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Healthdirect Australia is not responsible for the content and advertising on the external website you are now entering. Erectile dysfunction (male impotence) You may find it embarrassing if you are having difficulty maintaining an erection, or finding it hard to ejaculate, but you are not alone. As many as two and a half million men around the UK may have some sort of sexual dysfunction at any one time.

Although it may not be something you want to discuss with your friends, it is important that you get some advice if you are worried about it. The most common cause of erectile dysfunction for young men is anxiety.

This may include concerns about getting someone pregnant, not wanting to appear inexperienced, or worrying about using a condom without embarrassment or losing your erection while putting a condom on.

Common causes of erectile dysfunction for middle aged men may include stress, guilt, or having sex with a new partner after many years of monogamy. Although 70% of men over the age of 70 are still sexually active, erectile dysfunction does get more likely as you get older.

This may be linked to the deterioration to the blood vessels that carry blood to the penis, and also to the deterioration of heart or brain arteries.

Both men and women can – and do - have problems that affect their sex lives.

You may have lost interest in sex, or been unable to maintain an erection, or have difficulty with premature ejaculation, or be having difficulty having an orgasm.

There are many reasons why men may experience sexual problems.

Physical reasons for erectile dysfunction may include: Side effects from medication (mainly medication for

blood

Psychological reasons for erectile dysfunction may include: Stress, which may be related to sex and or other parts of your life Concerns about your current sexual relationship(s) Depression and related fatigue Any feelings of guilt about your sexual performance or your sexual health.

And although it is not an easy thing to talk about, there are trained professionals who can give you good advice about what may be the cause of your current predicament. Many men like to talk about sex, but like women, they may find it harder to talk about sex when it is not going well.

We are here to help you with some of the more private things in life.

And be aware that the vast majority of physical or psychological causes of erectile dysfunction buy sildenafil 25mg are temporary.

But if anything is bothering you or your partner, you should seek out confidential, professional advice. There is no point in worrying and not doing anything about it. Treatment for erectile dysfunction has improved a great deal over the last 10 years. The vast majority of men – and women – can look forward to a return to sexual activity after advice and or treatment. Indeed many men say that treatment has transformed their lives. Treatment for erectile dysfunction is available from Dr Fox and Doctor4U. Most commonly, diagnosis will be the result of your doctor asking you about your symptoms and medical history, in association with a physical exam.

Naturally, during the discussion, expect questions about the frequency, quality, and duration of your erections.

Other tests that can assist the diagnosis are as follows: Nocturnal Penile Tumescence Testing.

If you have erectile dysfunction but have normal erections during sleep, the problem may be emotional.

If you have problems with an erection even while you sleep, the problem may be physical. The test is done to check for blood flow in the penis.

It will also look for blockage in the arteries or veins that supply the penis. Whereas erectile dysfunction is a man’s inability to attain or maintain an erection sufficient for satisfactory sexual performance, premature ejaculation is ejaculation which occurs sooner than desired and typically before or shortly after penetration.

This is persistent,

diminishes

the

Premature ejaculation is the most common

sexual

Differentiating between erectile dysfunction and premature ejaculation is crucial in determining an appropriate treatment strategy. Treatment options include behavioral, topical, and oral therapies and can be selected following a discussion with your provider. Your doctor may prescribe: Phosphodiesterase inhibitors. (Do not take these medications if you are also taking nitrates.)

Oral

Alprostadil , either injected into the penis or inserted into the urethra as a suppository. Popular medications such as Sildenafil (Viagra) or Tadalafil (Cialis).

Use caution and talk to your doctor before taking any over-the-counter medications for erectile dysfunction. Prior buy sildenafil 25mg to sexual activity, a vacuum device pulls blood into the penis. A band is then placed around the penis to keep the erection. Most vacuum devices include: A plastic cylinder for the penis.

An elastic band for holding the erection after removal of the cylinder.

Prior to sexual activity, the implants are then inflated via fluid pumped from a small reservoir near the implants, thus creating an erection.

