These commonly prescribed medications affect sexual function in different ways depending on the specific type of drug and how it works. “Central regulation of erections relies on dopamine and serotonin, so any impact on these processes can worsen erectile function,” says Trost. He notes that Wellbutrin (buproprion) and Remeron (mirtazipine) are the antidepressants that likely have the least impact on erectile function.
Living alone in a remote rural area in the South-West of France, chances of finding a suitable partner were nihil. So I masturbated, using pornography (not of the more civilized kind). It worked well, up to today, but not anymore the way it used to be. Playing with my glans only works very well, BUT, without really noticing, after a while, my penis got only half-hard just before ejaculating.
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.
The following products are considered to be alternative treatments or natural remedies for Erectile Dysfunction. Their efficacy may not have been scientifically tested to the same degree as the drugs listed in the table above. However there may be historical, cultural or anecdotal evidence linking their use to the treatment of Erectile Dysfunction.
Loss of Desire: This is called loss of libido by doctors. It means that a person no longer desires sexual intimacy as they once had. Hormone changes as in low testosterone can cause erectile dysfunction, but so can so can neurological or psychological conditions, medications, or relationship issues. The reason should be investigated to resolve the issue. Erectile dysfunction (ED) drugs will not work for many of these patients. A person must feel a desire for sex to kick off the process that allows the medications to function properly.

Your ability to orgasm is not connected to the prostate gland, although a man who has had a radical prostatectomy will have a dry orgasm with no ejaculation. As long as you have normal skin sensation, you should be able to have an orgasm with the right sexual stimulation. This means that treating your ED should allow you to resume a normal, healthy sex life.
CBT is perhaps one of the most useful forms of therapy for addressing ED, especially related to performance anxiety, low self-esteem, and loss of sexual arousal. CBT is a proactive and actionable therapy targeted at helping you change the way you think and behave. It privileges the idea that thoughts, feelings, and physical sensations are all interlinked.
These medications work in pretty much the same way. They all increase blood flow to the penis, but they only work if you’re sexually aroused. These treatments are only right for you if you experience erectile dysfunction often and a doctor agrees they’re safe for you. A good option to choose could be ‘on demand’ Cialis (tadalafil), as it takes around 30 minutes to take effect and then can last up to 36 hours. 
ICI therapy often produces a reliable erection, which comes down after 20-30 minutes or with climax. Since the ICI erection is not regulated by your penile nerves, you should not be surprised if the erection lasts after orgasm. The most common side effect of ICI therapy is a prolonged erection. Prolonged erections (>1 hour) can be reversed by a second injection (antidote) in the office.
The vacuum device creates a vacuum to pull blood into the penis. Unlike a normal erection, the inflow of blood does not continue once the individual removes the vacuum device. The rubber band placed at the base of the penis constricts the penis to prevent the blood from leaving the penis. As there is no inflow or outflow of blood when the rubber band is in place, it is uncommon for the tip of the penis (the glans) to appear a little blue and the penis to be cooler. Once intercourse is completed, the individual removes the rubber band and the blood drains out of the penis.
These findings demonstrate the importance of recognizing a possible organic component of ED even in younger men. In fact, in younger, more than in older men, who are by definition at high CV risk, searching for signs of metabolic or CV disorders can help identify those men who apparently healthy, have subtle and subclinical conditions that can be treated before the damage becomes clinically overt.
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.

Psychological issues can affect more than just your mental health. Depression, anxiety, stress, and relationship problems can have a tremendous effect on your sexual function. If you’re experiencing ED along with psychological issues, talk with your doctor. Together, you and your doctor can find a cause and a treatment to bring your sexual health back to normal.

