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I had no ED issues before my RP and am a slim, fit, non smoker with lowish blood pressure and not on any medication. Is it just my age or as my wife suggests it may be partly in my mind and if so do you think therapy might help. My husband is 75, and had prostate surgery, due to cancer, in March 2018. He works out of town most of the time, so we have not had a good chance to try the remedies for ED. He also had open heart surgery sildenafil 50mg price several years ago, and his heart doctor has been reluctant to prescribe Viagra, or some similar drug. Is there anything that you might suggest that might help him when he is not home? There is some response, even at this late date after prostate surgery, when he is home, but he needs something to try in the meantime. Is Viagra safe in low doses, to help stimulate him? A viberator seems to help some enlargement and maybe some blood flow. I had a radical prostatectomy on October 31st, (for Halloween I was dressed as a hospital patient with nurses, IV’s and real blood), Sorry,…maybe a bit too graphic ?? Question; it is now 4 weeks since I had this procedure, so,…. Is it too soon to start with any kind of ED meds to “wake up” the sleeping giant??? Hello Tom, blog author and urologist Alastair Lamb has posted a reply to another comment sildenafil cream here (by Susan) which may be helpful to you, as he talks about the timing and purpose of taking ED drugs after prostatectomy. Best wishes, Sarah Chapman [Editor] My husband (52, fit, healthy, normal sexual function before surgery) has just had a radical nerve preserving surgery and was told to start on viagra straight away. We tried it 3 days after having the catheter, blood ... More

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Natural and over-the-counter (OTC) products for treating ED are widely available, especially on the internet. However, none of these products has been tested for safety or effectiveness by the Food and Drug Administration (FDA). And because the products aren’t regulated, the FDA warns that there’s no way to be certain of what these products actually contain. If you want to try a natural or OTC product for ED, you should first discuss it with your doctor. The American Urological Association doesn’t recommend using products that contain yohimbine, ginseng, and l-arginine for ED treatment. (This includes products that contain these ingredients either alone or in combination with other ingredients.) This is because there’s not enough evidence to cheap viagra 100 online say whether the products work. Examples of products that contain one or more of these ingredients include Libido-Max and Extenze. You should also avoid products you can buy online without a prescription that claim either to be generic forms of sildenafil or to contain sildenafil. (Sildenafil is the active drug in Viagra.) If these drugs are available without a prescription, that means that they haven’t been tested or approved by the FDA. As a result, it’s not known if they’re effective or even safe. And there’s no guarantee that the products actually contain sildenafil. You may wonder how Viagra compares with other medications that are prescribed for similar uses. Here we look at how Viagra and Cialis buy viagra buy are alike and different. Viagra contains the drug sildenafil, while Cialis contains the drug tadalafil. Both Viagra and Cialis belong to a class of drugs called phosphodiesterase type 5 (PDE5) ... More

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However, some primary care practitioners may recommend vacuum constriction devices. The device consists of an acrylic cylinder placed over the penis that uses a lubricant to achieve a good seal between the penile body and cylinder. An erection is then achieved by creating a vacuum inside the cylinder with a pump connected to the cylinder. Once an erection is achieved, a constriction band is applied to the base of the penis to maintain the erection. The cylinder can then be removed and the patient can engage in intercourse with the constriction band at the base of the penis maintaining the erection. The band can remain on for approximately 30 minutes and then must be removed. The erection produced by the device differs from a normal erection likely because of venous occlusion from the constriction band resulting in generalized swelling of the entire penis, with probable preservation of arterial inflow. Clinical studies have suggested that these devices are effective and acceptable to a large number of patients with ED of varying causes, including psychogenic erectile failure. These devices are safe and can restore a man’s ability to achieve penetrative intercourse, with one study suggesting nearly 95% success with adequate instruction and support. 30 However, satisfaction with this treatment modality typically wanes with time, as patients report dissatisfaction with how cumbersome or unnatural the devices are to use, hinging or buckling of the erection with thrusting, and dissatisfaction with the fact that the erection is ischemic and therefore cold, which can be off-putting to the partner. There are relatively few contraindications to the use of vacuum devices. Some ... More

