First line treatment will be medication with a phosphodiesterase inhibitor such as sildenafil (Viagra), tadalafil (Cialis) or avanafil (Spedra). These drugs only work when used together with sexual stimulation and will have no effect on your sex drive. There is no evidence that these drugs are dangerous if you have underlying heart disease. However, they should not be used if you are taking nitrates (e.g. GTN, isosorbide) for angina
Tags: elderly, erectile dysfunction, impotence, male, Men's Health, older adults, senior
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Men can have several types of issues including poor sex drive and problems with ejaculation. But ED refers specifically to trouble getting or keeping an erection. You might have a healthy sex drive, but a body that won’t respond. Most of the time there is a physical basis for the problem.
Unfortunately, some men may not recover their ability to have a natural erection.
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
Feelings of inadequacy or failure may complicate ED symptoms. ED may result in an inability to maintain an erection sometimes, but not every time. Other signs are the ability to get an erection but unable to maintain it to complete sexual relations, or an inability to attain an erection at all.
Exercisers in a recent study showed significantly higher levels of desire compared to those who did not exercise.
In patients who either fail to respond to first or second-line therapy, or are not interested in the conservative therapies, penile prosthesis implantation is available. Malleable and rigid implants were available for many years, but in 1973 the world of penile prosthetics took a giant leap forward with the advent of the inflatable penile implant. Most implants done nowadays are of the inflatable variety. Adverse events including malfunction and infection are rare, and patient satisfaction is very high.45
Men with a known hypersensitivity to alprostadil should not use intraurethral prostaglandin E1.
ED can be embarrassing to talk about. However, if it is affecting your relationship, you need to discuss it. Find tips for talking to your partner and getting successful treatment.
When medications are the culprit, a prescription change may resolve ED. “Occasionally we get referrals and speak to the patient’s psychiatrist, cardiologist, or primary care provider to see if his medication can be changed,” Dr. Baumgarten says. “We often see improvement once the switch is made.”
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The role of the endothelium in erectile function became clearer with the observation that the phosphodiesterase type 5 (PDE5) inhibitor, sildenafil, enhanced erectile function. Erection occurs with the release of nitric oxide (NO) from the vascular endothelial cells.17 The reduction in endothelial cell production of NO results in the negative impact on the smooth muscles in the corporal bodies and results in less relaxation of the smooth muscle cells with decrease in blood supply and resulting ED. A similar phenomenon is well known to impact the coronary arterial system resulting in CVD.
Erectile dysfunction is extremely common, and many men will experience it at some point in their lifetime. Healthy lifestyle habits are an excellent starting point for treating erectile dysfunction. Strengthening your muscles and consuming a healthy diet can improve your cardiovascular health as well as your erectile function.
When other treatment options are not successful, penile implant surgery can provide excellent patient and partner satisfaction. Both malleable (bendable) and inflatable devices can be implanted to allow penile rigidity and satisfactory sexual intercourse.