A daily glass of wine, beer or single malt over dinner or after work with your buddies will not lead to erectile dysfunction (ED), inability to get or maintain an erection during sex. Overindulging, though, will short-circuit your sex life. Besides waking up with a major hangover, overdoing it will eventually lead to hardening of the arteries and cardiovascular disease, which interferes with blood flow to your equation is simple: the less blood flow, the soft and skimpier the erection. Unless you can drink in moderation, avoid alcohol if you want to be at your best in bed.
Aging, liver and kidney problems, and concurrent use of certain medications (such as erythromycin [an antibiotic] and protease inhibitors for HIV) slows the metabolism (breakdown) of sildenafil. Slowed breakdown allows sildenafil to accumulate in the body and potentially may increase the risk of side effects. Therefore, in men over 65 years of age, in men with significant kidney and liver disease, and in men who also are taking medications called protease inhibitors, the doctor will initiate sildenafil at a lower dose (25 mg) to avoid accumulation of sildenafil in the body. A protease inhibitor ritonavir (Norvir) is especially potent in increasing the accumulation of sildenafil, thus men who are taking Norvir should not take sildenafil doses higher than 25 mg and at a frequency of no greater than once in 48 hours. Other medications that may affect the level of sildenafil include erythromycin and ketoconazole.
Fully restoring sexual health with treatment of a medical condition (such as high blood pressure with diet and/or exercise or by controlling diabetes or other chronic diseases) may not be possible. Identification and treatment of these conditions may prevent the progression of ED and affect the success of various ED therapies. Nutritional states, including malnutrition, obesity, and zinc deficiency, may be associated with erectile dysfunction, and dietary changes may prove a sufficient treatment. Masturbation and excessive masturbation are not felt to cause ED, however, if one notes weak erections with masturbation, this may be a sign of ED. Some men who masturbate frequently may have troubles with achieving the same degree of stimulation from their partner, but this is not ED.
Relationship problems often complicate erectile dysfunction. Improving your relationship may be part of the solution. It may be a good idea to get counseling together from a sex therapist, marriage counselor, or a medical specialist. "I almost always see couples together to discuss erectile dysfunction. It often turns out that both partners have issues regarding the sexual relationship and once they are out in the open, couples can work together on a more satisfying sexual experience," says Feloney.
Then you have to be able to make the right diagnosis. What is the basis for their erectile dysfunction? Is it psychogenic? Is it some sort of neurological or blood vessel or hormonal issue? So you have to make a diagnosis. You have to be able to make an assessment. And then only after those things are done, then you start to think about medications.
It's not easy to get in the mood when you're overwhelmed by responsibilities at work and home. Stress can take its toll on many different parts of your body, including your penis. Deal with stress by making lifestyle changes that promote well-being and relaxation, such as exercising regularly, getting enough sleep, and seeking professional help when appropriate.
Dr. Anna Murray, of the University of Exeter Medical School, is co-lead author on the study. She said: “Erectile dysfunction affects at least one in five men over 60, yet up until now little has been known about its cause. Our paper echoes recent findings that the cause can be genetic, and it goes further. We found that a genetic predisposition to type 2 diabetes is linked to erectile dysfunction. That may mean that if people can reduce their risk of diabetes through healthier lifestyles, they may also avoid developing erectile dysfunction.”
It would be convenient if a fairy dickmother flew from the sky and told you this would be the drink that renders you flaccid, but when it comes to figuring out your limit, you’re on your own. There’s no hard and fast rule as to how much will actually affect you, either; Dr Mills notes that some men may be able to drink a lot and get erections, as everybody’s threshold is different.
Diabetes is a serious disease requiring professional medical attention. The information and recipes on this site, although as accurate and timely as feasibly possible, should not be considered as medical advice, nor as a substitute for the same. All recipes and menus are provided with the implied understanding that directions for exchange sizes will be strictly adhered to, and that blood glucose levels can be affected by not following individualized dietary guidelines as directed by your physician and/or healthcare team.
ED may occur with or without other sexual dysfunction, including decreased libido (decreased interest in sexual activity), orgasmic dysfunction (troubles achieving an orgasm/climax), and ejaculatory dysfunction (problems with the fluid released during sex, including lack of ejaculation [anejaculation], small volume ejaculate, ejaculation that occurs too quickly [premature ejaculation], ejaculate that goes backward into the bladder [retrograde ejaculation] and pain with ejaculation).
