, tissue and organ in the body.The goal is to achieve a healthy weight, adopt a healthy diet, exercise regularly, get enough good quality sleep, stop using tobacco, consume alcohol in moderation, and reduce stress. Aside from general cardio and strength exercises, specific pelvic floor muscle exercises (“man-Kegels”) are beneficial to improve the strength, power and endurance of the penile “rigidity” muscles.

If a healthy lifestyle can be adopted, sexual function will often improve dramatically, as well as overall health improvements. Since many medications have side effects that negatively impact sexual function, a bonus of lifestyle improvement is potentially needing lower dosages or perhaps eliminating medications (blood pressure, cholesterol, diabetes), which can result in further improving sexual function.

It’s my opinion that oral ED medications should be reserved for when lifestyle optimization fails to improve sexual issues. This may be at odds with some sildenafil walmart coupon physicians who find it convenient to simply prescribe meds, and with some patients who want a quick and easy fix. However, as good as Viagra, Levitra, Cialis and Stendra may be, they are expensive, have side effects, are not effective for every patient and cannot be used by everyone, as there are medical situations and certain medications that may prevent their use.

In this category, I also include mechanical, non-pharmacological, non-surgical devices, including low-intensity penile shockwave therapy, vacuum suction devices, vibration devices and penile traction devices. Low-intensity shockwave therapy is an exciting new treatment option that uses acoustic energy to cause mechanical stress and microtrauma to erectile tissues. This stimulates the growth of new blood vessels and nerve fibers and potentially enables penile tissue to regain the ability for spontaneous erection.

Vacuum suction devices are mechanical means of producing an erection in which the penis is placed within a plastic cylinder that is connected to a manual or battery-powered vacuum. Negative pressure engorges the penis with blood and a constriction band is temporarily placed around the base of the penis to maintain the erection.

80% of men can achieve good rigidity, but many do not continue using the device because of its cumbersome nature. Venous constriction devices are used in conjunction with the vacuum suction devices to trap blood in the penis and help maintain the erection.

They also can be used without the suction devices in certain circumstances. Men who find these beneficial are usually able to obtain a reasonable quality rigid erection but tend to lose it prematurely.

Vibration devices were traditionally employed to provoke ejaculation in men with spinal cord injuries who desired to father children. Subsequently, they have achieved broader utility and are now also used to facilitate erections in men with ED.

Dual-armed vibratory stimulation of the penile shaft is capable of inducing an erection and ultimately ejaculation. Penile traction devices use mechanical pulling forces to lengthen and/or straighten the penis to manage or prevent penile shortening and angulation.

Vasodilator urethral suppositories and penile injections. These are suppositories and injections that increase penile blood flow and induce erections.

(Medical urethral system for erection) is a small medicated vasodilator pellet available in a variety of different dosages that is placed within the urinary channel of the penis after urinating. Absorption occurs through the urethra into the adjacent erectile chambers, inducing increased penile blood flow and potentially an erection. About 40% of men can achieve rigidity, but it is often inconsistent.

Prostaglandin E1 is injected directly into one of the erectile chambers of the penis, resulting in increased blood flow and erectile rigidity.

After being taught the technique of self-injection, vasodilator medications can be used on demand, resulting in rigid and durable erections. A combination of medications can be used for optimal results—one such popularly used combination consists of papaverine, phentolamine and alprostadil, known as “Trimix.” 90% or so of men achieve an excellent response, although many men are reluctant to put a needle into their penis.

Penile prostheses can be life changers for men who cannot achieve a sustainable erection. Surgically implanted under anesthesia on an outpatient basis, they provide the necessary penile rigidity to have intercourse whenever and for however long desirable. The semi-rigid device is a simple one-piece flexible rod, one of which is implanted within each of the paired erectile chambers. The penis is bent up for sexual intercourse and down for concealment. The inflatable device is a three-piece unit that is capable of inflation and deflation.

Inflatable inner tubes are implanted within the erectile chambers, a fluid reservoir is implanted behind the pubic bone or abdominal muscles and a control pump in the scrotum, adjacent to the testes.

When the patient desires an erection, he pumps the control pump several times, which transfers fluid from the reservoir to the inflatable inner tubes, creating a hydraulic erection that can be used for as long as desired.

When the sexual act is completed, the device is deflated via the control pump, transferring fluid back to the reservoir and restoring a flaccid state.

Implantica’s Solution, PotencyFlow® Implantica’s PotencyFlow® is subject to further development and approval process.

Although Viagra type of drugs has improved the situation for the around 150 million men suffering from Erectile Dysfunction, only 50% are able to use these drugs with a successful result.

PotencyFlow® is designed to treat impotence by hindering blood leakage from the penis during erection. The most common cause for erectile dysfunction is leakage of blood from the erectile system since pressurized blood causes the erection. Implantica’s PotencyFlow® is designed to help these patients suffering from erectile dysfunction, which occurs when the blood drains too quickly through the veins.

The device, which will use Implantica’s shared wireless energy platform, will be controlled wirelessly by a remote control or a push button under the skin resulting in a smooth chain of events that is expected to lead to a more natural erect penis. The device is designed to create erection by stimulation followed by restricting the blood flow leaving the penis using a penile blood flow restriction cuff, preventing the leak of the filling blood in the penis, thereby treating erectile dysfunction. The options available today are reconstructive surgery (often with poor long-term result) or a penile implant.