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There are several treatments for erectile dysfunction. Your doctor can advise you on the benefits and drawbacks of each.

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men taking erythromycin or ketoconazole should not take more than 5 mg of vardenafil in a 24-hour period;men taking high doses of ketoconazole (Nizoral) should not take more than 2.5 mg of vardenafil in a 24-hour period;men with moderately severe liver disease also should not take more than a 5 mg dose of vardenafil in a 24-hour period;men taking the protease inhibitor (for the treatment of HIV/AIDS) indinavir (Crixivan) should not take more than 2.5 mg of vardenafil in a 24-hour period; andmen taking another protease inhibitor ritonavir (Norvir), erythromycin, or ketoconazole, should not take more than 2.5 mg of vardenafil every 72 hours.
Aetna considers genetic polymorphism testing experimental and investigational for the evaluation of response to phosphodiesterase 5 (PDE5) inhibitors in members with erectile dysfunction. .

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Of the 90% of men who have an underlying physical cause, the main abnormalities found are: Cardiovascular disease in 40%; Diabetes in 33%; Hormone problems (e.g. high prolactin or low testosterone levels) & drugs (e.g. antihypertensives, antipsychotics, antidepressants, antihistamines, heroin, cocaine, methadone) in 11%; click here to watch a short video about testosterone deficiency from the NHS Health & Care Video Library. Neurological disorders in 10%; Pelvic surgery or trauma in 3-5%; and Anatomical abnormalities in 1-3% (e.g. tight foreskin, short penile frenulum, Peyronie's disease, inflammation, penile curvature). What treatments are available for this problem?
This test is done to confirm that a person is able to maintain erections at night or not. It is possible for an ordinary person to get an erection at night during a normal sleep routine. There are several causes of ED like emotional, mental, or physical and this test helps in determining the exact cause of the sexual problem.

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Aetna considers ESWT experimental and investigational for Peyronie’s disease because of a lack of evidence from prospective randomized controlled clinical studies of the effectiveness of ESWT for this indication.

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If you think any medicine you are taking may be causing erection problems, talk with your provider. You may need to lower the dose or change to another drug. DO NOT change or stop taking any medicine without first talking to your provider.

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According to Professor Bente Klarlund Pedersen from the University of Copenhagen and Ellids Kristensen, doctor and research scientist at the Sexological Clinic in Copenhagen, these conclusions are supported by known mechanisms that can explain the link to erectile dysfunction: Physical activity makes the blood vessels more elastic, allowing more blood to flow to the sex organs. Physical activity stimulates the body’s production of nitrogen oxide, allowing the blood vessels to expand. This is essentially just what the popular medicine, Viagra, does.

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    Journal of Sexual Medicine: “Prevalence and correlates of erectile dysfunction by race and ethnicity among men aged 40 or older in the United States: from the male attitudes regarding sexual health survey.

    A penile prosthesis is a pair of malleable (bendable) rods that are surgically inserted into the penis. It allows erections to happen by a mechanism of compressing on a special part by the device. Men disappointed with other treatments might be fit for penile prosthesis.
    Older men are more likely to take medication for health problems, which could influence their risk.

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    The recommended starting dose of tadalafil for use as needed for most patients is 10 mg taken orally approximately one hour before sexual activity. A doctor may adjust the dose higher to 20 mg or lower to 5 mg depending on efficacy and side effects. Doctors recommended that patients take tadalafil no more frequently than once per day. Some patients can take tadalafil less frequently since the improvement in erectile function may last 36 hours. Patients may take tadalafil with or without food. Tadalafil is currently the only PDE5 inhibitor that is FDA-approved for daily use for erectile dysfunction and is available in 2.5 mg or 5 mg dosages for daily use.

    A GP might recommend sex therapy, either on its own or in combination with other psychotherapy.
    By using advanced testing methods like this, our physicians can find the underlying causes of your ED and create more individual and effective erectile dysfunction treatments.

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    Aetna considers the following diagnostic workup of erectile dysfunction medically necessary: Comprehensive history and physical examination (including medical and sexual history and psychosocial evaluation) Duplexscan (Doppler and ultrasound) in conjunction with intracorporeal papaverine Dynamic infusion cavernosometry and cavernosography only for members who are to undergo re-vascularization procedures and meet medical necessity criteria for penile re-vascularization (see below) Pharmacological response test for erectile dysfunction (using vasoactive drugs, e.g., papaverine HCl, phentolamine mesylate, prostaglandin E1) Pudendal arteriography (angiography) only for members who are to undergo penile re-vascularization and meet the medical necessity criteria for penile revascularization (see below).

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    As your body becomes more familiar and used to these exercises, consider increasing the length of time you squeeze and hold the different pelvic muscles. You can also increase the number of repetitions or sets of exercises you do.

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    erectile dysfunctionendothelial dysfunctiontestosteronetestosterone deficiencyandrogen deficiencytestosterone replacementcardiovascular diseasestem cellsgene therapy

    The production of testosterone and other hormones naturally decreases with age, and this can disrupt erections. Also, in rare instances, kidney failure and liver disease may throw off the balance of hormones necessary for proper erection and intercourse. In most cases, testosterone replacement therapy can bring levels of the hormone back to normal.
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Surgery is an option in some cases of erectile dysfunction. Most surgery cases are performed for one of three reasons: to implant a device to initiate erections; to reconstruct arteries and increase penis blood flow; to block off veins that allow blood to leak from the penile tissues.

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There are times when the cause behind the sexual problem is not because of any physical cause but the psychological issues between a person or a couple. Problems like martial issues and lack of communication can be the reason for having a low sex desire or unpleasurable sex. By giving proper counseling and couples therapies doctors try to build a new bond between a couple and help them recover their ED issues.

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What are the side effects of sildenafil (Viagra) that may be different from some of the other PDE5 inhibitors?

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Picture of erection-measuring snap gauge. A number of devices have been developed to determine if an erection occurs during sleep. This snap gauge is fastened around the penis but opens when an erection occurs.

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