Erections are extremely complicated and surprisingly fragile. Erections involve chemical signals, nerve impulses, complicated blood pressure changes, and overall fitness in systems ranging from your heart and hormones to your mood. When medication changes how one of these factors works—like blood pressure drops or depression medication—ED is a common side effect. The problem with these completely predictable medically induced side effects is how people react.
The various PDE5 inhibitors for the treatment of ED share several common side effects, including headache, flushing, nasal congestion, nausea, dyspepsia (stomach discomfort), and diarrhea. Differences exist in side effects of the different PDE5 inhibitors, and thus it is important to be familiar with the prescribing information of the PDE5 inhibitor you are prescribed.
Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).
It's a really good article! Masturbation has a very bad for sexual stamina. If you watch porn, for example, it's up to you when you are coming. You don't need to pay attention to give orgasms to your woman. Porn is one of the main reason of erectile dysfunction. However, one thing we can learn from porn actors. How to keep their errections soo long that they can shoot scenes basically all day.
Sexual dysfunction is more common in women with hypertension (before treatment) compared to normotensive women (42% vs 19%).12 Although the sexual effects of antihypertensives have been poorly studied in women, these drugs may have similar adverse effects on the arousal phase as in men, leading to failure of swelling and lubrication. Decreased sexual desire (41% of women) and sexual pleasure (34%) have been reported.13 Alpha adrenergic drugs such as clonidine and prazosin also reduce desire (in a small, randomised trial)14 and arousal15. The angiotensin II receptor antagonist, valsartan, was associated with improved sexual desire and fantasies when compared with the beta blocker atenolol in women with hypertension.16
There are lifestyle changes that you can make to help improve erectile dysfunction. Losing weight if you are overweight will greatly improve your overall health. A healthier diet and regular exercise will help you to achieve and maintain a healthy weight, which can impact your sexual health. It also improves circulation and can help keep heart problems and diabetes under control.

If your doctor says it's OK, you may be able to stop taking blood pressure medications temporarily to see if your sex life improves. To make sure your blood pressure remains within a safe range, you may need frequent blood pressure readings while you're not taking the blood pressure lowering medication that may be causing your sexual difficulties. This can be done with a home blood pressure monitoring device for convenience.

Patients should continue testosterone therapy only if there is improvement in the symptoms of hypogonadism and should be monitored regularly. You will need periodic blood tests for testosterone levels and blood tests to monitor your blood count and PSA. Testosterone therapy has health risks, and thus doctors should closely monitor its use. Testosterone therapy can worsen sleep apnea and congestive heart failure.
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Options: Many patients with mild anxiety or insomnia don’t need benzodiazepines at all. And for all the conditions listed above, there are alternative drug and nondrug treatments. Melatonin, in doses from 3 milligrams to 10 milligrams before bedtime, for instance, sometimes helps to reestablish healthy sleep patterns. Elderly people should never use diphenhydramine (Benadryl) or any sleep aid with a name ending in “PM.” Talk with your doctor or other health care provider.
Why they’re prescribed: Anticonvulsant drugs are typically used to control seizures in people who have epilepsy. They are also used to treat some types of chronic pain, including neuropathic pain and migraines, even though they weren’t designed for that purpose. Anticonvulsants are also increasingly being used “off label” in the treatment of bipolar disorder.
Diabetes mellitus: Erectile dysfunction tends to develop 10 to 15 years earlier in diabetic men than among nondiabetic men. The increased risk of erectile dysfunction among men with diabetes mellitus may be due to the earlier onset and greater severity of atherosclerosis (hardening of the arteries) that narrows the arteries and thereby reduces the delivery of blood to the penis. Atherosclerosis can affect the arteries in the penis, as well as the arteries in the pelvis that supply the penile arteries. Diabetes mellitus also causes erectile dysfunction by damaging nerves that go to the penis, much like the effect of diabetes on nerves in other areas of the body (diabetic neuropathy). Diabetes can also affect the muscles in the penis, leading to troubles with erections. Smoking cigarettes, obesity, poor control of blood glucose levels, and having diabetes mellitus for a long time further increase the risk of erectile dysfunction in people with diabetes.
With coronary artery disease, a buildup of plaque inside the arteries can limit the amount of blood that’s able to flow through them. If the flow of oxygen-rich blood to your heart muscle is reduced or blocked by this hardening of the arteries, the result can be angina (chest pain) or a heart attack.17 Because the arteries that supply blood to the penis are much smaller than the ones that feed the heart, the problem may show up earlier as having difficulty getting an erection.18
Cognitive behavioral therapy (CBT) is a common and highly effective treatment for psychological issues in general, but also for ED. Facilitated by a therapist, this type of treatment helps you to identify and change unhealthy patterns of thought and action which may be contributing to your erectile issues. This kind of treatment is based on the idea that the situation itself (your inability to achieve or maintain an erection) is not the core problem, but rather your reaction to it. If you can learn to better understand yourself and your thought patterns, you can change them in a positive way to resolve your issues.
I found an interesting e-book about sexual performance methods by a porn star Aaron Wilcoxxx recently. He shares inside informations about how do male porn stars have so much sexual stamina and able to get it up and keep it up without drugs, erectile dysfunction and premature ejaculation. The Internet is a great place, even a gold mine to find for everything including sexual related informations, so you can even check out this book that might help you too guys to improve your sex life. bit.ly/pornstarstamina