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While researchers continue to investigate, I can tell you that regular aerobic exercise in combination with a healthy diet will reduce your chance of developing heart disease and type 2 diabetes — which is good for your sexual health. While there isn’t a lot of scientific evidence that supports using herbs to increase sexual urges, most of these supplements won’t hurt you. Try classic libido-enhancing herbs like maca, tribulus, rhodiola, ginseng, omega-3s, DHEA, and L-arginine. But be sure to consult your doctor first if you take blood thinners or other medications for heart health. Choose a setting that promotes intimacy and communication with your partner, which can reduce performance anxiety. We live in a society that expects high performance in every aspect of life — including sex. If you’re having erectile dysfunction issues, practice stress-reducing techniques every day so you can relax and enjoy intimacy without worrying about your performance. Sometimes low libido or sexual dysfunction can occur due to low testosterone levels. But that doesn’t necessarily mean you need a testosterone supplement. Your body usually can produce adequate testosterone, but it needs downtime to convert precursor hormones into testosterone. If you’re burning the candle at both ends, your body will convert those precursors into cortisol instead. So rest, relax, and allow your body to build up its testosterone stores. I mentioned taking herbs and supplements to treat erectile dysfunction, so I want to add a note of caution about using so-called “natural male enhancement” pills. The Food and Drug Administration (FDA) recalls dozens (if not hundreds) of these products each year for ... More

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ED and CVD share similar risk factors, including older age, hypertension, dyslipidemia, smoking, obesity, and diabetes. ED is associated with an increased risk of CVD, coronary artery disease (CAD), stroke, and all-cause mortality, and it is probably an independent risk factor for CVD.35. ED typically occurs two to five years before CAD, providing a potential window during which men diagnosed with ED can make lifestyle changes to prevent CAD.36 Men with ED are at higher risk of angina, myocardial infarction, stroke, transient ischemic attack, congestive heart failure, and cardiac arrhythmias compared with men who do not have ED.37 Men with ED have a 75% increased risk of developing peripheral vascular disease.38. ED has a positive predictive value for the development of CVD that is equal to or greater than that for smoking, hyperlipidemia, or a family history of myocardial infarction.37 , 39 ED can accurately predict silent CAD.40 – 45 ED in men 40 to cheap viagra for women 49 years of age is more predictive of CAD than in older men.36 In one study, the incidence of CAD in men younger than 40 years who had ED was seven times that in the control population.46 ED is a useful marker for assessing cardiovascular risk, particularly in younger men and minorities, for whom global risk assessment calculators may underestimate actual risk.47 , 48. Management of cardiovascular risk factors is recommended in men who have ED but no known CVD.49 , 50 Because diagnosing ED can help identify men at higher risk of CVD, use of the IIEF-5 is also recommended during CVD risk assessment. Abstract Diagnosis Causes and Related Conditions History and Physical Examination Laboratory Evaluation ... More

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This is, by far, the most common cause of ED in men over the age of 40. Like in other parts of the body, the arteries which take blood to the penis can become narrowed. The blood flow may then not be enough to cause an erection. Risk factors can increase your chance of narrowing of the arteries. These include getting older, high blood pressure, high cholesterol and smoking. For example, multiple sclerosis, a stroke, Parkinson's disease, etc. For example, a lack of a hormone called testosterone which is made in the testicles (testes). However, one cause of a lack of testosterone that is worth highlighting is a previous head injury. A head injury can sometimes affect the function of the pituitary gland in the brain. The pituitary gland makes a hormone that stimulates the testicle to make testosterone. So, although it may not at first seem connected, a previous head injury can in fact lead to ED. Other symptoms of a low testosterone level include a reduced sex drive (libido) and changes in mood. For example, spinal injury, following surgery to nearby structures, fractured pelvis, radiotherapy to the genital area, etc. The most common are some antidepressants; beta-blockers such as propranolol, atenolol, etc; some 'water tablets' (diuretics); cimetidine. Many other less commonly used tablets sometimes cause ED. ED after long-distance cycling is thought to be common. It is probably due to pressure on the nerves going to the penis, from sitting on the saddle for long periods. This may affect the function of the nerve after the ride. Excessive outflow of blood from the penis through the veins (venous leak) . This is rare but can be caused by various conditions of the penis. In ... More

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