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Although in the past it was commonly believed to be due to psychological problems, it is now known that for most men erectile dysfunction is caused by physical problems, usually related to the blood supply of the penis. Many advances have occurred in both diagnosis and treatment of erectile dysfunction. What are the risk factors for erectile dysfunction? According to the NIH, erectile dysfunction is also a symptom that accompanies many disorders and diseases. Direct risk factors for erectile dysfunction may include the following: Type 2 diabetes. Hypogonadism in association with a number of endocrinologic conditions. Hypertension (high blood pressure) Vascular disease and vascular surgery. Low levels of HDL (high-density lipoprotein) Peyronie's disease (distortion or curvature of the penis) Priapism (inflammation of the penis) Lack of sexual knowledge. Many chronic diseases, especially renal failure and dialysis. Smoking, which exacerbates the effects of other risk factors, such as vascular disease or hypertension. Age appears to be a strong indirect risk factor in that it is associated with increased likelihood of direct risk factors, some of which are listed above. It is estimated that about 4 percent of men in their fifties, and nearly 17 percent of men in their sixties, have difficulty achieving an erection. Accurate risk factor identification and characterization are essential for prevention or treatment of erectile dysfunction. The following are some sildenafil tablets online of the different types and possible causes of impotence: Premature ejaculation (PE) . Premature ejaculation is the inability to maintain an erection long enough for mutual satisfaction. Premature ejaculation is divided into primary and secondary forms: Primary premature ejaculation . Primary premature ejaculation is a learned behavior that begins when a male first becomes sexually active. This form of primary PE is psychogenic (as opposed to organic or physical) impotence. (Congenital venous leak is a subset of primary PE and is caused by a congenital condition in which the venous drainage system in the penis does not shut down properly.) Secondary premature ejaculation . Secondary premature ejaculation occurs when, after years of normal ejaculation, the duration of intercourse grows progressively shorter. Secondary PE is due to physical causes, usually involving the penile arteries, veins, or both. Performance anxiety is a form of psychogenic impotence, usually caused by stress. Depression is another cause of sildenafil tablets online sildenafil tablets online psychogenic impotence. Some antidepressant medications cause erectile failure. Organic impotence involves the penile arteries, veins, or both and is the most common cause of impotence, especially in older men. When the problem is arterial, it is usually caused by arteriosclerosis, or hardening of the arteries, although trauma to the arteries may be the cause. The controllable risk factors for arteriosclerosis--being overweight, lack of exercise, high cholesterol, high blood pressure, and cigarette smoking--can cause erectile failure often before progressing to affect the heart. Many experts believe that when veins are the cause, a venous leak, or cavernosal failure, is the most common vascular problem. have diabetes, and 35 to 50 percent of these men are impotent. The process involves premature and unusually severe hardening of the arteries. Peripheral neuropathy, with involvement of the nerves controlling erections, is commonly seen in people with diabetes. There are many neurological (nerve problems) causes of impotence. Diabetes, chronic alcoholism, multiple sclerosis, heavy metal poisoning, spinal cord and nerve injuries, and nerve damage from pelvic operations can cause erectile dysfunction. A great variety of prescription drugs, such as blood pressure medications, antianxiety and antidepressant medications, glaucoma eye drops, and cancer chemotherapy agents are just some of the many medications associated with impotence. Hormonal abnormalities, such as increased prolactin (a hormone produced by the anterior pituitary gland), steroid abuse by bodybuilders, too much or too little thyroid hormone, and hormones administered for prostate cancer may cause impotence. Rarely is low testosterone responsible for impotence. Diagnostic procedures for ED may include the following: Patient medical or sexual history . This may reveal conditions or diseases that lead to impotence and help distinguish among problems with erection, ejaculation, orgasm, or sexual desire. To look for evidence of systemic problems, such as the following: A problem in the nervous system may be involved if the penis does not respond as expected to certain touching. Secondary sex characteristics, such as hair pattern, can