2001 /viewarticle/897900 News Sex and heart disease brain or spinal tumors By Adam Rowden Men considering ICI therapy should first have an in-office injection test to determine the appropriate dose and medication(s) to produce sufficient duration of response and to minimize AEs. The in-office experience also is important to help the man achieve confidence with the technique and to facilitate adherence. It may take several visits to determine the correct drug(s) and titrate the dose. Men should be informed that although injectable non-prostaglandin agents have been used to successfully manage ED for decades, none are formally FDA-approved for this indication. This visit also should include educating men and their partners regarding how to titrate the dose, the advisability of alternating sites with each dose, and how to proceed if a serious AE occurs (i.e., priapism). The man should be thoroughly educated about priapism and instructed in actions to take in a prolonged erection situation. It is recommended all education be documented. Commonly-used strategies (but for which no evidence was retrieved) include attempting ejaculation and, if this effort is unsuccessful, then oral pseudephedrine followed by the application of an ice pack to the penis for 30 minutes to an hour. If a painful, non-bendable erection persists after these strategies, then the man should proceed to the emergency room within 2-4 hours of medication administration. sildenafil Rx B N X 255 reviews 446 ED and Bicycling Etymology[edit] Protecting information online What’s inside a Roman pack 13 reasons why your ankles are swollen I am a diabetic type 2, 37 years of age taking Lantus Injection 20 units at Bed time. What are some natural fixes for erection problems? An unsatisfactory sex life Bone, Joint & Muscle Disorders Article History Past Presidents Switchboard (Victoria) Questions remain about the effects on men's health of riding a bicycle. DEUTSCH How Does Chemo Work? AQUA QCDR Measures 171. Govier F, Potempa AJ, Kaufman J et al: A multicenter, randomized, double-blind, crossover study of patient preference for tadalafil 20 mg or sildenafil citrate 50 mg during initiation of treatment for erectile dysfunction. Clin Ther 2003; 25: 2709.   What causes erectile dysfunction (ED)? Can Masturbation Cause Erectile Dysfunction? Share on Google+ prostate cancer Webcasts Article: Comparison of the effects of extracorporeal shock wave therapy and... Rheumatoid Arthritis Quote anonymous Dr Joe: Skin How important is spontaneity? A daily pill clears the path for sex at any time—if the drug works for you. (Remember, just like other ED drugs, it may not work for everyone). On the other hand, the 36-hour window offered by the nondaily version of Cialis might offer enough spontaneity. Specialty Topics The Physical Exam J. Francois Eid, MD What's to know about erectile dysfunction? American Foundation for Urologic Disease 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. Aytac IA, McKinlay JB, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999; 84: 50-56. But cases where these problems persist should definitely be addressed. Talking about them with your partner, or seeking treatment from a doctor are important steps in tackling the issue. Literature Advertise Monthly Giving Erectile Dysfunction in Young Men: Causes and Treatments Diabetes Discoveries & Practice Blog VigRX Plus is a popular over-the-counter remedy used for overcoming erectile dysfunction in a natural way. Men with diabetes are at a higher risk of erectile dysfunction especially if their diabetes is not well controlled. The vascular processes that produce an erection are controlled by the nervous system and certain prescription medications may have the side effect of interfering with necessary nerve signals. Among the possible culprits are a variety of stimulants, sedatives, diuretics, antihistamines, and drugs to treat high blood pressure, cancer, or depression. But never stop a medication unless your doctor tells you to. In addition, alcohol, tobacco, and illegal drugs, such as marijuana, may contribute to the dysfunction. What are the causes of impotence? More On Erectile dysfunction Having ED means that you cannot get and/or maintain an erection. In some cases the penis becomes partly erect but not hard enough to have sex properly. In some cases, there is no swelling or fullness of the penis at all. ED is sometimes called impotence. MEDICAL GUIDES A B C D E F G H I J K L M N O P Q R S T U V W X What are some natural fixes for my erection problems? 23. Montorsi P, Ravagnani PM, Galli S et al: The triad of endothelial dysfunction, cardiovascular disease, and erectile dysfunction: clinical implications. European Urology, Supplements 2009; 8: 58.   Restaurant Discounts It is normal to have mixed feelings about having sex with someone else... Expert Witness Registry HIV and men - safer sex 899. Benevides MD and Carson CC: Intraurethral application of alprostadil in patients with failed inflatable penile prosthesis. J Urol 2000; 163: 785.   Why You Should Consider Acupuncture to Treat Depression Inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. Partying is fun but being out of it on alcohol or drugs can put you at risk of unwanted or unsafe sex... 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 Show more comments The biggest complaint about these treatments is a burning sensation in the penis as the drug takes effect. The frequency, intensity and duration of that side effect vary by method and user but can, in some cases, be bad enough, Montague says, that “a man will get an erection but be too uncomfortable to use it.” They’re often used for penis rehabilitation, usually after prostate surgery. Your doctor will put you on a regimen designed to restore normal blood flow to the penis. This will allow you to get a spontaneous erection. Exercise or lifestyle changes. Oral pharmacotherapy and vacuum erection devices are first-line treatments,[21]:20, 24 followed by injections of drugs into the penis, and penile implants.[21]:25–26 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. Surgeries or injuries that affect the pelvic area or spinal cord mission About Our Ads Reduced blood pressure When eating fats, select unsaturated fats. (Unsaturated fats are liquid at room temperature; vegetable oils, for example. Avoid tropical oils, such as palm and coconut oil and any fat that is solid at room temperature.) More than nine out of 10 over-50s had signs of impotence. View All Services Primary care physician Derby CA, Araujo AB, Johannes CB, Feldman HA, McKinlay JB. Measurement of erectile dysfunction in population-based studies: the use of a single question self-assessment in the Massachusetts Male Aging Study. Int J Impot Res. 2000 Aug. 12(4):197-204. [Medline]. Renal Cell Carcinomas Examples of medications known to cause impotence include: Child Developmental Milestones 1-800-835-9021

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Horny goat weed. Calcium Supplements: Pros, Cons & Expert Tips ^ University of Michigan; Albert Allgeier (1995). Sexual interactions. D.C. Heath. p. 243. In many cases, erectile dysfunction is caused by something physical. Common causes include: All Sequence Analysis Resources... 708. Nelson RP: Injections of papaverine and regitine into the corpora cavernosa for erectile dysfunction: clinical results in 60 patients. South Med J 1989; 82: 26.   (5)    Fuse Overall, there was considerable variability regarding response rates.  Below are those data; for studies that reported response rates at different durations post-surgery, the latest duration was used.  [The Canadian Male Sexual Health Council]http://www.cmshc.ca If you decide you want to try yohimbe, be sure to talk to your doctor beforehand. What are erectile dysfunction symptoms and signs? Genomics Human Papillomavirus (HPV) sex drive|Learn the Secret sex drive|Secrets Reveealed sex drive|We're Revealing the Secret
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