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Alprostadil should produce an erection in 5 to 20 minutes and, generally, the erection will last for 30 to 60 minutes. You should not use alprostadil more than once in a 24-hour period, and you should use it no more than 3 times a week.

Don’t try to use more than the recommended dose of alprostadil, as your erection may last longer than is medically safe. You should ask your doctor if alprostadil is suitable for you.

Your doctor will also be able to tell you how much alprostadil to use, depending on your condition and whether or not you are taking any other medications, and also how to use alprostadil properly. People with certain illnesses, such as leukaemia and sickle cell anaemia, or who have a penile implant or Peyronie’s disease, where the penis may be scarred and produces erections that are not straight, should not use alprostadil.

Men for whom sexual activity is not advised should not use alprostadil. The most common side effects of alprostadil include pain in the penis or bruising in the penis at the site of injection.

Fibrosis (the development of fibrous tissue) can also develop following injections into the penis. The most serious side effect is priapism (a persistent erection), which is a medical emergency.

Your doctor will inform you of what to do if you have an erection that persists for 2 hours or more.

It is very important that you follow your doctor’s instructions and inform them that you have experienced this side effect.

Vacuum erection devices work by creating a vacuum, which increases blood flow to the penis, producing an erection.

The penis is lubricated and placed inside a hollow plastic chamber.

Air is pumped out of the chamber, either manually or by a battery powered pump. This creates a vacuum which pulls blood into the penis to cause an erection. Once the penis is erect, the man fits a rubber ring around the base of his penis to keep the blood trapped inside the penis when the cylinder is removed.

After intercourse, the ring can be removed to return the penis to a limp state. Vacuum erection devices avoid surgery and can be used as often as required. However, they may be difficult to use, and many men and their partners feel they take much of the pleasure and spontaneity away from sexual activities. Vacuum pumps are not suitable for men who have problems with blood clotting, or blood disorders such as leukaemia.

Penile implant surgery is not a common procedure but in some cases it may be the most appropriate treatment for erectile dysfunction.

The procedure involves placing an implant inside the penis, along its length, so that it can become erect. The implant may be a pair of semi-rigid rods or a blue pill online pair of inflatable cylinders. The inflatable implants allow the penis to look and feel limp (flaccid) or erect, depending on how much the cylinders are

inflated

A release valve drains the saline out of the cylinders and back into the reservoir. With the semi-rigid, malleable rod type of implant, the rods run along the length of the penis and can be bent upwards to produce an erect penis, or downwards when an erect penis is not required.

Like all surgery, there are some risks, such as infection or bleeding.

If you have had surgery and have severe pain, fever, swelling or excessive bleeding, you should contact your doctor as soon as possible. In

cases

This treatment option is rarely recommended, and is usually only successful in younger men.

If there is a blockage that prevents blood from flowing into the penis, a doctor may recommend an blue pill online operation that bypasses the blocked blood vessels, using a length of vein or manufactured tubing, to allow more blood to flow into the penis and help produce an erection.

If the problem is that blood leaks back out of the penis, this can be corrected by tying off the major veins that drain the penis, a procedure known as venous ligation.

In a small number of men, blood tests may show abnormally low levels of testosterone, the male sex hormone. In such cases your doctor might prescribe a course of testosterone injections or a testosterone implant. The supplements can help boost sex drive as well as increasing the ability to have erections. Testosterone gel or patches, applied daily to the skin, are another option. There is a lack of scientific evidence supporting the effectiveness of complementary therapies for the treatment of impotence. Always check with your doctor before taking any herbal medicines or supplements for impotence. These formulations may contain ingredients that can interact with other medicines or cause dangerous side effects. Erectile dysfunction often has physical causes, but sometimes there is a psychological basis for erection problems.

A man may have had an episode of erectile dysfunction due to some passing cause like fatigue, stress, relationship difficulty or intoxication. This may have led to embarrassment or a feeling of failure.

Even if the physical cause does not remain, future attempts to have sex may trigger memories of this embarrassment and acute anxiety that it will happen again. This anxiety itself is capable of causing erectile dysfunction, and so a man may get trapped in a self-reinforcing cycle of anxiety and erectile dysfunction.

In these instances, seeing a GP, counsellor or psychologist can be very helpful.

Stress, anxiety, depression and low self-esteem, in fact, almost all significant emotional problems, can have a major effect on sexuality.

So do many chronic physical illnesses, even if they don't directly affect genital function.

Counsellors and psychologists can assist with these and a wide range of other sexual and relationship problems and can also help female partners suffering from sexual problems.

