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Erectile dysfunction (ED) is a term used when you can’t get or sustain an erection, and it can affect both men and their sexual partners. The Male Infertility & Sexual Health Program at University Hospitals offers advanced treatments and an experienced, multidisciplinary team to address many of the symptoms and causes of erectile dysfunction.

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What is the role of testosterone therapy in the treatment of erectile dysfunction?
1. Overview2. Symptoms3. Causes4. Diagnosis5. Prevention6. Treatment7. Everyday Life8. Questions9. Resources .

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These tests are only done in certain patients who have not responded to initial therapies, and may include: Ultrasonography (penile Doppler) to check blood flow in the penis A special injection into the penis to check erection Arteriography (an imaging test that uses X-rays and a special dye to see inside the arteries) Magnetic resonance imaging (MRI) or computed tomography (CT) scan Nocturnal penile tumescence or NPT (using a special electronic device to monitor nocturnal erections)
Vacuum Erection Device is one such external device that is FDA approved and is easy and safe to use. At IASH, we explain step by step procedure for the safe and competent use of this device.

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The side effects of ED medicine are mostly the same. Sildenafil and vardenafil can cause: Headache. Flushing (face and upper body turning red and warm). Stomach upset. Runny nose (sniffles). vision changes (things look blue).
Another second-line therapy is the use of alprostadil, either intracavernosal or intraurethral. Two products are available for direct injection, Caverject (Pfizer) or Edex (Actient). A small needle is used to inject the medication into the lateral aspect of the penis through a small-gauge needle.

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Also talk to the doctor if it's painful to get an erection or difficult because your penis is curved (a condition called Peyronie's disease).

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Studies have shown that for men with stress-related ED, when the partner is involved in the therapy, the problem is resolved 50%–70% of the time. When the man must go through counselling alone, the results are less successful. Psychosexual counselling is unlikely to be effective if a man drops out of treatment after just one or two sessions.44

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    Erectile Dysfunction is one of the most commonly seen sexual issues in males. The point to note is that if occasional erection issues are there, then there is no point of concern, but getting frequent ones can actually destroy your sexual life and your relationship as well.

    While its true medications can help improve blood flow and hormone levels, dietary changes and simple exercises can also help improve erectile function by supporting overall cardiovascular health. That being said, your first step should be to contact your doctor in order to determine the cause of your E.D. symptoms. In some men, E.D. is an early warning sign of cardiovascular disease.
    Men with a known hypersensitivity to alprostadil should not use intraurethral prostaglandin E1.

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    It is recommended that prior to proceeding with other therapies, patients reporting failure of their PDE5 inhibitors should be evaluated to determine whether the trial was adequate. This would include discussion of fatty food ingestion, which is important with sildenafil, and specific patient population such as prostatectomy and diabetes. Furthermore, patients should be encouraged to continue attempts at intercourse up to the eighth to tenth dose of PDE5 inhibitor as improvements in success rate are seen up to the eighth to tenth dose.

    “ED can definitely be a standalone issue,” Dr. Baumgarten says. “Erections are complicated, involving nerves, blood vessels, and the brain.” When the brain triggers anxiety or doesn’t trigger sexual desire, it can impact erectile function. “For example, patients may have performance anxiety, and sometimes they can benefit from sex therapy.”
    AntidepressantsBlood pressure medicines (especially beta-blockers)Heart medicines, such as digoxinSleeping pillsSome peptic ulcer medicines

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    Once you feel comfortable with this feeling, you can incorporate this into a daily routine of performing pelvic floor exercises. It won't take long, and will soon feel like second nature.

    Men with a rare heart condition known as long QT syndrome should not take vardenafil since this may lead to abnormal heart rhythms. The QT interval is the time it takes for the heart's muscle to recover after it has contracted and is measured on an electrocardiogram (EKG). In addition, vardenafil is not recommended for men taking medications that can affect the QT interval such as quinidine, procainamide, amiodarone, and sotalol.
    If BPH is Your Diagnosis, HoLEP May be Your Best Treatment OptionNovember 19, 2021

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    “Erectile Dysfunction (ED).” UW Health. Retrieved from: http://www.uwhealth.org/urology/erectile-dysfunction-ed/20537

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    ED is most commonly caused by medical conditions such as diabetes and high blood pressure or pelvic surgeries. Age related decline in erectile function is also thought to occur. An injury A disease (e.g. diabetes, high blood pressure, or high cholesterol) Various studies have estimated that between 20% – 71% of individuals with diabetes suffer from erectile dysfunction. An operation (e.g. prostate gland removal) Substance use (e.g. tobacco, drugs, alcohol or medications) Stress, anxiety, depression, psychological trauma Approximately 30 million American men suffer from erectile dysfunction. Most men with erectile dysfunction still have the ability to have an orgasm and father a child, but often have difficulty doing these things because they can’t get or sustain an erection. Erectile dysfunction is not normal, and is by no means an inevitable consequence of aging. Most men at one time or another during their sexual lives are unable to get or keep an erection. This is normal and does not indicate a problem. However, millions of men of all ages experience this inability as a continuing problem. In most cases, erectile dysfunction can be overcome using medical or surgical options. We typically start with questionnaires such as the International Index of Erectile Function (IIEF) to determine the severity. Penile injections such as Trimix may be used to assess the quality of your erection and to differentiate among the many causes. Occasionally a penile duplex ultrasound is indicated if there is concern for disease in the blood vessels or penile scarring. Treatment Options for Erectile Dysfunction

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On the horizon is gene therapy that would deliver genes that produce products or proteins that may not be functioning properly in the penile tissue of men with ED. Replacement of these proteins may result in improvement in erectile function. Experimental animal models have demonstrated improvement in erectile function with gene therapy. Human studies may also demonstrate success with this therapy. Gene therapy may take a long time for regulatory approval and public acceptance.

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Are you taking any medicines, including over-the counter medicines and supplements?Do you drink, smoke, or use recreational drugs?What is your state of mind? Are you stressed, depressed, or anxious?Are you having relationship problems?

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Kegels exercises can be helpful in maintaining the blood flow and strengthen the muscles of the pelvic- region thus enabling a normal erection.

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I have severe erectile dysfunction, and it’s really affecting my self-esteem and marriage. I’ve been too embarrassed to seek help, but my wife has put her foot down and demanded I seek treatment for impotence. What is the treatment for severe ED?

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