The urology specialists at University Hospitals understand the sensitive nature of your concerns. We provide empathetic and professional care, along with erectile dysfunction treatment options that can restore function and ease anxiety. Please contact us to schedule an appointment at 1-866-844-2273.
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What Is Erectile Dysfunction (ED)? Symptoms, Causes, Diagnosis, Treatment, and Prevention
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In addition to physical causes, mental health conditions may also be associated with impotence. These include depression, anxiety and stress, as well as relationship difficulties. Regardless of the underlying cause of erectile dysfunction, it can often have a significant impact on relationships and quality of life.
Medications such as erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), ritonavir (Norvir), and indinavir (Crixivan) can slow the breakdown of tadalafil. Therefore, men taking these medications should not take more than 10 mg of tadalafil and should not take tadalafil more frequently than every 72 hours.If you have kidney troubles, your doctor may recommend that you try a lower dose of tadalafil or change how often you use the tadalafil depending on your kidney function. Men with severe liver disease should not take tadalafil. Men with mild to moderate liver disease should not exceed tadalafil dose of 10 mg once daily.
The authors stated that this study has several drawbacks, most notably the small number of studies (n = 9) involved and the lack of a clear definition of ED. A single study assessed presence of ED by means of a single question (“How would you describe your ability to get and keep an erection that is adequate for satisfactory intercourse?”). The remaining studies used validated questionnaires: in detail, 4studies used the IIEF and 4 studies used the IIEF-5. However, most studies did not report separate measurements of serum Hcy based on the degree of severity of ED. Last Review 08/23/2021 Last Review 08/23/2021 Copyright Aetna Inc. All rights reserved. Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. Participating providers are independent contractors in private practice and are neither employees nor agents of Aetna or its affiliates. Treating providers are solely responsible for medical advice and treatment of members. This Clinical Policy Bulletin may be updated and therefore is subject to change. Glossary Aetna Mobile App Careers Accessibility Services Terms of Use Investor Info FAQs Program Provisions Interest-Based Ads Policy Legal Notices Plan Disclosures Nondiscrimination Notice Site Map Privacy Center State Directory Language services can be provided by calling the number on your member ID card. For additional language assistance: Español 中文 Tiếng Việt 한국어 Tagalog Pусский العربية Kreyòl Français Polski Português Italiano Deutsch 日本語 فارسی Other Languages… Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. Frontiers in Cardiovascular Medicine Atherosclerosis and Vascular Medicine Toggle navigation Section Article alerts This article is part of the Research Topic Erectile Dysfunction and Cardiovascular Disease: From Bench to Bedside View all Articles Articles Edited by Giuseppe Sangiorgi Reviewed by Sabine Steiner Giulia Rastrelli
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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A duplex ultrasound is a diagnostic technique that uses painless, high frequency sound waves to measure blood flow in structures such as the penis.The procedure itself is painless. It is usually performed before and after injection of a smooth muscle relaxing medication into the penis, which should significantly increase the diameter of the penile arteries.A duplex ultrasound is most useful in evaluating possible penile arterial disorders. Further studies of the venous drainage system as well as arterial imaging are usually recommended if vascular reconstructive surgery is anticipated.
