Intraurethral alprostadil is contraindicated in individuals who have abnormal penile anatomy (for example, urethral stricture, severe hypospadias with penile curvature), patients with acute or chronic irritation/infection of the urethra, individuals prone to priapism such as those with sickle cell anemia, thrombocytopenia, polycythemia, multiple myeloma, or are prone to blood clots. Intraurethral alprostadil should not be used for sexual intercourse with a pregnant woman.
If you are using a combination of drugs for high blood pressure, PDE-5 inhibitors could cause low blood pressure (hypotension). Also for this reason, you should not take alpha blockers—used to lower blood pressure and to treat an enlarged prostate—with these medicines without talking to your doctor. The combination could cause a dangerous drop in blood pressure.
Erectile Dysfunction is a condition when the person has trouble getting and also maintaining the penis hard enough for sexual activity. Today it is quite a common sexual disorder which affects more than 30 million men. Although it is not rare for a person to have issues with erection on an occasional basis when erectile dysfunction occurs progressively or routinely during sex, then it is not a normal condition, and it should be treated. Finding the cause of erectile dysfunction helps the physician to treat it in the most appropriate manner and assists in achieving the overall well being of the patient.

What is the best home remedy for ED?


While physical anatomy and chemical reaction are both important for getting and keeping an erection, the brain is one of the most vital parts of this puzzle. "An erection is controlled by multiple areas of your brain, including the hypothalamus, limbic system and cerebral cortex," notes Axe. "Stimulatory messages are sent to your spinal erection centers and this facilitates an erection. When there's an issue with your brain's ability to send these important messages, it can increase the smooth muscle tone in your penis and prevent the relaxation that is necessary to get an erection."

How can I treat erectile dysfunction at home?


Picture of penile tumescence monitor. This penile tumescence monitor is placed at the base and near the corona of the penis. It is connected to a monitor that records a continuous graph depicting the force and duration of erections that occur during sleep. The monitor is strapped to the leg. The nocturnal penile tumescence (NPT) test is conducted on several nights to obtain an accurate indication of erections that normally occur during the alpha phase of sleep.
#5 in firstl list is definitely my problem..Psychologocal ..the more I think about not gettin hard and gettin anxious the softer my errction gets…complete opposite effect im.lookin for..and I find my partner so sexxy , but cant deliver…its bad….all these remedies seem to have a solution but this one..I dont know how to just not think about it..especially when itd time to perform..need my mind to go blank and just enjoy wat im doin..easier said then done though..Help!!

erectile dysfunction symptoms


The surgery for placement of a penile prosthesis is typically an outpatient surgery. Doctors often perform a penile prosthesis through a single incision, and all of the components are hidden under the skin. Health care professionals often give patients antibiotics at the time of surgery and often after the surgery to decrease the risk of developing an infection. Depending on your health history, a health care provider may leave a catheter in your penis to drain your bladder overnight.
Depression and anxiety: Psychological factors may be responsible for erectile dysfunction. These factors include stress, anxiety, guilt, depression, widower syndrome, low self-esteem, posttraumatic stress disorder, and fear of sexual failure (performance anxiety). It is also worth noting that many medications used for treatment of depression and other psychiatric disorders may cause erectile dysfunction or ejaculatory problems.
In the Massachusetts Male Aging Study (MMAS) among a community-based survey of men aged 40-70 years, 52% of the men reported some degree of erectile difficulty. Complete ED, defined as the total inability to obtain or maintain suitable erections during sexual stimulation, as well as the absence of nocturnal erections (normal erections [four to six/night], which occur during sleep), occurred in 10% of the men in the study. Lesser degrees of mild and moderate ED occurred in 17% and 25% of participants.
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Men with a rare heart condition known as long QT syndrome should not take vardenafil since this may lead to abnormal heart rhythms. The QT interval is the time it takes for the heart's muscle to recover after it has contracted and is measured on an electrocardiogram (EKG). In addition, vardenafil is not recommended for men taking medications that can affect the QT interval such as quinidine, procainamide, amiodarone, and sotalol.
If laboratory tests are performed, they would normally start with an evaluation of your hormone status (testosterone or male hormone), particularly if one of your symptoms is low sexual desire (low libido). Blood tests for testosterone should ideally be taken early in the morning because that's when levels are usually at their highest. It is recommended that if the first testosterone level is low to repeat it as testosterone levels can vary. If the testosterone level is low, other blood tests, such a luteinizing hormone and prolactin, can help determine if there is a problem with the pituitary gland.
Try to think of love-making as fun, not a trial. Laugh more, be more playful, and try to create opportunities for being together in situations that would be enjoyable for you both, even if sex does not occur. Most importantly, explore non-penetrative styles of eroticism. These things will help increase your sexual comfort and confidence, and reduce the pressure you currently feel to be an on-demand sex machine. You are merely human.
Erectile Dysfunction is a condition when the person has trouble getting and also maintaining the penis hard enough for sexual activity. Today it is quite a common sexual disorder which affects more than 30 million men. Although it is not rare for a person to have issues with erection on an occasional basis when erectile dysfunction occurs progressively or routinely during sex, then it is not a normal condition, and it should be treated. Finding the cause of erectile dysfunction helps the physician to treat it in the most appropriate manner and assists in achieving the overall well being of the patient.
A physical examination is necessary. The doctor will pay particular attention to the genitals and nervous, vascular, and urinary systems. Your blood pressure will be checked because several studies have demonstrated a connection between high blood pressure and erectile dysfunction. The physical examination will confirm information you gave the doctor in your medical history and may help reveal unsuspected disorders such as diabetes, vascular disease, penile plaques (scar tissue or firm lumps under the skin of the penis), testicular problems, low male hormone production, injury, or disease to the nerves of the penis and various prostate disorders.
Prostate cancer isn’t considered a cause of ED on its own, but radiation treatments, hormone therapy, and surgery to remove the entire prostate gland can lead to difficulty in getting or keeping an erection. Sometimes erectile dysfunction related to prostate cancer treatment is only temporary, but many guys experience ongoing difficulties that need to be addressed by other means.

