0% Many factors can affect a man’s ability to get and keep an erection and several factors may be present at one time. Commonly there is a combination of physical and psychological factors. Sometimes there is no clear reason for the erectile dysfunction; however, most cases of erectile dysfunction have a physical cause. IMAGES PROVIDED BY: opioid painkillers synonymsSearch Urogynecology / Female Pelvic Health Creativity What is the role of testosterone therapy in the treatment of erectile dysfunction? Volunteer GET DAILY TIPS ON Sign Up Now Widower syndrome Nutrition for life Diabetes Mellitus Antihistamines–common as allergy medication Join NKF Whether the problem is coming from your brain or your body, we can help you find the right solution that works for you. New Smyrna Beach, FL 32168 Impotence, also known as erectile dysfunction or ED, is a condition in which a man is unable to get or hold an erection long enough to have a satisfactory sex life. Impotence is a common problem, affecting up to half of Australian men between the ages of 40 and 70 years. The risk of developing erectile dysfunction increases as you get older.In the past, doctors considered impotence to be a mainly psychological problem, caused by performance anxiety or stress. Now, doctors know that many cases of impotence have a physical cause, which usually can be treated. Often, a combination of physical and psychological factors contributes to erectile dysfunction.Physical causes of impotencePhysical causes of impotence can include:problems with blood to flow into and out of the penis;damage to the nerves that send signals from the body’s central nervous system to the penis; and, more rarely,a deficiency in testosterone or other hormones.Some medicines can contribute to impotence, as can some types of surgery and radiotherapy treatments.Blocked blood vessels to the penisA very common cause of impotence is when blood flow into the penis is reduced. This can be due to atherosclerosis, also known as hardening of the arteries. In atherosclerosis, the arteries are clogged and narrowed, resulting in reduced blood flow.Risk factors for atherosclerosis include:high cholesterol;high blood pressure;obesity;sleep apnoea;diabetes; andsmoking.If your erection problems are caused by atherosclerosis, there is a chance that the arteries in other parts of your body (e.g. the coronary arteries that supply your heart) are also affected by atherosclerosis. In fact, erection problems may be the first sign that you are at risk of coronary heart disease.Because the arteries to the penis are narrower than those to the heart, you may develop symptoms of erectile dysfunction before you experience any symptoms of heart disease, such as angina. So seeing your doctor about erection problems may be important for your overall physical health.Impotence can also be caused by a blood clot that prevents enough blood from flowing into the penis to cause an erection.Venous leakageIn some men, blood can flow in to the penis easily, but the problem is that it leaks out again, so an erection cannot be sustained. This is called venous leakage. Doctors aren’t certain of the cause of venous leakage, but they can perform surgery to help repair it.Medicines that can cause impotenceMany medicines can cause erection problems as a side effect, including:diuretics (sometimes known as ‘water tablets’ - often used for high blood pressure);high blood pressure medications;cholesterol-lowering medicines (including statins);some types of antipsychotics;antidepressants;cancer treatments;some medicines used to treat heartburn and stomach ulcers;antihistamines;some pain medicines; andcertain epilepsy medications.If you experience impotence after starting a new medication, tell your doctor, who may be able to prescribe a different medicine for you. Don’t stop taking a medicine without first consulting your doctor. You should also tell your doctor about any over-the-counter medicines or complementary remedies you may be taking.The following table contains a list of specific medicines that may cause or contribute to erectile dysfunction. This list may not cover all types of medicines that can cause erectile dysfunction, so always ask your doctor if you are in doubt. Also, for some of these medicines ED is a very rare side effect. Most men taking these medicines do not experience erectile dysfunction.Medicines that may cause erectile dysfunctionType of medicineExamplesACE inhibitorscaptopril (Capoten), enalapril (Renitec), perindopril (Perindo), ramipril (Tritace), and othersAntidepressantsamitriptyline (Endep), clomipramine (Anafranil), desvenlafaxine (Pristiq), fluoxetine (Prozac), paroxetine (Aropax), sertraline (Zoloft), venlafaxine (Altven, Efexor), and othersAnti-epilepticsclonazepam (Rivotril), pregabalin (Lyrica)Antifungalsitraconazole (Sporanox)Anti-ulcer drugscimetidine (Magicul), nizatidine (Tazac), ranitidine (Zantac), and othersBeta-blockerspropranolol (Inderal), metoprolol (Betaloc, Lopresor), and othersOther blood pressure-lowering medicinesclonidine (Catapres), lercanidipine/enalapril (Zan-Extra), losartan (Cozaar), perindopril/amlodipine (Coveram), olmesartan/amlodipine (Sevikar), telmisartan/amlodipine (Twynsta), valsartan/hydrochlorothiazide (Co-Diovan)Calcium-channel blockersdiltiazem (Cardizem), felodipine (Plendil), nifedipine (Adalat)Cholesterol-lowering drugsatorvastatin (Lipitor), ezetimibe/simvastatin (Vytorin), fluvastatin (Lescol, Vastin), gemfibrozil (Ausgem), pravastatin (Pravachol), simvastatin (APO-simvastatin, Lipex, Zocor), and othersDiuretics ('water tablets')bumetanide (Burinex), chlorthalidone (Hygroton), spironolactone (Aldactone), and othersSchizophrenia drugsamisulpride (Solian, Sulprix), haloperidol (Haldol, Serenace), olanzapine (Lanzek, Ozin, Zypine, Zyprexa), paliperidone (Invega), risperidone (Rispa, Risperdal), ziprasidone (Zeldox)Combination cholesterol-lowering and anti-hypertensiveamlodipine/atorvastatin (Caduet, Cadatin)Pain medicinesfentanyl (Denpax, Durogesic), hydromorphone (Jurnista), morphine (Momex SR, MS Contin), oxycodone (OxyContin, OxyNorm, Targin), tramadolMiscellaneousoestrogens, antiandrogens, anticancer drugs and some chemotherapy treatments, baclofen (Clofen, Lioresal); cyproterone (Androcur, Cyprohexal, Cyprostat), degarelix (Firmagon), etoricoxib (Arcoxia), finasteride (Proscar and Propecia), flutamide (Flutamin), rotigotine (Neupro), triptorelin (Diphereline)*The names in brackets are just some examples of the trade names each specific medicine is marketed under in Australia. The medicine may also be known by other trade names.Diabetes and erectile dysfunctionMen who have diabetes have a higher risk of developing impotence than other men. Diabetes contributes to impotence because it can damage blood vessels and cause a type of nerve damage known as peripheral neuropathy.Hormones and impotenceLow levels of the male hormone, testosterone, are more commonly linked to a lowered sex drive, rather than impotence itself. Only a small percentage of cases of impotence are caused by hormone deficiency.Low testosterone levels may be the result of a condition called hypogonadism, in which the testicles don’t produce enough testosterone. More rarely, low testosterone can be caused by the pituitary (a small gland at the base of the brain) not secreting sufficient hormones to stimulate the testes to produce testosterone. The pituitary is also sometimes affected by small benign (non-cancerous) tumours that secrete prolactin, another hormone that can cause impotence.Mildly decreased levels of testosterone are often not due to specific testicular or pituitary problems, but rather stress or depression. In this situation, testosterone replacement is rarely of any benefit.Other hormone problems, including thyroid disease, can also cause impotence.Prostate cancer and erectile dysfunctionThe advanced stages of prostate cancer can affect the nerves and arteries that are vital for an erection.Radiation treatment for prostate cancer can harm the erectile tissues of the penis, and prostate cancer surgery can cause nerve or artery damage to the penis.Treatment for advanced prostate cancer often includes medicines that counteract testosterone, and commonly cause erectile dysfunction as well as loss of sexual interest.Peyronie’s diseasePeyronie’s disease is an uncommon condition that affects a man’s sex life because his penis curves abnormally and causes pain when he has an erection. He might also be unable to have a hard erection. The curvature of the penis is caused by a scar, called a plaque, that forms in the penis.Other physical causes of impotenceSeveral other factors and conditions can contribute to erectile dysfunction, including the following.Depression. Many men find that when they’re suffering from depression, they lose interest in sex and can’t get or keep an erection. Asking your doctor for treatments for depression may help alleviate your erection problems as well.Smoking contributes to vascular disease (disease of the blood vessels), so it can contribute to erectile dysfunction by affecting blood flow to the penis. Giving up smoking often has a beneficial effect on erectile function.Excessive alcohol use. Alcoholism can cause permanent nerve damage, resulting in impotence. This nerve damage is called peripheral neuropathy. Long-term alcohol use can impair the liver’s ability to function, resulting in a hormone imbalance in which a man has too much of the female sex hormone, oestrogen. On a day-to-day level, alcohol dulls the central nervous system, adversely affecting sexual response.Illicit drug use. Illicit drugs such as marijuana, cocaine, heroin, barbiturates, and amphetamines act on the central nervous system, impairing the body’s ability to respond sexually.Certain exercises. Nerve and artery damage can be caused by prolonged cycling, rodeo riding, or use of a rowing machine, resulting in the inability to get an erection. Often, minimising the use of hard bicycle seats and exercise machine seats, as well as correct positioning of the seat, will help restore sexual function.Surgery to organs near the nerve pathways of the penis, such as the bladder, rectum and prostate, can cause nerve or artery damage to the penis, resulting in the inability to have an erection.Injuries. Impotence can be caused by spinal cord injury; injury to your sex organs; or a pelvic fracture, which can cause damage to the nerves of the penis, or damage the blood vessels, resulting in reduced blood flow to the penis.Conditions affecting the nervous system. Multiple sclerosis (MS) and other degenerative diseases of the nervous