Detailed report of the cause of erectile dysfunction, diagnosis, treatment and prevention of.
It is a male between general much older, erectile dysfunction also is referred to as impotence, can affect men of all ages. Men to experience occasional erectile dysfunction is normal. If the problem becomes chronic, it is relationship, emotional health, you can adversely affect self-esteem and. Also erectile dysfunction, it may be basic health symptoms of the condition. Erectile dysfunction, if you become an ongoing problem, it would be to consult with your doctor is important.
Cause of erectile dysfunction
- Psychological cause of erectile dysfunction, anxiety, depressive one, which contains the problem of stress and relationships.
- Lifestyle factors that increase the risk of erectile dysfunction, which includes smoking, alcohol use, drug abuse and other.
- Physical causes, you can include other health heart disease, hypertension, diabetes, and neurological disorders. Part of the drug used to treat these conditions, can cause erectile dysfunction.
Many treatments are available for erectile dysfunction. They are, oral medication, injections, mechanical devices, surgery, which includes psychotherapy. You must also address the state of health that may be associated with erectile dysfunction. Physicians human partner is recommended to be involved in the discussion of treatment options.
The most common treatment of erectile dysfunction is PDE5 inhibitors, including (Cialis) sildenafil (Viagra), vardenafil (Levitra), and tadalafil. Check out also stronger erection in morning. These drugs are effective for most men and generally safe. These drugs may not be appropriate for men with certain health conditions such as diabetes or uncontrolled hypertension, or history of severe heart disease, heart failure, stroke. Men taking nitrate drugs, the use of PDE5 inhibitors is I can not, these drugs also, you can interact with other drugs. Please consult your doctor about whether it is a safe choice for your inhibitor PDE5.
Warning of drug
Generally, the PDE5 inhibitor, has some serious side effects. Check out also herbal erection help. Have experienced vision problems a small number of men. In 2007, the Food and Drug Administration (FDA) has added a warning to the label of these drugs on the sudden deafness accompanied by ringing in the ears and dizziness often. If you have these side effects, you will need to contact your doctor immediately.
Erectile dysfunction (impotence) is that you can not achieve or maintain an erection sufficient rigidity for sexual intercourse that both, or ejaculation. Ability to have orgasm and sexual drive is not necessarily affected. Because you have erection problems from time to time all the people, doctors attempt of sexual intercourse, if you fail at least 25% of the time, please consider that there are impotence. See impotence herbs .
Erectile dysfunction, but is not new to any of the medicine and the human experience, it has not been openly discussed, or easily. You maybe interested in voilent death erection. Cultural expectations of sexuality of men, to inhibit many men from seeking help because of the failure can benefit from conventional medicine.Erectile function and penis
. Structure of the penis penis is made up in the following structure. See erection patches.
- Two parallel columns of spongy tissue, called the body or erection, corpus cavernosum.
- Sponge in the middle chamber, called the corpus cavernosum, including the tube that carries urine from the bladder through the urethra, the penis.
These structures are composed of erectile tissue. A small pool of blood vessels and erectile tissue called cavernous sinus is rich. Each of these vessels is surrounded by smooth muscle, and is supported by elastic fibrous tissue that consists of a protein called collagen.
Erectile function and nitric oxide depending on the state of arousal that penis is flaccid or erect. Unerect, in the penis, it or the next, relaxation, usually occurs.
- You can reduce the inflow of small arteries leading to the cavernous sinus agreement, of the blood.
- Smooth muscle also regulates a number of small blood vessels, limiting the amount of blood can be collected in the penis, available at the contract.
The following actions will take place during waking hours.
- The human central nervous system to stimulate the release of the number of chemicals, including nitric oxide present, the main contributor for induced erection, are thought to maintain.
- Nitrogen oxides, to stimulate the production of chemical substances cause relaxation of smooth muscle cyclic GMP, of the penis. This can flood the penis blood, that flows into the cavernous sinus, such as a small pool.
- This increase in blood flow is the diameter of the chamber will increase by a factor of almost spongy.
- Ambient vein, the pressure has been almost completely shut by this pressure chamber.
- Venous outflow of blood from the penis that can not be, the penis is erect and rigid.
- After arousal and ejaculation, cyclic GMP is degraded by an enzyme called phosphodiesterase 5 (PDE5), other compounds, can cause the penis to become flaccid (unerect) again will be released.
Appropriate balance of certain chemicals, gas and other substances is important for the health of the erection.
Collagen protein collagen is the main component of the body structure, in the organization, including the penis. Excessive amounts, however, can impair erectile function, form the scar tissue.
Oxygen-rich blood oxygen is one of the most important components for erectile health. Oxygen will affect the substance of two important in achieving an erection.