Male erectile problems often produce a significant emotional reaction based on the impact of erectile dysfunction on confidence, self-esteem, and morale in most men. This is described as a pattern of anxiety and stress that can further interfere with normal sexual function. Such "performance anxiety" needs to be recognized and addressed by a doctor.


"Primarily because people tend to get anxious around introducing these things. Also, introducing these things too early can perpetuate a myth that it's low desire that is leading to the erectile issue. Low sexual desire is often not the cause of the problem. There can be other factors, such as depression, anxiety, poor self-image or esteem, etc. Without proper processing, adding sexual aids can add to a sense of shame if they don't work."
Oral phosphodiesterase type 5 inhibitors (PDE5 inhibitors) unless contraindicated are the recommended first line medical therapy for erectile dysfunction. Currently, there are four different PDE5 inhibitors available. They all work the same way and have essentially the same results. They differ in how long they last in your body and in side effects.
Getting (and maintaining) an erection requires a surprising amount of things to go right. You have to get aroused, then pass that signal from your brain, through your nerves and hormones, to your blood vessels and muscles before an erection can even happen. If one thing goes wrong in that complicated exchange between your cardiovascular, and nerve system, and your hormone levels, blood vessels, and even your mood the result is usually erectile dysfunction. In other words, getting an erection is hard.
Having these factors work in tandem all at once is key. "So many things have to go right for you to achieve a strong erection, which is why the strength of a man's erection is a great indicator for their overall health," explains Reitano. "For starters, your hormones must be released on demand, your arteries need to carry blood to the penis with perfect efficiency, your nervous system must transmit its signals without a hitch, and your mind must be working in perfect harmony with your body. That is a lot to ask of your body on demand."
Not necessarily, but you could try and see if it works for you. If you always (or very regularly) masturbate to porn, it could make it harder for you to orgasm in other situations. You could try masturbating without porn, or cut down on masturbating generally, and see if it helps you maintain your erection during sex. You might still find one of the treatments listed above is a better solution.

Alprostadil should not be used in men with urethral stricture (scarring and narrowing of the tube that urine and the ejaculate pass through), balanitis (inflammation/infection of the glans [tip] of the penis, severe hypospadias (a condition where the opening of the urethra is not at the tip of the penis, rather on the underside of the penis), penile curvature (abnormal bend to the penis), and urethritis (inflammation/infection of the urethra).
Surgery to repair arteries (penile arterial reconstructive surgery) can reduce impotence caused by obstructions that block the flow of blood to the penis. The best candidates for such surgery are young men with discrete blockage of an artery because of a physical injury to the pubic area or a fracture of the pelvis. The procedure is less successful in older men with widespread blockage of arteries.