system, such as Parkinson’s disease, can damage the nerves involved in erections.Psychological causes of impotenceMost cases of impotence have physical causes, but, in some men, psychological factors are the main contributors to impotence.Impotence that’s triggered by psychological factors is more common in men who are sexually inexperienced. Psychological erectile dysfunction may only occur when you’re with just one particular person. You’re also more likely to have morning erections, and be able to have an erection when you masturbate, than men whose impotence has a physical cause.Here are some psychological factors that can have an impact on your erections.Stress and anxietyWhen you’re stressed and focusing on other issues apart from sex, you might find that you don’t want to have sex as often and there might be a drop in your ability to perform when you do try. You might find that tackling the source of your stress can have benefits in the bedroom as well.Fear of failureAnxiety about your sexual prowess (commonly called performance anxiety) can, in itself, contribute to failure. By putting pressure on yourself, you become too anxious to get an adequate erection.Most men experience isolated episodes of erectile failure. Even when the transient physical cause has passed, anxiety that it may recur is sufficient to prevent erection. Anxiety, whether about something specifically sexual or part of a wider anxiety syndrome, is never helpful to good sexual function.Problems with your relationship and impotenceImpotence may be a manifestation of a poor relationship, or a problematic time in a relationship. Sexual boredom, tension or anger among partners, and lack of intimacy and communication are all possible triggers of erectile dysfunction. In these cases, seeing a counsellor may help.It’s worth remembering that impotence is a complex medical condition, which may have more than one cause. For example, if impotence is the result of a side effect of medicine or an underlying disease, the anxiety caused by lack of performance may perpetuate the erectile dysfunction even after the physical cause has been dealt with.Almost any chronic (ongoing) physical or mental health disorder, including those with no direct effect on penile nerves or blood supply, can have a powerful effect on sexuality, sexual self-image and erectile function.If you’re worried about your sexual response or the quality of your erections, don’t be afraid to talk to your doctor, who has access to treatments that can help. Last Reviewed: 16 December 2016 Rogers RS, Graziottin TM, Lin CS, Kan YW, Lue TF. Intracavernosal vascular endothelial growth factor (VEGF) injection and adeno-associated virus-mediated VEGF gene therapy prevent and reverse venogenic erectile dysfunction in rats. Int J Impot Res. 2003 Feb. 15(1):26-37. [Medline]. Give hope to millions with diabetes wishing for cure. Cialis (Tadalafil) University of Iowa. WSJ.com According to a recent paper, naturally produced venoms could help design treatments for a range of diseases, including diabetes and chronic pain. Yellow Fever Vaccination Erectile Dysfunction Podcast Zoology (813) 971-6000 Perineal Injury in Males Quiz Sildenafil is available as oral tablets at doses of 25 mg, 50 mg, and 100 mg. Patients should take sildenafil approximately one hour before sexual activity. In some men, the onset of action of the drug may be as early as 11-20 minutes. It's best for men to take sildenafil on an empty stomach for best results since absorption and effectiveness of sildenafil can be diminished if it is taken shortly after a meal, particularly a meal that is high in fat. Sildenafil and the other PDE5 inhibitors don't cause an immediate erection. Sexual stimulation is necessary for these medications to work. Cardiovascular disease Forgot your password? Another Turkish study, in which ED was diagnosed with a thorough physical examination, employed a more extensive diagnostic workup, including color Doppler ultrasound, dynamic pharmacocavernosometry, selective pudendal pharmacoarteriography and NPT with RigiScan and found an organic cause in 45% of cases [4]. In an American study, 100 men with ED under 40 were evaluated, 72 were found to have vasculogenic ED, 12 neurogenic ED and only 13% had psychogenic ED [5]. Visit our Erectile Dysfunction / Premature Ejaculation category page for the latest news on this subject, or sign up to our newsletter to receive the latest updates on Erectile Dysfunction / Premature Ejaculation. What are erectile dysfunction risk factors? Vacuum devices, and penile implants may provide other options, if you are not responding to medication changes. Dyslipidemia Men with sleep disorders commonly experience ED. [40] Heruti et al recommended that in adult male patients, ED should be considered when a sleep disorder—especially sleep apnea syndrome—is suspected, and vice versa. [41] Yes, I would like to receive e-mail from the American Diabetes Association. Mayo Clinic researchers interested in ED have focused in several areas. The following are summaries of recent and current areas of research in ED. Warticon Sexual aversion: Being repelled by sex is rare. It is most common in people who suffered child abuse and those who have been brought up in strict religious surroundings. Aversion can also exist