They are particularly skilled in helping patients to overcome guilt or anxiety relating to sexual abuse, and in helping couples to sort out relationship difficulties. Simple problems can be dealt with in a few visits, but more complex problems may require several months or even years of therapy.

Your doctor may be able to recommend a psychologist or counsellor who specialises in sexual and relationship problems.

Erectile dysfunction (impotence) About erectile dysfunction.

Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection. Erectile dysfunction is a very common condition, particularly in older men.

It is estimated that half of all men between the ages of 40 and 70 will have it to some degree. See your GP if you have erectile dysfunction for more than a few weeks.

They will assess your general state of health because the condition can be the first sign of more serious health conditions, such as heart disease (when the heart’s blood supply is blocked or interrupted).

Erectile dysfunction can have a range of causes, both physical and psychological. Physical causes include: narrowing of the blood vessels going to the penis – commonly associated with high blood pressure (hypertension), high cholesterol or diabetes hormonal problems surgery or injury.

Psychological causes of ED include: anxiety depression relationship problems. Sometimes erectile dysfunction only occurs in certain situations.

For example, you may be able to get an erection during

masturbation

If this is the case, it is likely the underlying cause of erectile dysfunction is psychological (stress related).

If you are unable to get an erection under any circumstances, it is likely that the underlying cause is physical. Erectile dysfunction can also be a side-effect of using certain medicines.

Although you may be embarrassed, it's important to get a diagnosis so that the cause can be identified. This will involve answering questions about your symptoms, as well as a physical examination and some simple tests. Erectile dysfunction is primarily treated by tackling the cause of the problem, whether this is physical or psychological. The narrowing of the arteries (called atherosclerosis) is one of the most common causes of ED. In these cases your GP may suggest lifestyle changes, such as losing weight, to try to reduce your risk of cardiovascular disease.

This may help to relieve your symptoms as well as improving your general health.

You may also be

given

A number of treatments have been successful in the treatment of erectile dysfunction.

Medication, such as sildenafil (sold as Viagra), can be used to manage it in at least two-thirds of cases.

Vacuum pumps that encourage blood to flow to the penis and cause an erection are also successful in 90% of cases. Psychological treatments include cognitive behavioural therapy (CBT) and sex therapy. Overall, treatments for erectile dysfunction have improved significantly in recent years.

The main symptom of erectile dysfunction (ED) is the inability to get and maintain an erection for satisfactory intercourse.

ED should not be confused with ejaculation problems such as premature ejaculation, which is a condition where the process of arousal, orgasm and

ejaculation

In these circumstances, it is likely that the underlying cause of ED is primarily psychological (stress related).

However, if you are unable to get an erection under any circumstances, it is likely that the underlying

cause

They will assess your general state of health because the condition can be the first sign of more serious health conditions, such as heart disease (when the heart’s blood supply is blocked or interrupted). Many websites offer

treatments

The medications that are offered by these sites could be

fake

Even if the medications are genuine, they may not be suitable for you.

It is important that you only take medication for ED that your GP has prescribed for you. Erectile dysfunction (ED) can have many causes, such as certain medical conditions, medications and stress.

It's important to identify the cause of erectile dysfunction and treat any underlying conditions.

When a man becomes sexually excited (aroused), his brain sends signals to the nerves in his penis. The nerves increase the blood flow to the penis, causing the tissue to expand and harden.

Anything that interferes with the nervous system or the blood circulation could lead to erectile dysfunction. Anything that affects the level of sexual desire (libido) can also cause erectile dysfunction because a reduced libido makes it more difficult for the brain to trigger an erection.

Psychological conditions, such as depression, can reduce libido, as can changes in hormone levels (chemicals produced by the body). There are four main types of health conditions that can cause physical problems resulting in erectile dysfunction. These are: conditions affecting the flow of blood to your penis – vasculogenic conditions affecting your nervous system, which is made up of your brain, nerves and spinal cord – neurogenic conditions affecting your hormone levels – hormonal conditions affecting the physical structure of your penis – anatomical.

Penis injuries or surgical treatment of the penis, pelvis or surrounding areas can sometimes lead to erectile dysfunction.

Erectile dysfunction is also thought to occur in up to 15-25% of people who experience a severe head injury.

Examples of vasculogenic conditions that cause erectile dysfunction include: cardiovascular disease – a disease of the heart or blood vessels, such as atherosclerosis (hardening of the arteries) blue pill online high blood pressure (hypertension) diabetes – a condition caused by high blood sugar levels. This can affect both the blood supply and the nerve endings in your penis, so it is also a neurogenic condition.

