Men with diabetes, radical prostatectomy, and other complicating factors may still benefit from treatment with a phosphodiesterase type-5 inhibitor such as Viagra. Patients who fail a trial of PDE5 inhibitor should be informed of the benefits and risks of other therapies. This of a different PDE5 inhibitor is unlikely to have a profound effect on sexual function and someone who fails a first drug trial, but should be considered in selected cases. Second-line therapies include intra-urethral suppositories, intra-cavernous drug injection, vacuum-constriction devices, and penile prosthesis. Medicated Urethral System for Erection (MUSE). MUSE is an intra-urethral suppository of alprostadil, of vaso-active drug that relaxes smooth muscle in the penis and induces penile erection. Although not as effective as intra-cavernosal penile injection, MUSE is a less invasive treatment option. An initial trial dose of intra-urethral alprostadil should be administered under healthcare provider supervision due to the risk of fainting. The cost of intra-urethral suppositories is high with respect to the overall success and therefore should be used judiciously.
Most people who get shockwave therapy for ED will often see benefits within one to three months. The initial results (within the first several weeks) can be dramatic. There is still not enough long-term research and data to say how long the treatment might last, whether the effects of the treatment could wear off, or whether you will need additional treatment at a later time. Schedule a Consult with Our Specialists .
MetS is a combination of maladies that can cause ED. The five hallmarks of MetS are: hypertension, elevated fasting glucose levels, elevated triglycerides, central obesity, and reduced high density lipoprotein levels of cholesterol. MetS causes inflammation and hormonal imbalances that can lead to ED. Treatment for MetS can include lifestyle changes, testosterone replacement, pharmaceuticals, and bariatric surgery – such as gastric bypass.
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.
Zhou ES, Bober SL. Sexual problems. In DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2019:2220-2229.
Whilst erectile dysfunction may be related to both mental and physical disorders, in approximately 80% of cases, medical conditions may play a contributory role. It is therefore important for all patients experiencing erectile dysfunction to be reviewed by their GP.
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Talk to your provider if your erection problems have to do with a fear of heart problems. Sexual intercourse is usually safe for men with heart problems.
Blood levels of testosterone, prolactin, FSH (follicle-stimulating hormone), LH (luteinising hormone) and thyroid hormones will normally be measured.
Half of men with diabetes will experience ED within 10 years of their diagnosis. High blood sugar levels can damage the nerves that control sexual stimulation. They can also damage the blood vessels needed to provide adequate blood flow to the penis in order to have and maintain an erection.
But the main risk for having ED is age. Yes, unfortunately, the older you are, the more likely you are to have ED. You cannot be 67 and have a 21-year-old penis.
You have a question that many men are concerned about. You go online to research the question: do I have erectile dysfunction?
Worries about self-image and performance can sometimes lead to erection problems, too. Instead of letting go and feeling excited, a man may focus on whether he will be able to function, and fear of failure might make it happen. He may blame the resulting problem on his medical condition, even though he might be able to have an erection if he were able to relax.
Figures suggest more than half of men over the age of 50 have erectile dysfunction, which gets more common with age.
Liver toxicity has generally been associated with oral forms of TRT, but does not appear to be a risk in injection or transdermal therapy.39 In patients with marked obstructive sleep apnoea or untreated severe congestive heart failure, these issues should be resolved before initiating TRT.37
GAINSWave therapy is effective and safe for men who cannot take oral ED medicine, such as those with heart disease, diabetes, or high blood pressure. GAINSWave can be used to treat Peyronie’s Disease, which Viagra and other oral ED drugs cannot. Here is How Those With Erectile Dysfunction Can Still Provide and Achieve Sexual Pleasure What is GAINSWave? What to expect? How it works? Comparing treatments Frequently asked questions Medical advisory board Clinical research Find a provider near you → New York Texas Florida California Colorado Arizona Washington See all locations → Men’s Health Guide GW Magazine As Seen On For Providers Provider Resources For Affiliates For Press Partnership Facebook Instagram Twitter Youtube Linkedin Tiktok
To diagnose erectile dysfunction, the doctor will ask questions about the symptoms and medical history. A complete physical exam is done to detect poor circulation or nerve trouble. The physician will look for abnormalities of the genital area that could cause problems with erections.