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Information contained in the Ask the Pharmacist column by Dr. Armon B. Neel Jr. is intended to help individuals and their families become more informed about medication usage and interactions, and be better health care consumers. Any advice or information provided should not be followed in lieu of a personal consultation with a trained medical professional.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
Not only can guilt affect your ability to perform sexually, but so can low self-esteem. The correlation between erectile dysfunction and low self-esteem seems obvious from one direction – an inability to perform in the bedroom can cause you to feel bad about yourself. But how does low self-esteem cause ED? Self-esteem is defined as, “confidence in one’s own worth or abilities.”

For best results, men with ED take these pills about an hour or two before having sex. The drugs require normal nerve function to the penis. PDE5 inhibitors improve on normal erectile responses helping blood flow into the penis. Use these drugs as directed. About 7 out of 10 men do well and have better erections. Response rates are lower for Diabetics and cancer patients.
Other antidepressants such as venlafaxine and mirtazapine have variable negative effects on all aspects of sexual function. Initial reports on agomelatine in both male and female patients with major depressive disorder suggested significant antidepressant efficacy without significant sexual adverse effects. However, more recent reviews of the sexual effects are conflicting.26,27

Pharmacological treatment of T deficiency in the young essentially relies on the site of origin of the dysfunction: the testis (primary hypogonadism) or the hypothalamic-pituitary region (secondary hypogonadism). In the case of primary hypogonadism, the only available treatment is T replacement therapy (TRT). In secondary hypogonadism, patient needs dictate the therapy. If fertility is requested, gonadotropin is the only option, with the caveat of anti-estrogens in selected cases. If fertility is not an issue, TRT is again the primary choice (63).

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We always tell men; “sometimes your penis is smarter than you are.” If you are trying to have sex with someone who is critical towards you, shuts you out, gives you ultimatums or gets angry any time you aren’t erect, it is no surprise you are having trouble getting an erection. Medical experts cite poor communication as one cause of ED. It’s time to read some books or get some professional help as a couple to better communicate your feelings. As much as you might like to be immune to cruelty or criticism and just get it up anyway, it’s time to pay attention to your penis and make sure you are being treated with kindness and empathy!
Metabolism (breakdown) of vardenafil can be slowed by aging, liver disease, and concurrent use of certain medications (such as erythromycin [an antibiotic], ketoconazole [Nizoral, a medication for fungal/yeast infections], and protease inhibitors [medications used to treat AIDS]). Slowed breakdown allows vardenafil to accumulate in the body and potentially increase the risk for side effects. Therefore, in men over 65 years of age with liver disease, or who are also taking medication(s) that can slow the breakdown of vardenafil, the doctor will initiate vardenafil at low doses to avoid its accumulation. For example,
I am 67 and, up to 8 years ago, I had very satisfying sex with my (now ex) wife, although even she would not qualify as good-looking, was a bit of a tomboy and suffered from bipolar syndrome. Having sex with her was very pleasant, we usually orgasmed together. We used to have intercourse twice a day, as a rule. And I could even masturbate in-between, was able to manipulate my penis up to almost having an orgasm and then ejaculate, without touching, from a very hard penis.