Alcohol consumption is a common behavior in social circumstances worldwide. Epidemiological studies have suggested that moderate alcohol consumption reduces cardiovascular morbidity and mortality. The cardiovascular protective effects of alcohol may be attributed to its antioxidant, vasorelaxant, and antithrombotic properties, elevation of high-density lipoprotein or increase of nitric oxide production. Erectile dysfunction (ED) is a harbinger of cardiovascular diseases. Most epidemiological studies have also found that alcohol consumption, like its relationship with coronary artery disease, is related to ED in a J-shaped manner, with moderate consumption conferring the highest protection and higher consumption less benefits. In epidemio-logical studies, it is difficult to distinguish the ethanol effects from those of associated confounding factors. Meanwhile, long-term alcohol users, especially in those with alcohol liver disease, are highly associated with ED. More research is needed to investigate the true effects of alcohol consumption on cardiovascular diseases or ED.
While there are many ways to treat ED today, men with diabetes may require maximum doses of medications such as Viagra™, Cialis™, Levitra™ and Stendra™, yet still find drugs ineffective.7 In a study of nearly 20,000 men with ED, men with diabetes were 1.5 to 2 times more likely to move on to other treatments, such as pumps and penile implants than men without diabetes.9
Erectile dysfunction isn’t just about not being able to achieve an erection. Often times men can get an erection and still suffer from some of the early symptoms of erectile dysfunction. ED is more about the inability to get and maintain an erection that’s strong enough to have “satisfactory” sex. Satisfaction is the key word in that definition. And it encompasses a lot.
As a starting point, consider the National Health and Social Life Survey, which was the first nationally representative sex survey conducted in the United States . The data were collected in 1992 from thousands of Americans aged 18-59. As part of this survey, male participants were asked whether they’d had trouble maintaining or achieving an erection any time in the last year, to which they provided a simple yes/no answer.
Problems with the veins that drain the penis can also contribute to erectile dysfunction. If the veins are not adequately compressed, blood can drain out of the penis while blood is coming into the penis and this prevents a fully rigid erection and maintaining an erection. Venous problems can occur as a result of conditions that affect the tissue that the veins are compressed against, the tunica albuginea. Such conditions include Peyronie's disease (a condition of the penis associated with scarring [plaques] in the tunica albuginea that may be associated with penile curvature, pain with erections, and ED), older age, diabetes mellitus, and penile trauma (penile fracture).
In patients with low testosterone, testosterone treatment can improve libido and erectile dysfunction, but many men still may need additional oral medications such as sildenafil, vardenafil, or tadalafil. Some studies suggest that men with ED and low testosterone may respond better to PDE5 inhibitors when given testosterone therapy; however, this is controversial.
Where alcohol may succeed as an aphrodisiac in getting people “in the mood” it may fail in execution. During an erection, the penis fills with blood then the vessels close, preventing backflow, so that the penis remains erect. In the short term, overconsumption of alcohol causes the blood vessels in the penis to expand, allowing for more blood flow, but prevents those vessels from closing. As a result, the penis may become erect but not remain so, as there is nothing to prevent backflow.
This is a 17-year-old male with a past medical history of insomnia, anxiety and depression who presents with complaints of gradual onset (2 years ago) of decreased ability to obtain and maintain erections adequate for intercourse. He reports normal nocturnal erections “most days of the week”. He does not masturbate because he feels that masturbation may have desensitized his brain and caused ED; however, he can masturbate and have an erection with normal orgasm/ejaculation. He has had a successful erection and intercourse with a partner, last time 2 weeks ago. He feels that his ED might have been associated with SSRI treatment but noted no improvement after stopping his SSRI. Cialis 5 mg is effective. He reports normal libido “but not where it was”. His testosterone (T) and free T are normal. He is in the care of a sexual therapist and has read extensively on the internet. He takes trazodone nightly for sleep.
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Other medical therapies under evaluation include ROCK inhibitors and soluble guanyl cyclase activators. Melanocortin receptor agonists are a new set of medications being developed in the field of erectile dysfunction. Their action is on the nervous system rather than the vascular system. PT-141 is a nasal preparation that appears to be effective alone or in combination with PDE5 inhibitors. The main side effects include flushing and nausea. These drugs are currently not approved for commercial use.
Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.
A man needs to try the medicine at least four times before he concludes that it doesn’t work for him. It is unlikely that a man with diabetes who has other medical problems such as high blood pressure, is taking multiple medicines, and has not had sexual intercourse for several years will be able to have an erection adequate for intercourse the first time he takes a pill. Most men need to try the medicine several times before they have the desired results.
This man’s history is adequate to rule out arterial or venous insufficiency as he can masturbate to produce a rigid, sustainable erection and he responds well to tadalafil. Due to his report of gradual onset, his lack of response to ongoing sexual therapy, and his tremendous anxiety associated with the issue, the decision was made to offer a PCDU to assess for a vascular etiology for his disorder. PCDU revealed normal peak flow bilaterally of 40 cm/sec with no end diastolic flow and 100% rigidity obtained. His erection lasted more than 2 hours and required phenylephrine to resolve the erection.
Having learned a great deal more about erectile dysfunction including its risk factors and causes, you should be equipped to assess your own erectile function. If you have experienced erectile issues or you have some of the risk factors mentioned above, it may be worth making a trip to your doctor’s office. If you choose to seek help, give your doctor as much information as you can about your symptoms including their frequency and severity as well as the onset. With your doctor’s help, you can determine the best course of treatment to restore sexual function.
The contents of your medicine cabinet could affect your performance in the bedroom. A long list of common drugs can cause ED, including certain blood pressure drugs, pain medications, and antidepressants. But do not stop taking any medicines without talking to your doctor first. Street drugs like amphetamines, cocaine, and marijuana can cause sexual problems in men, too.
There was a significant reduction in the frequency of sexual intercourse per week over the last five years having decreased from a mean of 4.6 (± 2.6) times per week to 2.2 (± 2.2) times per week currently. Forty-eight per cent of the sample had more than one sexual dysfunction. Of the 24 subjects with only one complaint, the most frequent complaint was that of premature ejaculation in 18 subjects.
But when you or your partner notice a change in your erections, it’s important to talk to a doctor to discover the underlying cause of your ED. Erectile dysfunction is often an early warning sign of serious health conditions, like heart disease. High blood pressure, diabetes, low testosterone, and high cholesterol are all causes of ED in otherwise healthy men. Don’t assume that it’ll pass—especially if symptoms get worse over time.
When you become aroused, your brain sends chemical messages to the blood vessels in the penis, causing them to dilate or open, allowing blood to flow into the penis. As the pressure builds, the blood becomes trapped in the corpora cavernosa, keeping the penis erect. If blood flow to the penis is insufficient or if it fails to stay inside the penis, it can lead to erectile dysfunction.
Yes, excessive alcohol intake can affect sexual function. Erectile dysfunction is more common in people who abuse drugs and alcohol. Lifestyle changes such as drinking less alcohol and quitting smoking may help improve sexual function. Chronic heavy alcohol consumption can affect erectile ability through altered hormone metabolism and nervous system involvement.
Low intracavernosal nitric oxide synthase levels are found in people with diabetes, smokers, and men with testosterone deficiency. Interference with oxygen delivery or nitric oxide synthesis can prevent intracavernosal blood pressure from rising to a level sufficient to impede emissary vein outflow, leading to an inability to acquire or sustain rigid erection. Examples include decreased blood flow and inadequate intracavernosal oxygen levels when atherosclerosis involves the hypogastric artery or other feeder vessels and conditions, such as diabetes, that are associated with suboptimal nitric oxide synthase activity.
Occasional difficulties in bed do not constitute ED – it is the persistent and consistent inability to maintain an erection through satisfactory intercourse. It is more common than men might think, given that they are loath to discuss it with others, often even their doctors. The condition has many causes and, as a result, affects men of all ages – though it becomes increasingly prevalent with age.
Erectile dysfunction is no laughing matter. And although it is not an easy thing to talk about, there are trained professionals who can give you good advice about what may be the cause of your current predicament. Many men like to talk about sex, but like women, they may find it harder to talk about sex when it is not going well. You won’t be judged or talked about at BPAS. We are here to help you with some of the more private things in life.