Erectile dysfunction is strongly associated with cardiovascular disease. For this reason, it may be one of the first causes your GP considers when making a diagnosis and planning your treatment.

Examples of neurogenic conditions that cause erectile dysfunction include: multiple sclerosis – a condition that affects the body's actions, such as movement and balance Parkinson’s disease – a condition that affects the way that the brain coordinates body movements, including walking, talking and writing a spinal injury or disorder a stroke – a serious condition that occurs when the blood supply to the brain is interrupted.

Examples of hormonal conditions that cause erectile dysfunction include: hypogonadism – a condition that affects the production of the male sex hormone, testosterone, causing abnormally low levels an overactive thyroid gland (hyperthyroidism) – where too much thyroid hormone is produced an underactive thyroid gland (hypothyroidism) – where not enough thyroid hormone is produced Cushing's syndrome – a condition that affects the production of a hormone called cortisol.

Peyronie's disease, which affects the tissue of the penis, is an example of an anatomical condition that can cause erectile dysfunction. In some men, certain medicines can cause erectile dysfunction, including: diuretics – these increase the production of urine and are often used to treat high blood pressure (hypertension), heart failure and kidney disease antihypertensives – such as beta-blockers, that are used to treat high blood pressure fibrates – medicines used to lower cholesterol levels antipsychotics – used to treat some mental health conditions, such as schizophrenia antidepressants – used to blue pill online treat depression and some types of pain corticosteroids – medication that contains steroids, which are a type of hormone H2-antagonists – medicines used to treat stomach ulcers anticonvulsants – used to treat epilepsy antihistamines – used to treat allergic health conditions, such as hay fever anti-androgens – medication that suppresses androgens (male sex hormones) cytotoxics – medication used in chemotherapy to prevent cancer cells from dividing and growing.

Speak to your GP if you are concerned that a prescribed medicine is causing erectile dysfunction.

However, it is important never to stop taking a prescribed medicine unless you are advised to do so by a qualified healthcare professional who is responsible for your care.

Possible psychological causes of erectile dysfunction include: depression – feelings of extreme sadness that last for a long time anxiety – a feeling of unease, such as worry or fear. Erectile dysfunction can often have both physical and psychological causes.

For example, if you have diabetes, it may be difficult for you to get an erection, which may cause you to become anxious about the situation. The combination of diabetes and anxiety may lead to an episode of erectile dysfunction.

There are many emotional issues that may also affect your physical ability to get or maintain an erection. These include: relationship problems lack of sexual knowledge past sexual problems past sexual abuse being in a new relationship.

Other possible causes of erectile dysfunction include: excessive alcohol intake tiredness using illegal drugs, such as cannabis, heroin or cocaine.

Men who cycle for more than three hours per week may be recommended to try a period without cycling to see if this helps improve erectile dysfunction. Riding in the correct position with a properly fitted seat may also help to prevent regular cycling from leading to erectile dysfunction.

Erectile dysfunction (ED) can often be diagnosed by your GP. They will talk to you about your situation and may carry out a physical examination.

Your GP may ask you about: your symptoms your overall physical and mental health your alcohol consumption whether you take drugs whether you are currently taking any medication.

If you do not want to talk to your GP about erectile dysfunction, you can visit a genitourinary medicine (GUM) clinic. You can find your nearest GUM clinic on the British Association for

Sexual

Try not to be embarrassed because erectile dysfunction is a common problem.

You can request a male GP at your surgery if you prefer. You may be asked about: your previous and current sexual relationships what your sexual orientation is how long you have been experiencing erectile dysfunction whether you can get any degree of erection with your partner, on your own or when you wake up in the morning whether you have been able to ejaculate or orgasm your libido (your level of sexual desire) Erectile dysfunction that happens all the time may suggest an underlying physical cause. Erectile dysfunction that only occurs when you are attempting to have sex may suggest an underlying psychological (mental) cause. Narrowed blood vessels are a common cause of erectile dysfunction and linked with cardiovascular disease (conditions that affect the heart and blood flow). measure your blood pressure to see if you have high blood pressure (hypertension) listen to your heart rate to check for any abnormalities measure your height, weight and waist circumference to see if you are a healthy weight for your height ask you about your diet and lifestyle, for example, generic viagra pills online how much exercise you do test a sample of your blood for glucose (sugar) and lipids (fatty substances), as high levels can indicate conditions affecting your heart or blood vessels.