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Erectile Dysfunction is the consistent inability to sustain an erection sufficient for sexual intercourse. A total inability to achieve an erection – You can never get an erection. An inconsistent ability to do so – You can only occasionally get an erection. A tendency to sustain only brief erections – You can get an erection, but can’t keep it long enough for satisfying sex.

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For an algorithm to facilitate evaluation and treatment of patients with ED, see figure 2. .

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Chris Myers, study co-author, explained weak pelvic floor muscles 'may directly impact erectile strength and the ejaculatory process'.
Erectile dysfunction can be caused by any number of medical and psychological conditions. In general, ED is divided into organic (having to do with a bodily organ or organ system) and psychogenic (mental) impotence. Interestingly, and not surprisingly, most men with organic causes have a mental or psychological component, as well.

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Failure to stay erect is usually due to tiredness, stress, anxiety or alcohol, and is not a cause for concern.
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Penile prostheses are very effective, and most patients who have a prosthesis placed are satisfied with the prosthesis. However, placement of a prosthesis causes scarring of the tissue within the corpora cavernosa, and if the prosthesis requires removal, other forms of therapy, except for the vacuum device, are often not effective. Thus, most physicians reserve placement of a prosthesis for men who have tried and failed or have contraindications to other therapies.

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    About all the medications you takeIf you have any other health conditionsIf you drink alcohol or use tobacco products

    Aetna considers Xiaflex (collagenase clostridium histolyticum) for the treatment of Peyronie’s disease medically necessary when the following criteria are met: The member has stable Peyronie’s disease without clinical changes (e.g., worsening curvature) for at least three months; and The member has a palpable plaque and curvature deformity of at least 30 degrees and less than 90 degrees prior to initiating Xiaflex therapy; and The member has intact erectile function (with or without medication); and The member is 18 years of age or older; and The member will receive a maximum of one treatment course with a maximum of 8 injections total, including any injections the member has received for any previous treatment.
    There are also injectable drugs for erectile dysfunction. Some men sustain stronger erections by injecting these medications directly into the penis. These drugs work by widening the blood vessels, causing the penis to become engorged with blood. Another option is a medicated pellet that is inserted into the urethra and can trigger an erection within 10 minutes. Patients should discuss the use of these injections in detail with their doctor before use. Erectile Dysfunction Treatment: Vacuum Devices (Pumps)

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    Erectile dysfunction can be caused by many factors and may have a gradual or sudden onset. It can be very upsetting and result in a lot of stress and worry. It can feel embarassing to discuss this with your doctor but it is important that you do, so that you can receive the appropriate help. Erectile dysfunction can also be a sign of other illnesses such as heart disease or diabetes, so it is important that you seek medical advice. What are the facts about impotence? Erectile dysfunction becomes commoner with increasing age and is seen in 50 - 55% of men between 40 and 70 years old; It is often associated with obesity, high blood pressure, high cholesterol & diabetes which are all significant risks to health; Investigation is only indicated if both partners wish to pursue treatment; Most treatable causes can be identified by a clinical history, physical examination and routine blood tests; If there is no treatable cause, treatment with tablets is the first option for most men; Other methods of treatment are only indicated if medication proves ineffective, causes side-effects or cannot be used because of specific medical conditions. What should I expect when I visit my GP?

    A man’s psychological state is clearly an essential consideration when addressing issues of sexual function. While ED that is purely psychological is not common, many men who experience difficulty with erections may develop anxiety or fear about being able to get an erection the next time they try. This anxiety may lead to a stress response involving activation of the sympathetic nervous system and release of adrenaline, which will tend to make it even more difficult to get an erection. Conflict with a partner (or the absence of a partner) will also tend to increase stress and potentially interfere with erectile function.
    When psychological factors are believed to be the principle cause of ED– particularly in men who are experiencing anxiety or depression – psychological counseling is mandatory. Consultation with a mental health professional with expertise in sexuality should be considered in all cases as this consultation is seldom harmful and the majority of patients will have some psychogenic or relational component to their sexual symptoms.

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    These tests are only done in certain patients who have not responded to initial therapies, and may include: Ultrasonography (penile Doppler) to check blood flow in the penis A special injection into the penis to check erection Arteriography (an imaging test that uses X-rays and a special dye to see inside the arteries) Magnetic resonance imaging (MRI) or computed tomography (CT) scan Nocturnal penile tumescence or NPT (using a special electronic device to monitor nocturnal erections)

    The role of the endothelium in erectile function became clearer with the observation that the phosphodiesterase type 5 (PDE5) inhibitor, sildenafil, enhanced erectile function. Erection occurs with the release of nitric oxide (NO) from the vascular endothelial cells.17 The reduction in endothelial cell production of NO results in the negative impact on the smooth muscles in the corporal bodies and results in less relaxation of the smooth muscle cells with decrease in blood supply and resulting ED. A similar phenomenon is well known to impact the coronary arterial system resulting in CVD.
    According to the American Urological Association, ED affects as many as 30 million men in the United States.

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    Psychoteraphy is often the first form of treatment recommended for depression. Psychotherapy helps depression by helping people understand the behaviors, emotions and ideas that contribute to their depression, regain a sense of control and pleasure in life, and learn coping techniques as well as problem solving skills.

    Improvements in your lifestyle, such as a eating healthy diet, reducing alcohol intake, losing weight and increasing your exercise can dramatically improve erectile dysfunction. More specific treatment usually involves: weight loss and increased exercise (this may reduced the risk of erectile dysfunction by up to 70%) treatment of any hormone abnormality (testosterone treatment is only indicated if your testosterone levels are low and may be harmful if your the levels are normal); lifestyle modification (e.g. reduce stress, stop smoking, reduce alcohol consumption & stop illicit drugs); treatment of any anatomical abnormality if present (e.g. circumcision, frenuloplasty, penile straightening); psychological support if necessary.
    To calculate the overall star rating and percentage breakdown by star, we don’t use a simple average. Instead, our system considers things like how recent a review is and if the reviewer bought the item on Amazon. It also analyzes reviews to verify trustworthiness. Top reviews Most recent Top reviews No real exercise to give just general info ... I was expecting more !

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Aetna considers Xiaflex as experimental and investigational for all other indications except for Dupuytren's contracture, see CPB 0800 - Dupuytren's Contracture Treatments.

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The recommended starting dose is 100 mg taken as early as 15 minutes prior to sexual activity, no more than once a day. The maximum dose is 200 mg. Avanafil may be taken with or without food. As with the other PDE5 inhibitors, sexual stimulation is necessary for avanafil to work.

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Some types of cancer surgery can affect erections. (See Managing Male Sexual Problems Related to Cancer to learn more.) If any of these surgeries are part of your treatment plan, talk to your doctor before the procedure. Ask doctor about how your erections might be affected by surgery and what may be the best way to manage the problem.

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Erectile dysfunction (ED), also known as impotence, is the most common sexual problem amongst men. ED is defined as the inability to achieve or sustain an erection for sexual intercourse. At least 25% of men over the age of 50 are diagnosed with ED. The numbers continue to increase as age increases. Young males can suffer from ED as well. Roughly 8-10% of men between 20-30 years old suffer from ED.

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