- Oxygen suppresses the conversion of (TGF-B1) growth factor beta 1. TGF-B1 is a component of the immune system called cytokines, which are produced by smooth muscle cells. Appears to stimulate collagen production in the corpus cavernosum that it can lead to erectile dysfunction. You maybe interested in west coast iron erection.
- Oxygen, increases the activity of prostaglandin E1. Prostaglandin E1 is generated by muscle cells of the penis during erection. It activates the enzyme to start the release of calcium in the smooth muscle cells to mitigate them, to allow blood flow. Prostaglandin E1 also suppresses the production of collagen.
Oxygen levels can vary greatly in height from very reduced levels in the erect state in the relaxed state. During sleep, the oxygen concentration is high, five male erection usually from three nights, you can have each one lasting 20 - 40 minutes.
Although its exact role is not obvious, hormones such as testosterone. Level, testosterone is essential for normal erectile function, especially of hormone.Oxygen deficiency and erectile dysfunction
When the penis is deprived of oxygen-rich blood, erectile dysfunction occurs most commonly. When the level of oxygen to the penis is low, TGF-B1 and prostaglandin E1 is an imbalance occurs in two important substances.
- TGF-B1 levels increase, to form all types of connective tissue production, including trigger, the scar tissue of collagen, a tough protein.
- In addition, prostaglandin E1, to suppress collagen production, erection, as a result, there is a reduction of chemical substances cause relaxation of smooth muscle to allow blood flow.
Degradation of prostaglandin E1 and levels of TGF-B1 levels increase, collagen scarring in the penis, loss of elasticity and smooth muscle decline, causing a decreased blood flow, and will be excessive. Number of conditions, you can deprive the penis of oxygen-rich blood. See erection trousers.
. (Ischemia) is a major cause of oxygen deficiency is a blockage in a blood vessel ischemic - blockage of blood vessels. May contribute to erectile dysfunction and also under the same conditions that lead to heart problems. For example, when cholesterol and other factors such imbalanced, fatty substance called plaque forms on artery walls. As plaque accumulates, the walls of the arteries narrow, you can reduce the blood flow gradually. This process, known as atherosclerosis, we have contributed greatly to the development of coronary heart disease. View massage avoid erection. It may also play a role in the development of erectile dysfunction.
More than 18 million American men over the age of 20 has an erectile dysfunction, erectile dysfunction experience some degree every year from age 40 to 70 of about 600,000 men.
Most men, erectile dysfunction is associated with age mainly. 17% of men in their 40s, about - ED 34% of men less than 10% of men in their 20s, 70s affect the ED On the other hand has 5 - 15. Nevertheless, impotence is not inevitable with age. The survey of men over the age of 60, 61% have been reported in sexually active, if it is not as long as the profit emotional more, derived from the sex life of their as we did in the 40s almost half. Check out also does vicodin cause impotence.
Severe erectile dysfunction, in many cases, it has a way related to the disease than age itself. In particular, there is an older man, likely to have heart disease, diabetes, high blood pressure than young men. Part of this situation and its treatment is a major risk factor for erectile dysfunction. Check out also remedies for erections. Smoking and obesity also is a major risk factor for ED.
Physical and psychological situation of many, it can cause erectile dysfunction, impotence is normal for a short period. Every man is from when erectile dysfunction occurs. Nevertheless, if they are persistent problems, male erectile dysfunction, also, is the usual care, there is a symptom of the problem you are having basic health, especially since, should seek professional help.
Lifestyle and psychological cause
Over the past few decades, the medical point of view has shifted about the causes of erectile dysfunction. See checklist for structural steel erection. The common wisdom used to attribute almost all cases of impotence to psychological factors. Now researchers are estimated to be caused by physical problems with medical care and up to 85 percent of impotence cases. Only 15% is now based on a psychologically.
It even if there is cause of erectile dysfunction, to determine whether it is or some combination, either physical or psychological is difficult. The following may be helpful.
- Physical impotence, causes of internal medicine (for example, diabetes and hypertension) or external factors (eg, surgery, medicine, or injury) may be caused by. Erectile dysfunction due to medical condition, you usually have developed gradually over time. Impotence is sustained over three months, if not due to a known medical condition, the patient is required for examination by a urologist specializing in impotence stressful events, drug use, alcohol, or. See increase erections.
- Psychological impotence, there is a tendency to develop rapidly, and events related to the recent situation. View erection natural. Patient is not in some circumstances, may be able to have an erection of others. Or that you can have an erection when you wake up in the morning, to keep suggesting that the mental is physical rather than a problem.
