Psychological Causes of ED – Between 10% and 20% of ED cases have a psychological cause. Because arousal starts in the brain, psychological issues can be a significant contributing factor to erectile dysfunction. Mental health conditions like depression or anxiety can negatively impact your libido, making it more difficult for you to become aroused.

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.
Epidemiological studies consistently show that prevalence of erectile dysfunction (ED) increases with ageing. Nonetheless, complaints of ED even in younger men are becoming more and more frequent. Healthcare professionals working in Sexual Medicine but even those operating in different clinical contexts might be adequately prepared to answer this increasing requirement. ED in younger men is likely to be overlooked and dismissed without performing any medical assessment, even the most basic ones, such as collection of medical history and physical exam. This is due to the widespread assumption that ED in younger individuals is a self-limiting condition, which does not deserve any clinical evaluation or therapy and can be managed only with patient reassurance. However, evidence shows that, in younger subjects, organic, psychological and relational conditions can contribute to the pathogenesis of ED and all these conditions might be evaluated and treated, whenever necessary. Among the organic conditions contributing to the onset of ED, metabolic and cardiovascular (CV) risk factors are surprisingly of particular relevance in this age group. In fact, in younger men with ED, even more than in older ones, recognizing CV risk factors or conditions suggestive of cardio-metabolic derangements can help identifying men who, although at low absolute risk due to young age, carry a high relative risk for development of CV events. In this view, the assessment of a possible organic component of ED even in younger individuals acquires a pivotal importance, because it offers the unique opportunity to unearth the presence of CV risk factors, thus allowing effective and high quality preventive interventions.
Erectile dysfunction is a common problem for more than half of men with diabetes. Musicki says that an estimated "50 percent to 75 percent of diabetic men have erectile dysfunction to some degree, [a rate] about threefold higher than in non-diabetic men."  This is not the same type of erectile dysfunction seen in non-diabetics, and it is less effectively treated with conventional drugs like Viagra. 
Also, even if rates of erectile difficulties are rising in young guys, we definitely can’t say why. While many like to point to increased access to online porn as the likely culprit, we need to be mindful of the fact that a ton of other things could potentially be playing a role. For example, young people today are much more likely to be using antidepressants than they were in the past, which we know can cause a number of sexual side effects. There may also have been changes in condom use patterns—we know that a lot of guys have erectile difficulties when using condoms, so if guys today are using more condoms, that could translate to more difficulties.
With all of that said, it should be clear that we lack evidence from nationally representative sex surveys to support claims about a massive increase in erectile difficulties among young men. It may be that reports of mild problems are increasing in this group (we need more data to know), but even if this is true, the data don’t suggest anything along the lines of, say, a 1000% increase.
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 [1]. 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.
For oral erectile dysfunction medicines to work as desired, they must be used properly in the first place. This means taking the medicine 30–45 minutes before engaging in sexual intimacy; taking the drug on an empty stomach or at least avoiding a heavy or high-fat meal before taking the drug (this is especially important when using sildenafil); and engaging in adequate genital stimulation before attempting intercourse. Drinking small amounts of alcohol (one to two drinks) should not compromise the effectiveness of erectile dysfunction medicines, but larger amounts of alcohol can diminish a man’s ability to have an erection.

Erectile dysfunction is either physical or mental in nature.  If you have erectile dysfunction and have a family history of heart disease, diabetes, multiple sclerosis, low testosterone or thyroid disease you should see your doctor for a physical to be checked for any of these conditions.  Even if there is no family history of these conditions in your family, it is recommended to be checked for these diseases anyway to rule out causes of your youthful impotence.
The bottom line is that nearly all men with diabetes who wish to have an erection adequate for sexual intercourse can do so with the therapies currently available. And with commitment and communication, the experience of erectile dysfunction can be changed from a potential personal tragedy to an opportunity for greater emotional intimacy in a couple.
The improvement of both man and woman sexual function in couples whose male partner is treated with PDE5i has been further confirmed by randomized clinical trials (RCTs) comparing the effectiveness of PDE5i vs. placebo in improving couple sexual function (91-95). In a more recent RCT, the use of vardenafil 10 mg oral dispersible tablets has been compared to the use of the drug itself in association with cognitive behavioral sexual therapy (CBST) for 10 weeks in 30 couples with ED male partners, randomly assigned to one study arm (96). Results from this RCT showed that vardenafil is able to improve male sexual function, but this improvement is maintained only in patients receiving both vardenafil and CBST. Furthermore, female sexual function and satisfaction are enhanced only in the arm with vardenafil and CBST combined therapy, thus suggesting that a therapy healing the couple is more effective and has a longer-lasting efficacy than the use of a medication focusing only on ED.
Many men who suffer from erectile dysfunction feel guilty about being unable to please their partner. If the problem persists, the guilt becomes more than just a side effect – it can contribute to the ongoing cycle of ED as well. Guilt is often paired with low self-esteem, and not just in men with erectile dysfunction. Guilt and shame are feelings that are commonly linked to mental health issues such as depression. In fact, feelings of worthlessness and inappropriate guilt is one of the clinical criteria for major depressive disorder, according to the DSM-5.

Some doctors prefer to start a man on the lowest dose of an oral medicine and increase the dose until an effective one is found. Others prefer to start with the highest dose and go to a lower dose only if a man complains of side effects. In either case, it’s important for a man to communicate with his doctor to let him know how the dose he’s using is working.
If the patient reports intermittent ability to obtain and maintain an erection, evaluation with combined injection and stimulation test (CIS) will give you additional diagnostic and potentially therapeutic answers. It will determine if he has adequate inflow to obtain erection and if he has adequate venous occlusive function to maintain erection. It may also provide reassurance to the patient that his anatomy is functional. However, it is well documented that due to increased sympathetic tone these young men will often require additional injection or a separate visit in order to respond appropriately with complete smooth muscle relaxation (7,20,21).

Because blood vessel problems are the leading cause of erectile dysfunction, erections have been described as a useful barometer for a man’s overall health. The American Heart Association urges that physicians screen for cardiovascular risks in patients who have erectile dysfunction, even if no other risk factors are present; the onset of ED can precede cardiac events by two to five years.
Can apple cider vinegar treat erectile dysfunction? Apple cider vinegar is thought to have many health benefits, but can it help treat erectile dysfunction (ED)? ED can result from cardiovascular problems, diabetes, and other factors. Apple cider vinegar may help improve symptoms of conditions related to ED. Find out how it may help, and how to use it safely. Read now

Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).
This category of treatments includes external vacuum therapies: devices that go around the penis and produce erections by increasing the flow of blood in, while constricting the flow out. Such devices imitate a natural erection, and do not interfere with orgasm. External vacuum therapy mechanisms are approximately 95 percent successful in causing and sustaining an erection. All are portable, and costs range between $200-$500, covered under most insurance plans and Medicare Part B.
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