Some men may be able to gain an erection by self-injecting drugs into the penis, causing it to become engorged with blood. The advantage of injection therapy that it can easily be self-administered and in most patients leads to a strong erection when given the right dose. Potential side effects of injection therapy include: fibrosis (scarring) and long-lasting painful erections. Injections are shown to have a long-term dropout rate of about 37% – 76%. Reasons for dropping out of drug therapy include: Desire for a permanent treatment alternative Inadequate response Return of spontaneous erections Fear of needles Concern over side effects
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Want to know how the Russian Invasion of Ukraine impacts India? Subscribe to Express PremiumAmid Russia offensive, Ukraine President speaks with PM Modi, urges political support in UNSCGovt clears up to 20% FDI in LIC ahead of mega IPOExplained: What India’s abstention on UNSC vote over Russia’s invasion of Ukraine meansEndless walk for hours, freezing night, hypothermia: Indian students stranded at Poland border describe ordealJP Nadda interview: ‘There is a pro-incumbency phenomenon… only Modi, Yogi talk of development’Explained: Ahom warrior Lachit Borphukan and the battles of Alaboi & SaraighatRaja Bhaiya vs Akhilesh bhaiya: In 'foregone' Kunda, a new contestWhy Wriddhiman Saha got support and Wasim Jaffer didn’t HomeLifestyleHealthErectile Dysfunction: Symptoms, treatment options, and why it continues to be a taboo Erectile Dysfunction: Symptoms, treatment options, and why it continues to be a taboo The condition can limit daily life, affect intimacy, contribute to low self-esteem and impact personal relationships In India, people consider erectile dysfunction to be a taboo, which prevents many people from seeking help. (Representational image/Pixabay)
Heart diseaseHypertensionHigh cholesterolObesityStressPsychological factors- stress, anxiety, and depression
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.
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Urology, Male Infertility & Reproductive Health, Stone Disease, Urologic Oncology
It is likely to improve ED management and benefit a large number of men, particularly in terms of recognising ED as a sentinel of vascular disease.
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Aetna considers the following therapies for the treatment of erectile dysfunction medically necessary:
Erectile dysfunction or impotence is a man's inability to achieve and maintain a penile erection suitable for sexual intercourse.
DepressionAnxietyOther mental health disordersStressFeeling self-conscious or nervous about sexRelationship problems
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Causes and risk factors for erectile dysfunction are as follows:StrokeObesityProstate cancerSmokingAlcohol useHigh cholesterol dietLow levels of physical activityCardiovascular disease
On the mental and emotional side of things, anxiety, depression, and stress all play a role. Relationship issues can also be a factor.
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Our doctors, including Dr. Honig, are leaders in the field and stand at the forefront of research in men's health issues.
The evaluation of a man who presents to our office includes an open, honest and absolutely confidential discussion about the current sexual function and overall medical health. A thorough physical exam and generalized, as well as specialized, bloodwork are often done. We also offer patients blood circulation studies of the penis to further delineate the cause of ED. At Broward Urology Center, we focus on a goal-oriented approach to erectile dysfunction treatment. The treatment options for ED include: The Priapus Shot Or P-Shot® PRP (Platelet Rich Plasma) Penile Injection
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Some chemo drugs like cisplatin, vincristine, paclitaxel, bortezomib, and thalidomide can damage parts of the nervous system, usually the small nerves of the hands and feet. (This is called peripheral neuropathy.) These drugs have not been found to directly injure the nerve bundles that allow erection. But some people have concerns because the drugs are known to affect nerve tissue, and there are many nerves involved in sexual function.
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Picture of rigid penile implant. Two rigid cylinders have been placed into the penis. This type of implant has no inflation mechanism but provides adequate rigidity to the penis to allow penetration.
Some herbal products and supplements can cause side effects or interact with other medicines. Talk to your doctor or pharmacist before you try an alternative treatment for erectile dysfunction, especially if you're taking medications or you have a chronic health problem such as heart disease or diabetes.
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Blood levels of testosterone, prolactin, FSH (follicle-stimulating hormone), LH (luteinising hormone) and thyroid hormones will normally be measured.
A self-test erection is a test that any person can do all by himself just by sitting at his house and following whether the cause of the issue is psychological or physical.
Compared to aerobic exercise like jumping on a treadmill, performing pelvic floor muscle exercises are super discreet. In fact, the pelvic floor muscles aren't visible — but you'll feel them!
Did Eating Day-Old Leftovers Lead to a 19-Year-Old Having His Legs and Fingers Amputated?
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Erectile dysfunction (ED) is a common male sexual disorder. It is the inability to get or keep an erection that allows for satisfying sexual activity. It can happen occasionally or regularly, with or without any clear reason. Some men with ED are not able to get an erection at all.
In many cases, erectile dysfunction is caused by something physical. Common causes include:
You shouldn’t use these medicines if you take nitroglycerin or any other nitrates for chest pain. If you have heart problems, tell your doctor before taking any ED medicines. These medicines can have serious side effects in people who have heart problems.