How they can cause sexual dysfunction: While high blood pressure in itself can lead to sexual dysfunction, studies show that many of the drugs used to treat this condition also can cause sexual difficulties. In men, the decreased blood flow can reduce desire and interfere with erections and ejaculation. In women, it can lead to vaginal dryness, a decrease in desire, and difficulties achieving orgasm.


Total testosterone levels: Health care professionals should obtain a patient's blood samples for total testosterone levels in the early morning (before 8 a.m.) because the testosterone levels go up and down throughout the day. If you have a low testosterone level, a health care professional should check it again to confirm that it is truly low. In some men, a specialized test measuring the active form of testosterone (free or bioavailable testosterone) may be recommended.

We know depression is linked to many unhappy outcomes, but it can be particularly related to erectile dysfunction and is suggested as a common cause. There is no doubt the two are closely connected, but it’s not clear which precedes the other. If a man is depressed about, for example, his career prospects, this can be reflected in his lack of interest in his sexual relationships and an experience of erectile dysfunction.


The relationship between ED and couple relation impairment is well documented. In our population of subjects consulting for sexual dysfunction, subjects reporting conflicts within the couple were characterized by a broad spectrum of sexual symptoms, including a severe extent of ED, and they had a higher SIEDY Scale 2 score, indicating a strong relational component in the pathogenesis of ED (88). If on one hand, it is easy to understand that problems in couple relationship can cause ED, the other way around is also feasible. In the Female Experience of Men’s Attitudes to Life Events and Sexuality (FEMALES) study, 292 female partners of men aged more than 20 years complaining for ED were involved in a survey assessing the quality of their sexual experience (89). In this study, women reported a significant deterioration of satisfaction for sexual intercourse after the onset of ED in their partners. The satisfaction, sexual desire, arousal and orgasm were then improved in women whose partner used PDE5i (89). The role of ED as a risk factor for female dysfunction, including impairment in arousal, orgasm, sexual satisfaction and sexual pain, has been also confirmed in a study involving 632 sexually active couples, whose male partner age ranged 18–80 years (90).
The recommended starting dose of tadalafil for use as needed for most patients is 10 mg taken orally approximately one hour before sexual activity. A doctor may adjust the dose higher to 20 mg or lower to 5 mg depending on efficacy and side effects. Doctors recommended that patients take tadalafil no more frequently than once per day. Some patients can take tadalafil less frequently since the improvement in erectile function may last 36 hours. Patients may take tadalafil with or without food. Tadalafil is currently the only PDE5 inhibitor that is FDA-approved for daily use for erectile dysfunction and is available in 2.5 mg or 5 mg dosages for daily use.

Heart disease and diabetes are often linked together because coronary artery damage is a complication of diabetes as well. Coronary artery disease also can affect sexual function on its own, but erectile dysfunction is nine times as likely in men who suffer from both coronary artery disease (CAD) and diabetes than men who have diabetes without the addition of CAD. Erectile dysfunction is so prevalent in both coronary artery disease and diabetes that it could be considered a risk factor for both. 