After sexual activity, the fluid then returns to the reservoir, thus deflating the implants and allowing the penis to return to non-erect size. (See associated illustration.) Vascular surgery is done to repair blood vessel leaks in the penis. Sex therapy with a qualified counselor may help erectile dysfunction resulting from: Ineffective sexual techniques. To reduce your future chance of having erectile dysfunction: Take medications to manage your blood pressure and diabetes. Ask your doctor about changing medications Maintain a healthy weight and eat a healthful diet.

Smoking is significantly associated with erectile dysfunction in older men.

If you have anxiety, stress, or sildenafil online boots emotional difficulty in your life, consider talking to a therapist or counselor. Definition Prevalence Pathophysiology Signs and Symptoms Diagnosis. Since the 1990s, erectile dysfunction (ED) has been recognized as a common problem.

Higher rates of reporting, diagnosis, and treatment of ED have been driven by effective treatments, direct to consumer advertising, and screening by health care providers. Erectile dysfunction or disorder (ED) is the inability to develop and maintain an erection for satisfactory sexual intercourse or activity.

Erectile dysfunction or erectile disorder are the preferred terms as opposed to impotence .

There are no uniform criteria defining how consistent the problem has to be and for what duration it must be present to considered ED.

The Diagnostic and Statistical Manual of Mental Disorder-5 specifies a duration of at least 6 months in its definition of ED.

The Massachusetts Male Aging Study reported a prevalence of 52%. 2 The study demonstrated that ED is increasingly prevalent with age: approximately 40% of men are affected at age 40 and nearly 70% of men are affected at age 70.

The prevalence of complete ED increased from 5% at age 40 to 15% at age 70.

2 Age was the variable most strongly associated with ED. Incidence estimates have been published using data compiled from the Massachusetts Male Aging Study. 3 Incidence data are necessary to assess risk and plan treatment and prevention strategies. The Massachusetts study data suggest there will be approximately 17,781 new cases of ED in Massachusetts and 617,715 in the United States annually.

A larger national study, the National Health and Social Life Survey, looked at sexual function in men and women. 4 This study surveyed 1,410 men aged 18 to 59 and also documented an increase in ED with age.

Additionally, the study found a decrease in sexual desire with increasing age.

Men in the oldest cohort (50 to 59) were more than 3 times as likely to experience erection problems and to report low sexual desire compared with men 18 to 29.

Experience of sexual dysfunction was more likely among men in poor physical and emotional health.

The study also concluded that sexual dysfunction is an important public health concern and that emotional issues are likely to contribute to the experience sexual dysfunction.

The development of an erection is a complex event involving integration of psychologic, neurologic, endocrine, vascular, and local anatomic systems. Positron emission tomography scanning studies have suggested that sexual arousal is activated in higher cortical centers that then stimulate the medial preoptic and paraventricular nuclei of the hypothalamus.

5 These signals ultimately descend through a complex neural network involving the parasympathetic nervous system and eventually activate parasympathetic nerves in the sacral area (S2 to S4). The neurovascular events that ultimately occur result in the

inhibition

Nitric oxide is believed to be released from nonadrenergic, noncholinergic nerves and endothelial cells. It subsequently stimulates the guanylate cyclase enzyme system in penile smooth muscle. This results in increased levels of cyclic guanosine monophosphate (cGMP) and ultimately in smooth muscle relaxation, enhancement of arterial inflow, and veno-occlusion, producing adequate firmness for sexual activity. Recognized risk factors for ED include cardiovascular disease (CVD) (hypertension, atherosclerosis, and hyperlipidemia), diabetes, depression, alcohol use, smoking, pelvic/perineal surgery or trauma, neurologic disease, obesity, pelvic radiation, and Peyronie’s disease.

One study suggested that the relationship between arterial disease and ED is very strong, with 49% (147 of 300) of patients with coronary artery disease noted on cardiac catheterization reporting significant erectile dysfunction.

6 Endothelial dysfunction has been indicated as the pathophysiologic mechanism responsible for both CVD and ED. 7 The Boston Area Community Health survey demonstrated a dose-response between smoking and incidence of erectile dysfunction.