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Dr. Chirag also shared views and guidance over sexual health and issues with online consultation services to help people get over their personal issues with expert guidance from any corner of the country.

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General good health, particular cardiovascular, is important for sexual function. Avoiding obesity and belly fat can help you avoid and treat erectile dysfunction. A good diet and exercise should be part of your daily regimen.
It's also important to know that drinking alcohol won't help you maintain an erection. In fact, excessive alcohol use can be a cause of erectile dysfunction.

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Psychoteraphy is often the first form of treatment recommended for depression. Psychotherapy helps depression by helping people understand the behaviors, emotions and ideas that contribute to their depression, regain a sense of control and pleasure in life, and learn coping techniques as well as problem solving skills.
Some men have occasional trouble getting or keeping an erection, which can be considered normal.

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Besides PDE5 inhibitors and among second-line therapies are VCDs which are clear plastic chambers placed over the penis, tightened against the lower abdomen with a mechanism to create a vacuum inside the chamber. This directs blood into the penis. If an adequate erection occurs inside the chamber, the patient slips a small constriction band off the end of the VCD and onto the base of the penis. An erection beyond 30 min is not recommended. These devices can be a bit cumbersome, but are very safe.40

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Erectile dysfunction, also known as impotence, is when a man is unable to get or maintain an erection.

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    Other times, ED occurs as a result of treatment for another condition or as a side effect of medication. For example, prostate cancer treatment can lead to ED, as can surgery for bladder cancer. Medications linked to ED include antidepressants, blood pressure pills, and opioid painkillers.

    Many men are unhappy with their ability to get or maintain an erection, but only 5% of these men seek help. This is because most men, in general, are unwilling to discuss their sex life, even when it is going well.
    André B Silva1, Nelson Sousa1,2, Luís F Azevedo3,4, http://orcid.org/0000-0001-8561-5167Carlos Martins1 1 Family Medicine Unit, Social Sciences and Health Department of the Faculty of Medicine of Porto, Porto, Portugal 2 Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Trás-os-Montes e Alto Douro, Vila Real, Portugal 3 CIDES—Department of Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal 4 CINTESIS—Centre for Health Technology and Services Research, University of Porto, Porto, Portugal Correspondence to Dr André B Silva, Faculdade de Medicina da Universidade do Porto, Al. Prof. Hernâni Monteiro, Porto 4200-319, Portugal; andreborgessilva{at}outlook.com

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    Our team of clinicians and health experts can support you along every step of your treatment journey. Getting a health check-up from home is easier than ever. Take a look at our home blood tests to find the perfect test for you.

    In fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.
    3. Keep everything else relaxed. Make sure you aren't inadvertently tensing your glutes, abs or leg muscles — it's only the pelvic muscles we want to engage. And remember to breathe!

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    This information was updated by the EAU Patient Information Working Group, July 2021.

    Erectile dysfunction or ED (also known as impotence) is when a man cannot achieve or sustain an erection for sexual intercourse. This can be: a total inability, inconsistent ability, or a tendency to sustain only brief erections.
    Urology Care Foundation is an organization that supports and improves urological care by funding research, developing patient education, and pursuing financial support. They offer downloadable fact sheets and patient guides to help you understand ED.

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    If these fail to improve symptoms, second-line treatments include a topical cream (alprostadil, prostaglandin E1) which works by relaxing the blood vessels, improving blood supply to the penis, and so causing an erection. Alternatively, alprostadil (prostaglandin E1) may also be injected into the penis, to relax blood vessels

    Erectile Dysfunction Treatment Comparison PDE5 Inhibitors Intraurethral Gels Injection Therapy Testosterone Vacuum Devices Implants Herbals Low Testosterone Treatment Comparison Testosterone Cypionate Testosterone Gel Testosterone Pellets Testosterone Supplement Climax Control Treatment Comparison Topical Sprays MYHIXEL Behavior Modification Medications Other Conditions BPH Hair Loss Herpes Peyronie’s Disease Find A Physician
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PDE 5 inhibitors are broken down primarily by enzyme, cytochrome P450enzyme CYP3A4. Medications that decrease or increase the activity of CYP3A4 may affect levels and effectiveness of PDE 5 inhibitors. Such drugs include medications for the treatment of HIV (protease inhibitors) and the antifungal medications ketoconazole and itraconazole. Thus caution is recommended.

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Furthermore, an UpToDate review on “Treatment of male sexual dysfunction” (Cunningham and Seftel, 2014) does not mention nicardipine and statins as therapeutic options.

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For an algorithm to facilitate evaluation and treatment of patients with ED, see figure 2.

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Note: Routine nocturnal penile tumescence (NPT) and/or rigidity testing has no proven value. Nocturnal penile tumescence testing using the postage stamp test or the snap gauge test is rarely medically necessary; it is considered medically necessary where clinical evaluation, including history and physical examination, is unable to distinguish psychogenic from organic impotence and any identified medical factors have been corrected. Nocturnal penile tumescence testing using the RigiScan is considered medically necessary only where NPT testing is indicated, and the results of postage stamp or snap gauge testing are equivocal or inconclusive.

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