Erectile Dysfunction and Your Health: 5 Things You Need to Know

Cialis works by maintaining the level of cGMP in the smooth muscle cells. When you make the appointment, be sure to ask if there's anything you need to do in advance. Blood loss is typically small. Healthy blood flow is also necessary for erectile function. Alpha blockers tend to be less likely to cause this problem. If you are trying to access this site from the United States and believe you have received this message in error, please reach out to [email protected]

Many medicines and recreational drugs can affect a man's sexual arousal and sexual performance. PDE5i medications vary in dosage, how long they work, and side effects. 8 natural remedies for erectile dysfunction (ed, impotence), ceratin medications, such as alprostadil, papaverine, and phentolamine, can be injected directly into the side or base of the penis. These include: Due to the lack of large clinical trials with long followup period designed for ED identification and with cardiovascular morbidity and mortality as endpoints, it is premature to assure that ED identifies an increased cardiovascular risk among hypertensive patients that extends beyond the risk represented by blood pressure elevation [62]. Some research even suggests the effect of blood pressure drugs may be more psychological than physical.

See your doctor if: The choice may depend on: Alert about the necessity of sexual excitement to reach an erection under PDE5 inhibitor. Other risk factors for erectile dysfunction include neurologic problems (multiple sclerosis, stroke), depression and medications for treating diabetes, hypertension, heart disease and depression. Others need help from prescription high blood pressure medication.

It is important to acknowledge and discuss ED, particularly when it causes depression or anxiety. Secondary premature ejaculation occurs when, after years of normal ejaculation, the duration of intercourse grows progressively shorter. Side effects can include pain, minor bleeding, dizziness or fibrous tissue formation inside the penis. Similarly, effects of sildenafil on blood pressure in hypertensive patients on multiple antihypertensive drugs were minimal and well tolerated [79, 80].

Antidepressants. It is, of course, a condition that’s been with us through the ages and, until relatively recently, the sort of problem that men (and their partners) suffered in silence. Last updated on Feb 28, 2020. This condition may cause permanent impotence if not treated. It’s estimated that less than 25% of ED is primarily caused by psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure.

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If you have pulmonary hypertension and you forget to take a dose of sildenafil, take it as soon as you remember and then continue as usual. The side effects of ED medications are mostly the same. Most often, one small surgical cut is made. Water pills (diuretics). PDE-5 inhibitors should also be used with caution in men who:

That means daily tracking and recording. Here's the good news: Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections. Alprostadil will usually produce an erection after five to 15 minutes. For some women, this leads to a decrease in sexual desire or arousal, vaginal dryness, or difficulty achieving orgasm. 7 surprising reasons for erectile dysfunction, in recent months, my husband is also returning home later and avoiding sex. Mechanical problems with the implants may occur within five years in five per cent of cases.

Penile vascular surgery is not recommended for older men with hardened arteries. High blood pressure can make this more difficult by damaging blood vessels. If you get your doctor’s okay, you might be able to temporarily stop taking blood pressure medication to see if your sex life improves.

That's something you may want to consider based on your sexual habits.


One hundred and four patients (mean age 62. )Many times, men will avoid sexual situations due to the emotional pain associated with ED, causing their partner to feel rejected or inadequate. Self-injection lessons should be given in your doctor's office by an experienced professional.

Some patients develop orthostatic hypotension when PDE5 inhibitors are used in conjunction with an alphablocker (typically for urologic conditions, such as benign prostatic hypertrophy) but some studies suggest that the interaction is less clinically relevant if the patient has been undergoing long-term alpha-blocker therapy [81].

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Usually, a man takes 1 tablet 30 minutes to 1 hour before he plans to have sex. Erectile function preservation is essential for sexually active man while having a lower weight for other who has no intercourses. Development of erectile dysfunction in connection with betablockers might be biased by psychological effects derived from the awareness of being treated with a certain substance. The treatment for erectile dysfunction depends on what is causing it. The treatment for ED starts with taking care of your heart and vascular health. However, the failure to achieve an erection more than 50% of the time generally means that there is a problem and treatment is needed.

Some high blood pressure medications are less likely to cause sexual side effects, such as:

Parkinson disease medicines: If you have erectile dysfunction (ED), treatment will depend on what's causing it. Examples include papaverine, alprostadil and phentolamine. If sexual side effects persist, ask your doctor about other medication options. Cialis is available in two dosages: Staxyn is an orally disintegrating tablet that contains the same active ingredient as Levitra but is not interchangeable with Levitra tablets. Sildenafil (Viagra) is effective for all sorts of erectile dysfunction in 69% of people.

