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Neuroimaging findings suggest that watching porn may have a similarly harmful effect on the brain as that of addictive substances.

As their porn habit develops, a person’s neural structure may change, thus increasing their reliance on an external reward system to achieve certain psychological states.

This may explain a person’s tendency to depend increasingly on porn for feelings of sexual excitement themselves (rather than being able to generate these mindstates, and associated bodily changes such as erections), and/or to feel the need to seek out media with increasingly extreme subject matter.

[31] “Erectile Dysfunction (Impotence).” Patient.

↩ ↩ ↩ “Erectile dysfunction (impotence).” NHS Inform. ↩ “Management of sexual dysfunction in Parkinson’s disease.” Therapeutic Advances in Neurological Disorders. ↩ “Treatment of erectile dysfunction in multiple sclerosis.” Expert Review of Neurotherapeutics.

↩ ↩ “How to use Vitaros: an introductory guide.” Treated.com. ↩ ↩ ↩ “Erectile dysfunction (impotence).” The British Association of Urological Surgeons.

↩ “Erectile dysfunction (impotence) - Diagnosis](http://www.nhs.uk/Conditions/Erectile-dysfunction/Pages/Diagnosis.aspx).” NHS Choices.

↩ “Erectile dysfunction (impotence) - Treatment.” NHS Choices. ↩ “The PDE-5 inhibitors.” Sexual dysfunction after radical prostatectomy. ↩ ↩ “Alprostadil for erectile dysfunction.” Patient. ↩ “Alprostadil: side effects.” National Institute for Health and Care Excellence (NICE).

↩ “Preventing Erectile Dysfunction - What You Should Know.” Urology Care Foundation. ↩ “A syndrome of erectile dysfunction in young men.” Translational Andrology and Urology.

↩ “How erection problems can affect your relationship.” Patient.

↩ “Penile rehabilitation following radical prostatectomy.” Current Opinion in Urology.

↩ “Does maturbation cause erectile dysfunction (ED)?.” International Society for Sexual Medicine. ↩ ↩ “Sex and relationships.” Prostate Cancer UK. ↩ “Porn use linked to erectile dysfunction.” Medscape.

↩ Erectile Dysfunction (ED) Appointments and Referrals.

Call us at 401-793-4636 (4MEN) for more information about our services, or to make an appointment, or refer a patient. The Men's Health Center 180 Corliss Street, Suite C Providence, RI 02904. Erectile dysfunction is defined as the inability to attain and or maintain an erection adequate for sexual intercourse. The main categories of erectile dysfunction are vasculogenic (due to poor blood flow), neurogenic (when the nerve pathways that trigger an erection are affected as in diabetes) and psychogenic (when physical changes triggered by worry or anxiety interfere with normal erection). Most men suffer from a combination of factors, and a careful history of the problem often leads to a diagnosis.

Nearly 50 percent of men ranging in age from 40 to 70 years of age are affected by ED.

Men report guilt, shame and frustrations related to inability to perform. Due to repeated failed attempts, performance anxiety may present with subsequent attempts.

What is a little known fact about erectile dysfunction that the public should be aware of?

The

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

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 if additional cardiovascular testing is necessary. Surgical treatment options are available, and the incorporation of psychology and physical therapy provides a level of care not available at other centers. Are support groups available for erectile dysfunction?

Support groups are available for prostate cancer survivors who

are

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.

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 relations less satisfactory.

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

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 erectile dysfunction.

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 to both the nerves as well as blood vessels.

It is important for men to control their

diabetes

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 visits to have their questions about erectile dysfunction treatment options answered too.

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 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 be causing the problem.

In some cases you can take a different medicine that doesn't cause erection problems.

Taking prescription medicine that can help you get sildenafil teva 100 mg kob 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 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 an orgasm before or right after entering your partner ( premature ejaculation ), you may feel frustrated and believe you aren't pleasing your partner.

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 problems. 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.

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