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Conditions like vascular disease, surgery, diabetes, and medications are some of the top causes of erectile dysfunction. If you suffer from ED, schedule an evaluation with your doctor and get the help you need

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Nearly every man can experience brief problems with erectile function. In almost all cases it is related to certain and specific life circumstances, problems, or stressful situations. Usually, these erectile problems disappear once the situation is resolved or changed. You generally don’t need to go to the doctor. .

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Sometimes, all does not go well. Occasional problems aren’t anything that need treatment. If issues happen more often, you may have erectile dysfunction or ED. Article Low Testosterone: How to Tell Slideshow Embarrassing Male Body Problems Article Low Sex Drive: Is Low T to Blame? Video How Erections Change as We Age Article 10 Foods to Boost Men’s Health Article Treatments for Erectile Dysfunction Tools & ResourcesHow an Erection OccursLifestyle Changes to Improve EDED Myths and FactsWhy Can't I Get an Erection?Erections: Use It or Lose It?Protect Your Erection: 11 Tips WebMD Special Sections Taking On Erectile Dysfunction Erectile Dysfunction: Chewable Medications Health Solutions Penis Curved When Erect? Could I have CAD? Treat Bent Fingers Treat HR+, HER2- MBC Tired of Dandruff? Benefits of CBD Rethink MS Treatment AFib-Related Strokes Risk of a Future DVT/PE Is My Penis Normal? Relapsing MS Options Liver Transplants Save Lives Finance Plastic Surgery Bent Finger Causes Living With Psoriasis? Missing Teeth? More from WebMD 5 Tips to Help With Relapsing MS How to Thrive With Narcolepsy Relief for Blocked Hair Follicles Psoriatic Arthritis and Your Sleep What Psoriasis Feels Like First Psoriatic Arthritis Flare Talking to Your Doctor About RA Crohn's: A 'Full-Body' Disease Avoiding Crohn’s Flares Health Benefits of Hemp Seed Oil Live Better With Psoriatic Disease Types of B-Cell Therapy for MS 5 Health Benefits of Hemp Why Prostate Cancer Spreads Living with Advanced Breast Cancer Where Breast Cancer Spreads Visit WebMD on Facebook Visit WebMD on Twitter Visit WebMD on Pinterest PoliciesPrivacy PolicyCookie PolicyEditorial PolicyAdvertising PolicyCorrection PolicyTerms of UseAboutContact UsAbout WebMDCareersNewsletterCorporateWebMD Health ServicesSite MapAccessibilityWebMD NetworkMedscapeMedscape ReferenceMedicineNeteMedicineHealthRxListOnHealthWebMDRxFirst AidWebMD MagazineWebMD Health RecordDictionaryPhysician DirectoryOur AppsWebMD MobileWebMD AppPregnancyBabyAllergyMedscapeFor AdvertisersAdvertise with UsAdvertising Policy
A lot of women may be familiar with Kegels, as these are often recommended after childbirth, and are named after Dr. Kegel (yep, he was a real person!) who studied and practised sexual medicine in the 1940s.

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© 2022 American Cancer Society, Inc. All rights reserved. The American Cancer Society is a qualified 501(c)(3) tax-exempt organization. Tax ID Number: 13-1788491. Cancer.org is provided courtesy of the Leo and Gloria Rosen family. Health News Vitamin D Deficiency Linked to Severe COVID Switching to a Healthy Diet Can Add 10 Years to Life Spinal Cord Implant Allows Paraplegics to Walk Again Herpes Virus May Help Fight Deadly Brain Cancer Ketamine May Be Emergency Help for People at Risk of Suicide Featured Topics Special Report Psychedelics Meet Mainstream Medicine Get Our Newsletters Health News and Information, Delivered to Your Inbox Men's Health Resources News Reference Slideshows Quizzes Videos Questions & Answers Subscribe to Newsletters Men's Health Guide Diet and Fitness Sex Health Concerns Look Your Best Related to Men's Health Enlarged Prostate Erectile Dysfunction Flat Abs Exercises Hair Loss Manage Your Migraine Prostate Cancer Sexual Conditions Strength Training More Related Topics In this Article Kegel Exercises to Help Erectile Dysfunction and Premature Ejaculation Safety Considerations
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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Problems faced by urologists at all stages when returning to surgery after a prolonged absence

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    Physical reasons for ED range from heart disease and diabetes to high blood pressure and obesity. Damage to your nerves or arteries can cause problems with erections, too. Lack of exercise, drinking, and smoking can lead to problems.

