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What are the different types of treatments for erectile dysfunction? What can be expected during a physician’s visit to discuss ED and treatments of ED? Treatment for erectile dysfunction always starts with an assessment of the root causes of the problem and making healthy lifestyle changes to address those risks. Addressing psychological factors is always part of the treatment plan and is sometime the most important aspect of care. Non-invasive testing like an ultrasound and Doppler can help guide decisions about using oral medications, gels inserted into the urethra or intracavernosal (penile) injections.

For men who have difficult to treat erectile dysfunction, or who prefer a more permanent solution, implant surgery is an option with a high rate of patient satisfaction.

Are there any new treatments available for erectile dysfunction?

Several newer therapies are in development and show promise. Low-intensity shockwave therapy (LISWT) has been used successfully to help with wound healing and healing of bone fractures.

Research in animals shows that this type of treatment stimulates the growth of new blood vessels and recruitment of stem cells to the penis.

Clinical studies in men with ED responsive to medications like Viagra show promise, but this treatment has not been standardized and is not yet FDA approved for the treatment of erectile dysfunction.

The American Urologic Association guidelines do not currently recommend this treatment outside of clinical trials. How effective are the treatments for erectile dysfunction? Response to treatment depends on the cause of the problem and the type of treatment. Response to oral therapies can be as high as 70%, and the rate of satisfaction in men who have surgical treatment for ED is more than 90 percent.

Men who are committed to addressing the root cause of the problem (diabetes, sleep disorder, smoking) have a better response to treatment. Having a supportive partner is also an important factor.

Is the Men’s Health Center at The Miriam Hospital unique in the treatment and services it offers for erectile dysfunction? The Men’s Health Center employs a multidisciplinary model of care that takes into account all factors that may contribute to sexual dysfunction. Patients undergo a thorough “cardiometabolic” workup to address the root cause of the problem and

determine

Are support groups available for erectile dysfunction? Support groups are available for prostate cancer survivors

who

Forums include questions about oral and injectable meds, urinary incontinence and coping after a diagnosis.

Some groups meet face to face while others are entirely online. Online forums may be more appropriate for some individuals given the nature of the conversations.

Erectile dysfunction (commonly referred to as “ED”) is defined as a man being unable to achieve and/or maintain an erection firm enough or long enough to engage in sexual intercourse that is mutually satisfactory.

What many men do not know is that erectile dysfunction can be treated and many treatment options are available.

Most men believe erectile dysfunction is a normal sign of aging, that it does not affect younger men, or that erectile dysfunction is caused by psychological problems.

In fact, men of all ages can suffer from erectile dysfunction. Statistically, this condition does increase with age but it can affect men as young as 20 years old.

41 Erection problems occur in approximately 20% of men over the age of 20.

41 Some men may become embarrassed and reluctant to discuss their condition with anyone, including their partners or medical professionals.

It’s important for men with erectile dysfunction to talk to their doctors or find a physician who specializes in sexual medicine.

Erectile dysfunction can be a symptom of an underlying condition that needs treatment.

71 Not everyone knows that it can be a sign of a bigger health problem. The most common causes of erectile dysfunction are related to blood flow issues to the penis. 71 Serious conditions such as diabetes, heart disease, prostate cancer, peripheral vascular disease — and some of the medications prescribed to treat these conditions – can all

cause

Erectile dysfunction can be a symptom of an underlying condition that needs treatment. Not only are diabetes, heart disease, peripheral vascular disease, prostate cancer, and medications to treat these diseases causes of erectile dysfunction, but other factors such as smoking can play a role in the disease. 1 Male sexual arousal is a complex function that requires hormones, nerves, blood vessels, and emotions, and an erection can be affected by one or all of these factors.

While masturbation and pornography will not lead to erectile dysfunction, some forms of masturbation and pornography may desensitize men, making it more difficult for them to ejaculate, therefore making

sexual

If you are concerned about your erections it is important to speak with your doctor. They will use tests to determine the cause of your erectile dysfunction. Treating an underlying condition could be enough to help with your erections.

If you continue to have problems with your erections, there are many effective treatment options for erectile dysfunction.

Effective treatment options for erectile dysfunction. A variety of treatment options for erectile dysfunction are available.

