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Erection problems usually produce a significant psychological and emotional reaction in most men. This is often described as a pattern of anxiety, low self-esteem, and stress that can further interfere with normal sexual performance. This "performance anxiety" needs to be recognized and addressed by your health care provider.

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https://pubmed.ncbi.nlm.nih.gov/16526979/ Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies. (2018)
Finally, Dr Montorsi et al found that severe ED was more common in patients with multivessel coronary involvement as compared with those with single-vessel disease (31% vs 12.5%; p<0.01). They also found a significant inverse relationship between the extent of CVD and IIEF scores.31

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Please see your primary care provider before scheduling an appointment with one of our specialists. If you don't have a primary care provider, we can help you find one. Locations Urology - Charlois 336-716-4131 336-713-0328 (FAX) Urology - Foothills 336-786-5108 336-783-6842 (FAX) Urology - Janeway Tower 336-716-3325 336-716-9916 (FAX) View All Locations Urology - Lexington 336-716-2011 Urology - Medical Plaza North Elm 336-713-9164 (FAX) Urology - Gatewood 336-878-6511 336-878-6512 (FAX) Close All Locations Referring Physicians

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Medications, such as treatment for high blood pressure, can also play a role. These drugs reduce blood pressure by reducing blood flow, which can affect erections. It is not recommended that men stop their blood pressure medications, of course. But some patients can eliminate their need for the treatment through changes in diet and exercise.

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    If stress, anxiety, or other emotional issues are causing the condition, counseling may help. Some men experience erectile dysfunction because of past experiences that cause a lack of self-esteem, fear, or guilt, and counseling can help you overcome those negative feelings. Couple counseling can also help improve mutual understanding and acceptance in a relationship, allowing you to feel more comfortable during intimacy.

    In randomized placebo-controlled trials, an estimated 60% of men with diabetes, and 80% of men without diabetes experienced improved erections with sildenafil.
    Health conditions or lifestyle choices that affect blood circulation, structural anomalies in the penis, certain neurological conditions, hormonal deficiencies, and medication side effects, can all contribute to erectile dysfunction. The chart below lays out examples of potential biological reasons for a man’s erectile dysfunction. Circulation Nervous System Structural Some Medications Atherosclerosis Parkinson’s Disease Peyronie’s Disease For high blood pressure Diabetes Multiple Sclerosis Injury or Trauma to the penis For anxiety, depression & other psychiatric conditions Stroke Prostate or Bladder Surgery Past issues w/ Priapism* Antidepressants *prolonged erections over 4 hrs Antihistamines

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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

    ED is common and has a significant impact on men and their partners. The first step is acknowledging that ED is affecting you and that it bothers you. If so, then it is time to get help. Often your primary care health provider can start the evaluation of your ED to determine if there are any potential reversible causes. It is important to be evaluated if you have ED as ED is often caused by medical conditions, which if not recognized and treated, could cause you harm. Did you know that the ED is a strong predictor of underlying cardiovascular disease? If you have underlying cardiovascular disease, your primary health care provider or a specialist (if needed) needs to make sure it is safe for you to participate in sexual activity.
    In general, there are three main pelvic floor muscles that are used when performing a kegel:

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    Strengthening your pelvic floor muscles can help urinary incontinence, treat pelvic organ prolapse, and make sex better too. Find your pelvic floor muscles

    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:
    What are truly the norms for testosterone levels in men and could we better determine which might actually benefit, and thus, should receive TRT?

