So here’s something that’s really fascinating. Healthy eating is a way to reduce anxiety and stress. Now how, you may be asking, right? Well, think about it. We live in a world where there are so many variables and where we don’t have control over our lives. But now, with healthy eating, we have control over what goes into our body. And now having that control empowers us to be even healthier, to be more directive in what we do. And certainly, that begins then to reduce the anxiety and the stress. So all in one, you have a healthier body, but certainly a healthier mind.

There are a number of reasons a man may not achieve the desired result from an oral erectile dysfunction drug. In some cases, a man may experience drug side effects severe enough to outweigh any potential benefit of taking the drug. Possible side effects of these drugs include headache, facial flushing, nasal congestion, and transient abnormal vision. (In October 2007, the FDA added a warning about sudden hearing loss to the package labels of oral erectile dysfunction drugs. While it’s not absolutely clear that the drugs can cause sudden hearing loss, a number of cases have been reported in men within hours or days of taking one of the drugs.)
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).

Never ever use Viagra for ED or PE. It has got its own side effects. You can use this successfully for a couple of years to maximum up to 5 years after that our body stops responding to these allopathic salts and I have learnt this thing the hard way. Better way of handling this problem is by using herbal medicines which do not have side effects. Moreover there are herbal medicines which can also cure this problem and there is no need to continue the medicine after it is cured. Shivalik Gold is one such product, you can give it a try.
Sexual dysfunction appears to be common among male subjects with alcohol dependence. Seventy-two per cent of the subjects with alcohol dependence complained of one or more problems with sexual functioning. This is similar to what has been reported in earlier studies.[10,16] Multiple co-existing dysfunctions seemed to be the norm in the sample studied. The most common condition reported in our study was premature ejaculation followed closely by low sexual desire and erectile dysfunction.
This man’s situational ED, possibly due to performance anxiety or perhaps fear of a repeat injury and pain. Structural, neurogenic, arteriogenic, and venous occlusive erectile dysfunction can be ruled out as he has normal self-stimulated erections. He responds well to low dose oral PDE5 inhibitors. Additional assessment with cold and hot perception testing and biothesiometer were performed due to his complaint of decreased sensation; both test results were normal. He was started on low dose terazosin once daily at bedtime along with Cialis 5 mg as needed. He is responding well to treatment.
Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He's a practicing Gastroenterologist and Hepatologist with a focus on Men's and Women's Health, and a regular contributor to Women's health, Shape and Prevention Magazine.
To understand what happens in ED, it's helpful to know some anatomical basics. When aroused by either sensory or mental stimuli, the brain sends a signal through the nerves to the penis, causing the muscles there to relax. This opens up space for blood to flow in and engorge the penis. A membrane within the penis traps blood inside to help maintain the erection, which subsides when the penile muscles contract, forcing blood back into the rest of the body. Any number of things can go wrong in this process, leading to erectile dysfunction.
Currently, there are no therapies that cure erectile dysfunction. However, a number of effective therapies are available that allow an individual to have an erection when desired. Depending on the cause of the erectile dysfunction, certain therapies may be more effective than others. Although there is limited data on lifestyle modification, intuitively, decreasing risk factors for erectile dysfunction may help prevent progression of disease.
The pills currently available by prescription all work the same way—by boosting the effects of NO in the penis. They typically have mild side effects. Some work faster but others last longer. There is no “best” drug, as some will work better for some men than others, but they all are about equally effective at increasing the hardness of an erection. Pills don’t work for everyone. The main risk is using them with nitroglycerine which can be fatal and must absolutely be avoided.

The initial step in evaluating ED is a thorough sexual history and physical exam. The history can help in distinguishing between the primary and psychogenic causes. It is important to explore the onset, progression, and duration of the problem. If a man gives a history of “no sexual problems until one night,” the problem is most likely related to performance anxiety, disaffection, or an emotional problem. Aside from these causes, only radical prostatectomy or other overt genital tract trauma causes a sudden loss of male sexual function.


