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Combination therapy for the treatment of erectile dysfunction has been under investigation. Most of these studies have been small trials, and long-term data regarding their effectiveness and safety are lacking. However, with thorough evaluation and counseling, there may be a use for combination therapy for certain individuals with ED.

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Can't get or keep an erection so you can have sex? That's what doctors call erectile dysfunction, or ED.
Couples can learn new ways to please one another and to show affection. This can reduce anxiety about having erections. Feeling nervous about sex. This could be because of a bad experience or a previous episode of ED. Feeling stressed, including work and family stress. Feeling depressed. Feeling self-conscious about your body or performance. Thinking your partner is reacting negatively toward you. .

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Physical disorders associated with erectile dysfunction can sometimes be related to hormones in the body. Non-hormonal causes include conditions that affect the blood supply to the penis (such as high blood pressure, type 1 or type 2 diabetes and smoking) and those that affect the nerves supplying the penis (such as Parkinson’s disease and damage to the nerves in the body e.g. due to both type 1 or type 2 diabetes). Erectile dysfunction can also be a side-effect of a medical intervention or treatment. Potential treatments that may be implicated in the cause of erectile dysfunction include certain antidepressants and treatment for high blood pressure (antihypertensives).
Writing in the journal Physiotherapy, Mr Myers said 30 per cent of men suffer from premature ejaculation. Figures suggest more than half of men over the age of 50 have erectile dysfunction, which gets more common with age

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Patient can inject medications directly into the corpora cavernosa to help attain and maintain erections. Medications such as papaverine hydrochloride, phentolamine, and prostaglandin E1 (alprostadil) can be used alone or in combinations to attain erections. All of these medications are vasodilators and work by increasing blood flow into the penis. Prostaglandin E1 (Caverject, Edex) is easier to obtain; however, it is associated with penile pain in some individuals. The use of combinations of two or three of these medications can decrease the risk of having penile pain.
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Pelvic floor exercises could help men overcome erectile dysfunction or premature ejaculation, physiotherapists say.

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Kegels can strengthen the pelvic floor muscles, which support the bladder, bowel, and may have an impact on sexual function.

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    Writing in the journal Physiotherapy, Mr Myers said 30 per cent of men suffer from premature ejaculation. Figures suggest more than half of men over the age of 50 have erectile dysfunction, which gets more common with age

    If you are experiencing erectile issues, it is important to speak with your physician. There could be a health condition contributing to your erectile dysfunction. A men’s health specialist will play an active role in your health and treatment plan for ED. Top 5 Common Causes of ED Vascular disease Endocrine disorders Medications Pelvic surgery Neurological disorders ED & Vascular Disease
    Can be part of a combination therapy plan if properly supervisedPellet must be inserted directly into penis through urethral opening

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    Spinal cord traumaMultiple sclerosisDiabetic neuropathyPelvic surgery (prostate, bowel)Parkinson’s diseaseAlzheimer’s diseasePoor Blood Flow

    Finally, there are NO-releasing polymers that are capable of delivering NO in a pharmacologically useful way. Such compounds include compounds that release NO upon being metabolised and compounds that release NO spontaneously in aqueous solution. Initial animal studies suggest that cavernosal injections of NO polymers can significantly improve erectile function.48
    ED is a complex condition that can be caused by a variety of factors. Often, there’s more than one issue that’s responsible for ED.

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    Other than strengthening the pelvic floor, the most effective workout is aerobic. Aerobic exercise of moderate-to-vigorous intensity can help improve function and reduce other conditions that can contribute to ED such as high blood pressure and excess weight. Even a regular routine of gentle walking can contribute to penis health.

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    The common PDE5 inhibitor drugs approved in the United States are sildenafil (Viagra), vardenafil (Levitra and Staxyn, the generic form), tadalafil (Cialis), or avanafil (Stendra). All of the currently approved PDE5 inhibitors work in the same way. They differ in the number of available doses, how quickly they work and last in your system, the dosing, and to some extent in the side effects. However, they generally share the same indications and contraindications. Currently, tadalafil is the only medication that patients can take on a daily basis and is approved for the treatment of both ED and BPH (benign enlargement of the prostate).

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    This asana is also known as the standing forward bend Uttansana is mentioned in many popular yoga routines. Doing this erectile dysfunction exercise will help you deal with stress and anxiety. Doctors even say that Uttanasana can treat infertility and improve digestion and organ stimulation of the abdomen.

    Following completion of a full interview, physical examination, and laboratory testing, your doctor should be able to determine the general type of dysfunction and the need for any additional testing. Such tests include penile or pelvic blood flow studies, nocturnal penile tumescence testing, penile biothesiometry (nerve testing), and/or more blood tests.
    However, it can be a sign of an underlying medical condition such as high blood pressure or cholesterol, side effects of medication, or hormonal issues.

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When sexually stimulated/aroused, the nerves supplying the penis release a chemical, nitric oxide (NO). Nitric oxide is important because it stimulates the production of a chemical called cyclic guanosine monophosphate (cGMP). cGMP causes the muscle in arteries of the penis to relax and increase blood flow into the penis. NO is broken down in the body by phosphodiesterase enzymes. PDE5 inhibitors thus prevent the breakdown of NO and thus promote increased blood flow into the penis.

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Men with a known hypersensitivity to alprostadil should not use intraurethral prostaglandin E1.

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Diagnostic injections of impotence medications by the treating physician are also considered medically necessary.

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Oral phosphodiesterase type 5 inhibitors (PDE5 inhibitors) unless contraindicated are the recommended first line medical therapy for erectile dysfunction. Currently, there are four different PDE5 inhibitors available. They all work the same way and have essentially the same results. They differ in how long they last in your body and in side effects.

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