Effective treatment options for erectile dysfunction range in approach and patient satisfaction results vary. Most men have heard of oral medications, but pills are not the only option available to treat the condition.

Effective treatment options include pills, vacuum erection pumps, injection therapy, and a permanent solution: the penile implant.

These can be effective for some men, but for others the side effects and ineffectiveness will cause them to look for other options.

The next step prescribed by a urologist specializing in erectile dysfunction may be to consider using a vacuum pump or injection therapy to treat

the

These two treatment options can be effective as well, but may not be for everyone. Some men relay that the vacuum erection device or penis pump results in a cold penis erection.

This treatment option is an implantable medical device that gives men an erection whenever they desire, for as long as needed.

This option must be discussed with an erectile dysfunction specialist, a doctor that specializes in penile implant surgery also known as a prosthetic urologist.

Hispanic men are at a greater risk for erectile dysfunction compared to non-Hispanic men due to the increased frequency of health conditions such as heart disease and diabetes within the culture. 73 Diabetes affects the blood flow throughout the body, including the penis and uncontrolled blood sugar levels can be

damaging

It is important for men to control their diabetes to ensure minimal

damage

Erectile dysfunction can also be linked to other conditions such as high blood pressure and heart disease. It is important for someone taking nitrates for heart conditions to understand that they are not a candidate for oral medications. When oral medications for erectile dysfunction are not an option, other erectile dysfunction treatments including the penile implant are available. Hispanic men are at a greater risk for erectile dysfunction compared to non-Hispanic men due to the increased frequency of health conditions such as heart disease and diabetes within the culture. Erectile dysfunction can impact men’s mental and emotional health as well. The ability to have and maintain an erection can influence men’s self-esteem or sense of manhood. A man may become depressed and relationships may suffer. Men with erectile dysfunction tend to emotionally and physically withdraw from their partners.

In fact, a common issue among couples dealing with erectile dysfunction starts with failures of sexual advances.

This can have an effect on issues of trust, intimacy, and closeness.

The man withdraws emotionally and physically because of fear of failure. If someone is struggling to achieve or maintain an erection, it is important to discuss the problem with their doctor to help determine the cause of the erectile dysfunction.

Erectile dysfunction can be an early indicator of a serious medical condition that would need to be treated first. A prosthetic urologist can provide patients with a complete evaluation or work up and provide them with more detailed information about all treatment options. Supportive partners are encouraged to attend

office

Regardless of age or health condition, it is important to remember that men are not alone. Erection Problems (Erectile Dysfunction) Topic Overview. A man has erection problems if he cannot get or keep an erection that is firm enough for him to have sex. Erection problems are also called erectile dysfunction or impotence. Most men have erection goodrx for sildenafil problems every now and then.

But they are more common in older men, who often have other health problems.

These include: Physical problems, such as injury to nerves or loss of blood supply to the penis . Other health problems, such as diabetes , high blood pressure , anxiety , and depression .

The only symptom of an erection problem is being unable to get and keep an erection that is firm enough to have sex. But even with an erection problem, a man may still have sexual desire and be able to have an orgasm and to ejaculate.

Your doctor can find out if you have an erection problem by asking questions about your health and doing a physical examination.

Your doctor will want to know how often the problem happens.

The examination, lab tests, and sometimes mental health tests can help find out the cause of the problem. Doctors usually start with lifestyle changes and medicines.

They usually don't advise surgery or other treatments unless those first steps don't help. Treatment can include: Avoiding tobacco and drugs and limiting alcohol. Talking about the issue with your partner, doing sensual exercises, and getting counselling. Finding and then stopping medicines that

may

In some cases you can take a different medicine that doesn't cause erection problems. Taking prescription medicine that can help you get erections. These include pills such as sildenafil (for example, Viagra), tadalafil (for example, Cialis), and vardenafil (for example, Levitra). Check with your doctor to see if it is safe for you to take one of these medicines with your other medicines.

These pills can be dangerous if you have heart disease that requires you to take nitroglycerin or other medicines that contain nitrates.

Taking medicines and getting counselling for depression or anxiety.

Using vacuum devices or getting shots of medicine into the penis. Erection problems are most often caused by a physical problem. So it's important to eat healthy foods and get enough exercise to help you stay in good health. To reduce your risk of having an erection problem, don't smoke, drink too much alcohol, or use illegal drugs.