In diagnosing the cause of erectile dysfunction, an ultrasound may be done on the lower abdomen, the pelvis, and the testicles, or it may be restricted to just the penis.
Side effects of intraurethral alprostadil include pain in the penis and sometimes in the testicles, mild urethral bleeding, dizziness, and vaginal itching in the sex partner. Patients rarely report syncopal (fainting) episodes with initial use, and thus the first trial of this medication should be performed in the physician's office.
Sildenafil (Viagra) may affect another phosphodiesterase enzyme in the eye causing transient abnormal vision (seeing a bluish hue or brightness).
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Penile prosthesis is the primary form of surgical therapy and is reserved for those men who fail, are intolerant of, or have contraindications to other forms of therapy. Currently, there are several different types of penile prostheses. The simplest is the malleable penile prosthesis, and the most complex is the three-piece inflatable penile prosthesis.
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Erectile dysfunction (ED) is when you can’t get and maintain a satisfying erection for sex. ED affects more than 30 million men in the United States. It is a topic that several men still find hard to talk about.
Secondary premature ejaculation can be caused by both psychological and physical factors and has been linked to drinking too much alcohol.
Health conditions like diabetes, high blood pressure, stroke, neurological disorders, high cholesterol or narrowing of the blood vessels may contribute to erectile dysfunction. The main issue is not enough blood flow to the penis. Other issues include low levels of the male hormone testosterone, injury or nerve damage to the penis or surrounding area and surgery to the penis or surrounding area (e.g. prostate surgery). Some medications can also cause erectile dysfunction as a side effect, particularly if they affect hormone levels like testosterone.
Erectile dysfunction is the inability to either achieve or maintain an erection. This may happen either occasionally or regularly, but may occur only in certain situations depending on the cause (i.e. patients may still have early morning erections).
The symptoms include persistent trouble getting or keeping an erection, reduced sexual desire or premature ejaculation. “These symptoms can also be a sign of an underlying health condition. So, one should not be embarrassed and must consult the doctor as treating the underlying condition is sufficient to reverse ED,” Dr Banga explains.
AtherosclerosisDiabetes High blood pressureChronic kidney diseaseHeart diseaseMultiple sclerosisPeyronie’s diseaseProstate cancerInjury to the penis or surrounding organs
A penile prosthesis or implant is an effective treatment for erectile dysfunction. Penile implant surgeries take about an hour and are typically done in an outpatient center.
A common misconception is that erectile dysfunction only occurs in older men. While that is mostly true, it doesn’t mean that ED isn’t common among younger men. Lifestyle choices among younger men has led to a sharp increase in the number of young men suffering from erectile dysfunction. A 2013 study published by the Journal of Sexual Medicine found that 1 in every 4 men who were newly diagnosed with ED were below the age of 40, and roughly 50% of them were suffering from severe ED. Causes of Erectile Dysfunction Obesity Fatigue Excessive smokingAlcoholism Substance abuse Diabetes Prostate cancer Cardiovascular disease Treatment for Erectile Dysfunction
Diuretics (pills that increase urine flow)High blood pressure medsAntihistaminesAntidepressantsParkinson's disease drugsAntiarrhythmics (drugs for irregular heartbeat)Tranquilizers and sedativesMuscle relaxantsNonsteroidal anti-inflammatory drugs (NSAIDs)Histamine H2-receptor antagonistsHormonesChemotherapy medicationsProstate cancer drugsAnti-seizure medications
Sometimes called Doppler ultrasound, this is another way to check blood flow to the penis. It may be used along with the injection test.
If you have a problem getting or keeping an erection hard enough for you to have sex with your partner, you may have erectile dysfunction. The condition is common in men over 40 years of age, although it can affect men of all ages. Symptoms may differ from person to person. Some men do not get an erection at all, others may be able to get an erection but can’t maintain it long enough for sex and some men get an erection, but it is not hard enough for sex. Lose weight if you are overweight Stop smoking, as it damages blood vessels Don’t drink more than 14 units of alcohol per week Eat a healthy, balanced diet Exercise regularly Try to reduce your stress levels
Sexual dysfunction and ED become more common as you get older. Only about 5% of men age 40 have it. But the number rises to 15% of men age 70. This doesn’t mean growing older is the end of your sex life. Doctors can treat ED no matter your age. Age isn’t the only cause. Type 2 diabetes, obesity, smoking, and high blood pressure all make it more likely.