point to hormonal problems, which involve the endocrine system. Circulatory problems could be indicated by an aneurysm. Unusual characteristics of the penis itself could suggest the basis of the impotence. These can include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. When low sexual desire is a symptom, measurement of testosterone in the blood can yield information about problems with the endocrine system. This is done to help reveal psychological factors that may be affecting performance. The sexual partner may also be interviewed to determine expectations and perceptions encountered during sexual intercourse. Specific treatment for erectile dysfunction will be determined by your doctor based on: Your age, overall health, and medical history. Your tolerance for specific medications, procedures, or therapies. Some of the treatments available for ED include: Medical treatments: Sildenafil citrate (Viagra) . A prescription medication taken orally for the treatment of ED. Viagra does not directly cause penile erection, but affects the response to sexual stimulation. In clinical studies, Levitra has been shown to work quickly and improve sexual function in men the first time they take the medication. It has been shown to work well in men of all ages, in men with diabetes, and in men who have had the surgical procedure called radical prostatectomy. Studies have indicated that Cialis stays in the body longer than other medications in its class. Most men who take this medication find that an erection occurs within 30 minutes and the effects of the medication may last up to 36 hours. The FDA recommends that men follow general precautions before taking a medication for ED. Men who are taking medications that contain nitrates, such as nitroglycerin, should NOT use Viagra, Levitra, or Cialis. Taking nitrates with one of these medications can lower blood pressure too much. In addition, men who take Levitra or Cialis should not use alpha blockers, as they could result in hypotension (abnormally low blood pressure). Experts recommend that men have a complete medical history and physical examination to determine the cause of ED. Men should tell their doctor about all the medications they are taking, including over-the-counter medications. In addition, men should not take these medications if they have a history of heart attack or stroke, or if they have a bleeding disorder or stomach ulcers. Men with medical conditions that may cause a sustained erection, such as sickle cell anemia, leukemia, or multiple myeloma, or a man who has an abnormally-shaped penis, may not benefit from these medications. Also, men with liver diseases or a disease of the retina, such as macular degeneration or retinitis pigmentosa, may not be able to take these medications, or may need to take the lowest dosage. These medical treatments should NOT be used by women or children. Elderly men are especially sensitive to the effects of these medical treatments, which may increase their chance of having side effects. Testosterone replacement therapy may improve energy, mood, and bone density, increase muscle mass and weight, and heighten sexual interest in older men who may have deficient levels of testosterone. Testosterone supplementation is not recommended for men who have normal testosterone levels for their age group due to the risk of prostate enlargement and other side effects. Testosterone replacement therapy is available in an oral and injectable form, cream or gel, and as a skin patch. Three types of implants are used to treat ED, including: Hydraulic pump . A pump and two cylinders are placed within the erection chambers of the penis, which causes an erection by releasing a saline solution; it can also remove the solution to deflate the penis. Two semi-rigid but bendable rods are placed within the erection chambers of the penis, which allows manipulation into an erect or nonerect position. These are placed within the erection chambers of the penis and can be inflated or deflated using a cable that passes through them. Infection is the most common cause of penile implant failure and is treatable with antibiotics. In some cases, the infected implant must be replaced by a new implant. Implants are usually not considered until other methods of treatment have been tried. Many times, men will avoid sexual situations due to the emotional pain associated with ED, causing their partner to feel rejected or inadequate. It is important to communicate openly with your partner. Some couples consider seeking treatment for ED together, while other men prefer to seek treatment without their partner's knowledge. A lack of communication is the primary barrier for seeking treatment and can prolong the suffering. The loss of erectile capacity can have a profound effect on a man. The good news is that ED can usually