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    The authors would like to acknowledge the University of Gondar for its support and facilitation of the study. The authors also want to thank all the study participants for their collaboration and participation in the study. 1. Gebreyohannes EA, Bhagavathula AS, Gebresillassie BM, Tefera YG, Belachew SA, Erku DA. Recreational use of phosphodiesterase 5 inhibitors and its associated factors among undergraduate male students in an Ethiopian University: a cross-sectional study. World J Mens Health. (2016) 34:186–93. doi: 10.5534/wjmh.2016.34.3.186 2. Guay AT, Perez JB, Jacobson J, Newton RA. Efficacy and safety of sildenafil citrate for treatment of erectile dysfunction in a population with associated organic risk factors. J Androl. (2001) 22:793–7. Erratum in: J Androl. (2002) 23:113. doi: 10.1002/j.1939-4640.2001.tb02582.x 3. Harte CB, Meston CM. Recreational use of erectile dysfunction medications and its adverse effects on erectile function in young healthy men: the mediating role of confidence in erectile ability. J Sex Med. (2012) 9:1852–9. doi: 10.1111/j.1743-6109.2012.02755.x 4. Zusman RM, Morales A, Glasser DB, Osterloh IH. Overall cardiovascular profile of sildenafil citrate. Am J Cardiol. (1999) 83:35C−44C. doi: 10.1016/S0002-9149(99)00046-6 5. Delate T, Simmons VA, Motheral BR. Patterns of use of sildenafil among commercially insured adults in the United States: 1998-2002. Int J Impot Res. (2004) 16:313–8. doi: 10.1038/sj.ijir.3901191 6. Bechara A, Casabé A, De Bonis W, Helien A, Bertolino MV. Recreational use of phosphodiesterase type 5 inhibitors by healthy young men. J Sex Med. (2010) 7:3736–42. doi: 10.1111/j.1743-6109.2010.01965.x 7. Makwana S, Solanki M., Raloti S., Dikshit R. Evaluation of recreational use of aphrodisiac drugs and its consequences: an online questionnaire based study. Int J Res Med. (2013) 1:51–9. 8. Harte CB, Meston CM. Recreational use of erectile dysfunction medications in undergraduate men in the United States: characteristics and associated risk factors. Arch Sex Behav. (2011) 40:597–606. doi: 10.1007/s10508-010-9619-y 9. Schnetzler G, Banks I, Kirby M, Zou KH, Symonds T. Characteristics, behaviors, and attitudes of men bypassing the healthcare system when obtaining phosphodiesterase type 5 inhibitors. J Sex Med. (2010) 7:1237–46. doi: 10.1111/j.1743-6109.2009.01674.x 10. Gebregeorgise DT, Belay YM, Kälvemark Sporrong S. Sildenafil citrate use in Addis Ababa: characteristics of users and pharmacists' dispensing practices. Int J Clin Pharm. (2018) 40:67–73. doi: 10.1007/s11096-017-0558-8 11. Both R. Sex, tension, and pills: young people's use of contemporary reproductive and sexual health technologies in Addis Ababa, Ethiopia (Doctoral dissertation). Anthropology Department, University of Amsterdam, Amsterdam, Netherland (2017). Available online at: https://pure.uva.nl/ws/files/9794196/Thesis_complete_.pdf 12. Both R. A matter of sexual confidence: young men's non-prescription use of Viagra in Addis Ababa, Ethiopia. Cult Health Sex. (2016) 18:495–508. doi: 10.1080/13691058.2015.1101489 13. Cheitlin MD, Hutter AM Jr, Brindis RG, Ganz P, Kaul S, Russell RO Jr, et al. Use of sildenafil (Viagra) in patients with cardiovascular disease. Technology and Practice Executive Committee. Circulation. (1999) 99:168–77. doi: 10.1161/01.CIR.99.1.168 14. Santtila P, Sandnabba NK, Jern P, Varjonen M, Witting K, von der Pahlen B. Recreational use of erectile dysfunction medication may decrease confidence in ability to gain and hold erections in young males. Int J Impot Res. (2007) 19:591–6. doi: 10.1038/sj.ijir.3901584 15. Schiefer J, Sparing R. Transient global amnesia after intake of tadalafil, a PDE-5 inhibitor: a possible association? Int J Impot Res. (2005) 17:383–4. doi: 10.1038/sj.ijir.3901301 16. Pomara G, Morelli G, Menchini-Fabris F, Dinelli N, Campo G, LiGuori G, et al. Epistaxis after PDE-5 inhibitors misuse. Int J Impot Res. (2006) 18:213–4. doi: 10.1038/sj.ijir.3901383 17. Tiryakioglu SK, Tiryakioglu O, Turan T, Kumbay E. Aortic dissection due to sildenafil abuse. Interact Cardiovasc Thorac Surg. (2009) 9:141–3. doi: 10.1510/icvts.2009.205849 18. Nachtnebel A, Stöllberger C, Ehrlich M, Finsterer J. Aortic dissection after sildenafil-induced erection. South Med J. (2006) 99:1151–2. doi: 10.1097/01.smj.0000240732.65859.aa 19. Suleman S, Woliyi A, Woldemichael K, Tushune K, Duchateau L, Degroote A, et al. Pharmaceutical regulatory framework in ethiopia: a critical evaluation of its legal basis and implementation. Ethiop J Health Sci. (2016) 26:259–76. doi: 10.4314/ejhs.v26i3.9 20. Gebretekle GB, Serbessa MK. Exploration of over the counter sales of antibiotics in community pharmacies of Addis Ababa, Ethiopia: pharmacy professionals' perspective. Antimicrob Resist Infect Control. (2016) 5:2. doi: 10.1186/s13756-016-0101-z 21. Jackson G, Montorsi P, Cheitlin MD. Cardiovascular safety of sildenafil citrate (Viagra): an updated perspective. Urology. (2006) 68(3 Suppl):47–60. doi: 10.1016/j.urology.2006.05.047 22. Kloner RA, Jackson G, Emmick JT, Mitchell MI, Bedding A, Warner MR, et al. Interaction between the phosphodiesterase 5 inhibitor, tadalafil and 2 alpha-blockers, doxazosin and tamsulosin in healthy normotensive men. J Urol. (2004) 172(5 Pt 1):1935–40. doi: 10.1097/01.ju.0000142687.75577.e4 23. Ethiopia CC. Summary and Statistical Report of the 2007 Population and Housing Census. Addis Ababa: Federal Democratic Republic of Ethiopia population Census Commission (2008). 24. Ausó E, Gómez-Vicente V, Esquiva G. Visual side effects linked to sildenafil consumption: an update. Biomedicines. (2021) 9:291. doi: 10.3390/biomedicines9030291 25. Gebreslassie M, Feleke A, Melese T. Psychoactive substances use and associated factors among Axum University students, Axum Town, North Ethiopia. BMC Public Health. (2013) 13:693. doi: 10.1186/1471-2458-13-693 26. Lindsey WT, Stewart D, Childress D. Drug interactions between common illicit drugs and prescription therapies. Am J Drug Alcohol Abuse. (2012) 38:334–43. doi: 10.3109/00952990.2011.643997 27. Murtadha M, Raslan MA, Fahmy SF, Sabri NA. Changes in the pharmacokinetics and pharmacodynamics of sildenafil in cigarette and cannabis smokers. Pharmaceutics. (2021) 13:876. doi: 10.3390/pharmaceutics13060876