These tests aren’t painful, and are helpful since they can provide useful information about your condition.
Dr. Chirag Bhandari and a team of sexual health experts have now made it possible to cure ED with only medication. Dr. Chirag and other experts are making every possible effort to make people aware of sexual problems in men like Erectile dysfunction and its early signs to alert the young generation from getting into big trouble too soon.
Men who want to treat their ED have another option. The GAINSWave® treatment is a safe, non-surgical therapy that can restore sexual function and help to prevent erectile dysfunction in men who don’t have ED.
Aetna considers ESWT experimental and investigational for Peyronie’s disease because of a lack of evidence from prospective randomized controlled clinical studies of the effectiveness of ESWT for this indication.
Important note: Before beginning any new exercise program, consult your doctor. Stop immediately if you experience pain.
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Blood in the semen (haematospermia) Blood in the urine (haematuria) Erectile dysfunction (impotence) Fertility problems Incontinence of urine Kidney stones Male menopause (androgen deficiency in the ageing male) Premature ejaculation Prostate symptoms (bladder outlet obstruction) Raised PSA Testicle missing Testicular lump Tight foreskin (phimosis) Urinary infection (adult) Urinary infection (child)
Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.
Forty-three percent of women and 31% of men have some form of sexual dysfunction, with obesity and a lack of exercise often being factors, according to the National Institutes of Health. A study published in The Journal of Sexual Medicine found men with either a high waist circumference or elevated BMI were 50% more likely to have erectile dysfunction, while approximately half of obese women reported problems with sexual activity, desire and performance, at least some of the time, in a study published in Obesity.
With so many possible causes for ED, your doctor has a number of tests they can use to figure out the best treatment for you.
There are lifestyle changes that you can make to help with ED including pelvic floor muscle exercises that are evidenced to help in idiopathic ED. Consider buying a special saddle that reduces perineal pressure If you are overweight, consider reducing it If you do not take regular exercise, consider getting fitter Talking to a counsellor is often useful. Your GP or physiotherapist can recommend a specialist psychosexual counsellor or in many regions you can self-refer for talking therapy If you are a smoker, consider smoking cessation If you drink alcohol regularly, consider reducing the number of units you have per week or you may feel you need support to help you reduce your input: If you use recreational drugs, consider reducing these Where to go to next Speak to your GP who may wish to refer you for investigations You can also ask your GP if there is a specialist Men’s Health physiotherapy service that he/she can refer you to. If this isn’t available in your area or there is a long waiting list and you would like to find a specialist private physiotherapist, use the link below: A specialist men’s health physiotherapist can help you to strengthen your pelvic floor muscles, particularly the small pelvic floor muscles called the bulbocavernosus and the ischiocavernosus. If your pelvic floor muscles are tight, treatment will targeted at down training them. The physiotherapist will advise on lifestyle changes and support you in gradually adopting these new strategies. Your physiotherapist will discuss whether or not you feel there is a psychological component to your ED and will be able to sign post you to psychological help/talking therapy if you agree that this would be useful/ appropriate. Pelvic Health Physiotherapy: Managing complex female pelvic pain and pelvic floor dysfunction - advancing your practice : Stockport Explore Further Events Designed & Developed by LightMedia Cookie Policy Privacy Policy Retention Policy Login ‹ › × × Previous Next
Erosion of the prosthesis, whereby it presses through the corporal tissue into the urethra, may occur. Symptoms and signs may include pain, blood in the urine, discharge, abnormal urine stream, and malfunction. If the prosthesis erodes into the urethra, a physician must remove it. If the other cylinder remains intact, it can be left in place. A physician leaves a catheter in place to allow the urethra to heal.
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