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Erectile dysfunction or impotence is a man's inability to achieve and maintain a penile erection suitable for sexual intercourse.

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Conditions like vascular disease, surgery, diabetes, and medications are some of the top causes of erectile dysfunction. If you suffer from ED, schedule an evaluation with your doctor and get the help you need
The pulses in your legs will normally be assessed and the nerve reflexes involving your legs, and your penis or anus (back passage). Rectal examination (pictured) may be performed to assess the tone of your anal muscles and to feel your prostate gland. .

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Doctors have not tested the PDE5 inhibitors in patients with retinitis pigmentosa, an eye condition that affects the retina and can cause blindness, and so caution is recommended if you have this health condition.
The ACP did not recommend for or against routine use of hormonal blood tests or hormonal treatment in the management of patients with ED.

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This information was updated by the EAU Patient Information Working Group, July 2021.
Many factors can contribute to sexual dysfunction in older men, including physical and psychological conditions, comorbidities and the medications used to treat them. Aspects of an ageing man’s lifestyle and behaviour and androgen deficiency, most often decreasing testosterone levels, may affect sexual function as well. A study of men between the ages of 30 and 79 years showed that 24% had testosterone levels below 300 ng/dL and 5.6% had symptomatic androgen deficiency.2

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Your GP should work through a recommended scheme of assessment for men with erectile dysfunction (impotence). This will normally include some or all of the following:

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Problems in your relationship with your sexual partner can also cause erectile dysfunction. Improving your relationship may help your sex life. If you decide to seek therapy, it will probably be most effective if your sex partner is included.

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    But before taking the test let’s understand what Erectile dysfunction is and why it is important to get it tested on time?
    #covid19 #instagood #mensmentalhealth #mentalhealth #mentalhealthawareness #mentalhealthmatters #selfcare covid and ed ed ohn post-covid Alternative Medicine Treatments for ED Morning Erection and Erectile Dysfunction Is Erectile Dysfunction a Genetic Disease?

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    Causes and risk factors for erectile dysfunction are as follows:How does exercising help in erectile dysfunction?Kegel ExercisesActivating Pelvic Floor MusclesSitting pelvic floor activationPilates exercisesKnee falloutsSupine foot raisesPelvic curl

    As with surgery, the older you are, the more likely it is you will have problems with erections. And men with heart or blood vessel disease, diabetes, or who have smoked heavily seem to be at greater risk for erection problems. This is because their arteries may already be damaged before radiation treatment. Doctors are looking at whether early penile rehabilitation could help after radiation therapy, too. (Penile rehabilitation is discussed above, in the surgery section.)
    Urology Associates provides various treatment options for erectile dysfunction (ED). Our urology team will help treat your ED safely and effectively.

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    Call your doctor right away if you take one of these medications and have a prolonged erection that lasts 4 hours or longer. This condition may cause permanent impotence if not treated.
    Erectile dysfunction is a common symptom and causes problems in men. About 30 million men in the United States have erectile dysfunction. Based on this figure, more than 100 million men worldwide are sexually impotent. About 52% of men aged 40-70 years of sexual dysfunction among these people, there are many stressors that affect family relationships. And may cause depression, decreased self esteem and bad image of themselves. Drink up to 2 glasses of alcohol a day. Non smoking Consult a therapist about improving communication with your partner. 90/5 Moo 13, King Kaew Rd., Tambon Rachadeva, Amphoe Bangplee, Samutprakarn 10540

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    If you have a partner, involve them in treatment by discussing your sexual function with them. Include them in physical activity, even if it's starting with a home-based walking program.

    For many of the 30 million Americans affected by erectile dysfunction, Viagra, Levitra, and Cialis are the first line of ED treatment — and they’re successful for about 80 percent of men. These drugs, called phosphodiesterase-5 inhibitors, are approved by the U.S. Food and Drug Administration (FDA) and work by increasing blood flow to an erection. Common side effects include nasal congestion and headache. Note: If you take nitroglycerin pills for heart disease, you won’t be able to take ED pills, as they can cause a dangerous drop in blood pressure.
    Kasraeian Urology introduced this new ED treatment in 2021 for their patients in the Jacksonville, FL area.