In all cases there is an emotional issue could affect the relationship between self-esteem of man on the fact of serious erectile dysfunction. See male impotence supplement. You can perpetuate erectile dysfunction was caused by medical conditions that have been processed successfully even if the negative feelings. View cant keep erections teen age. They are many men it is for the powerlessness of their own, tend to be the fault itself even if they are caused by physical problems have a control on the little or no clearly.Emotional disorder that is associated with erectile dysfunction
Anxiety. Anxiety can affect the erectile function has both emotional and physical impact. You maybe interested in prolonged erection injury. It is one of the most frequently cited contribution to psychological impotence. Excessive concern about sexual performance is, in many cases, you may be called or performance anxiety and "honeymoon", causing intense fear of failure and self doubt. It allows you to set off a cycle of chronic impotence from time to time. See homeopathic cures for maintaining an erection. To release chemicals in response to anxiety, the brain known as neurotransmitters that constrict arteries and smooth muscle of the penis. See ejaculation erection massage. Reduces the blood flow to this constriction, increases the blood flow of the penis. Check out also longer stronger erections. Simple stress, there is likely to promote the release of brain chemicals disrupt the efficacy in a similar way. You maybe interested in pantoprazole erection.
Depression. Depression is associated with erectile dysfunction strongly. Depression, but you can certainly reduce sexual desire, but it is not clear how such a condition often comes first.Related issues
Trouble in a relationship is a direct impact on sexual function frequently. Partners of men with erectile dysfunction, the man who will be affected if you have not confessed my anxiety and depression in particular, is denied, you may feel resentment. Both partners, each of which experience a sense of guilt for what recognized as a personal failure in general. Occurs between people who can not tension and anger to discuss sexual or emotional problems of each other frequently. A man to perform sexually when both partners have negative feelings might be very difficult.Smoking
Smoking is the main reason to increase the effect of other vascular disease, including atherosclerosis and hypertension has contributed to the development of impotence.Alcohol
Alcohol also has been implicated to cause impotence. But to release a small amount of suppression, to have more than one drink, you may impair sexual function and to suppress the central nervous system.Frequent lack of erection
Erections deprive the penis of oxygen-rich blood. See erection trousers in rare cases. Every day without erection, increased collagen production, and ultimately, it is possible to form a tough tissue interfere with blood flow. Men have erections spontaneously awake or sleeping, it may be a natural protection against this process.
Number of conditions, they share the common problems in erectile dysfunction - Open the normal blood flow, the impaired ability of blood vessels to allow.
The following conditions is associated with a very erectile dysfunction.Heart disease
Heart disease, atherosclerosis, high cholesterol is a major risk factor for erectile dysfunction. Check out also remedies for erections. In fact, erection problems, the risk of atherosclerosis in men may be warning signs of these conditions. Men experience ED has the potential risk of stroke angina, or heart attack is high. ED patients should be evaluated for cardiovascular disorders. For more information about [is, at a depth of Report # 3 Please refer to the following. Coronary artery disease . ]High blood pressure (hypertension)
Because erectile dysfunction is probably due to age, in men with high blood pressure more than 40 percent of men with erectile dysfunction in. itoccurs is a very common problem that you have high blood pressure. In the disease process is a major factor in impotence (eg,-blockers and calcium channel blockers, such as ) many of the drugs used to treat high blood pressure can cause it. For more information [, please refer to the detailed report # 14. Hypertension . ]Diabetes
Diabetes is a major risk factor for erectile dysfunction. Check out also remedies for erections. During the 30 days - 50% of all people with diabetes, we will report some form of sexual difficulty. See encore deluxe battery erection system. Artery occlusion and nerve damage is a complication of diabetes that are common to both. If the blood vessels and nerves of the penis is involved, can cause erectile dysfunction. Diabetes is associated with another risk factor for heart disease, of ED. For more information [, please refer to the detailed report # 60. Type 2 diabetes . ]Obesity
Obesity increases the risk of diabetes, heart disease, erectile dysfunction. See strong products erection in 3 minutes.Metabolic syndrome
Is a risk factor for erectile dysfunction. Check out also remedies for erections in men over the age of 50 - also a cluster of conditions including obesity and abdominal fat, cholesterol and triglyceride levels, hypertension, insulin resistance and unhealthy - metabolic syndrome. View does losartan potassium cause erectile dysfunction.Benign prostate hypertrophy
Lower urinary tract symptoms associated with benign prostatic hyperplasia, you can reduce the nitrogen monoxide of the penis. View cant keep an erection during sex. Such as surgery or drug treatment also (Proscar), you can increase the risk of such impotence finasteride. For more information about [is, at a depth of Report # 71, please refer to the next. Benign prostatic hyperplasia . ]Neurological conditions
Disease affecting the central nervous system can cause erectile dysfunction. These conditions include Parkinson's disease, multiple sclerosis, and stroke. For more information [, please refer to the detailed report # 51 Parkinson's disease ; 17 multiple sclerosis ; # 45: stroke . ]Endocrine and hormonal conditions
Low level of male hormone testosterone, in men with other risk factors will be the factor to erectile dysfunction. Check out also erection noose. As the sole cause of erectile dysfunction (low testosterone, affects only about 5% of men. In general, rather than low testosterone levels can cause impotence, may reduce the sex drive abnormalities of the pituitary gland also cause high-level.) the higher the hormone prolactin, are associated with erectile dysfunction. Endocrinological cause of erectile dysfunction and other hormones, which includes the thyroid and adrenal problems.