    Medication can be a big help if the extent of the ED is not that considerable and a couple faces it occasionally.
    The authors thanks Dr. Heinz Schönhofen from Center of Radiology Baden in Switzerland for excellent implementation of CT cavernosography and high quality CT images. 1. NIH Consensus Conference. Impotence. NIH consensus development panel on impotence. Jama. (1993) 270:83–90. doi: 10.1001/jama.270.1.83 2. Nguyen HMT, Gabrielson AT, Hellstrom WJG. Erectile dysfunction in young men-a review of the prevalence and risk factors. Sex Med Rev. (2017) 5:508–20. doi: 10.1016/j.sxmr.2017.05.004 3. Rogers JH, Goldstein I, Kandzari DE, Köhler TS, Stinis CT, Wagner PJ, et al. Zotarolimus-eluting peripheral stents for the treatment of erectile dysfunction in subjects with suboptimal response to phosphodiesterase-5 inhibitors. J Am Coll Cardiol. (2012) 60:2618–27. doi: 10.1016/j.jacc.2012.08.1016 4. Dicks B, Bastuba M, Goldstein I. Penile revascularization–contemporary update. Asian J Androl. (2013) 15:5–9. doi: 10.1038/aja.2012.146 5. Rogers JH, Karimi H, Kao J, Link D, Javidan J, Yamasaki DS, et al. Internal pudendal artery stenoses and erectile dysfunction: correlation with angiographic coronary artery disease. Catheter Cardiovasc Interv. (2010) 76:882–7. doi: 10.1002/ccd.22646 6. Lue TF. Erectile dysfunction. N Engl J Med. (2000) 342:1802–13. doi: 10.1056/NEJM200006153422407 7. Rebonato A, Auci A, Sanguinetti F, Maiettini D, Rossi M, Brunese L, et al. Embolization of the periprostatic venous plexus for erectile dysfunction resulting from venous leakage. J Vasc Interv Radiol. (2014) 25:866–72. doi: 10.1016/j.jvir.2014.01.015 8. Shafik A, Shafik I, El Sibai O, Shafik AA. On the pathogenesis of penile venous leakage: role of the tunica albuginea. BMC Urol. (2007) 7:14. doi: 10.1186/1471-2490-7-14 9. Doppalapudi SK, Wajswol E, Shukla PA, Kolber MK, Singh MK, Kumar A, et al. Endovascular therapy for vasculogenic erectile dysfunction: a systematic review and meta-analysis of arterial and venous therapies. J Vasc Interv Radiol. (2019) 30:1251–8. doi: 10.1016/j.jvir.2019.01.024 10. Diehm N, Marggi S, Ueki Y, Schumacher D, Keo HH, Regli C, et al. Endovascular therapy for erectile dysfunction-who benefits most? insights from a single-center experience. J Endovasc Ther. (2019) 26:181–90. doi: 10.1177/1526602819829903 11. Wespes E. Erectile dysfunction in the ageing man. Curr Opin Urol. (2000) 10:625–8. doi: 10.1097/00042307-200011000-00016 12. Rhoden EL, Teloken C, Sogari PR, Vargas Souto CA. The use of the simplified International Index of Erectile Function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction. Int J Impot Res. (2002) 14:245–50. doi: 10.1038/sj.ijir.3900859 13. Kaufman JM, Borges FD, Fitch WP III, Geller RA, Gruber MB, Hubbard JG, et al. Evaluation of erectile dysfunction by dynamic infusion cavernosometry and cavernosography (DICC). Multi-institutional study. Urology. (1993) 41:445–51. doi: 10.1016/0090-4295(93)90505-5 14. Gratzke C, Angulo J, Chitaley K, Dai YT, Kim NN, Paick JS, et al. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med. (2010) 7:445–75. doi: 10.1111/j.1743-6109.2009.01624.x 15. Ye T, Li J, Li L, Yang L. Computed tomography cavernosography combined with volume rendering to observe venous leakage in young patients with erectile dysfunction. Br J Radiol. (2018) 91:20180118. doi: 10.1259/bjr.20180118 16. Katzenwadel A, Popken G, Wetterauer U. Penile venous surgery for cavernosal venous leakage: long-term results and retrospective studies. Urol Int. (1993) 50:71–6. doi: 10.1159/000282455 17. Lewis RW. Venous surgery for impotence. Urol Clin North Am. (1988) 15:115–21. 18. Aschenbach R, Steiner T, Kerl MJ, Zangos S, Basche S, Vogl TJ. Endovascular embolisation therapy in men with erectile impotence due to veno-occlusive dysfunction. Eur J Radiol. (2013) 82:504–7. doi: 10.1016/j.ejrad.2012.10.030 19. Fernandez Arjona M, Oteros R, Zarca M, Diaz Fernandez J, Cortes I. Percutaneous embolization for erectile dysfunction due to venous leakage: prognostic factors for a good therapeutic result. Eur Urol. (2001) 39:15–9. doi: 10.1159/000052406 20. Bookstein JJ, Lurie AL. Transluminal penile venoablation for impotence: a progress report. Cardiovasc Intervent Radiol. (1988) 11:253–60. doi: 10.1007/BF02577012 21. Kutlu R, Soylu A. Deep dorsal vein embolization with N-butyl-2-cyanoacrylate and lipiodol mixture in venogenic erectile dysfunction: early and late results. Radiol Oncol. (2009) 43:17–25. doi: 10.2478/v10019-009-0011-2 22. Yasumoto R, Nishisaka N, Sakakura T, Kawano M, Shindow K, Takashima S, et al. Ethanol embolization for impotent patients with venous leakage: a new technique and initial results. Minim Invasive Ther Allied Technol. (1996) 5:564–6. doi: 10.3109/13645709609152705 23. Schild HH, Müller SC, Mildenberger P, Strunk H, Kaltenborn H, Kersjes W, et al. Percutaneous penile venoablation for treatment of impotence. CardioVasc Interv Radiol. (1993) 16:280–6. doi: 10.1007/BF02629158 24. Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. A prospective study of risk factors for erectile dysfunction. J Urol. (2006) 176:217–21. doi: 10.1016/S0022-5347(06)00589-1 25. Dean RC, Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am. (2005) 32:379–95. doi: 10.1016/j.ucl.2005.08.007