Having learned a great deal more about erectile dysfunction including its risk factors and causes, you should be equipped to assess your own erectile function. If you have experienced erectile issues or you have some of the risk factors mentioned above, it may be worth making a trip to your doctor’s office. If you choose to seek help, give your doctor as much information as you can about your symptoms including their frequency and severity as well as the onset. With your doctor’s help, you can determine the best course of treatment to restore sexual function.
In the Massachusetts Male Aging Study (MMAS) among a community-based survey of men aged 40-70 years, 52% of the men reported some degree of erectile difficulty. Complete ED, defined as the total inability to obtain or maintain suitable erections during sexual stimulation, as well as the absence of nocturnal erections (normal erections [four to six/night], which occur during sleep), occurred in 10% of the men in the study. Lesser degrees of mild and moderate ED occurred in 17% and 25% of participants.
Men with a rare heart condition known as long QT syndrome should not take vardenafil since this may lead to abnormal heart rhythms. The QT interval is the time it takes for the heart's muscle to recover after it has contracted. An electrocardiogram (EKG) measures the QT interval. Some people have longer than normal QT intervals, and they may develop potentially life-threatening abnormal heart rhythms, especially when given certain medications. Men with a family history of long QT syndrome should not take vardenafil, as it is possible to inherit long QT syndrome. Furthermore, vardenafil is not recommended for men who are taking medications that can affect the QT interval such as quinidine (Quinaglute, Quinidex), procainamide (Pronestyl, Procan-SR, Procanbid), amiodarone (Cordarone), and sotalol (Betapace).
Smoking and other tobacco use is connected to many health problems, including erectile dysfunction. The use of tobacco decreases blood flow throughout your entire body. This includes the blood vessels in a man’s penis. If the blood supply is decreased there, it becomes much more difficult for you to achieve and maintain an erection. Thankfully, this is reversible. If you stop smoking, you’ll notice your erections will improve.
Men with a rare heart condition known as long QT syndrome should not take vardenafil since this may lead to abnormal heart rhythms. The QT interval is the time it takes for the heart's muscle to recover after it has contracted. An electrocardiogram (EKG) measures the QT interval. Some people have longer than normal QT intervals, and they may develop potentially life-threatening abnormal heart rhythms, especially when given certain medications. Men with a family history of long QT syndrome should not take vardenafil, as it is possible to inherit long QT syndrome. Furthermore, vardenafil is not recommended for men who are taking medications that can affect the QT interval such as quinidine (Quinaglute, Quinidex), procainamide (Pronestyl, Procan-SR, Procanbid), amiodarone (Cordarone), and sotalol (Betapace).
Did you know that a cock ring can help you maintain an erection? This O-shaped toy fits around your penis and helps keep blood in the shaft, where you want it. A cock ring also helps prevent venous leakage, a form of erectile dysfunction where blood flows to your penis, but has trouble staying there. (Giddy, a new cock-ring-like gadget designed to treat ED, may also help guys with venous leakage maintain stronger erections.)
Get a blood test to evaluate your testosterone levels. Testosterone naturally peaks in adolescence and young adulthood and drops off as you age. If a blood test reveals that you have low testosterone levels, there's a good chance this could be the culprit behind your erectile dysfunction. Your doctor will likely recommend natural lifestyle changes first, such as losing weight or increasing muscle mass. If your testosterone levels are lower than average for your age, they may prescribe taking supplemental testosterone.[12]
These four medications accelerate the influence of the chemical nitric oxide, which relaxes the penis muscles. This leads to an increase in the blood flow and causes the penis to get erect and hard in response to sexual stimulation. Consuming one of these oral drugs automatically produces an erection in men. You should always consult the doctor for determining which of the oral medicine works best for you. This oral medication will not treat the ED immediately. You are required to work with your ED specialist to find out the right drug and its dosage for you.
Instead of injecting a medicine, some men insert a suppository of alprostadil into the urethra. A suppository is a solid piece of medicine that you insert into your body where it dissolves. A health care professional will prescribe a prefilled applicator for you to insert the pellet about an inch into your urethra. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes. 

What can you do for severe erectile dysfunction?


Nerve or spinal cord damage: Damage to the spinal cord and nerves in the pelvis can cause erectile dysfunction. Nerve damage can be due to disease, trauma, or surgical procedures. Examples include injury to the spinal cord from automobile accidents, injury to the pelvic nerves from prostate surgery for cancer (prostatectomy), and some surgeries for colorectal cancer, radiation to the prostate, surgery for benign prostatic enlargement, multiple sclerosis (a neurological disease with the potential to cause widespread damage to nerves), and long-term diabetes mellitus.
Getting from a turn-on to a hard-on is a bit like dominoes: you experience stimuli, your brain relaxes the muscles in your penis, the arteries fill with blood, your penis closes off the blood’s escape route so it stays hard, and — voilà! Your erection is sustained. However, if even one of these dominoes isn’t lined up, things can go awry. Here’s a quick overview of just some of the issues that could be at play:
The penis is composed of three cylinders, two on the top and one on the underside of the penis. The top two cylinders are involved in the erectile process. The urethra, the tube that urine and semen pass through, is on the underside of the penis. The top two penile cylinders, the corpora cavernosa, are composed of tissue that is analogous to a sponge, containing spaces that can fill with blood and expand. These two cylinders are surrounding by a strong layer of tissue, like Saran wrap, the tunica albuginea. For an erection to occur, there must be properly functioning nerves, arteries, veins, and normal penile tissues.

How many times should a man release sperm in a week?


