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If pills don't work for you or the side effects bother you severely, we can use alternative treatments. These include: injections, suppositories, vacuum devices, shockwave therapy, or surgery. ED Vacuums

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Many men find relief through a combination of these treatments. Your doctor will help you decide the fastest and best method for curing your erectile dysfunction. SLIDESHOW Sex-Drive Killers: The Causes of Low Libido See Slideshow
Certain oral medications can be used to relax the penis and allow for proper blood flow when sexually aroused. .

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An erection occurs because of increased blood flow to your penis. ED can occur as a problem in any stage of the erection process. It may be related to problems with blood flow to your penis, nerve damage, or stressors and emotions. Being able to achieve an erection sometimes but not every time you want to have sex Being able to achieve an erection that doesn’t last long enough for intercourse Being unable to achieve an erection at all
ED is usually easy to diagnose. If you are tempted to self-diagnose, talk to your doctor. He or she will want to make sure it isn’t related to another health condition.

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Brindley, G. S. (1983) Cavernosal alpha-blockade: a new technique for investigating and treating erectile impotence. British Journal of Psychiatry, 143, 332–337.CrossRefGoogle ScholarPubMed
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The pathogenesis of organic ED is related to dysfunction of the endothelium. Endothelial cells can become injured through a variety of mechanisms, most of which cause oxidative stress on the tissues. Many of these causes of oxidative stress are related to lifestyle issues which lead to hypertension, diabetes and dyslipidaemia (figure 1). Endothelial cell dysfunction results in reduction of endothelium-dependent vasorelaxation as well as increased adhesion of leukocytes to the endothelium. Endothelial cell injury then leads to a variety of sequelae, including ED, other types of vasoconstriction, atherosclerosis and thrombus formation.18

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Medicinal causes of ED can include; the effect of certain medicines such as antidepressants, diuretics, beta blockers, corticosteriods and cytotoxics.

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    Problems faced by urologists at all stages when returning to surgery after a prolonged absence

    Testosterone replacement therapy is used to treat men with low testosterone levels as the functions of testosterone do not occur properly. Testosterone may be administered in the form of pills, injections, or patches. This would help improve the symptoms that occur due to low testosterone in the body. Khera M. Treatment of Male Sexual Dysfunction. UpToDate. https://www.uptodate.com/contents/treatment-of-male-sexual-dysfunction Kim ED. Erectile Dysfunction Treatment & Management. Medscape. https://emedicine.medscape.com/article/444220-treatment#d9 Mayo Clinic. Dietary Supplements for Erectile Dysfunction: A Natural Treatment for ED?. https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/in-depth/erectile-dysfunction-herbs/art-20044394 https://www.nih.gov/news-events/nih-research-matters/understanding-how-testosterone-affects-men https://www.drugs.com/drug-interactions/testosterone-with-viagra-2167-0-2061-1352.html
    It's more likely to be an emotional problem if you only have erection problems some of the time. For example, you get an erection when waking up in the morning, but not during sexual activity.

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    You can buy sildenafil (Viagra) over the internet. Be very careful if you do this as many websites sell fake medicines.

    Once the treatment is complete, you will be able to return home. You should be able to safely drive yourself home. If you experience pain, your doctor will recommend over-the-counter (OTC) medications, such as acetaminophen or ibuprofen for pain relief. Most people can return to normal activity the following day after shockwave therapy, but your urologist will discuss whether you should restrict your activity for longer to recover. Shockwave Therapy Risks You may experience some side effects, but they are rare and generally mild. These may include: pain at the site during the procedure, bleeding or bruising on and around the penis, blood in the urine, skin infection on the penis, painful erection, or penile curvature that worsens.
    This depends on whether you know what it is causing your ED. There are some things you can do that may help prevent ED, including: Avoid drinking too much alcohol, smoking, or abusing drugs. Ask your doctor if ED is a side effect of a new or current medicine you are taking. He or she may have an alternative medicine. Control your blood sugar and blood pressure. Try to relax and avoid stress.

