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Some types of chemo can also cause short-term or life-long infertility. (See Fertility and the Male Adult with Cancer for more information.)

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Certain feelings can interfere with normal sexual function, including feeling nervous about or self-conscious about sex, feeling stressed either at home or at work, or feeling troubled in your current sexual relationship. In these cases, treatment incorporating psychological counseling with you and your sexual partner may be successful. One episode of failure, regardless of cause, may propagate further psychological distress, leading to further erectile failure. Los of desire or interest in sexual activity can be psychological or due to low testosterone levels. .

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The vacuum device is relatively well tolerated but may cause pain, bruising and numbness.
'However, the optimum combination of frequency and exercise will vary from individual to individual.'

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The needle used is very fine, so pain from the injection site is usually minimal. It is very important that you receive these injections by a trained urologist. Penile injections not administered under the supervision of a urologist or other trained medical professional can result in serious side effects in some men. Most insurance plans will cover the cost of these injections when you are under the care of a urologist. Erection occurs in five to 20 minutes following injection and lasts up to one hour Can be used anytime Erection feels natural No surgery necessary Can be costly if not covered by insurance May cause bleeding and scarring at the injection site Can cause painful erections that last longer than two hours Lack of spontaneity May require surgery if erection is prolonged 75 percent of men stop using injections after one year Urethral Suppositories
While erectile dysfunction can occur at any age, the risk of developing erectile dysfunction increases with age. According to the Massachusetts Male Aging Study, the prevalence of erectile dysfunction was 52% in men 40-70 years of age. The prevalence of complete erectile dysfunction increases from 5% at 40 years of age to 15% among men 70 years of age and older.

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Studies show about 5 percent of men who are 40 years old have full-blown ED, and that percentage jumps to 15 percent for men who are 70.

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Quitting smoking, exercising regularly, losing excess weight, curtailing excessive alcohol consumption, controlling hypertension, and optimizing blood glucose levels in patients with diabetes are not only important for maintaining good health but also may improve or even prevent progression of erectile dysfunction. It is unclear if such lifestyle changes can reverse erectile dysfunction. However, lifestyle improvements may prevent progression of the erectile dysfunction. Some studies suggest that men who have made lifestyle improvements experience increased rates of success with oral medications.

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    • Nerve damage from pelvic surgery or radiation (e.g. treatment of prostate, bladder, or rectal cancer) or from conditions known to lead to neuropathy (e.g. HIV, diabetes)

    Aetna considers the diagnosis and treatment of erectile dysfunction (ED; impotence) medically necessary according to the criteria outlined below.
    Pelvic surgeries are a common cause of sexual dysfunction. Erectile dysfunction is a potential complication following prostate cancer surgery.

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    Erectile dysfunction is the type of sexual dysfunction that a man can experience anytime in their life. By taking the proper test and evaluation you can eliminate the ED signs and symptoms at an early age.

    The authors stated that this study has several drawbacks, most notably the small number of studies (n = 9) involved and the lack of a clear definition of ED. A single study assessed presence of ED by means of a single question (“How would you describe your ability to get and keep an erection that is adequate for satisfactory intercourse?”). The remaining studies used validated questionnaires: in detail, 4studies used the IIEF and 4 studies used the IIEF-5. However, most studies did not report separate measurements of serum Hcy based on the degree of severity of ED. Last Review 08/23/2021 Last Review 08/23/2021 Copyright Aetna Inc. All rights reserved. Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. This Clinical Policy Bulletin may be updated and therefore is subject to change. Glossary Aetna Mobile App Careers Accessibility Services Terms of Use Investor Info FAQs Program Provisions Interest-Based Ads Policy Legal Notices Plan Disclosures Nondiscrimination Notice Site Map Privacy Center State Directory Language services can be provided by calling the number on your member ID card. For additional language assistance: Español 中文 Tiếng Việt 한국어 Tagalog Pусский العربية Kreyòl Français Polski Português Italiano Deutsch 日本語 فارسی Other Languages… Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. HomeHealth Information and ToolsMyHealth VideosFind HealthcareAbout MyHealth.Alberta.caHealthier Together MyHealth Records MyHealth Account MyHealth.Alberta.ca
    Erectile dysfunction (ED, impotence) varies in severity; some cannot have an erection at all, whereas other men sometimes have troubles getting a hard erection, and others get a hard erection but it only lasts for a short period of time. Approximately 50% of men over the age of 40 have troubles with erectile dysfunction.

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    Some men experience symptoms of sexual disorders that are related to erectile dysfunction, including: Ejaculation happens too fast — this is called premature ejaculationEjaculation happens too slowly (a man needs stimulation for more than 30 minutes) — this is called delayed ejaculationEjaculation doesn’t happen, or a man doesn’t orgasm — this is called anorgasmia What Causes ED?

    • Conditions such as diabetes, high blood pressure, heart or thyroid conditions, poor blood flow, depression, or neurologic disorders (such as multiple sclerosis or Parkinson's disease)
    It is also more common in older patients, but is not, itself, a natural consequence of aging.

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    You need at least three healthy things for an erection: a penis, blood vessels, and nerves. The most simplistic explanation of an erection is that nerves send signals to the blood vessels to deliver more blood to the penis. Then, spongy (erectile) tissue of the penis (corpus cavernosum) gets filled with blood and an erection occurs. If any of the above components are not functioning well, erection may not happen.

    Certain medications can alter testicular function, including some diuretics (water pills), some seizure medications, long-acting oral opiate pain medications, antipsychotic medications, and oral steroids.
    Similarly, if you are taking an alpha-blocker for prostate symptoms, the recommended starting dose of avanafil is 50 mg.

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Kegel exercises are very common impotence exercises, and although they are typically associated with women, studies have shown that they can also benefit men. These pelvic floor exercises work by alternatively contracting and relaxing certain muscles that make up the pelvic floor, especially the pubococcygeus muscle. This muscle runs from the anus to the urinary sphincter, and by strengthening this muscle, many men find that they are able to achieve an erection easier. Erectile dysfunction exercises are one possible way to treat the condition.

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For those men with persistent erectile dysfunction, a penile implant can restore sexual function. An inflatable implant uses two cylinders that are surgically placed inside the penis. When an erection is desired, the man uses a pump to fill the cylinders with pressurized fluid. Alternatively, a malleable implant with surgically implanted rods can be used to bolster erections.

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Physical reasons for ED range from heart disease and diabetes to high blood pressure and obesity. Damage to your nerves or arteries can cause problems with erections, too. Lack of exercise, drinking, and smoking can lead to problems.

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Bullet point: The relationship between the risk factors for CVD and ED are intimately interwoven, one with the other. Clinicians need to factor this in when counselling the man with ED.

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