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Any exercise which increases your heart and breathing rate is known as aerobic exercise - so that includes many different types of exercise, from football, running and badminton to spinning, dancing and swimming.

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You should not take more than 1 dose in 24 hours. Tadalfil and vardenafil come in tablets of 2.5 mg, 5 mg, 10 mg and 20 mg. Sildenafil comes in tablets of 25 mg, 50 mg and 100 mg.
Folic acid, also known as folate, can decrease high levels of homocysteine. Homocysteine is an amino acid. At high concentrations, it can damage the lining of your blood vessels. High levels of homocysteine have been linked to heart disease and stroke. .

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2. Strengthen the pelvic floor muscles: Once you have located your pelvic floor muscles, try squeezing them for three seconds, then relax for three seconds. Try it in your seat now.
Getting an erection is a complicated process. During an erection, the blood vessels that let blood into your penis relax and widen (dilate). This lets more blood in, which causes the sponge-like tissues of your penis to swell and harden. Your thoughts and senses (touch, hearing, smell and sight) influence a part of your brain that can trigger an erection.

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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.
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Lifestyle changes are one of the most effective treatments. Weight loss, increased physical activity, cutting out smoking, getting enough sleep and reducing alcohol can all have a big effect on erectile dysfunction. If you have obstructive sleep apnoea, make sure you are using your CPAP machine.

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    GAINSWave® therapy does not involve drugs or invasive procedures. There are few to no side effects. The therapy is clinically proven to treat erectile dysfunction and enhance sexual performance. When a man improves blood flow in the penis, sexual performance benefits. GAINSWave® therapy uses extracorporeal shockwave therapy to increase blood flow. The sound waves help men grow new tissue, including blood vessels, in the penis, thereby increasing blood flow.

    The occasional inability to achieve a satisfactory erection doesn't normally constitute a problem. What's the risk? Most men will experience an erection problem at least once. This could be due to stress, exhaustion, too much alcohol or simply not feeling like sex. Persistent erectile dysfunction (ED) is estimated to affect about 10% of men at any one time. Although age itself isn't a cause of erectile dysfunction (ED), the risk nevertheless increases as you get older: 18% of 50—59 year olds have trouble with their erections compared with 7% of 18—29 year olds. What causes it?
    The main causes could be due to stress, tiredness, anxiety or drinking too much alcohol. If it happens often, it could be due to physical or emotional problems.

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    Men being treated for prostate cancer with treatments such as radical prostatectomy, radiation therapy or the use of Lutenizing hormone-releasing hormone (LHRH) agonists and antagonists can expect that ED may accompany these treatments.12

    The presence of normal skin sensation adequate to produce an erection is measured with this device. Click to view larger image. Medically reviewed by Michael Wolff, MD; American Board of Urology
    Liver toxicity has generally been associated with oral forms of TRT, but does not appear to be a risk in injection or transdermal therapy.39 In patients with marked obstructive sleep apnoea or untreated severe congestive heart failure, these issues should be resolved before initiating TRT.37

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    Men can have several types of issues including poor sex drive and problems with ejaculation. But ED refers specifically to trouble getting or keeping an erection. You might have a healthy sex drive, but a body that won’t respond. Most of the time there is a physical basis for the problem.

    The severity of ED has been correlated with the extent of CVD. Banks et al reported that the risk of future CV events increased progressively according to ED severity.28 This was shown in both men with and without known CVD at baseline and after controlling for confounders. Solomon and colleagues found an inverse correlation between international index of erectile function (IIEF) scores and plaque burden seen on coronary angiography.29 In addition, Yaman et al demonstrated a significant correlation between ED severity on IIEF questionnaires and coronary artery calcification.30
    Acupuncture is the practice of inserting needles into the body to reduce pain or induce anesthesia. More broadly, acupuncture is a family of procedures involving the stimulation of anatomical locations on or in the skin by a variety of techniques.

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    Tadalafil (Cialis) has an effect on another phosphodiesterase enzyme, PDE11, which is located in muscle. Tadalafil is associated with muscle aches in some men.

    Men who smoke are about twice as likely to develop ED as nonsmokers. Smoking hampers circulation to all areas of the body, including the genitals, making it tougher to get and keep an erection.
    New research suggests that you might be able to reverse erectile dysfunction without medication.

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If nothing else works (or if these other options don't fit into the patient's lifestyle), there is always a penile implant. A penile implant (or Inflatable Penile Prosthesis – IPP, as most urologists call it) is a hydraulic device that gets implanted into the penis and replaces the erectile tissue with two cylinders. There is a little pump that gets placed into the scrotum, next to the testicles (not into the testicles) to inflate and deflate the device.

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Figure 2. 50-year old man with erectile dysfunction due to veno-occlusive disease. (A) Contrast enhanced CT cavernosography (coronal maximum intensity projection) demonstrates right sided venous leak via periprostatic veins (arrow). (B) Cavernosography with access via the deep dorsal vein and injection of contrast medium demonstrates right sided venous leaks predominatentely via periprostatic veins (arrow). (C) Post embolization of periprostatic veins (arrow) using N-butyl-2-cyanoacrylate mixed with Lipiodol demonstrating radiopaque intravenous embolization material (arrow).

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Picture of inflatable penile prosthesis. This inflatable penile prosthesis has fluid located at the base of the device. When the tip of the device is squeezed, the fluid is transferred into the cylinder. Erection problems usually produce a significant psychological and emotional reaction in most men. This is often described as a pattern of anxiety, low self-esteem, and stress that can further interfere with normal sexual performance. This "performance anxiety" needs to be recognized and addressed by your health care provider.

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Dr. Clavijo is fellowship trained in Andrology (having also completed a Urology residency) and strives to practice up-to-date evidence based medicine when treating patients with erectile dysfunction. Along with treating patients medically for ED, he also performs a high volume of penile implants.

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