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    Contributors DFM and NB wrote the majority of the manuscript. MK wrote the section on testosterone and made review comments and approved the final manuscript along with the attached figure.

    Sildenafil (Viagra) was the first oral phosphodiesterase type 5 (PDE5) inhibitor approved by the FDA in the United States for the treatment of erectile dysfunction (it is not approved for women). Sildenafil inhibits PDE5, which is an enzyme that destroys cGMP. By inhibiting the destruction of cGMP by PDE5, sildenafil allows cGMP to accumulate. The cGMP in turn prolongs relaxation of the smooth muscle of the corpora cavernosa. Relaxation of the corpora cavernosa smooth muscle allows blood to flow into the penis resulting in increased engorgement of the penis. In short, sildenafil increases blood flow into the penis and decreases blood flow out of the penis.
    When you have heart disease, or coronary artery disease (blocked blood vessels), it will affect the tiny arteries in your penis sooner. Many times, we will refer you to a cardiologist to determine if you have cardiovascular disease that is causing your ED. increasing physical activity, quitting tobacco products, losing weight, and consuming a healthy, well-balanced diet.

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    While low T isn't the only cause of erectile dysfunction, the two do seem to be connected. However, the connection between low testosterone and erectile dysfunction is complicated. Researchers believe the two are connected because they both seem to coincide as a man ages. However, some men with low testosterone continue to produce healthy erections.

    Risk exposure is important to consider in the PDE5 inhibitors. Cardiovascular diseases may be a contraindication to treatment, as severely impaired patients may run the risk of a cardiac complication related to vigorous sexual activity. Likewise, patients actively taking nitrates, including nitroglycerine and other agents, are contraindicated from receiving prescriptions for PDE5 inhibitor. Relative contraindications to the use of PDE5 inhibitor include alpha-adrenergic antagonists. Visual disturbances can be seen with sildenafil (blue haze to the visual field) as a result of inhibition of the PDE6 enzyme.
    A vacuum constriction device (VCD) is an external pump with a band on it that a man with erectile dysfunction can use to get and maintain an erection.