Qaseem, A., Snow, V., Denberg, T. D., Casey, D. E., Forciea, M. A., Owens, D. K., & Shekelle, P. (2009). Hormonal testing and pharmacologic treatment of erectile dysfunction: A clinical practice guideline from the American College of Physicians. Annals of internal medicine, 151(9), 639-649. Retrieved from http://annals.org/aim/article/745155/hormonal-testing-pharmacologic-treatment-erectile-dysfunction-clinical-practice-guideline-from
Tadalafil should not be used with alpha-blockers (except Flomax), medicines used to treat high blood pressure, and benign prostate hypertrophy (BPH) because the combination of tadalafil and an alpha-blocker may lower the blood pressure greatly and lead to dizziness and fainting. Examples of alpha-blockers include tamsulosin (Flomax), terazosin (Hytrin), doxazosin (Cardura), alfuzosin (Uroxatral), and prazosin (Minipress). Tamsulosin (Flomax) is the only alpha-blocker that patients can use safely with tadalafil. When tadalafil (20 mg) was given to healthy men taking 0.4 mg of Flomax daily, there was no significant decrease in blood pressure and so patients on this dose of tamsulosin (Flomax) can be prescribed tadalafil. The only alpha-blocker not tested with tadalafil is alfuzosin (Uroxatral), and no recommendations can be made regarding the interaction between the two.
Sexual dysfunction is common in patients with diabetes mellitus. Vascular, neurological and hormonal alterations are involved in this complication. Many studies showed altered endothelium-dependent and neurogenic relaxations in corpus cavernosum from diabetic patients with erectile dysfunction (ED). This finding has been associated with a lack of nitric oxyde (NO) production and a significant increase in NO synthase (NOS) binding sites in penile tissues, induced by diabetes. Advanced glycation endproducts (AGEs) concur to diabetic vascular complications by quenching NO activity and by increasing the expression of mediators of vascular damage such as vascular endothelial growth factor (VEGF), possessing permeabilizing and neoangiogenic effects, and endothelin-1 (ET-1), with vaso-constricting and mitogenic action. Moreover, the differential gene expression for various growth factors in penile tissues may be involved in the pathophysiology of ED associated with diabetes. Neuropathy is also likely to be an important cause of diabetic ED: morphological alterations of autonomic nerve fibers in cavernosal tissue of patients with diabetic ED have been demonstrated. Finally, androgens enhance nNOS gene expression in the penile corpus cavernosum of rats, suggesting that they play a role in maintaining NOS activity. However, sexual dysfunctions in women with diabetes has received less attention in clinical research. Several studies suggest an increased prevalence of deficient vaginal lubrication, making sexual intercourse unpleasant. Sexual dysfunction is associated with lower overall quality of marital relation and more depressive symptoms in diabetic women.

Alprostadil should not be used in men at higher risk for priapism (erection lasting longer than six hours) including men with sickle cell anemia, thrombocytopenia (low platelet count), polycythemia (increased red blood cell count), multiple myeloma (a cancer of the white blood cells), and is contraindicated in men prone to venous thrombosis (blood clots in the veins) or hyperviscosity syndrome who are at increased risk for priapism.

After a full history and physical examination, the urologist likely has a perception of the etiology of the problem. Additional laboratory evaluations may be necessary to evaluate for specific types of organic disease. These tests might include serum chemistry, complete blood count, lipid profile, thyroid stimulation hormone/free thyroxine, and early morning serum testosterone to assess for metabolic abnormalities, such as diabetes mellitus, hyperlipidemia, renal dysfunction, thyroid disease, and hypogonadism (16). These are not mandatory components of the assessment in a patient with hypertonic cavernous smooth muscle as the source of ED.

If you have been diagnosed with depression, stress or anxiety and do not want to take an anti-depressant or anxiety medication due to the side effects, then Mind Over ED, by Joel Block, MD might be the remedy for you.   This natural technique requires no pills, and uses your mind to help you overcome many of the issues that cause erectile dysfunction permanently.  If you already suffer from impotence as a result of your mental issues, drugs that treat these condition also lead to erectile dysfunction, so you will be on a never ending chase to cure your erection problems.  I have been using this technique for three years.  It cured my stress and anxiety quickly and naturally.  Read more about it here.
For many men, stopping smoking is an erectile dysfunction remedy, particularly when ED is the result of vascular disease, which occurs when blood supply to the penis becomes restricted because of blockage or narrowing of the arteries. Smoking and even smokeless tobacco can also cause the narrowing of important blood vessels and have the same negative impact. 
Alprostadil should not be used in men with urethral stricture (scarring and narrowing of the tube that urine and the ejaculate pass through), balanitis (inflammation/infection of the glans [tip] of the penis, severe hypospadias (a condition where the opening of the urethra is not at the tip of the penis, rather on the underside of the penis), penile curvature (abnormal bend to the penis), and urethritis (inflammation/infection of the urethra).

