Penile ultrasonography with doppler can be used to examine the penis in erected state. Most cases of ED of organic causes are related to changes in blood flow in the corpora cavernosa, represented by occlusive artery disease, most often of atherosclerotic origin, or due to failure of the veno-occlusive mechanism. Preceding the ultrasound examination with Doppler, the penis should be examined in B mode, in order to identify possible tumors, fibrotic plaques, calcifications, or hematomas, as well as to evaluate the appearance of the cavernous arteries, which can be tortuous or atheromatous.[22]


I know. You probably already know that being overweight is bad for your health. But, did you know that being overweight actually causes your body to turn testosterone into estrogen? This is one of the reasons scientists believe obesity and a sedentary lifestyle (little to no exercise, unhealthy food choices, etc.) lead to problems with erectile dysfunction.
Stage 3: When you feel you are ready for next step then move to stage 3. This stage is a bit tricky and requires patience & good concentration. Start contracting the PC muscle slowly and lightly, hold for 2-3 seconds then release. Again contract a bit deeper than previous one and release. Repeat the process till you reach the deepest point and hold there for 20 seconds at least. Then release slowly. This way one set done. Do 2 sets daily.
Diabetes leads to vascular complications throughout the body and the penis is no exception. A large survey reported that the majority of men with diabetes and ED had never even been asked about their sexual function. That means they never received treatment for ED. If you think you might have diabetes or even prediabetes, talk to your doctor about ED.
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.
While erectile dysfunction can occur at any age, the risk of developing erectile dysfunction increases with age. According to the Massachusetts Male Aging Study, the prevalence of erectile dysfunction was 52% in men 40-70 years of age. The prevalence of complete erectile dysfunction increases from 5% at 40 years of age to 15% among men 70 years of age and older. 

Obesity and metabolic syndrome can cause changes in blood pressure, body composition, and cholesterol which may lead to ED. Other conditions that may contribute to erectile dysfunction include Parkinson’s, multiple sclerosis, Peyronie’s disease, sleep disorders, alcoholism, and drug abuse. Taking certain medications can also increase your risk for ED.
Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He’s a practicing Gastroenterologist and Hepatologist with a focus on Men’s and Women’s Health, and a regular contributor to Women’s health, Shape and Prevention Magazine.
If the inability to get or maintain an erection happens to you once or twice, you may not need to see a doctor. Many lifestyle factors, such as stress or drinking too much alcohol, can affect your sexual ability. If you notice the problem is happening on a routine basis and it’s impacting your ability to have a satisfying sex life, then it’s time to consider seeing a doctor.

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Penile injection therapy, intracavernous injection, involves the injection of a vasodilator (a chemical that relaxes arteries to increase blood flow) into the penis. Penile injected therapy is recognized as the most effective nonsurgical treatment for erectile dysfunction. However, due to the invasive nature, it is often used in men who have failed or have contraindications to other treatments such as oral therapies.

Medications used to treat high blood pressure (hypertension), including diuretics and beta-blockers, may cause ED. Not all blood pressure medications are associated with ED; alpha-blockers, ACE inhibitors, calcium channel blockers, and angiotensin II receptor blockers don't appear to cause ED. If you are on a blood pressure medication, have an ED talk with your doctor about whether or not your medication may be contributing to your ED and if there is an alternative blood pressure medication that is safe for you to try.

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.

Many commonly used drugs can cause erectile dysfunction. Prescription medication and over-the-counter drugs can decrease libido, interfere with normal blood flow, or even cause absent seminal emission or retrograde ejaculation. In fact, 8 of the 12 most commonly prescribed medications list ED as a side effect. Medications that commonly cause ED include:


Don’t panic. That will only make it worse. Erectile dysfunction is common. In younger age groups it is more likely to be a psychogenic issue around performance anxiety (don’t seek to be like a porn star is a top tip). In men between the ages of 40 and 70, it is estimated that 50 per cent will have some degree of erectile dysfunction. In this age group, there may be a more of a physical issue around blood flow. In either case, consult your doctor and they will be able to give you some more advice. An erectile litmus test is, if you are getting nighttime or early morning erections, it is likely a psychological not a physical vascular issue.
While the end product is the same, the journeys take three very different routes. The most common erection is your reflexogenic erection, caused by physical contact. The second is your psychogenic erection, caused by audiovisual arousal or imagination (but no contact). The third and final is your nocturnal erection that comes when you are in the deep REM stage of sleep – and which, in fact, has very little do to with sexual stimulation.
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 only one cause of sexual dysfunction. Other causes of sexual dysfunction include troubles with ejaculation, decreased libido, and troubles achieving an orgasm (climax). Some men may have premature ejaculation, which is a condition in which the entire process of arousal, erection, ejaculation, and climax occur very rapidly, often in just a few minutes or even seconds, leaving the partner unsatisfied. Premature ejaculation may accompany an erection problem such as ED but is generally treated differently. Troubles with erectile function may lead to decreased libido or interest in sex, however, many men with decreased libido have normal erectile dysfunction. Libido may be affected by psychologic factors, such as stress, anxiety, or depression but often is the result of a low testosterone (the male hormone) level.