Varicocele, the expansion of code that connects to the testicle is a vein (varicose). Varicoceles have been discovered in the 15 - 40% of male infertility - 20% of all men and 25. varicoceles is, if it occurs in both testicles, they may contribute to hormonal imbalances lead to erectile dysfunction.Physical trauma and injuries
Pelvic trauma, such as pelvic fracture or spinal cord injury like that, as a result of impotence can cause nerve damage. View my son funny erection story. Other conditions that can damage the spine and effect impotence, which contains the history spinal cord tumors, spina bifida and polio.Surgery
Surgery for prostate cancer. Radical prostatectomy, may cause a loss of sexual function. Nerve-sparing surgery has been proven to be useful in reducing the risk of erectile dysfunction. View can neutered dog get erection ejaculate. (Prostate cancer, external beam radiation therapy for a problem may occur in particular less than surgery) For more information [, please refer to the detailed report # 33. Prostate cancer . ]
Colon and rectal cancer surgery. Surgery and radiation treatment of colorectal cancer, in some patients can cause impotence. In general, the colostomy is usually does not affect the sexual function. However, wide rectal surgery, may cause a short-term or long-term sexual dysfunction. For more information [, please refer to the detailed report # 55. Colon and rectal cancer . ]
Surgical treatment of inflammatory bowel disease. Although resection of the rectum can cause impotence for inflammatory bowel disease (IBD), rate (2 - 4%) is low.
Of fistula surgery. Surgery to repair the anal fistula, causing an inability at times, can affect the muscles that control the rectum (external anal sphincter muscles). (Repair of these muscles, you may want to restore erectile function.)
Orthopedics. Erectile dysfunction can be attributed, in orthopedic surgery and sometimes affect the pelvic nerve.
Note: The pipe is cut, can cause erectile dysfunction does not have.Medicine
Many medications increase the risk of erectile dysfunction. View can neutered dog get erection ejaculate. They include:
- Medicine for high blood pressure, diuretics,-blockers , especially calcium channel blockers. Check out also can men have erection during day.
- Heart and cholesterol medications such as digoxin fibrate, or gemfibrozil.
- Psychotropic drug, inhibitor (SSRI), tricyclic antidepressants, monoamine oxidase inhibitors, used to treat depression and bipolar disorder such as lithium and selective serotonin reuptake such . Can cause erectile dysfunction, such as antipsychotics (eg haloperidol), butyrophenone also certain types (such as compazine) phenothiazine such.
- Such rantidine (Zantac), cimetidine to reduce gastric acid (such as Tagamet) Gastroesophagelal reflux disease treatment drug use (GERD),,. Check out also does smokeless tobacco affect erections.
- Hormone estrogen, as an inhibitor of corticosteroid ,5- reductase like this.
- Chemotherapeutic drugs such as methotrexate.
Premature ejaculation. Premature ejaculation is a male sexual dysfunction most common, many of the male occurs in 40%. It has been defined as inability to delay ejaculation to the point that both partners have been met. This will vary greatly depending on the preference of the partners. Than older men than young men, tend to have this problem. Anxiety is a major factor at any age. In general, longer than the period between ejaculation, they are faster. Various techniques, you can help delay orgasm.
The standard drug used to this condition, including the selective serotonin reuptake inhibitors Prozac or Paxil is (SSRI). In several studies, it (Viagra) is useful it was suggested that sildenafil in combination with SSRI. Drug is not approved for the treatment of premature ejaculation is not yet concrete. Check out also tall men with erection.
Peyronie's disease. Peyronie's disease is the accumulation of scar tissue in the shaft of the penis causing it to curve. Curvature, it is possible and Seiko erectile difficulties and painful. You maybe interested in erections and diabetes. This state, that is associated with damage to the penis, clear information to be present in its origin is not possible. Some individuals can become the type of disease is often spontaneous remission, previously experienced erectile dysfunction to resume sexual activity. View prescription drugs that affect erections. Scar, even in these cases, however, can cause erection problems yet. See penis erection erect.
Treatment options, which includes oral medication, injections, and surgery. Penile implant may be beneficial also.
All men, need to be the treatment of Peyronie's disease is not available. Sometimes the condition can improve their own without treatment.
Priapism. Priapism, despite the lack of sexual stimulation, are eliminated, painful persistent erection is unnecessary. Smooth muscle tissue, leave relaxed leak to occur at constant flow of blood to the blood vessels of the penis is not back, in general, as a result of priapism. View nipple erection male. Development of priapism, a self-injection therapy used for impotence, in recent years, associated with urinary tract stones, certain medications, and neurological disorders, has been.
