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Second line therapies for ED include the use of intraurethral prostaglandin E1 (Muse), the vacuum device, and intracavernous injection therapies.

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If you are suffering from any sexual problems, then try to look for some basic symptoms of Erectile dysfunction.
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This section offers general information about treatment options and situations can vary in different countries.
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Injection therapy: The modern age of such drug therapies began in 1993 when the injection of papaverine (Pavabid), an alpha-blocker that produces vasodilatation (widening of the blood vessels), was shown to produce erections when injected directly into the penis. Soon afterward, other vasodilators, such as prostaglandin E1 (PGE 1) monotherapy (Caverject, Edex), PGE1 and phentolamine (Regitine), and Trimix (papaverine, phentolamine and prostaglandin E1), were demonstrated to be effective. The benefit of combination therapy is the decreased dosing of each with less side effects. Most important is the reduction of the prostaglandin PGE1 dosing, which is associated to the localized pain.

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Patients with organic erectile dysfunction should be examined with color Doppler flow analysis using direct pharmacological stimulation with an intracavernosal injection of 10–20 μg prostaglandin E1. Diagnostic criteria for veno-occlusive dysfunction are a high systolic flow rate >25 cm/s (peak systolic velocity) and a persistent end-diastolic velocity of >5 cm/s 15 min post-injection (rigid phase) with a resistive index <0.75 (7).

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    Extra weight can make a man more likely to develop diabetes or cardiovascular disease, which are both associated with erectile dysfunction. Also, carrying fat around the middle can affect a man’s hormones, which can contribute to penile dysfunction.

    Continuing Professional Development (CPD) Education Committee E-Learning Revalidation
    However, Pedersen and Kristensen are doubtful that such a precise conclusion can be drawn without further research. The study indicates that intense exercise has an effect on erectile dysfunction, but whether that means 30, 40, or 50 minutes of training three or four times a week is something that should be studied further, they say.

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    1. Overview2. Symptoms3. Causes4. Diagnosis5. Prevention6. Treatment7. Everyday Life8. Questions9. Resources

    With so many possible causes, your doctor has a number of tests they can use to figure out the best treatment for you.
    Response is dose related and usually occurs within 10–15 min, and does not require stimulation. The intraurethral preparation, medicated urethral suppository for erection (MUSE), consists of a tiny pellet of drug inserted into the urethral meatus. Response is also dose related, and onset similar to the cavernosal preparations.

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    If regular exercise doesn’t resolve the issue, consult with your doctor. There are other options available to treat erectile dysfunction. Your doctor may suggest any of the following:

    In men, Kegel exercises can help with erectile dysfunction (ED) and enhance sexual performance. One study of men with ED found that after 6 months of performing Kegel exercises, 40% of men regained normal erectile function. Helping prevent incontinence (which can be important after prostate surgery) Longer time between bathroom visits Fewer “accidents” and leaking Drier underwear Preventing accidental passage of gas or stool Bulbocavernosus (BC) muscle Squeezes semen or urine out of the urethra Squeezes more blood into the end of the penis This is the main muscle used when performing Kegels Pubococcygeus (PC) muscle Plays a role in urination and bowel movements Forms a large part of the pelvic floor, supporting lower organs Contracts during orgasm Iliococcygeus (IC) muscle Forms part of the strength of the pelvic floor Pulls the anus back up after a bowel movement
    Mechanical vacuum devices cause an erection by creating a vacuum around the penis that draws blood into the penis, engorging it, and expanding it. The devices have three components:

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    Erectile dysfunction, also known as impotence, is when a man is unable to get or maintain an erection.

    Aerobic exercises, such as walking or running, improve cardiovascular health, help men maintain a healthy weight, and decrease the risk of high blood pressure. In a review of studies on exercise and E.D., researchers discovered that 160 minutes of moderate to vigorous aerobic activity per week divided over four days decreased E.D. (Gerbild et al., 2018).
    Adopt a regular exercise program, and your general health will improve. Working out may even help you stave off serious conditions such as high blood pressure and diabetes, which sometimes require medications that inhibit arousal. These two medical conditions also can damage the tiny arteries in the penis, resulting in erectile dysfunction. In fact, erectile dysfunction is often one of the first noticeable side effects of high blood pressure and diabetes.

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You can help yourself by cutting down on alcohol, stopping smoking and reducing the stress in your life. References Sexual dysfunction in men – when Viagra doesn't work Goodfellow Unit, NZ, 2019 Erectile dysfunction BPAC, NZ, 2008 Erectile problems Best Health, UK, 2014 Dietary supplements for erectile dysfunction – a natural treatment for ED? Mayo Clinic, US, 2017 Reviewed by Jeremy Steinberg is a GP with special interests in musculoskeletal medicine, evidence-based medicine and use of ultrasound. He's been reviewing topics for Health Navigator since 2017 and in his spare time loves programming. You can see some of the tools he's developed on his website. A compact guide to sexual health Lifelong sexuality Related topics Anxiety | Mate māharahara Sex & cancer Sexual health overview Men's health Sildenafil Tadalafil Vardenafil Credits: Health Navigator Editorial Team. Reviewed By: Dr Jeremy Steinberg, FRNZCGP Last reviewed: 13 May 2020 Page last updated: 09 Dec 2021

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National Comprehensive Cancer Network (NCCN). Clinical practice guidelines in oncology: Survivorship [Version 2.2019]. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf on January 31, 2020.

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In men, Kegel exercises can help with erectile dysfunction (ED) and enhance sexual performance. One study of men with ED found that after 6 months of performing Kegel exercises, 40% of men regained normal erectile function. Helping prevent incontinence (which can be important after prostate surgery) Longer time between bathroom visits Fewer “accidents” and leaking Drier underwear Preventing accidental passage of gas or stool Bulbocavernosus (BC) muscle Squeezes semen or urine out of the urethra Squeezes more blood into the end of the penis This is the main muscle used when performing Kegels Pubococcygeus (PC) muscle Plays a role in urination and bowel movements Forms a large part of the pelvic floor, supporting lower organs Contracts during orgasm Iliococcygeus (IC) muscle Forms part of the strength of the pelvic floor Pulls the anus back up after a bowel movement

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