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    When it comes to your manhood, blood flow is everything. If you’re not able to provide your “package” with the amount of blood it needs, you will experience mild to severe performance issues. When you turned 20 years of age, two significant changes began to take place in your body without you knowing. Your body stopped generating new blood vessels within your manhood. Blood vessels are vital to your erections because they are the only channels that deliver blood to your manhood. Less channels equals less blood, which results in weaker erections. Micro-plaque began to build within these blood vessels – called atherosclerosis. As you age, the micro-plaque within your vessels continues to build up, and acts like a dam to restrict blood flow. More micro-plaque build-up equals less blood passing through. Because of this, men in their thirties may begin to notice that their erections aren’t as robust as they used to be. Ultimately, this leads to ED. The GAINSWave procedure breaks up the micro-plaque formation in your blood vessels and stimulates the growth of new blood vessels. This vastly increases the blood flow to your manhood, resulting in more robust and powerful erections. Best of all, GAINSWave is non-invasive, drug-free and leaves you with no down-time. I’ve had 7 treatments. I’ve noticed that after the GAINSWave protocol, my sexual performance improved dramatically in terms of firmness, length and quality of orgasm, and just overall sexual pleasure. I don’t have ED, but I don’t want to experience it when I’m in my mid-forties. So, I decided to try it out after hearing about Dave Asprey’s experience with it. After treatment, I noticed that I hadn’t woken up with an erection in a few years. Now, things are not just working, they’re working at a crazy level. It’s like I’m in my twenties again and I just turned 40 this year. You should try it even if you don’t have ED... trust me. I’m 70 years-old and I had Peyronie’s disease. I tried GAINSWave 3 years ago for the first time and within just the first couple of treatments I felt a complete revitalization of my sexual activity. I feel more confident, stronger and I’m able to keep an erection longer. I'm going for an hour to an hour and a half every night now... A few years ago, I went through a divorce. I was married a long time and I started having some issues with being intimate in bed with new women, which led to more and more confident issues, and that’s not fun when you’re single in today’s world. I’ve tried so many other treatments, and nothing seemed to work...So I tried GAINSWave. It has been without a doubt the best thing I have tried so far. Nothing else I’ve ever tried has come close to bringing me the results GAINSWave has. I no longer suffer from confidence issues, I’m happy and everything works better than before. I was having some issues. I couldn’t get it up like I used to, which started affecting my partner because he thought it was because of him. Intimacy is a big part of our marriage, so when I began having experiencing issues, it became a struggle for us. My partner began to question his self-image, confidence and all that stuff. I tried GAINSWave and it worked really well. I can’t say enough positive things of how it helped us get our marriage back together. You need to speak with someone about this. It can be fixed. We’ve partnered with hundreds of physicians across the nation to provide you with a streamlined and effective experience. With no downtime, you can test drive your new results immediately after treatment!

    MUSE offers an alternative route for administration of prostaglandin using a small pellet inserted using an applicator into the tip of the urethra (water pipe opening). Once massaged the prostaglandin is released and helps the blood to flow into the penis to gain an erection. Some men experience a mild burning sensation afterwards in the water pipe but this is a good alternative option for men who do not like the idea of using injection therapy.
    5. Lee M, Sharifi R. Chapter 99: Erectile Dysfunction. Pharmacotherapy: A Pathophysiologic Approach, 11e. McGraw Hill; 2020. Accessed March 31, 2022. https://accesspharmacy.mhmedical.com/content.aspx?bookid=2577§ionid=230460622

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    But studies have shown that aerobic exercise can improve both endothelial function and NO production. This, by contrast, is great news for strong erections. And it gets better.

    If you enjoy relying on inconvenient meds and injections, love experiencing headaches and blurry vision, or can’t wait to eliminate spontaneity from your sex life, then GAINSWave is not for you.
    Research in stem cell therapy and gene therapy for erectile dysfunction is also ongoing. Penis Curved When Erect Could I have CAD? Treat Bent Fingers Treat HR+, HER2- MBC Tired of Dandruff? Life with Cancer Cuzin, B. "Alprostadil cream in the treatment of erectile dysfunction: clinical evidence and experience." Ther Adv Urol 8.4 Aug. 2016: 249-256. Diamond, L.E., et al. "Co-administration of Low Doses of Intranasal PT-141, a Melanocortin Receptor Agonist, and Sildenafil to Men With Erectile Dysfunction Results in an Enhanced Erectile Response." Urology 65 (2005): 755. Jackson G., et al. "The second Princeton consensus on sexual dysfunction and cardiac risk: new guidelines for sexual medicine." Journal of Sexual Medicine 3 (2006): 28. Kim, E.D. "Erectile Dysfunction Treatment & Management." Medscape.com. Oct. 12, 2015. Matz, E.L., et al. "Stem cell therapy for erectile dysfunction." Sex Med Rev 2018 April 6 epub ahead of print. United States. Food and Drug Administration. "Hidden Risks of Erectile Dysfunction 'Treatments' Sold Online." Mar. 23, 2015. Yafi, F.A., et al. "Erectile dysfunction." Nat Rev Dis Primers 2 (2016): 16003.

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Erectile dysfunction can occur if a man doesn't meet one or more of these requirements. The following are 13 common causes of erectile dysfunction, and many men have more than one potential cause:

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Sildenafil treats erectile dysfunction of either physical or psychological causes. It is effective in treating erectile dysfunction in men with coronary artery disease, diabetes mellitus, hypertension, depression, coronary artery bypass grafting (CABG), and men who are taking antidepressants and several classes of antihypertensives.

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Smith, A. D. (1981) Causes and classification of impotence. Urology Clinics of North America, 8, 79–89.Google ScholarPubMed

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They also have different onsets of action with Viagra, sildenafil, Levitra and Cialis being active within 30-60 mins but the newest medication to be introduced, Spedra, as its name would suggest, can be active in as little as 15 mins, and therefore is the quickest to have an affect.

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