    Brindley, G. S. (1984) New treatment for priapism. Lancet, ii, 220–221.CrossRefGoogle Scholar
    GAINSWave is a proven protocol for men that improves sexual performance and keeps the penis healthy.

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A clear, plastic tube that slides over the penisA manual or battery-operated pump that sucks air out of the cylinder, sending more blood to the penisAn elastic ring that is placed around the base of the penis after an erection is obtained. It’s like a rubber band. It helps maintain firmness by preventing blood from draining out of the penis. If you have venous leak syndrome, this may help you.

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Erectile dysfunction can cause stress, self-confidence, and relationship problems. It's no wonder men are embarrassed to talk about it and often seek solutions on their own. Urologist Dr. John Smith says a majority of th... View More in Health Feed Site Links Find an Interpreter About Us Academics & Research Billing Jobs Giving Maps & Directions Newsroom Referring Providers Helpful Links Price Estimate Patient Rights & Responsibilities Disclaimer Privacy Statement DNV GL Public Information Policy Statement Non-Discrimination Policy Surprise Billing Rights Webmaster 801-587-1454 Facebook Twitter Youtube

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Before we dive into the exercises, you should know that you are one of many people struggling to get hard or keep an erection.

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All drugs have some side effects and these may vary according to the dosage used and the sensitivity of the individual to the substance. Prolonged Erection (Priapism) An erection lasting for more than 4 hours has occurred in some cases following penile injection. Sometimes this is due to people injecting themselves with excessive doses of the drug. Occasionally it can happen at the first injection because of the persons sensitivity to the drug. If this happens it may be necessary for a doctor to give an injection of a different drug to counteract this effect. If the counteracting drug is given within 5-6 hours of the original injection it will usually reverse the effect and no long term harm will result.

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