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All men receiving testosterone replacement need to have periodic measurement of haemoglobin and haematocrit to monitor for erythrocytosis. Feldman HA , Goldstein I , Hatzichristou DG , et al . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994;151:54–61. Araujo AB , Esche GR , Kupelian V , et al . Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab 2007;92:4241–7. doi:10.1210/jc.2007-1245 Lindau ST , Schumm LP , Laumann EO , et al . A study of sexuality and health among older adults in the United States. N Engl J Med 2007;357:762–74. doi:10.1056/NEJMoa067423 Shah J . Erectile dysfunction through the ages. BJU Int 2002;90:433–41. doi:10.1046/j.1464-410X.2002.02911.x Mobley D . Early history of inflatable penile prosthesis surgery. Asian J Androl 2015;17:225–9. Roumeguère T , Wespes E , Carpentier Y , et al . Erectile Dysfunction is associated with a high prevalence of hyperlipidemia and coronary Heart Disease Risk European Urology.44:355–9. Klein R , Klein BE , Lee KE , et al . Prevalence of self-reported erectile dysfunction in people with long-term IDDM. Diabetes Care 1996;19:135–41. doi:10.2337/diacare.19.2.135 Larsen SH , Wagner G , Heitmann BL . Sexual function and obesity. Int J Obes 2007;31:1189–98. doi:10.1038/sj.ijo.0803604 McWaine DE , Procci WR . Drug-induced sexual dysfunction. Med Toxicol Adverse Drug Exp 1988;3:289–306. doi:10.1007/BF03259941 Croft H , Settle E , Houser T , et al . A placebo-controlled comparison of the antidepressant efficacy and effects on sexual functioning of sustained-release bupropion and sertraline. Clin Ther 1999;21(4):643–58. doi:10.1016/S0149-2918(00)88317-4 Janeway M , Baum N . Managing the enlarged prostate gland in elderly men. Clinical Geriatrics http://www.consultant360.com/articles/managing-enlarged-prostate-gland-elderly-men. Kumar RJ , Barqawi A , Crawford ED . Adverse events associated with hormonal therapy for prostate Cancer. Rev Urol 2005;7 Suppl 5:S37–S43. Aksam A , Yassin A , Saad F . Testosterone and erectile dysfunction. J Andrology 2008;29. Gades NM , Nehra A , Jacobson DJ , et al . Association between smoking and erectile dysfunction: a population-based study. Am J Epidemiol 2005;161:346–51. doi:10.1093/aje/kwi052 Mobley D , Baum N . Smoking: it’s impact on urologic conditions. Rev Urology 17 2015. Stein RA . Endothelial dysfunction, erectile dysfunction, and coronary heart disease: the pathophysiologic and clinical linkage. Rev Urol 2003;5(Suppl 7):S21–S27. Andersson K , Stief C . Penile erection and cardiac risk: pathophysiologic and pharmacologic mechanisms. Am J Cardiol 2000;86:23–6. doi:10.1016/S0002-9149(00)00887-0 Feldman HA , Johannes CB , Derby CA , et al . Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study. Prev Med 2000;30:328–38. doi:10.1006/pmed.2000.0643 Vlachopoulos C , Ioakeimidis N , Terentes-Printzios D , et al . The triad: erectile dysfunction-endothelial dysfunction-cardiovascular disease Curr Pharm Des. 2008;14:3700–14. Watts GF , Chew KK , Stuckey BG et al . The erectile-endothelial dysfunction nexus: new opportunities for cardiovascular risk prevention. Nat Clin Pract Cardiovasc Med 2007;4:263–73. doi:10.1038/ncpcardio0861 Montorsi F , Briganti A , Salonia A , et al . Erectile dysfunction prevalence, time of onset and association with risk factors in 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease. Eur Urol 2003;44:360–5. doi:10.1016/S0302-2838(03)00305-1 Vlachopoulos C , Rokkas K , Ioakeimidis N , et al . Prevalence of asymptomatic coronary artery disease in men with vasculogenic erectile dysfunction: a prospective angiographic study. Eur Urol 2005;48:996–1003. doi:10.1016/j.eururo.2005.08.002 Mulhall J , Teloken P , Barnas J et al . Vasculogenic erectile dysfunction is a predictor of abnormal stress echocardiography. J Sex Med 2009;6:820–5. doi:10.1111/j.1743-6109.2008.01087.x Hodges LD , Kirby M , Solanki J , et al . The temporal relationship between erectile dysfunction and cardiovascular disease. Int J Clin Pract 2007;61:2019–25. doi:10.1111/j.1742-1241.2007.01629.x Inman BA , Sauver JL , Jacobson DJ , et al . A population-based, longitudinal study of erectile dysfunction and future coronary artery disease. Mayo Clin Proc 2009;84:108–13. doi:10.4065/84.2.108 Ponholzer A , Temml C , Obermayr R , et al . Is erectile dysfunction an indicator for increased risk of coronary heart disease and stroke? Eur Urol 2005;48:512–8. doi:10.1016/j.eururo.2005.05.014 Thompson IM , Tangen CM , Goodman PJ , et al . Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005;294:2996–3002. doi:10.1001/jama.294.23.2996 Banks E , Joshy G , Abhayaratna WP , et al . Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: a prospective cohort study. PLoS Med 2013;10:e1001372. doi:10.1371/journal.pmed.1001372 Lewis RW , Fugl-Meyer KS , Corona G , et al . Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med 2010;7:1598–607. doi:10.1111/j.1743-6109.2010.01778.x Yaman O , Gulpinar O , Hasan T , et al . Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity. Int Urol Nephrol 2008;40:117–23. doi:10.1007/s11255-007-9293-8 Montorsi P , Ravagnani PM , Galli S , et al . Association between erectile dysfunction and coronary artery disease. role of coronary clinical presentation and extent of coronary vessels involvement: the COBRA trial. Eur Heart J 2006;27:2632–9. doi:10.1093/eurheartj/ehl142 Montorsi P , Ravagnani PM , Galli S , et al . Association between erectile dysfunction and coronary artery disease:matching the right target with the right test in the right patient. Eur Urol 2006;50:721–31. doi:10.1016/j.eururo.2006.07.015 Yassin AA , Saad F . Testosterone and erectile dysfunction. J Androl 2008;29:593–604. doi:10.2164/jandrol.107.004630 Khera M . Androgens and erectile function: a case for early androgen use in postprostatectomy hypogonadal men. J Sex Med 2009;6:234–8. doi:10.1111/j.1743-6109.2008.01159.x Aversa A , Isidori AM , De Martino MU , et al . Androgens and penile erection: evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction. Clin Endocrinol 2000;53:517–22. doi:10.1046/j.1365-2265.2000.01118.x Wespes E , Amar E , Hatzichristou D , et al . EAU guidelines on erectile dysfunction: an update. Eur Urol 2006;49:806–15. doi:10.1016/j.eururo.2006.01.028