If priapism occurs, applying ice to the inner thigh over 10 minutes, you can reduce the blood flow. The last four hours or more, erection that requires emergency medical care.
Temporary erectile dysfunction is very common, usually not a problem to worry about. You maybe interested in foods that prevent unwanted erections. May nevertheless if it is persisted state, the greater the psychological effect. Erectile dysfunction, there is a possibility can have a devastating effect on the relationship, become chronic if not treated, can cause extreme depression. Consistent pattern of sexual dysfunction, if you want to extend over a long period of time, you may serious physical or mental disorder is present.
To treat the underlying disease that may cause erectile dysfunction is important.
Doctors usually, the patients about the physical and psychological factors of a number of interviews.
Personal history doctors should take on or a personal history and medical care, you may ask about the contents of the next.
- Past and current medical problems
- Drug or drugs being used
- Stress, anxiety, psychological problems such as depression, history of any
Sexual history may further include a doctor, to ask questions about, the patient's sexual history.
- The nature of the onset of dysfunction
- The duration of the erection of any, whether they occurred in the morning or night frequency, quality, and
- Certain circumstances has occurred erectile dysfunction
- Technical Details
- Motivations and expectations of treatment for patients
- The problem is whether or not to exist in the current relationship
Interview with sexual partners. If appropriate, also a doctor, there are interviews to sexual partners. In fact, it has been proven to be an important component in making the best choices of treatment of partners, including the process of counseling. View low dose aspirin side effects erections.Physical examination
The doctor, examination of the genital area, (insert a gloved doctor to the patient's rectum, lubricated finger) rectal exam to check for prostate abnormalities there is a need to perform a careful physical examination, including.Test was used to treat erectile function
Convenient approach is to manage the treatment of erectile dysfunction, to observe the response. You maybe interested in penis erection atrophy. Doctors usually recommend a trial of (Viagra) sildenafil in erectile response to test the 30 - 60 minutes after the drug is administered. View erection defunction. This drug has been replaced, such as injection of papaverine and prostaglandin E1, a more invasive and expensive test. These drugs, to extend the blood vessels in the penis, to generate an erection in about 15 minutes.
After managing the treatment, waiting for the appropriate time, the doctor then, in order to evaluate the blood flow, sometimes using the ultrasound scanner, erectile response after erection, curved penis, and then monitor the response .Inspection
To test the blood for hormonal abnormalities. Blood tests can be used to the level of testosterone, as necessary to determine whether there is a problem of the hormone, prolactin level to measure. Also doctor, you may be screened for thyroid or adrenal dysfunction. In addition, you can perform certain tests for a variety of erectile dysfunction.
Evidence of other medical conditions that can cause erectile dysfunction should be sought to test the medical condition hypertension, diabetes, atherosclerosis, especially of nerve damage.Monitoring an erection at night
Monitoring test is the cause of erectile dysfunction can be used to determine whether high could be a mental than a physical erection at night.
To test the snap gauge. With the Snap gauge test, in order to achieve an erection during sleep, to monitor the ability of human beings. This is a very simple test.
- When a man goes to bed, he will place the band around the shaft of his penis.
- (With this genetic disease, people do not produce phosphodiesterase-5 and do not respond to PDE5 inhibitors.)
PDE5 inhibitors work only when the man experiences some sexual arousal. They are generally effective within 15 - 45 minutes. Sildenafil should be taken on an empty stomach; vardenafil and tadalafil may be taken with or without food. See erection enhancher. The effects of these drugs may last for several hours, and tadalafil may last for up to 36 hours. Check out also lose erection during intercorse. PDE5 inhibitors should not be used more than once a day. You maybe interested in men cum more.
Success rates increase with the number of attempts, so a man should not be discouraged if the drug does not work at first.
PDE5 inhibitors can also be used in combination with testosterone replacement therapy for men with hypogonadism (low testosterone levels).Side Effects
Common side effects of PDE inhibitors include flushing, upset stomach, headache, nasal congestion, back pain, and dizziness.
Effects on the Heart. There have been reports of fatal heart attacks in a small percentage of men taking sildenafil (Viagra). View home remidy for erection. Viagra can cause sudden and dangerous drops in blood pressure when the drug is taken with nitrate drugs, such as nitroglycerine, which are used for angina. You maybe interested in male erection size. No one taking nitrates, including the recreational drug amyl nitrate, should take sildenafil or any other PDE5 inhibitors. Check out also erection failure atorvastatin.
Intercourse itself involves an increase in physical exertion and a small risk of heart attack for patients with known heart disease or those at risk.
Visual Effects. About 2.5% of men have vision problems that include seeing a blue haze, temporary increased brightness, and even temporary vision loss in a few cases. You maybe interested in how to get a male erection. Experts believe that visual disturbances are related to the inhibition of phosphodiesterase enzymes in the retina, but the effect appears to be temporary and insignificant, lasting a few minutes to several hours. Men at risk for eye problems who take PDE5 inhibitors regularly should have frequent eye examinations with an ophthalmologist. Men should also see an eye doctor if visual problems last more than a few hours.