You may be able to avoid erection problems related to anxiety and stress by talking with your partner about your concerns.

Health Tools help you make wise health decisions or take action to improve your health.

Erection Problems: Should I Try Injection Treatments? Erection problems may be caused by physical problems related to the blood vessels, nerves, and hormones.

Normally, an erection occurs when your imagination or senses (vision, hearing, touch, smell, taste) are stimulated and you become aroused.

Your central nervous system sends nerve impulses that increase blood flow to your penis. Physical problems cause about 8 out of 10 cases of erectile dysfunction.

Physical problems are often the cause of erection problems in men age 50 or older. They include: Side effects of medicines, including some medicines used to treat benign prostatic hyperplasia (BPH), depression, and prostate cancer. In some cases it may be possible to change the dose of the medicine or to use another medicine. Stopping or reducing the use of these substances may make the erection problem less severe. These problems may prevent blood from filling the penis or from staying there long enough to maintain an erection.

For example, long-term high blood pressure can cause damage to blood vessels and lead to erection problems. These may prevent arousal signals from travelling from the brain and spinal cord to the penis.

Nerve disorders such as Parkinson's disease , Alzheimer's disease , multiple sclerosis , and stroke may interfere with a man's ability to have an erection. Nerve damage from diabetes, complications from surgery, and spinal cord injury also may cause problems. Problems with the structure of the penis or its surrounding tissues. Hormonal factors, such as a low level of the hormone testosterone .

Pelvic injuries and complications of prostate or other surgeries that interfere with nerve impulses or blood flow to the penis.

Psychological issues seem to be involved in many cases of erection problems. These mental issues include: Depression (which also has a physical component).

These things interfere with the erection process by distracting the man from things that would normally arouse price of sildenafil 50 mg him. Erection problems in men younger than 40 who have no physical risk factors are more likely to be caused by mental factors than physical

causes

Symptoms of erection problems include being unable to: Have an erection, most of the time.

Keep an erection firm enough for sexual intercourse. Keep an erection long enough to complete sexual intercourse.

Even with an erection problem, a man may still have sexual desire and be able to have an orgasm and to ejaculate.

But when erection problems are lasting, they can affect your self-image, sex life, and relationship.

When you have erection problems often, "performance anxiety" can make the problem worse.

If you cannot keep an erection that is firm enough for intercourse, or if you

have

All of these things could affect how you view your relationship. Fortunately, many of the things that cause erection problems can be treated. Your risk of having an erection problem increases with age. Other things that increase your risk include: Diseases that affect blood vessels, such as diabetes, high blood pressure, and high cholesterol.

About half of men with diabetes develop erection problems.

These include multiple sclerosis and Parkinson's disease. Other health problems, such as low testosterone levels. Injuries to the pelvic area, a spinal cord injury, or treatment such as pelvic surgery or radiation in the pelvic area. Using substances, such as long-term (chronic) alcohol abuse. Psychological risk factors, such as depression or a recent life change. Activities that constrict blood flow to the penis may increase the risk for

erection

For example, frequent long-distance bicycle riding on a hard, narrow saddle may increase risk. But the possible link between bike riding and erection problems has not been proved.

A vasectomy usually doesn't cause erection problems.

But pain after the operation may affect sexual performance for a time.

And if a man wasn't comfortable with his decision to have a vasectomy, or if he's having second thoughts, it could affect him psychologically. Call your doctor now or seek medical care right away if: You have an erection that lasts longer than 3 hours.

You have taken sildenafil (for example, Viagra) or vardenafil (for example, Levitra) in the past 24 hours or tadalafil (for example, Cialis) in the past 48 hours, and you have chest pain. Make sure all the doctors you see know that you took one of these medicines.

You have erection problems that occur along with pain or difficulty with urination, fever, or pain in the lower belly.

Call a doctor if erection problems occur: With any type of injury to the back, legs, sildenafil citrate at walgreens buttocks, groin, penis, or testicles.

With other symptoms such as loss of hair, enlargement of the breasts, or backache. If your erection problem happens just now and then, there is no reason to call your doctor. If it happens often and upsets you or your partner, it is okay to call your doctor.