A sexual impotence problem in men has always been a problem which has caused marriages as well as romantic relationships to be broken. This is regarded as a problem, but it can be solved with just a few methods. Online Silagra 100mg is the potent medication in the group of anti-ED medicines. Silagra 100mg contains Sildenafil Citrate which belongs to the PDE-5 blocker class of medicine. Male impotence or ED in men can be treated with the help of this drugs. By suppressing the action of PDE-5 enzyme on the blood vessels, this medicines helps in correcting the blood vessels flowing to the penis and keeps it steady till the organ attains perfect hardness. Man can become potent for many hours post-consumption of the medicine. It is possible because of the best activity of the drugs on the root cause of the problems. For more about you can visit: http://www.assertmeds.com/silagra.html
Currently, however, there are certain restrictions on what you can and cannot get for ED with an NHS prescription. Most people will be given a prescription for a course of unbranded treatment (usually Sildenafil) for the standard NHS prescription fee. Only certain people will be able to get branded drugs (Viagra, Cialis, Levitra or Spedra): for example, anyone who has diabetes. 
For most men, improving erectile dysfunction means improving blood flow to the penis. Immediate relief often requires medications that increases nitric oxide (NO) in the blood vessels of the penis. NO causes the smooth muscle cells in the blood vessels of the penis to stretch, which increases the flow of blood. NO also keeps the smooth muscle cells younger and helps prevent and even reverse hardening and narrowing of the blood vessels over time. Proper diet (see more below) and regular exercise are key because both can boost NO.

Cultivating and maintaining a healthy relationship is not easy. It takes time to truly get to know someone and to trust them. If you and your partner are experiencing trouble with your relationship, it could very well bleed over into your sex life. It could also be the case that your erectile dysfunction is creating problems in the relationship – it is another example of the cycle of ED that can affect many different aspects of your life. Communication is the first step in resolving this particular cause for psychological ED but it is also one of the most difficult steps to take.

Erections are neurovascular events, meaning that nerves and blood vessels (arteries and veins) are involved in the process of an erection and all must work properly to develop a hard erection that lasts long enough. Erection begins with sexual stimulation. Sexual stimulation can be tactile (for example, by a partner touching the penis or by masturbation) or mental (for example, by having sexual fantasies, viewing porn). Sexual stimulation or sexual arousal causes the nerves going to the penis to release a chemical, nitric oxide. Nitric oxide increases the production of another chemical, cyclic GMP (cGMP), in the muscle of the corpora cavernosa. The cGMP causes the muscles of the corpora cavernosa to relax, and this allows more blood to flow into the penis. The incoming blood fills the corpora cavernosa, making the penis expand.
If on one hand, depression and anxiety can lead to ED, drugs commonly used for their treatment can cause ED, as well. Sexual dysfunctions are common side effects of several psychotropic drugs that can disrupt sexual health by several different mechanisms (83). In particular, ED has been reported in subjects using serotonin selective re-uptake inhibitors (SSRI), lithium and benzodiazepines (83). SSRI are associated with a broad spectrum of sexual dysfunctions, but the most commonly reported complaints are delayed ejaculation or anorgasmia and reduced sexual desire (84). Several mechanisms could be advocated including the agonist effect on serotonin receptors type 2 and the increase in PRL levels. ED is a frequent complaint as well (84,85). The relationship between the use of SSRI and ED can be secondary to loss of sexual desire but SSRI, in particular paroxetine, are also able to inhibit cholinergic receptors and nitric oxide synthase (86). In addition, it has been observed that SSRIs might down-regulate hypothalamic-pituitary-testis axis in depressed men (87).
Some people believe that low testosterone levels could cause ED. If you’re thinking about getting testosterone replacement therapy (TRT), it’s important to know that low testosterone is rare, and doesn’t always affect sex drive or the ability to get an erection. Treatment should only be started by a specialist after you have proper testing and counselling about treatment.
Regular exercise for about 20 to 30 minutes a day may act as a libido enhancer and certainly will improve your overall health. "Exercising improves blood flow to all areas of your body and that includes the pelvic region where the blood vessels needed for sexual functioning are located," says Feloney. Some other ways that regular exercise can improve your sexual performance include building up your stamina, lowering your blood pressure, relieving stress, and helping you look and feel better.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of hims, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.
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