be treated safely and effectively. Feeling embarrassed about being impotent may prevent many men from seeking the medical attention they need, which can delay diagnosis and treatment of more serious underlying conditions. Impotence itself is often related to an underlying problem, such as heart disease, diabetes, liver disease, or other medical conditions. Since impotence can be a forewarning symptom of progressive coronary disease, doctors should be more direct when questioning patients about their health. By asking patients more directly about their sexual function through conversation or a questionnaire during a checkup, doctors may be able to detect more serious health conditions sooner. Erectile dysfunction is the inability to obtain an erection that is sufficient for satisfactory intercourse. Millions of men in the United States suffer from erectile dysfunction and many men do not seek treatment for this very common problem. At Urology Centers of Alabama we specialize in the non-surgical and surgical treatment of erectile dysfunction. Our surgeons and nurses have a strong commitment to treating patients with erectile dysfunction and their partners with compassion, respect and empathy. A man does not need to feel embarrassed when he comes to a physician or a nurse at Urology Centers of Alabama seeking treatment for erectile dysfunction. Our goal is to return patients to these most intimate and private activities that can truly improve the quality of life. The non-surgical and surgical treatment options for erectile dysfunction can be highly effective. We encourage you to begin the journey toward erectile restoration by coming to see us. Erectile dysfunction results from inadequate blood flow into the penis that would normally allow for a rigid erection. There are a number of medical conditions that can cause erectile dysfunction, but the most common causes are diabetes and high blood pressure. Other conditions such as spinal cord injury can also lead to erectile dysfunction or the side effects of radical surgeries used to treat prostate cancer or bladder cancer. As a man increases in age it is increasingly common for the quality and stiffness of his erections to diminish. Again, the good news is that regardless of the cause of erectile dysfunction we can almost always be successful with our treatments. Non-surgical Options to Treat Erectile Dysfunction. Medications can be used to treat erectile dysfunction, such as Viagra, Levitra and Cialis. Oral medications are effective in about 70% of men with erectile dysfunction. Other non-surgical treatment options would include the use of penile injection therapy. In this treatment a small needle and syringe are sildenafil the generics pharmacy used to inject medication directly into the penis. These medications can increase blood flow into the penis causing a firm erection. The discomfort associated with penile injection therapy is not severe and the risk of complications is low. A side effect of non-surgical treatments is priapism, an erection that persists for several hours. Adjustment of the dosage of medications injected is critical to avoiding priapism, and the physicians and nurses in our ED Department are well schooled in helping the patient to determine the appropriate dose of injectable medications. Another non-surgical treatment is a vacuum erection device (VED). It is a plastic cylinder that goes over the penis and produces a vacuum. The vacuum draws blood into the penis and then a rubber constriction ring placed around the base of the penis holds the blood in the penis allowing for penile rigidity. We work with a patient to instruct him how to use the VED. Penile Prosthesis are surgical treatments for men with erectile dysfunction. Penile prostheses are safe and have been used for several years and are continually being improved. Patients have several different types of prostheses to choose from and your prosthetic urologist will help you make the decision that is best for you. Erectile dysfunction is when a man cannot achieve or maintain an erection that is firm enough for sexual intercourse. Having ED once in a while is normal, but if you experience ED for more than three months, talk to your doctor. Causes The most common cause of erectile dysfunction is a cardiovascular problem. The blood vessels in the penis are among the smallest in the body and are often the first to exhibit symptoms of high blood pressure (hypertension) or arthersclerosis (hardening of the arteries), or diabetes. Other causes of erectile dysfunction include surgery, such as prostate cancer surgery, that affects the nerves or blood vessels that play a role in getting erections. Side effects from medications such as antidepressants or antihistamines, emotional or mental stress, and lifestyle choices including smoking and alcohol and