You will be trained by your health professional on how to inject, how much to inject and how to safely raise the drug's dosage if necessary. Erectile dysfunction studies suggest that the prevalence of impotence in men with diabetes can range from 35 to 75 percent vs. Diabetes and erectile dysfunction: what is the connection?, 16 aimed to test the hypothesis that ED improves CVD prediction beyond traditional risk factors. Medical treatments: The loss of erectile capacity can have a profound effect on a man.

This test is usually performed by a specialist in an office.

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When you’re experiencing medically-induced ED, this has to be your starting point. The various treatments for erectile dysfunction are outlined below. In other cases, medications or other direct treatments might be needed.

3% of ED prevalence [33]. Vardenafil is an oral PDE5i drug. Or perhaps smoking is the culprit of your symptoms, in which case kicking the habit may be all you need. It all has to do with blood flow. High blood pressure can reduce blood flow to the vagina. Get help for anxiety, depression or other mental health concerns. A survey of 104 men with hypertension, published in the October 2020 issue of The Journal of Urology, found that the vast majority -- 71 patients -- had some form of erectile dysfunction.

The majority of erectile dysfunction cases are curable, as long as the underlying cause is established. Intracavernosous self-injection and penile prostheses constitute the most common path for men refractory to oral therapy [11]. Erectile dysfunction is a very common experience.

How do I know my ED is physical and not mental?

Penile implants. Preparations of maritime pine extract, Pinus pinaster, and maca, Lepidium meyenii, also showed promising results, but more research is needed. Your doctor will consider your particular situation to determine which medication might work best. Certain high blood pressure drugs may even improve erectile dysfunction for some men. Drinking too much alcohol can raise your blood pressure, as well as potentially lowering the effects of blood pressure medication.

To initiate an erection, the patient squeezes the pump (located in scrotum) to release fluid into the penis. Take these steps to prepare for your appointment: And another whammy in the high blood pressure-ED equation is medication. Implants are usually not considered until other methods of treatment have been tried. Erectile dysfunction is common in men who have Type 2 diabetes, especially for those who have sustained nerve and/or blood vessel damage as a result of long-term poor blood sugar control.

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If a penis pump is a good treatment choice for you, your doctor might recommend or prescribe a specific model. Your doctor may talk to you about alprostadil if oral medicines aren’t an option for you. Thanks for visiting! Take sildenafil up to 4 hours before you want to have sex. If you are taking either of these medicines and are worried about erectile dysfunction, your GP may be able to change your medicines.

Your doctor might recommend making changes to your lifestyle, or they may recommend using medication to regulate your blood pressure. Cialis does not cause a man to be sexually aroused. Levitra starts working in about 30 to 60 minutes and lasts four to five hours. How can I improve my erectile dysfunction? PDE5 inhibitors act to relax penile erectile tissues with sexual stimulation thus enhancing your ability to get an erection. Involve your sexual partner. This and other authors [63] argue that ED should represent a clinical sign of a deeper vascular damage in hypertensive patients and an increased risk of cardiovascular events. Most males experience at least one episode of being unable to achieve an erection when desired.

Psychological Treatments

On average, Cialis becomes effective within the hour although some men have reported that Cialis works best after a few hours. But some patients can eliminate their need for the treatment through changes in diet and exercise. Use a reliable blood pressure cuff and the free personal Hello Heart App (iOS, Android). It starts with you both agreeing not to have sex for a number of weeks or months. Having erection trouble from time to time isn't necessarily a cause for concern.

Cozaar belongs to a class of anti-hypertensive drugs known as angiotensin II receptor blockers, or ARBs. Some men find that intense anxiety about sex prevents certain treatments from working. Share with each other the types of sexual activity you enjoy most. They all work by enhancing the effects of nitric oxide, a chemical created in the body that relaxes smooth muscles in the penis in response to sexual stimulation and allows the increased blood flow needed for erection. If a penile prosthesis is removed, other non-surgical treatments may no longer work. © 1998-2020 Mayo Foundation for Medical Education and Research (MFMER).

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Alprostadil injections, which produce an erection in five to 20 minutes that lasts for about an hour. Likewise, Lamina et al. Impulses in the brain, spinal column, and area around the penis cause the muscles of the corpora cavernosa to relax, allowing blood to flow in through the arteries and fill the spaces. Inflatable devices allow you to control when and how long you have an erection. These could stem from relationship conflicts, life's stressors, depression or anxiety from past problems with ED (performance anxiety). Psychosocial examination. To reduce the risk of side effects from these medications, including sexual problems, take medications exactly as prescribed.