And yes, this may all seem easier said than done, when it comes to a condition that is more often than not the subject of jokes—or the cause of embarrassment. Talking to your doctor is the first step in dealing with this complication, which can wreak havoc on your quality of life. Keeping diabetes in check and enjoying a healthy lifestyle can make a huge difference in reducing ED risk, but if that isn't enough, there are successful treatments. Sex brings a range of physical and psychological benefits, whether you have diabetes or not. Preventing or reversing ED isn't just about sex—it's a step toward better health and a more satisfying life.

Regular exercise for about 20 to 30 minutes a day may act as a libido enhancer and certainly will improve your overall health. "Exercising improves blood flow to all areas of your body and that includes the pelvic region where the blood vessels needed for sexual functioning are located," says Feloney. Some other ways that regular exercise can improve your sexual performance include building up your stamina, lowering your blood pressure, relieving stress, and helping you look and feel better.


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.
Although ED and diabetes are two separate conditions, they tend to go hand in hand. Half of men with diabetes will experience ED within 10 years of their diagnosis.8 For some men, ED may be the first symptom of diabetes even if they have not yet been diagnosed, particularly in men younger than 45.6 Left untreated, ED can damage self-confidence and relationships.
The first goal in treating ED is to manage your diabetes. This includes keeping your blood sugar and blood pressure under control. If ED persists, treatments are available. While oral medications are a common first therapy, they don’t work for all men with diabetes. The penile implant may be an option. The implant is concealed inside the body. It offers support for an erection whenever and wherever desired.
The recommended starting dose of tadalafil for use as needed for most patients is 10 mg taken orally approximately one hour before sexual activity. A doctor may adjust the dose higher to 20 mg or lower to 5 mg depending on efficacy and side effects. Doctors recommended that patients take tadalafil no more frequently than once per day. Some patients can take tadalafil less frequently since the improvement in erectile function may last 36 hours. Patients may take tadalafil with or without food. Tadalafil is currently the only PDE5 inhibitor that is FDA-approved for daily use for erectile dysfunction and is available in 2.5 mg or 5 mg dosages for daily use.
No matter what the cause of erectile dysfunction, it is likely to cause feelings of stress and other emotional reactions. It’s also not uncommon for erection problems to cause tension in a relationship, particularly if one or both partners withdraws emotionally and the problem is not talked about. And it’s possible for a man’s renewed ability to have intercourse after a period of no sexual activity to stir up relationship issues.
The most common diagnostic test for erectile dysfunction is called penile ultrasound. This test uses sound waves to look for abnormal penile blood supply. Another test that may be done is nocturnal penile tumescence testing, in which a type of computer is attached to the penis to see if nighttime erections are occurring. If a young man is having nighttime erections but can’t get an erection during sex, a psychological cause becomes more likely.

Condom troubles. Can the simple act of putting on a condom cause so much stress that it actually leads to erectile dysfunction? Sure it can — in fact, one recent survey of 234 young men conducted by the Children's Memorial Hospital in Chicago found that 25 percent had lost an erection while putting on a condom. “Putting on a condom requires a break from stimulation, and when it is on, it can reduce sensation,” says Dr. Montague.

Sexual dysfunction and ED become more common as men age. The percentage of complete ED increases from 5% to 15% as age increases from 40 to 70 years. But this does not mean growing older is the end of your sex life. ED can be treated at any age. Also, ED may be more common in Hispanic men and in those with a history of diabetes, obesity, smoking, and hypertension. Research shows that African-American men sought medical care for ED twice the rate of other racial groups.