drug abuse can also cause ED. Although common among older men, ED isn’t part of normal aging . Aging increases the chance of developing the above causes of erectile dysfunction, but age in itself should not be considered a cause of ED. Moreover, there is no reason that getting older should prohibit an active sex life. Diagnosing erectile dysfunction involves a discussion of your medical history and symptoms; a physical examination to look for signs of problems with your circulatory, nervous, and endocrine system; and routine lab tests to check for underlying conditions such as heart disease, diabetes, and low testosterone. Medication Adjustments: Adjusting a medicine that is triggering ED may be all you need to do Behavioral Changes : The first step in treating ED is to eliminate possible reversible causes. These changes include controlling hypertension and diabetes. Quitting smoking, exercising, or losing weight can improve ED. Counseling : This can help if your ED is affected by stress, depression or anxiety Medications : Sildenafil (Viagra®) is an oral medication that revolutionized the treatment of erectile dysfunction. It and newer medications of the same class work by preventing the breakdown of cyclic GMP, a molecule in the penile blood vessels involved in normal erections. It augments and prolongs the normal penile mechanism and is generally very safe. It does, however, interfere with nitrate metabolism; therefore, if a patient takes any form of nitroglycerin, he cannot take Viagra. It requires intact penile and pelvic nerves to work. Vacuum Erection Device : Also called a penis pump, this device draws blood into your penis using a plastic tube and pump. A constriction ring/band at the base of your penis helps you keep the erection. These devices require practice but are safe and reliable. Penile injections and Suppositories : Various medicines can be injected into the penis to cause an erection. These medications act as direct penile vascular tissue relaxants, bypassing the need for nerves and relaxing penile blood vessels allowing inflow of blood. The needle used is small and is inserted with minimal discomfort. An erection occurs in 5-15 minutes and may last for an hour.In pellet therapy, rice-sized pellets are inserted into the urethra relax the muscles and blood vessels in your penis to allow blood to flow in to create an erection. Surgery/Penile Implant : When other treatments have not worked, the surgical placement of a penile implant or penile prosthesis can allow men to be sexually intimate. Sensation and orgasm do not change with the placement of a penile implant. ShockWave Therapy: We are pleased to introduce Low-intensity extracorporeal ShockWave therapy for the treatment of erectile dysfunction. The ideal patient to receive this type of therapy has mild to moderate erectile dysfunction; however, it has also been shown to be effective in patients with severe ED who respond poorly to traditional medication. ShockWave therapy requires six treatments in the clinic. While the therapy is not currently FDA-approved, ShockWave technology has been peer-reviewed and shows encouraging results. Download our Erectile Dysfunction educational handout. Some men may experience Erectile Dysfunction following a prostatectomy to treat prostate cancer. Read more about Erectile Dysfunction Rehabilitation after a Radical Prostatectomy. Metabolic Syndrome has also been linked to Erectile Dysfunction. Over-the-counter pills sold on late night TV and in men’s magazines are herbal supplements that are not regulated by the FDA and have not been shown to be effective for erectile dysfunction or penile enlargement. How can I bring up my erectile dysfunction with my doctor? Start the conversation by acknowledging that this is a hard subject for you to talk about. You might also mention that you’re concerned about erectile dysfunction being an early indicator of a more severe problem like cardiovascular disease or diabetes. Your urologist will discuss your concerns with the professionalism you’d expect when discussing any other medical condition and will help put you at ease. We're the leading provider of drug-free treatments for Erectile Dysfunction (ED) in the Dallas-Fort Worth area. Today, major advances in technology are helping men of all ages overcome erectile dysfunction and a general decline in sexual performance. Without potentially harmful prescription drugs and their unwanted side effects. Dallas Anti-Aging & Wellness is at the very sildenafil tablets online forefront of these breakthroughs. We offer an array of ED treatments to fit your condition (and your budget), administered by our expert physicians and medical support team. Review these innovative treatments then contact us to discuss your options. You could be experiencing better sex within hours of your first