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Men who smoke are about twice as likely to develop ED as nonsmokers. Smoking hampers circulation to all areas of the body, including the genitals, making it tougher to get and keep an erection.

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8. Viagra (sildenafil citrate) [Prescribing Information]. New York, NY: Pfizer Labs; December 2017.
The vacuum device creates a vacuum to pull blood into the penis. Unlike a normal erection, the inflow of blood does not continue once the individual removes the vacuum device. The rubber band placed at the base of the penis constricts the penis to prevent the blood from leaving the penis. As there is no inflow or outflow of blood when the rubber band is in place, it is uncommon for the tip of the penis (the glans) to appear a little blue and the penis to be cooler. Once intercourse is completed, the individual removes the rubber band and the blood drains out of the penis. .

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Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 23,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health care policy. To learn more about the AUA visit: www.auanet.org

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ED is a potentially treatable medical condition and is not related to masculinity or sexual prowess. Men who have ED symptoms should consult with a doctor.
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Like many health conditions, erectile dysfunction can cause a lot of stress or shame, which doesn't help and can often exacerbate the problem further. So, there are two important things to keep in mind:

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Erectile dysfunction essentially refers to not being able to obtain or keep an erection and is often coupled with a reduced desire for sex. ED can have a range of causes, both physical and psychological. Certain risk factors for developing erectile dysfunction can include:

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    DiabetesDiabetes is a known risk factor for ED, and its prevalence in patients with diabetes is estimated to be greater than 50%. When compared to a healthy control group, men with diabetes were found to be 3.5 times more likely to have ED than those without diabetes.21 While PDE5Is have proven to be highly efficacious in the treatment of ED, men with diabetes tend to have a poorer response with this drug class compared with those without, although some of the evidence is mixed. Because the release of NO is mediated by neuronal and endothelial NO synthase, it is postulated that neuropathy and endothelial disease (commonly diagnosed in patients with diabetes) diminish the effects of PDE5Is.22
    Pelvic floor exercises and aerobic exercises are a great natural way to first confront ED before you consider taking medication. Chances are, you’ll see improvements with just doing the exercise and thus not have to take ED medications at all. Some people may also not qualify to take ED medication if they have other conditions that could be affected by ED medications such as heart disease.

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    Lakin, M. M., Montague, D. K., Vanderbrug Medendorp, S., et al (1990) Intracavernous injection therapy: analysis of results and complications. Journal of Urology, 143, 1138–1141.CrossRefGoogle ScholarPubMed

    GAINSWave therapy provides excellent improvements to the sexual health of men with erectile dysfunction, including: Improved sexual performance Better orgasms Increased sensitivity Harder, long-lasting erections Enhanced confidence Good Candidates for GAINSWave
    Complete List Top Erectile Dysfunction (ED, Impotence) Related Articles Acupuncture

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    You don’t have to suffer from erectile dysfunction on your own. Did you know you can get affordable erectile dysfunction treatment with the K Health app? Chat with a doctor and get prescription treatment for as low as $11. Learn more here. Frequently Asked Questions What causes an erection? During the arousal process, a man’s brain sends signals through his nervous system to the muscles around the arteries in his penis, telling them to relax and allow increased blood flow. That blood engorges and stiffens the penis, readying it for sexual activity. How long can the average man stay erect? There is no universally average amount of time that a man should have an erection. According to one study that timed 500 heterosexual couples having sex, men’s erections last anywhere from less than a second to 44 minutes. How can you maintain an erection? Healthy lifestyle habits can help your erections feel healthier and last longer. Eating well, exercising, abstaining from smoking or drinking alcohol, getting enough sleep, communicating with your partner, and reducing stress can all play a role in improving your sexual responsiveness. Why can’t I get an erection? Factors like heart disease, obesity, diabetes, hypertension, alcohol, drugs, and age can negatively affect your penis’s ability to perform. If you chronically struggle with achieving or maintaining an erection, talk to your doctor about erectile dysfunction and whether a prescription drug might be right for you. K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. 11 SOURCES

    Because ED can be caused, at least partially, by elements of lifestyle - from suffering from anxiety, to poor diet choices, obesity, smoking and substance abuse - the risk of developing the condition can be reduced by making lifestyle changes. Among these improvements are losing weight and keeping to a healthy diet, exercising regularly, stopping smoking, moderating alcohol intake, and taking steps to reducing stress levels by a number of means.
    Steege, J. F., Stout, A. L. & Carsen, C. C. (1986) Patient satisfaction in Scot and Small carrion penile implant recipients: a study of 52 patients. Archives of Sexual Behaviour, 15, 393–399.CrossRefGoogle Scholar

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    Tools & Resources Are You Ready to Quit Smoking? Low Libido Equals Low T? Talk with Your Doc About ED Best Food for Your Teeth Subtle Symptoms of Low T Tips for Living Better With Migraine Health guides > Erectile Dysfunction > Exercises for ED... Exercises to Alleviate Erectile Dysfunction By Zina Semenovskaya, MD December 3, 2021

    Most men who use sildenafil citrate do so for recreational purposes, and use of sildenafil citrate for 2 years or less was associated with recreational use. The availability of sildenafil without a prescription paper and lack of concomitant monitoring of its utilization were some of the main contributing factors for its misuse. Consumption of sildenafil with illicit drugs was also reported. There should be a collaborative effort among pharmacists, health professionals, and policymakers to improve the rational use of sildenafil citrate.
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Not everyone can use these medicines. Your doctor may talk to you about alprostadil if oral medicines aren’t an option for you. Alprostadil is a synthetic version of prostaglandin E. It can be injected into the penis or inserted as a tiny suppository into the urethra (the hole at the end of the penis). Your doctor will help you decide which treatment is best for you.

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A number of men will have difficulties maintaining an erection for a satisfactory period of time whilst others may be completely unable to get an erection at all.

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35-90% of diabetic men also experience ED. Hyperglycemia can have a negative impact on several aspects of erectile function. Complications and changes associated with diabetes can compromise macrovascular and microvascular structures, the nervous system, and blood vessel linings.

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ED is a treatable condition and most men are able to return to healthy sexual function.

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