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One must be very careful using both PDE5 inhibitors and medications commonly used to treat an enlarged prostate, alpha-blockers (for example, tamsulosin [Flomax], terazosin [Hytrin]). It is recommended that one be on a stable dose of the alpha-blocker prior to starting a PDE5 inhibitor and that one start on a low dose of the PDE5 inhibitor and increase as tolerated and needed to treat the erectile dysfunction. Similarly, if you are on a PDE5 inhibitor and your doctor recommends that you start an alpha-blocker for your prostate, you should start at a low dose and increase as tolerated and needed to treat your prostate symptoms.

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The vacuum device creates a vacuum to pull blood into the penis. Unlike a normal erection, the inflow of blood does not continue once the individual removes the vacuum device. The rubber band placed at the base of the penis constricts the penis to prevent the blood from leaving the penis. As there is no inflow or outflow of blood when the rubber band is in place, it is uncommon for the tip of the penis (the glans) to appear a little blue and the penis to be cooler. Once intercourse is completed, the individual removes the rubber band and the blood drains out of the penis.

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Collagenases are proteinases that hydrolyze collagen in its native triple helical conformation under physiological conditions, resulting in lysis of collagen deposits. The signs and symptoms of Peyronie’s disease have been found to be caused by a collagen plaque. Injection of collagenase clostridium histolyticum into a Peyronie’s plaque, which is comprised mostly of collagen, may result in enzymatic disruption of the plaque. Following this disruption of the plaque, penile curvature deformity are reduced (Endo Pharmaceuticals, 2021). Measurement of Serum Melatonin Levels for the Diagnosis of Erectile Dysfunction

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