appointment! This latest groundbreaking procedure developed in Europe uses sound waves to unclog blood vessels in the penis and promote the growth of new ones, resulting in strong, sustainable erections and more intense orgasms. Unlike similar procedures, our proprietary Big D Wave protocol delivers a patented soft shot pulse, making the treatment virtually painless yet just as effective. A single-injection treatment for erectile dysfunction, the P-Shot ® uses the patient's own enriched blood platelets to activate growth factors that rejuvenate the penis, allow greater blood flow, enhance sensation, and improve overall sexual performance. The treatment is non-allergenic and free of harmful side effects. Another breakthrough, Big D Shot™ enhances the effectiveness of the platelet-rich plasma(PRP) with Allograft, a tissue graft that combines with platelet-rich plasma to increase growth factors with mesenchymal stem cells (MSCs). Patients report improved erectile function in firmness and sensitivity and a possible increase in penis size. A robust sex life helps you feel younger, healthier, happier. Contact us or call 214.646.1523 for your Free ED Consultation. Dallas Anti-Aging & Wellness is here to help you feel youthful, regain your vitality, and restore your confidence. Our clinic is a member of the American Academy of Anti-Aging medicine, and our professionals bring more than a century of combined experience and expertise. Our highly trained, certified staff has the qualifications and the passion to help you appear and feel your best. Find a Doctor Find a Location Care & Services Appointments Patients & Visitors Classes & Events Billing & Payment. Language assistance services are available free of charge during your Aurora visit. Espanol Hmoob Ðóññêèé Shqip ??????? Bosanski ?????? Lai (Chin) Hakha Laizo (Chin) Falam ???? ???? Hrvatski Francais Deutsch ???????? Gujarati Hindi Italiano ??? unDusdm ??? ??????? Bahasa Melayu ?????? Pennsylvaanisch Deitsch Polski ?????? Ruainga Romana Srpski Af-Soomaali Kiswahili Tagalog ???? Ti?ng Vi?t. Adobe Acrobat Reader is required to view PDF files. This is a free program available from the Adobe website. Follow the download directions on the Adobe website to get your copy of Adobe Acrobat Reader. Sexual/Erectile Dysfunction (ED) What Can Cause ED Diagnosis and Treatment. If you’re feeling frustrated because of sexual problems, we can help. Erectile dysfunction (ED) means that a man can’t get and hold an erection during sex. If it happens just sometimes – less than one in five times-- this is normal and usually doesn’t require treatment. Think of it as just an “off day.” If it’s an ongoing problem, you want to talk it over with your urologist at John Muir Health. There may be an underlying physical problem that needs to be treated before you can get your sexual function back to where you want it to be. ED can happen at any age, but is more likely to occur in older men. According to the Massachusetts Male Aging Study, severe ED increases from 5 percent in men 40 years of age to 15 percent in men 70 years and older. There is usually a physical problem behind erectile dysfunction. That why it’s important to talk it over with your doctor. What Can Cause Erectile Dysfunction (ED) ED is not a natural part of aging. In most cases, it is caused by a physical problem, which can include: Cardiovascular disease, such as clogged blood vessels or sildenafil tablets online hardening of the arteries. The main artery in the penis is only 1 millimeter in size. If blood cannot flow freely through this vessel, then ED can occur. Cardiovascular risks like high cholesterol, obesity, and high blood pressure Diabetes Nervous system diseases like multiple sclerosis and Parkinson’s Low testosterone. ED can also be caused by lifestyle choices that put your health at risk, such as drinking too much alcohol, use of narcotics, and smoking – or by behavioral conditions like anxiety and stress. Sometimes medications can cause ED, but this not common. If you are taking a new medication and begin having erection problems, talk to your doctor; your medication or the dose you take may need to be changed. Making some lifestyle changes on your own can help you get erectile dysfunction under control. Avoid smoking and the use of alcohol and narcotics Get regular exercise to help reduce stress, lose weight, and increase blood flow Talk the problem over with your partner – often it helps to get it out into the open and see what the two of you can do to relieve stress Learn relaxation techniques through the practice of yoga or mediation to help reduce stress. Biofeedback therapy, a technique that trains you to control certain physiological processes by giving you immediate feedback, can also be very effective in reducing stress.
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