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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, or a combination of both. 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?

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

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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 your partner talk about sex, it will help reduce your stress and anxiety.

Erections may gradually become more difficult to get sildenafil online boots and keep as you get older.

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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.

They also may be used along with counselling to treat erection problems that have psychological causes.

Commonly used oral medicines include: PDE-5 inhibitors such as sildenafil (for example, Viagra), tadalafil (for example, Cialis), and vardenafil (for example, Levitra).

Other medicines that may be used include: Injected medicines.

Hormones and other medicines may be prescribed for men who have low testosterone or high prolactin levels.

Erection Problems: Should I Try Injection Treatments? Although oral medicines for erection problems can be purchased over the Internet, you need to talk with your doctor before using this medicine.

This is especially important if you have a heart problem. PDE-5 inhibitors should never be used if you may need to take a nitrate-containing medicine, such as nitroglycerin. Taking nitroglycerin and a PDE-5 inhibitor within 24 hours of each other may greatly lower your blood pressure. This could lead to a heart attack, stroke , or death.

Talk with your doctor about whether medicines for erection problems are safe for you if you: Have heart disease.

If you are taking a PDE-5 inhibitor and are going to have a test for heart disease, make sure that your doctor knows you are taking it. You should not take sildenafil (for example, Viagra) or vardenafil (for example, Levitra) for 24 hours before the test.

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If you have a heart condition and have not been sexually active for a while, talk with your doctor to make sure you can engage in sexual activity safely.

In a few cases, surgery may be an option to treat erection problems.

Surgery will rarely be recommended before non-surgical treatment and counselling have been tried. Think carefully about non-surgical options and about the possible risks of surgery.

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Specially trained urologic surgeons usually do blood vessel repair surgery. Vacuum devices are useful for all types of erection problems—physical, psychological, or both. You pump the device to create a vacuum that leads to an erection.

Counselling (psychotherapy) is recommended for men whose erection problems are caused, at least in part, by psychological factors. It focuses on ways to improve attitudes toward sex. Evidence shows that group therapy helps with erection problems in some men.

Adding group therapy to treatment with sildenafil (for example, Viagra) helped more than sildenafil alone. Men who were taking part in group therapy also were more likely to keep taking their medicine.



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