In 2005, the FDA began investigating reports of partial vision loss in men who took sildenafil (Viagra), vardenafil (Levitra), and tadalafil. Check out also stronger erection in morning (Cialis). The vision loss was caused by non-arteric anterior ischemic optic neuropathy (NAION), a condition that occurs from poor blood flow to optic nerves. However, experts note that erectile dysfunction is itself linked to the same vascular problems that cause NAION. Patients who suffer from diabetes, high blood pressure, and heart disease are at higher risk for erectile dysfunction as well as other vascular problems such as NAION. See flexible penile erection. Information concerning vision loss has been added to the labels of these drugs, but the risk of blindness appears small. Still, patients who use this medication and experience a sudden loss of vision should immediately stop taking the drug and contact their doctor.
Hearing Loss . In 2007, the FDA added a warning about potential hearing loss associated with PDE5 inhibitors. A small number of men have experienced sudden hearing loss in one ear, sometimes accompanied by ringing in the ears and dizziness. If you have this symptom, immediately contact your doctor.
Seizures. There have been a few reports of seizures in men taking sildenafil. You maybe interested in treatment for impotence. These are rare occurrences and it is not clear if there is any causal association.
Risk of Priapism. PDE5 inhibitors pose a very low risk for priapism in most men. (Priapism is sustained, painful, and unwanted erection.) Exceptions are young men with normal erectile function.
Interactions with Other Drugs. In addition to serious interactions with nitrates, PDE5 inhibitors may also interact with certain antibiotics, such as erythromycin, and acid blockers, such as cimetidine (Tagamet). View more sperms. Patients should tell their doctor about any medications they are taking.
Injections or Topical Treatments
Alprostadil is derived from a natural substance, prostaglandin E1, and opens blood vessels. This medicine is an effective treatment for some men. It can be administered by:
- Injection into the erectile tissue of the penis (such as Caverject or Edex)
- A system that administers the drug in pellets placed in the urethra (MUSE system)
Candidates. Regardless of how it is administered, alprostadil works in many men with a wide range of medical disorders related to erectile dysfunction, including men with:
- Prostate cancer treatments (early use of alprostadil injections after prostate cancer treatment, particularly when followed by a PDE5 inhibitor, may be helpful)
- Cholesterol problems treated with nitrates
Alprostadil is not an appropriate choice for men with:
- Severe circulatory or nerve damage
- Bleeding abnormalities or men who are taking medications that thin the blood, such as heparin or warfarin
- Penile implants
Injected Alprostadil. Injected alprostadil (Caverject, Edex) uses a very small needle that the man injects into the erectile tissue of his penis. About 80% of men describe the pain of administering the injection as very mild.
The drug should not be injected more than 3 times a week or more than once within a 24-hour period.
MUSE System. The MUSE system delivers alprostadil through the urethra. It works in the following way:
- The device is a thin plastic tube with a button at the top.
- The man inserts the tube into his urethral opening right after urination. You maybe interested in women and erections. (Urinating or urine leakage right after administration may reduce the amount of medication.)
- He presses the button, which releases a pellet containing alprostadil.
- The man rolls his penis between his hands for 10 - 30 seconds to evenly distribute the drug. To avoid discomfort, the man should keep the penis as straight as possible during administration.
- The man should be upright, either sitting, standing or walking for about 10 minutes after administration. By that time, he should have achieved an erection that lasts 30 - 60 minutes. (If a man lies on his back too soon after administration, blood flow to the penis may decrease and the erection may be lost.)
- The erection may continue after orgasm.
The MUSE system should not be used more than twice a day and is not appropriate for men with abnormal penis anatomy. You maybe interested in encore vaccum erection device manufacturer.
Side Effects of Most Alprostadil Methods . Certain side effects are common to all methods of administration, although they may differ in severity depending on how the drug is given:
- Pain and burning at the application site. In one study half of the men who injected alprostadil experienced some burning and pain at the injection site. Check out also impotence problems.
- Scarring of the penis (Peyronie's disease), which is most likely to occur with injections.
- Sudden, low blood pressure. Symptoms include dizziness, lightheadedness, and fainting. If these symptoms occur, the man should lie down immediately with his legs raised.
- Priapism (prolonged erection). Possible with any method, but less chance with the MUSE system than with injections. If priapism occurs, applying ice for 10-minute periods to the inner thigh may help reduce blood flow. Erections that last 4 hours or longer require emergency care.
- Women partners may experience vaginal burning or itching. The drug may have toxic effects if it reaches the fetus in pregnant women, so men should not use alprostadil for intercourse with pregnant women without the use of a condom or other barrier contraceptive device.