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    Information about your personal and sexual history may be useful when making a diagnosis. Your doctor might ask questions, such as:

    Top Picks Talking to Your Partner About ED Penis Enlargement: Does It Work? ED: Tips for Talking With Your Doctor Men's Super Foods: Some Fight ED Photos: When Your Body Won't Cooperate 10 Things That Can Deflate Your Erection further reading Slideshow: Erectile Dysfunction Causes Healthy Sex Life: Better Health Evaluator from WebMD How to Talk With Your Doctor About ED Managing Sexual Concerns if You Have BPH Symptoms of Male Sexual Problems Preventing Male Sexual Problems Sex Problems in Men Topics
    You may see many herbs and supplements that claim to help sexual performance or desire. However, none have been proven to successfully treat ED. Plus, they may not always be safe. DO NOT take anything without talking with your provider first.

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“Quite often, oral medications may be the only treatment required and men can resume normal sexual life. If a patient does not respond to oral medications, penile prosthesis (implants) is a viable and long-term option especially in severe cases. While least-chosen, it is important to know penile implants are easy to use and men report a high satisfaction rate. Speaking to an andrologist or urologist is the best option, as they can explain the risks and benefits of each treatment.”

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Discussing ED with your family doctor or urologist may be uncomfortable, but it is important to do so. Together you can discuss which treatment is right for you.

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Certain feelings can interfere with normal sexual function, including feeling nervous about or self-conscious about sex, feeling stressed either at home or at work, or feeling troubled in your current sexual relationship. In these cases, treatment incorporating psychological counseling with you and your sexual partner may be successful. One episode of failure, regardless of cause, may propagate further psychological distress, leading to further erectile failure. Individuals suffering from psychogenic ED may benefit from psychotherapy, treatment of the ED, or a combination of the two. Also, medications used to treat psychologic troubles may cause ED; however, it is best to consult with your physician prior to stopping any medications that you are taking. Althof, S.E., E.W. Corty, S.B. Levine, et al. "EDITS: development of questionnaires for evaluating satisfaction with treatments for erectile dysfunction." Urology 53.4 April 1999: 793-799. American Foundation for Urologic Disease. American Foundation for Urologic Disease. American Urological Association. "Erectile Dysfunction." 2011. . Andersson, K.E., and G. Wagner. "Physiology of Penile Erection." Physiol Rev 75.1 January 1995: 191-236. Cheitlin, M.D., A.M. Hutter Jr., R.G. Brindis, et al. "ACC/AHA Expert Consensus Document. Use of Sildenafil (Viagra) in Patients With Cardiovascular Disease. American College of Cardiology/American Heart Association." J Am Coll Cardiol 33.1 January 1999: 273-282. The European Alprostadil Study Group. "The Long-Term Safety of Alprostadil (Prostaglandin-E1) in Patients With Erectile Dysfunction. Br J Urol 82.4 October 1998: 538-543. Feldman, H.A., I. Goldstein, D.G. Hatzichristou, et al. "Impotence and Its Medical and Psychosocial Correlates: Results of the Massachusetts Male Aging Study." J Urol 151.1 January 1994: 54-61. Laumann, E.O., A. Paik, and R.C. Rosen. "Sexual Dysfunction in the United States: Prevalence and Predictors." JAMA 281.6 Feb. 10, 1999: 537-544. National Kidney and Urologic Diseases Clearinghouse. National Kidney and Urologic Diseases Clearinghouse. Available at http://kidney.niddk.nih.gov/. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 270.1 July 7, 1993: 83-90. The Process of Care Consensus Panel. "The Process of Care Model for Evaluation and Treatment of Erectile Dysfunction." Int J Impot Res 11.2 April 1999: 59-70; discussion 70-74. Segraves, R.T., M. Bari, K. Segraves, and P. Spirnak. "Effect of Apomorphine on Penile Tumescence in Men With Psychogenic Impotence." J Urol 145.6 June 1991: 1174-1175. United States. FDA Center for Drug Evaluation and Research. FDA Center for Drug Evaluation and Research. Available at http://www.fda.gov/cder/.

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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.

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