In prescribing sildenafil, a doctor considers the age, general health status, and other medication(s) the patient is taking. The usual starting dose for most men is 50 mg, however, the doctor may increase or decrease the dose depending on side effects and effectiveness. The maximum recommended dose is 100 mg every 24 hours. However, many men will need 100 mg of sildenafil for optimal effectiveness, and some doctors are recommending 100 mg as the starting dose.
For an adult, there are not too many effects of diet on growth and development, but for children effects can be dramatic. The adolescent body needs a certain amount of protein, vitamins, and fat for healthy development. Speak to a pediatrician before putting a child on a diet. For an adult, if you are obese, use a high protein diet, but only for a short time to jump start weight loss, then move to a healthy eating program.
If this treatment approach fails, it is useful, however frustrating, to start again from the beginning. Reassess the history to ensure that nothing was missed originally. Obtain labs and perform a PCDU. This will give the objective information that you might need in order to make a diagnosis of a known etiology for ED and to provide the patient reassurance that your evaluation has been thorough.
An erection involves the brain, nerves, hormones, muscles, and circulatory system. These systems work together to fill the erectile tissue in the penis with blood. A man with erectile dysfunction (ED) has trouble getting or maintaining an erection for sexual intercourse. Some men with ED are completely unable to get an erection. Others have trouble maintaining an erection for more than a short time.
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.
Lifestyle choices that impair blood circulation can contribute to ED. Smoking, excessive drinking, and drug abuse may damage the blood vessels and reduce blood flow to the penis. Smoking makes men with atherosclerosis particularly vulnerable to ED. Being overweight and getting too little exercise also contribute to ED. Studies indicate that men who exercise regularly have a lower risk of ED.
Anxiety, stress, and depression can lead to ED. In a small study, 31 men newly diagnosed with ED either took tadalafil (Cialis) only, or took tadalafil while also following an eight-week stress management program. At the end of the study, the group who participated in the stress management program saw more improvement in erectile function than the group who took only tadalafil.
As recently as two decades ago, doctors tended to blame erectile dysfunction on psychological problems or, with older men, on the normal aging process. Today, the pendulum of medical opinion has swung away from both notions. While arousal takes longer as a man ages, chronic erectile dysfunction warrants medical attention. Moreover, the difficulty is often not psychological in origin. Today, urologists believe that physical factors underlie the majority of cases of persistent erectile dysfunction in men over age 50.
In fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.
Sildenafil is available as oral tablets at doses of 25 mg, 50 mg, and 100 mg. Patients should take sildenafil approximately one hour before sexual activity. In some men, the onset of action of the drug may be as early as 11-20 minutes. It's best for men to take sildenafil on an empty stomach for best results since absorption and effectiveness of sildenafil can be diminished if it is taken shortly after a meal, particularly a meal that is high in fat. Sildenafil and the other PDE5 inhibitors don't cause an immediate erection. Sexual stimulation is necessary for these medications to work.
If on one hand, depression and anxiety can lead to ED, drugs commonly used for their treatment can cause ED, as well. Sexual dysfunctions are common side effects of several psychotropic drugs that can disrupt sexual health by several different mechanisms (83). In particular, ED has been reported in subjects using serotonin selective re-uptake inhibitors (SSRI), lithium and benzodiazepines (83). SSRI are associated with a broad spectrum of sexual dysfunctions, but the most commonly reported complaints are delayed ejaculation or anorgasmia and reduced sexual desire (84). Several mechanisms could be advocated including the agonist effect on serotonin receptors type 2 and the increase in PRL levels. ED is a frequent complaint as well (84,85). The relationship between the use of SSRI and ED can be secondary to loss of sexual desire but SSRI, in particular paroxetine, are also able to inhibit cholinergic receptors and nitric oxide synthase (86). In addition, it has been observed that SSRIs might down-regulate hypothalamic-pituitary-testis axis in depressed men (87).
Diabetes occurs when you have too much sugar circulating in your bloodstream. There are two main types of diabetes: type 1 diabetes, which affects less than 10 percent of those who have diabetes, and type 2 diabetes, which accounts for over 90 percent of diabetes cases. Type 2 diabetes often develops as a result of being overweight or inactive. Approximately 30 million Americans have diabetes, and about half of them are men.