- Other side effects. Other side effects include minor bleeding or spotting, redness in the penis, and aching in the testicles, legs, and area around the anus.
Until the introduction of alprostadil, the two drugs used for injection therapy had been papaverine (Pavabid, Cerespan) and phentolamine (Regitine). Adverse reactions are usually minor but include pain, ulcers, and prolonged erections (priapism). These drugs are rarely used now.Testosterone Replacement Therapy
Testosterone replacement therapy works best for men with ED who have been diagnosed with hypogonadism (low testosterone levels). Men who have ED and normal testosterone levels are not likely to benefit from testosterone therapy. Studies indicate that testosterone therapy can modestly improve erectile function and libido.
Forms of testosterone therapy include:
- Muscle injections using testosterone enanthate (such as Andryl or Delatestryl) or cypionate (Andro-Cyp, Depo-Testosterone, or Virion). This has been the standard administration.
- Skin patch (Testoderm, Testoderm TTS, or Androderm). Depending on the brand, patches may be applied to the skin of the scrotum every 24 hours or to the abdomen, back, thighs, or upper arm. See encore erection device body shield. In the latter case, two patches are required every 24 hours. Testoderm and Testoderm TTS may cause less skin irritation than Androderm.
- Skin gel (such as Androgel or Testim). The gel is applied only to the same parts of the body as the patch. A gel applied to the penile skin is being investigated for men with hypogonadism and erectile dysfunction. Pregnant women must avoid contact with the gel because the testosterone may harm the fetus.
Oral forms of testosterone are not recommended because of the risk for liver damage when taken for long periods of time.
Testosterone therapy may increase the risk for the following adverse effects, particularly in men with normal testosterone levels:
- Lowering of HDL ("good" cholesterol)
- Rapid growth of prostate tumors in men with existing prostate cancers. (Taking testosterone does not appear to increase the risk for prostate cancer, but experts remain concerned.)
- Lower sperm count
- Sleep apnea
- Polycythemia, an abnormal increase in red blood cells
- Benign prostatic hyperplasia
Vacuum devices, or external management systems, are effective, safe, and simple to use for all forms of impotence except when severe scarring has occurred from Peyronie's disease.
Using the Device. Patients must receive thorough instructions in the proper use of such devices. They typically work as follows:
- The man places the penis inside a plastic cylinder.
- A vacuum is created, which causes blood to flow into the penis, thereby creating an erection. See maintain erections longer.
- A band is tightly secured around the base of the penis, which retains the erection, and the cylinder is removed. View erection penis cream.
- It takes about 3 - 5 minutes to produce an erection.
Lack of spontaneity is this method's major drawback. The erection involves only part of the penis shaft, and the process will certainly seem peculiar in the beginning. You maybe interested in male erection oils. When these psychological obstacles are overcome, many couples find the result highly satisfactory.
Success Rates. Studies have found that success with the vacuum device is about equal to other methods. Up to two-thirds of men using it reported the device to be effective.
Side Effects. Side effects include blocked ejaculation and some discomfort during pumping and from use of the band. Check out also can kidney stones effect erections. Minor bruising may occur, although infrequently. It is very important to use a medically approved pump. There have been reports of injury from vacuum devices that do not have a pressure-release valve or other safety elements.Venous Flow Controllers
Vacuum-less devices that trap blood within the penis are also available. They are called venous flow controllers or simple constricting devices. These devices are typically rubber or silicone rings or tubes that are placed at the base of the erect penis to trap the erection. They can be used by men who can achieve erections but lose them easily. These devices should not be used for longer than 30 minutes or lack of oxygen can damage the penis, and they should not be used by patients who have bleeding problems or are taking anticoagulant medicines ("blood thinners"). See tank erection company.Penile Implants
Penile implants are available for men who cannot take medication or for who less invasive treatments do not work. In general, they work well in restoring sexual function, and men are usually satisfied with the results.
Three types of surgical implants are used for the treatment of erectile dysfunction:
- A hydraulic implant consists of two cylinders placed within the erection chambers of the penis and a pump. The pump releases a saline solution into the chambers to cause an erection, and removes the solution to deflate the erection. You maybe interested in erections after heart surgery.
- A penile prosthesis is composed of two semi-rigid but bendable rods that are placed inside the erection chambers of the penis. The penis can then be manipulated to an erect or non-erect position.
- A third implant uses interlocking soft plastic blocks that can be inflated or deflated using a cable that passes through them. You maybe interested in best male enhancement pill.
There appear to be no long-term immune problems related to the silicon or other materials in the devices.
Limitations. Erectile tissue is permanently damaged when these devices are implanted, and these procedures are irreversible. Although uncommon, mechanical breakdown can occur, or the device can slip or bulge, especially if the patient coughs or vomits vigorously after the operation. In addition, a less than optimal quality of erection may result. (Using the MUSE system may restore or improve the function of a penile prosthesis in patients with a failed device.)