in homosexual or bisexual people who attempt to lead a heterosexual life against their basic inclinations. Impotence means that a man's penis doesn't get hard enough to have sexual intercourse. The man cannot get or maintain an erection. The medical term is erectile dysfunction (ED). ​This Might Be the New Cure For Erectile Dysfunction If the medicines aren’t right for you, you could also try using a penile implant, vacuum pump devices, or you could have surgery. Your doctor may send you to an urologist to talk about these options. Books and more - Mayo Clinic Marketplace Monday, March 14, 2016 Disability services What treatment is best for me? Similarly, if you are taking an alpha-blocker for prostate symptoms, the recommended starting dose of avanafil is 50 mg. Cancer Care Philanthropy at Mayo ClinicYour support accelerates powerful innovations in patient care, research and education. Give today. Pelvic radiation, such as for prostate cancer and some colorectal cancers unknown – in a few cases, neither physical nor psychological causes are obvious. Vascular disease is likely to be the underlying cause in these cases. weakness ED is defined as trouble getting or keeping an erection that's firm enough for sex. All women should have access to accurate information about abortion so they can make their own informed decisions... Readers Comments 2 What is the treatment for erectile dysfunction? severe heart problems If PDE5 drugs don't work or cannot be used because of potential side effects, your doctor can recommend other therapies. The drug alprostadil (Caverject, Edex, Muse) allows blood to flow more freely in the penis, leading to an erection. The drug can be injected with a tiny needle into your penis. Or, a small pellet (suppository) can be inserted into the opening of the penis. Suppositories and injections are effective in the majority of men. Sell Your Services on Amazon Chikungunya Save Men with impotence may continue to have normal orgasm and ejaculation without a full erection. Erectile dysfunction medications Search the Site impotent 3 / 11 Delayed ejaculation (when ejaculation takes too long) Keep the booze under control William H. Hall Find a location near you. 2. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol. 1994;151:54–61. TABLE 4 Lamm says he thinks a better way to measure erectile function is with a new tool called a rigidometer. A man presses the head of his erect penis against a sensor attached to the digital device, which measures the precise hardness of his penis in grams of pressure. According to the manufacturer, 400 grams is limp; 400-500 is "borderline," and 500-1,000 is sufficient for sexual activity. A number over 1,000 is considered optimum. Search entire library by keyword Hormone replacement may benefit men with severe hypogonadism and may possibly be useful as adjunctive therapy when other treatments are unsuccessful. Replacement androgens are available in oral (rarely used), injectable, gel, and transdermal preparations. Your support accelerates powerful innovations in patient care, research and education. Give today.. Christian Cares Magazine Kegel Exercises for Your Pelvic Muscles this week What Is Cystic Fibrosis? What Causes It? 3. Taking Medications Vascular anatomy of the penis. The Spotlight of Attention Is More Like a Strobe Light Thursday, December 3, 2015 If you would be delivered from your impotence—oh, fear not to say, “I will, I will!” Last updated Thu 7 December 2017 Last updated Thu 7 Dec 2017 Kawanishi Y, Lee KS, Kimura K, Koizumi T, Nakatsuji H, Kojima K, et al. Screening of ischemic heart disease with cavernous artery blood flow in erectile dysfunctional patients. Int J Impot Res. 2001 Apr. 13(2):100-3. [Medline]. Symptoms, treatments, and more. 9 Ways Men Can Make Their Orgasms Even Better When to see a doctor This page has been produced in consultation with and approved by: Andrology Australia Laboratory tests. These can include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measurement of testosterone in the blood is often done in men with ED, especially with a history of decreased libido or diabetes. Sections Podcast Series American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association; 2013:426-9. العربية STI Test Kits > Quality Used Products Whole Foods Market Post View 11 Comments Stop smoking, limit or avoid alcohol, and don't use illegal drugs. Michel T, Feron O. Nitric oxide synthases: which, where, how, and why?. J Clin Invest. 1997 Nov 1. 100(9):2146-52. [Medline]. [Full Text]. chastity Hormonal Conditions, for example, overactive or underactive thyroid, Cushing’s syndrome or hypogonadism When to See a Sex Therapist Michel T, Feron O. Nitric oxide synthases: which, where, how, and why?. J Clin Invest. 1997 Nov 1. 100(9):2146-52. [Medline]. [Full Text]. Contact Information Browse Through Our Free Educational Materials Introduction Tests can determine if the blood flow to the penis is affected. Blood tests can also help to determine if hormone problems, such as low testosterone, are causing the erectile dysfunction. Erectile dysfunction-Virginia Spotsylvania Partlow 22534 VA Erectile dysfunction-Virginia Caroline Port Royal 22535 VA Erectile dysfunction-Virginia Caroline Rappahannock Academy 22538 VA
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