Sexual dysfunction and ED become more common as men age. The percentage of complete ED increases from 5% to 15% as age increases from 40 to 70 years. But this does not mean growing older is the end of your sex life. ED can be treated at any age. Also, ED may be more common in Hispanic men and in those with a history of diabetes, obesity, smoking, and hypertension. Research shows that African-American men sought medical care for ED twice the rate of other racial groups.
Alprostadil should not be used in men with urethral stricture (scarring and narrowing of the tube that urine and the ejaculate pass through), balanitis (inflammation/infection of the glans [tip] of the penis, severe hypospadias (a condition where the opening of the urethra is not at the tip of the penis, rather on the underside of the penis), penile curvature (abnormal bend to the penis), and urethritis (inflammation/infection of the urethra).
Long-term erectile dysfunction. The risk for long-term erectile dysfunction has been linked to chronic heavy use of alcohol. In fact, studies show that men who are dependent on alcohol have a 60 to 70 percent chance of suffering from sexual problems. The most common of these are erectile dysfunction, premature ejaculation, and loss of sexual desire.
Pornography addiction or dependence is a potential cause for ED that many men fail to consider. If you spend a great deal of time watching and masturbating to pornography, it could cause you to develop unrealistic expectations about sex or about your sexual partners. When this happens, your brain becomes “trained” to not only expect but, in a way, to need that kind of experience in order to achieve arousal and climax. Researchers have actually studied this effect and have given the condition its own name – pornography-induced erectile dysfunction (PIED).
All three of these involve specific bodily systems including the hormones, muscles, blood vessels, nervous system, and emotions. If any of these systems become compromised, it can cause ED. In the case of anxiety and stress, these things can affect the brain’s ability to send the necessary signals to trigger the desired physical response – an erection. Stress and anxiety can also contribute to an ongoing cycle of ED, as mentioned earlier.

ED usually has something physical behind it, particularly in older men. But psychological factors can be a factor in many cases of ED. Experts say stress, depression, poor self-esteem, and performance anxiety can short-circuit the process that leads to an erection. These factors can also make the problem worse in men whose ED stems from something physical.
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.
Sexual dysfunction is common in patients with diabetes mellitus. Vascular, neurological and hormonal alterations are involved in this complication. Many studies showed altered endothelium-dependent and neurogenic relaxations in corpus cavernosum from diabetic patients with erectile dysfunction (ED). This finding has been associated with a lack of nitric oxyde (NO) production and a significant increase in NO synthase (NOS) binding sites in penile tissues, induced by diabetes. Advanced glycation endproducts (AGEs) concur to diabetic vascular complications by quenching NO activity and by increasing the expression of mediators of vascular damage such as vascular endothelial growth factor (VEGF), possessing permeabilizing and neoangiogenic effects, and endothelin-1 (ET-1), with vaso-constricting and mitogenic action. Moreover, the differential gene expression for various growth factors in penile tissues may be involved in the pathophysiology of ED associated with diabetes. Neuropathy is also likely to be an important cause of diabetic ED: morphological alterations of autonomic nerve fibers in cavernosal tissue of patients with diabetic ED have been demonstrated. Finally, androgens enhance nNOS gene expression in the penile corpus cavernosum of rats, suggesting that they play a role in maintaining NOS activity. However, sexual dysfunctions in women with diabetes has received less attention in clinical research. Several studies suggest an increased prevalence of deficient vaginal lubrication, making sexual intercourse unpleasant. Sexual dysfunction is associated with lower overall quality of marital relation and more depressive symptoms in diabetic women.
The most common diagnostic test for erectile dysfunction is called penile ultrasound. This test uses sound waves to look for abnormal penile blood supply. Another test that may be done is nocturnal penile tumescence testing, in which a type of computer is attached to the penis to see if nighttime erections are occurring. If a young man is having nighttime erections but can’t get an erection during sex, a psychological cause becomes more likely.

Hormonal disorders, such as low testosterone, may contribute to ED. Another possible hormonal cause of ED is increased production of prolactin, a hormone produced by the pituitary gland. Additionally, an abnormally high or low thyroid hormone level can result in ED. Young men who use steroids to help build muscle mass are also at a higher risk for ED.
Intraurethral alprostadil (Muse) provides a less invasive alternative to intrapenile injection. It is a pellet that is inserted 5–10 min before intercourse, and its effects last for 1 h. The response rate is ∼50–60%. It can be used twice daily but is not recommended for use with pregnant partners. Complications of priapism and penile fibrosis are less common than after alprostadil given by penile injection. The cost is ∼$18–24 per treatment.
There are a number of reasons a man may not achieve the desired result from an oral erectile dysfunction drug. In some cases, a man may experience drug side effects severe enough to outweigh any potential benefit of taking the drug. Possible side effects of these drugs include headache, facial flushing, nasal congestion, and transient abnormal vision. (In October 2007, the FDA added a warning about sudden hearing loss to the package labels of oral erectile dysfunction drugs. While it’s not absolutely clear that the drugs can cause sudden hearing loss, a number of cases have been reported in men within hours or days of taking one of the drugs.)
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