Most often, the side effects of PDE5 inhibitors are mild and often last just a short time. Exercise frequently. The main adverse effects of avanafil include headache, flushing and nasal congestion, as well as loss of hearing or vision. Various risk factors can contribute to erectile dysfunction, including: There are risks to prosthetic surgery and patients are counselled before the procedure. With the implant, men can control firmness and, sometimes, the size of the erection. Initial efforts should identify and treat all modifiable risk factors.

This device, on the market for 30 years, basically gives men an erection at their discretion but does not affect the ability to ejaculate or feel orgasm.


Comparable results were obtained with newer PDE5 inhibitors vardenafil and tadalafil [80]. Better options include calcium channel blockers, which lower high blood pressure through a different mechanism. Erectile dysfunction: best options beyond medication, lifestyle changes – health essentials from cleveland clinic. Why are there different doses? The recommended dose of Viagra is 25-100 mg taken 30 minutes to four hours before sexual activity. If so, do you currently take any medications or get psychological counseling (psychotherapy) for it?

Whether it be suggesting lifestyle changes, like doing more exercise or reducing your alcohol consumption, or recommending one of the many effective men’s health medications available, your doctor will be able to guide you through the best and most appropriate treatment. If you develop any sexual difficulties after taking your medication, don't suffer in silence. The procedure involves implanting a device that enables immediate erections. Some men may be able to regain sexual function by making healthy lifestyle changes such as quitting smoking, reducing alcohol consumption, losing weight, and increasing physical activity. Vardenafil citrate (Levitra). For many men, erectile dysfunction is caused or worsened by lifestyle choices.

In fact, it’s estimated that more than 30 million American men have experienced erection problems (Nunes, 2020). The drugs are equally effective — helping about 70 percent of men who take them —but differ in the standard dose, length of the effect, how they interact with food and other medications, and the side effects that can accompany them. What are the risk factors for erectile dysfunction? Be sure to disclose all medical issues and any supplements or prescription drugs you take. High blood sugar can damage blood vessels and nerves responsible for erectile function. Many men don’t mention it, even to their doctor.

If your first dose doesn’t help, call your doctor.

About Sildenafil

In addition to PDE5i drugs, there are other medications that treat erectile dysfunction, like alprostadil. What websites do you recommend? If an underlying condition, such as diabetes, is causing ED, treating it will often reverse ED or prevent it from worsening. Erectile dysfunction (impotence) causes in older and younger men, anti-depressant medications such as Paxil and Zoloft are often prescribed and are taken by the patient 2 hours prior to sexual activity. Many drugs used to treat hypertension can make erectile dysfunction worse, especially beta blockers, and to a lesser extent, diuretics.

When the erection is no longer needed, squeezing the pump returns the fluid to the reservoir. At least 75% of ED is the result of a physical cause, such as disease, injury, or the side effects of drugs. This can cause anxiety, which might make erectile dysfunction worse. Testosterone, produced mainly in the testes, is the most important male sex hormone. This is not an indication of a security issue such as a virus or attack. It's best to take oral medications on an empty stomach 60 to 90 minutes before having sex. If the results suggest an increased risk for cardiovascular disease, a referral to a cardiologist is reasonable for detailed diagnostic testing and initiation of therapy [73].

  • Of the many substances that affect blood vessel tone, nitric oxide is the most important.
  • Sometimes a combination of physical and psychological issues causes erectile dysfunction.

High Blood Pressure and Male Sex Drive

This association remained after controlling for other variables such as age and census region. Avanafil should not be used by people with severe liver disease. Testosterone replacement therapy may improve energy, mood, and bone density, increase muscle mass and weight, and heighten sexual interest in older men who may have deficient levels of testosterone.

Drugs known as PDE type-5 inhibitors increase penile blood flow. Many men who do not respond to oral PDE5 inhibitors can be ‘rescued' with ICI. When low sexual desire is a symptom, measurement of testosterone in the blood can yield information about problems with the endocrine system. Because there are so many contributing factors to erectile dysfunction, it’s always a good idea to speak with your doctor and discuss all of your erectile dysfunction treatment options, like prescription medication. July 20, 2020. Talk to your doctor if you have any side effect that bothers you.

Is my medication still necessary? Conversations about your sexual health can be awkward. They work by temporarily increasing the blood flow to your penis.

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