This is the best exercise to increase penis size and penis strength. As a male, by strengthening your core sex muscles (PC muscles) you can increase your penis size as well as the strength of your penis. This can lead to more ease in gaining erections, especially as you become older. Download instructions for the best penis exercise here (no email required.)
My husband is suffering from erectile dysfunction. He has been to many doctors, including a urologist, neurologist, orthopedist, you name it. After many diagnostic tests, it seems that nothing physical can be found. He used to have full erections almost daily. Now nothing. Although he can get hard, he cannot maintain enough for intercourse. What can we do at this point?
Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain a hard enough erection for satisfactory completion of sexual activity. Erectile dysfunction is different from other health conditions that interfere with male sexual function, such as lack of sexual desire (decreased libido) and problems with ejaculation release of the fluid from the penis (ejaculatory dysfunction) and orgasm/climax (orgasmic dysfunction), and penile curvature (Peyronie's disease), although these problems may also be present. ED affects about 50% of men age 40 and over. This article focuses on the evaluation and treatment of erectile dysfunction.
It is normal for a man to have five to six erections during sleep, especially during rapid eye movement (REM). Their absence may indicate a problem with nerve function or blood supply in the penis. There are two methods for measuring changes in penile rigidity and circumference during nocturnal erection: snap gauge and strain gauge. A significant proportion of men who have no sexual dysfunction nonetheless do not have regular nocturnal erections.
#5 Take time, don’t rush in. This is something most guys don’t know and don’t care to know. Foreplay always helps the guy hold on longer. You may think it’s pointless, but by indulging in foreplay for 15 minutes before penetration, your little guy would get more time to warm himself up for the act. Just don’t think about your erection until you have to penetrate her. And when it’s time, you can rest assured that he’ll be ready. [Read: The beginners guide to sexual role playing]
Treatment depends on the underlying cause. In general, exercise, particularly of the aerobic type, is effective for preventing ED during midlife.[24]:6, 18–19 Counseling can be used if the underlying cause is psychological, including how to lower stress or anxiety related to sex.[25] Medications by mouth and vacuum erection devices are first-line treatments,[24]:20, 24 followed by injections of drugs into the penis, as well as penile implants.[24]:25–26 Vascular reconstructive surgeries are beneficial in certain groups.[26] Treatments, other than surgery, do not fix the underlying physiological problem, but are used as needed before sex.[27]
The placement of a penile prosthesis is typically an outpatient procedure and is typically performed through a single incision. All of the parts of the prosthesis are hidden under the skin. Antibiotics are given to decrease the risk of an infection. A catheter may be left in the penis in some men for a short period. After placement, there will be a time period of healing prior to the ability to use the prosthesis.

Oral phosphodiesterase type 5 inhibitors (PDE5 inhibitors) unless contraindicated are the recommended first line medical therapy for erectile dysfunction. Currently, there are four different PDE5 inhibitors available. They all work the same way and have essentially the same results. They differ in how long they last in your body and in side effects.


The penis is composed of three cylinders: two on the top, the corpora cavernosa and one on the bottom, the corpus spongiosum. All of these are involved in the process of an erection. The corpora cavernosa are composed of potential spaces that can distend with blood, causing rigidity of the penile shaft. The corpus spongiosum is important for rigidity of the glans of the penis. When aroused, stimulated chemicals are released from the nervous system (nitric oxide is one) that stimulate the arteries to the penis to relax and increase blood flow into the penis. These potential spaces, like a sponge, can expand when more blood flow comes in the penis. Each corpora cavernosa is surrounded by an outer coating the tunica albuginea. When the penis fills with blood, these potential spaces, the sinusoids, compress the veins in the corpora against the side of the tunica albuginea, thus preventing blood from leaving the penis. It is this compression of the veins that allows for the erection to become fully rigid.
Smoking and other tobacco use is connected to many health problems, including erectile dysfunction. The use of tobacco decreases blood flow throughout your entire body. This includes the blood vessels in a man’s penis. If the blood supply is decreased there, it becomes much more difficult for you to achieve and maintain an erection. Thankfully, this is reversible. If you stop smoking, you’ll notice your erections will improve.
The most common inflatable prosthesis is the three-piece penile prosthesis. It is composed of paired cylinders, which doctors surgically insert inside the penis. Patients can expand the cylinders using pressurized fluid (see figure 3). Tubes connect the cylinders to a fluid reservoir and pump, which doctors also surgically implant. The reservoir is usually in the pelvis. A doctor places the pump in the scrotum. By pressing on the pump, sterile fluid transfers from the reservoir into the cylinders in the penis. An erection is produced primarily by expansion of the width of the penis, however, one model can increase in length a small amount also. Lock-out valves in the tubing prevent the fluid from leaving the cylinder until a release valve is pressed. By pressing the relief valve and gently squeezing the penis, the fluid within the cylinders transfers back into the reservoir.

keep erection firm

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