Most cases of ED are 'secondary. Causes of a new and persistent problem are usually physical. Less commonly, psychological factors cause or contribute to ED, with factors ranging from treatable mental health illnesses to everyday emotional states that most people experience at some time. It is important to note that there can be overlap between medical and psychosocial causes.
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For instance, if a man is obese, blood flow changes can affect his ability to maintain an erection, which is a physical cause. However, he may also have low self-esteem, which can impact erectile function and is a psychosocial cause. Some research has raised concerns that men who regularly cycle for long hours could have a higher risk of ED, in addition to other men's health issues such as infertility and prostate cancer.
The most recent study to investigate this found that there was no link between riding a bike and ED, but it did find an association between longer hours of cycling and the risk of prostate cancer. However, prostate surgery to remove the cancer and radiation therapy to treat prostate cancer can cause ED.
The good news is that there are many treatments for ED, and most men will find a solution that works for them. Treatments include:. Most of these pills are taken 30 to 60 minutes before sex - the best known being the blue-colored pill sildenafil Viagra.
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Other options are:. PDE-5 inhibitors are only available on prescription.
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- Erectile Dysfunction | ED | Impotence | MedlinePlus.
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A doctor will check for heart conditions and ask about other medications being taken before prescribing. Less commonly used drug options include prostaglandin E1, which is applied locally by either injecting it into the penis or inserting it down the opening of the urethra. Most men prefer a pill, however, so these locally acting drugs tend to be reserved for men who cannot take oral treatment. The United States U. Food and Drug Administration FDA has a consumer safety guide about this, including a recommendation to check that the online pharmacy:.
The FDA also offers tips for spotting the dangers of an unsafe website, including watching out for the following clues:. The FDA adds that these illegal sites may send drugs of unknown quality and origin, even sending the wrong drug or a dangerous product. Vacuum erection devices are a mechanical way of producing an erection for men who do not want or cannot use drug treatments, or find they are not working. The penis is made rigid by the use of a vacuum pump sealed around it that draws up blood. This is prevented from then leaving the penis by the use of an accompanying band.
The lack of spontaneity with the use of vacuum devices means that many men find other treatments for ED preferable. Surgery is a last resort and will only be used in the most extreme cases. Recovery time varies, but success rates are high.
No guidelines followed by doctors, nor any established sources of evidence, support the use of dietary supplements, such as herbal pills. In addition to there being no evidence in favor of non-prescription alternatives for ED, the FDA has warned of hidden risks of "treatments" sold online. Men may not always successfully achieve an erection, and if this rarely happens, it is not considered a medical problem. However, ED does not only refer to a complete inability to achieve an erect penis. Symptoms can also include struggling to maintain an erection for long enough to complete intercourse or an inability to ejaculate.
There are often also emotional symptoms, such as embarrassment, shame, anxiety, and a reduced interest in sexual intercourse. The best way to treat erectile dysfunction without medication is by strengthening the pelvic floor muscles with Kegel exercises. These are often associated with women looking to strengthen their pelvic area during pregnancy, but they can be effective for men looking to regain full function of the penis.
Firstly, find the pelvic floor muscles. You can achieve this by stopping mid-stream two or three times the next time you urinate. The muscles you can feel working during this process are the pelvic floor muscles, and they will be the focus of Kegel exercises. One Kegel exercise consists of tightening and holding these muscles for 5 seconds and then releasing them. Try to do between 10 and 20 repetitions each day. This may not be possible when you first start doing the exercises.
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However, they should become easier over time. Make sure you are breathing naturally throughout this process and avoid pushing down as if you are forcing urination. Instead, bring the muscles together in a squeezing motion.
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Aerobic exercise, such a jog or even a brisk walk, can also help the blood to circulate better and can help improve ED in men who have circulation issues. The numerous potential causes of ED mean that a doctor will typically ask a lot of questions and arrange for blood tests to be performed. Such tests can check for heart problems, diabetes, and low testosterone, among other things.
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The doctor will also carry out a physical examination, including of the genitals. Before considering a diagnosis that requires treatment, a doctor will look for symptoms that have persisted for at least 3 months. Once a medical history has been established, a doctor will then undertake further investigation. One simple test, known as the 'postage stamp test,' can be helpful in determining if the cause is physical rather than psychological.
Men usually have 3 to 5 erections a night. This test checks for the presence of erections at night by seeing if postage stamps applied around the penis before sleep have snapped off overnight. Other tests of nocturnal erection include the Poten test and Snap-Gauge test. Article last updated by Adam Felman on Thu 7 December All references are available in the References tab. Begot, I. The American Journal of Cardiology, 5 , Erectile dysfunction. Erectile dysfunction ED. Erectile dysfunction - genitourinary disorders.
How high blood pressure can affect your sex life. Hollingworth, M. An observational study of erectile dysfunction, infertility, and prostate cancer in regular cyclists: cycling for health UK study. Journal of Men's Health, 11 2 , Penile implants: Understanding your treatment options. Schwartz, B. Cardiovascular implications of erectile dysfunction. Circulation, 21 , ee VIPPS-accredited pharmacies list. Qaseem, A. Hormonal testing and pharmacologic treatment of erectile dysfunction: A clinical practice guideline from the American College of Physicians.
Erectile dysfunction (impotence)
Annals of internal medicine, 9 , MediLexicon, Intl. Regardless of whether the nerves were spared during surgery or whether the most precise dose planning was used during radiation therapy, erectile dysfunction remains the most common side effect after treatment. This is because the nerves and blood vessels that control the physical aspect of an erection are incredibly delicate, and any trauma to the area can result in changes. However, even if you do experience some side effects of treatment, there is also room for optimism: many excellent options for managing erectile function exist on the market today.
However, within one year after treatment, most men with intact nerves will see a substantial improvement. The best predictor of how you will be after treatment is how healthy you were going into treatment. Four main components of erectile function may be affected by prostate cancer treatment: Libido sex drive is most commonly affected by hormone therapy, or treatment that decreases your testosterone.
You can have a low libido and still obtain an erection, but it is usually more difficult for men who have less interest in sex. This will return once your testosterone returns to normal after completing hormone therapy. Couples counseling should be considered if there is a possibility of causing stress in a relationship.
Mechanical ability is the ability to achieve a firm erection. It is controlled by the nerves and vessels that are intimately associated with the prostate and structures near the penis. Mechanical ability is most affected by surgery or radiation therapy. Also, sometimes there can be some discomfort initially after treatment when you climax.
This usually is transient and will resolve.