How can I treat ED at home?


You've probably heard of the old saying "use it or lose it". Your sex muscles are just like any other muscles. If you're not using them regularly (masturbation doesn't count) they will lose size and strength. This commonly happens as you age. Considering most people judge a healthy sex life to be 3-5 times per week, that's not a lot of use for these important muscle groups. Therefore, it's best to exercise the muscles which support a healthy sex life so you can enjoy sex well into your 80's.
Diabetes leads to vascular complications throughout the body and the penis is no exception. A large survey reported that the majority of men with diabetes and ED had never even been asked about their sexual function. That means they never received treatment for ED. If you think you might have diabetes or even prediabetes, talk to your doctor about ED.
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.
Don't forget mental health, either! "If you are experiencing stress at work, in your relationships or at home, open up communication about these issues," notes Axe. "Try natural stress busters like spending time outdoors, taking some vacation time for yourself or seeing a therapist. You also need to make sure that you are getting enough rest every night — seven to nine hours of sleep per night."

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.
In patients with low testosterone, testosterone treatment can improve libido and erectile dysfunction, but many men still may need additional oral medications such as sildenafil, vardenafil, or tadalafil. Some studies suggest that men with ED and low testosterone may respond better to PDE5 inhibitors when given testosterone therapy; however, this is controversial.

What is the main cause of erectile dysfunction?


The PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are prescription drugs which are taken by mouth.[24]:20–21 As of 2018, sildenafil is available in the UK without a prescription.[28] Additionally, a cream combining alprostadil with the permeation enhancer DDAIP has been approved in Canada as a first line treatment for ED.[29] Penile injections, on the other hand, can involve one of the following medications: papaverine, phentolamine, and prostaglandin E1, also known as alprostadil.[24] In addition to injections, there is an alprostadil suppository that can be inserted into the urethra. Once inserted, an erection can begin within 10 minutes and last up to an hour.[25] Medications to treat ED may cause a side effect called priapism.[25]

While the end product is the same, the journeys take three very different routes. The most common erection is your reflexogenic erection, caused by physical contact. The second is your psychogenic erection, caused by audiovisual arousal or imagination (but no contact). The third and final is your nocturnal erection that comes when you are in the deep REM stage of sleep – and which, in fact, has very little do to with sexual stimulation.
In prescribing sildenafil, a doctor considers the age, general health status, and other medication(s) the patient is taking. The usual starting dose for most men is 50 mg, however, the doctor may increase or decrease the dose depending on side effects and effectiveness. The maximum recommended dose is 100 mg every 24 hours. However, many men will need 100 mg of sildenafil for optimal effectiveness, and some doctors are recommending 100 mg as the starting dose.
A “cycle”, as you put it, can certainly become established after a man experiences a number of erectile failures and begins to lose confidence. Once the idea of attempting intercourse produces anxiety rather than excitement, it becomes less and less likely he will successfully produce a reliable erection. Pharmaceutical agents can bypass this cycle, but it can also be extremely important to learn to be less fixated on erectile ability and instead focus on pleasure. Learning it is possible to give and receive enormous pleasure without an erection can be a vital aspect of a return to sexual health. This knowledge can lead to a reduction of the pressure you mentioned, as well as to a lifetime of sexual confidence and enjoyment.

Improve your nutrition. Certain foods, such as those that are fatty, fried, sugary, and processed, can result in decreased blood flow throughout your body and can contribute to a vascular form of erectile dysfunction. Increase your intake of fruits, vegetables, whole grains, and heart-healthy fats to improve your blood circulation and increase the amount of time you’re able to maintain an erection.
A number of treatments are available to treat erectile dysfunction. The typical treatment strategy starts with simple to use, noninvasive therapies and progresses to more invasive surgical therapies as needed. In all men, the first step is determining if there are any modifiable risks factors that can either improve or prevent progression of erectile dysfunction. Since the risk of developing ED is increased in the presence of diabetes, heart disease, and hypertension, it is thought that better control/prevention of these conditions may have a benefit in ED. Similarly, it is thought that lifestyle modifications to improve vascular function such as avoiding smoking, maintaining ideal body weight, and engaging in regular exercise might either prevent or reverse ED. Sexual counseling may also be useful in addressing relationship stressors as you work on improving your erectile function.

Which oil is best for erectile dysfunction?


Though few things are worse for your erection than a cigarette habit, coffee can actually help you out below the belt. A study by the University of Texas Health Science Center at Houston found that men who consumed the caffeine equivalent of 2-3 cups of coffee per day were less likely to suffer from erectile dysfunction than those who preferred to wake up with caffeine-free beverages.

What age does a man stop getting hard?

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