Complications. Infection is the major concern with these devices. Redness and fever often accompany a full-blown infection. Any intermittent pain that continues to occur after an implant may be an indicator of a low-grade infection. If the infection can be caught early enough, implant failure can be prevented. Most infections are treated with antibiotics for at least 10 - 12 weeks. If antibiotics fail, a surgical exchange, in which the infected implant is simultaneously replaced with a new one, should be considered. This is a complex procedure, but some surgeons have reported a 90% success rate.Vascular Surgery
For men whose impotence is caused by damage to the arteries or blood vessels, vascular surgery might be an option. Check out also non stop scaffold erection instructions. Two types of operations are available: revascularization (bypass) surgery, and venous ligation. The American Urologic Association stresses that vascular surgery is still investigational.
Revascularization. The revascularization procedure usually involves taking an artery from a leg and then surgically connecting it to the arteries at the back of the penis, bypassing the blockages and restoring blood flow. In a related procedure called deep dorsal vein arterialization, a penile vein is used for the bypass. Check out also no erection problem. Young men with local sites of arterial blockage or those with pelvic injuries generally achieve the best results. In studies of selected patients erectile function improved in 50 - 75% of men after 5 years.
Venous Ligation. Venous ligation is performed when the penis is unable to store a sufficient amount of blood to maintain an erection. This operation ties off or removes veins that are causing an excessive amount of blood to drain from the erection chambers. The success rate is estimated at 40 - 50% initially, but drops to 15% over the long term. It is important to find an experienced surgeon. In a variation of this technique, called venous ablation, ethanol is injected into the deep dorsal vein, the main vein that drains blood from the penis. The ethanol causes scarring that closes off smaller veins and prevents blood leakage, thereby bolstering erectile function. Check out also homeopathic remedy for erectile dysfunction.
Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. See penile enhancement. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from herbal products. Patients should always check with their doctors before using any herbal remedies or dietary supplements.
There are several special concerns for people taking alternative remedies for erectile dysfunction. Check out also erection problems and aderall.
Yohimbe. Yohimbe, which is similar to yohimbine, is derived from the bark of a West African tree. Side effects include nausea, insomnia, nervousness, and dizziness. Large doses of yohimbe can increase blood pressure and heart rate and may cause kidney failure. View erectile dysfunction and hypertension treatment.
Gamma-Butyrolactone (GBL). GBL is found in products marketed for improving sexual function (Verve, Jolt). This substance can convert to a chemical that can cause toxic and life-threatening effects, including seizures and even coma.
Gingko. Although the risks for gingko appear to be low, there is an increased risk for bleeding at high doses and interaction with vitamin E, anti-clotting medications, and aspirin and other NSAIDs. Large doses can cause convulsions. Commercial gingko preparations have also been reported to contain colchicine, a substance that can be harmful in people with kidney or liver problems.
L-arginine (also called arginine). Arginine may cause gastrointestinal problems. It can also lower blood pressure and change levels of certain chemicals and electrolytes in the body. It may increase the risk for bleeding. Some people have an allergic reaction to it, which in some cases may be severe. It may worsen asthma.
Dehydroepiandrosterone (DHEA). DHEA is a supplement related to certain male and female hormones. Studies show inconclusive results in its treatment for erectile dysfunction. DHEA may interact dangerously with other medications.
Aphrodisiacs. Aphrodisiacs are substances that are supposed to increase sexual drive, performance, or desire. Examples include:
- Viramax is a well-marketed product that contains yohimbine and three herbal aphrodisiacs: catuaba, muira puama, and maca. It has not been proven to be either effective or safe, and interactions with medications are unknown.
- Spanish fly, or cantharides, which is made from dried beetles, is the most widely-touted aphrodisiac but can be particularly harmful. It irritates the urinary and genital tract and can cause infection, scarring, and burning of the mouth and throat. In some cases, it can be life threatening. No one should try any aphrodisiac without consulting a doctor.
Other Alternative Products Marketed for Erectile Dysfunction. Vinarol is an over-the-counter supplement that was recalled by the FDA in 2003 after reports surfaced that it contained the same ingredients found in Viagra. View hard bump on penis during erection. Herbal supplements sold as Viagro and Vaegra have no association with Viagra.
There are numerous other products marketed as 'all-natural' dietary supplements and promoted as treatments for erectile dysfunction and sexual enhancement. The FDA has not approved any of these products and has issued many warnings concerning them. In recent years, the FDA has warned that 'True Man,' 'Energy Max,' 'Rhino Max,' 'VMax,' Libidus,' and similar dietary supplements contain illegal chemicals that can interact with prescription drugs and cause dangerously low blood pressure. These products are particularly dangerous for men with diabetes, high blood pressure, high cholesterol, or heart disease who take prescription drugs that contain nitrates.
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