If an erection problem doesn't bother you or your partner, you may choose not to call your doctor.

A single episode of an erection problem is often a temporary problem that is easy to reverse. Try to forget about it, and expect a more successful experience the next time. If you or your partner is concerned about it, talk about the problem.

If self-care has not helped after 2 weeks and you are concerned about your erection problem, see a doctor who has experience in dealing with these problems. Your family doctor or general practitioner can evaluate symptoms of erection problems. You may be referred to an internist or a urologist , depending on what may be causing your erection problem. If it is possible that a psychological problem is contributing to

your

Because both physical and mental factors are often involved, it may be difficult to diagnose the exact cause of your erection problem.

To start, your doctor may: Review your risk factors for an erection problem. Do a complete physical examination of the abdomen, penis, prostate, rectum, and testicles. A low level of testosterone may reduce sexual desire, leading to an erection problem.

Prolactin, follicle-stimulating hormone, and luteinizing hormone.

If you have low testosterone levels, your doctor may recommend these blood tests. A thyroid hormone level that is too high or too low may cause problems with sexual desire or erections.

A high blood sugar level may mean the presence of diabetes , which can contribute to erection problems.

At this point, pills such as sildenafil (for example, Viagra), tadalafil (for example, Cialis), and vardenafil (for example, Levitra) are often recommended unless an easily treated cause (such as a medicine side effect or testosterone deficiency) has been identified. If pills don't work or if your doctor feels more testing is needed, he or she may recommend: Specific tests for erection problems. These tests help find out whether physical or mental factors are causing your erection problem. A psychological evaluation, if a mental issue is suspected.

An ultrasound may be done if your doctor thinks you may have a circulation problem ( peripheral arterial disease ).

Treatment for an erection problem depends on the cause of the problem.

The cause may be mental,

physical

Many doctors take a step-by-step approach to treating erection problems.

The treatment steps are: Looking for and then stopping medicines that may be causing your condition. Trying testosterone or another treatment to fix a hormone problem if tests show you have one.

Trying pills called PDE-5 inhibitors, such as sildenafil (for example, Viagra), tadalafil (for example, Cialis), and vardenafil (for example, Levitra).

Trying counselling if a psychological cause is suspected.

Trying medicines that are injected or inserted into the penis.

Erection Problems: Should I Try Injection Treatments?

If you are taking nitrate-containing medicines, such as nitroglycerin, you cannot use sildenafil (for example, Viagra), tadalafil (for example, Cialis), or vardenafil (for example, Levitra). You also should not take certain alpha-blockers—used to lower blood pressure and to treat an enlarged prostate gland —with these medicines. There is a risk of a dangerous drop in blood pressure. Check with your doctor to see whether you can take PDE-5 inhibitors with your alpha-blocker.

Oral medicines are commonly tried first before other medicine or surgery.

It is important to involve your partner in your decision, regardless of the treatment you choose.

Many men overestimate how important being able to have erections is to their relationships. Some men find that when they are able to have erections again, the hassle of using the treatment isn't worth the effort. Other men may find that being able to have erections doesn't change their relationship as much as they or their partners had expected.

You may be able to avoid erection problems related to anxiety and stress by taking a more relaxed approach to sex. Talk to your partner about your problems and concerns. If you and goodrx sildenafil 50 mg your partner talk about sex, it will help reduce your stress and anxiety. Erections may gradually become more difficult to get and keep as you get older.

But foreplay—erotic stimulation

before

Here are some other things you can do that may reduce your risk for erection problems: Quit smoking.

Even small amounts of alcohol can cause erection problems.

Keep your cholesterol level low to reduce the risk of hardening of the arteries (atherosclerosis).

Keep your blood sugar in your target range if you have diabetes. In some cases, occasional episodes of erection problems can be treated at home, without a doctor's help. And don't be embarrassed about seeking professional help if erection problems are consistent and troublesome. You may be able to help yourself by: Some men may try methods available in health food stores or through magazine ads. Most of these methods have never been medically proved to work.

Making lifestyle changes such as quitting smoking and drinking less alcohol can also help make erection problems less likely.

Medicines that can help produce an erection may be used to treat erection problems that are caused by blood vessel (vascular), hormonal, nervous system, or psychological problems.