Psychological Causes of ED – Between 10% and 20% of ED cases have a psychological cause. Because arousal starts in the brain, psychological issues can be a significant contributing factor to erectile dysfunction. Mental health conditions like depression or anxiety can negatively impact your libido, making it more difficult for you to become aroused.
"Smoking is a short- and long-term cause of erectile dysfunction," warns Feloney. "In the short-term nicotine constricts the blood vessels that you need to get an erection, and in the long-term nicotine contributes to hardening of the arteries that can cause erectile dysfunction." Some approaches for quitting include making a clean break, avoiding the triggers of smoking, trying a nicotine patch or gum, and joining a smoke cessation program.
Surgical or radiation treatments for prostate cancer, bladder cancer, or prostate enlargement (BPH) can sometimes damage nerves and blood vessels near the penis. Occasionally, the nerve damage is permanent and the patient requires treatment to achieve an erection. Sometimes, surgery causes temporary erectile dysfunction that improves on its own after 6 to 18 months.
Yes, the vacuum device is effective. In fact, with use of the vacuum device, 88% of men will have an erection that is satisfactory for completion of sexual activity. The vacuum device may be the only therapy that is effective after the removal of a penile prosthesis. Patients also use vacuum devices as part of penile rehabilitation after radical prostatectomy to help preserve the tissue of the penis and prevent scarring within the penis and loss of penile length. Its use, however, is limited by the mechanical nature of it and the time taken to pump the device and apply the band. Sex partners may complain of the penis being cool to touch.
"Smoking is a short- and long-term cause of erectile dysfunction," warns Feloney. "In the short-term nicotine constricts the blood vessels that you need to get an erection, and in the long-term nicotine contributes to hardening of the arteries that can cause erectile dysfunction." Some approaches for quitting include making a clean break, avoiding the triggers of smoking, trying a nicotine patch or gum, and joining a smoke cessation program.
You’ve probably heard of Viagra, but it’s not the only pill for ED. This class of drugs also includes Cialis, Levitra,  Staxyn, and Stendra. All work by improving blood flow to the penis during arousal. They're generally taken 30-60 minutes before sexual activity and should not be used more than once a day. Cialis can be taken up to 36 hours before sexual activity and also comes in a lower, daily dose. Staxyn dissolves in the mouth. All require an OK from your doctor first for safety.

The time the dose should be taken and how long the effects last depend on the medication used. The most common side effect of these medications is a headache. However, there is a potential for certain dangerous drug interactions. Anyone prescribed this medication must let his doctor know about any medications he's on, and especially if he's taking nitrates (e.g., nitroglycerin spray, nitroglycerin pills, or nitroglycerin patch) for heart problems.
Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. The physician squeezes the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus.
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.

When you become aroused, your brain sends chemical messages to the blood vessels in the penis, causing them to dilate or open, allowing blood to flow into the penis. As the pressure builds, the blood becomes trapped in the corpora cavernosa, keeping the penis erect. If blood flow to the penis is insufficient or if it fails to stay inside the penis, it can lead to erectile dysfunction.
ED can also occur among younger men. A 2013 study found that one in four men seeking their first treatment for ED were under the age of 40. The researchers found a stronger correlation between smoking and illicit drug use and ED in men under 40 than among older men. That suggests that lifestyle choices may be a main contributing factor for ED in younger men.

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.

Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing some men to function normally. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections.
Diabetes can cause nerve, blood vessel, and muscle damage that results in problems like pain, numbing or loss of sensation in the hands and feet.12 These issues can also result in ED problems, because nerve signals and blood flow are necessary to the process of getting an erection.6 And as men with diabetes get older, ED problems become even more common.13
Your GP will check your blood pressure, cardiovascular health (heart and blood vessels) and perform blood tests to check your cholesterol and blood sugar levels. If you are over 50, it is important that your GP also examines your prostate. Depending on your general health, the GP may need to do other tests, for example blood tests for hormone levels.
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
Sure, this condition might be common – but isn’t erectile dysfunction a problem that only middle and senior-aged men get? It is true that erectile problems are common in older men. It often happens due to lower levels of testosterone and reduced blood flow to the penis. But this study showed that a quarter of all men under the age of 40 experience erectile dysfunction of some kind!
There are many circumstances that could lead a man to become sexually indifferent. Long-term relationships which become marked by routine, boredom and conflict represent one major culprit. It shouldn’t come as a surprise that if you’re not really interested in having sex anymore, you’re not likely to have an erection. What’s the brain science behind this?

"For difficulty with getting an erection, it is important to have a thorough medical exam; however, erectile dysfunction is often due to performance anxiety," says Connolly. "The more that you worry about having an erection (just like the harder you try to fall asleep), the more likely it is that you’ll have difficulty. Therapy can help men let go of their worry about the erection and learn to relax and enjoy the sexual and sensual experience."
In 2011, Men’s Health reached a similar conclusion in their investigation into finasteride and so-called “post-finasteride syndrome” (PFS). They quoted Dr. Michael Irwig, an endocrinologist at George Washington University as saying “What we do want is for patients and doctors alike to understand the potential risk of persistent problems that may not, in fact, be reversible when you stop this drug.”

Accurate statistics are lacking on how many men are affected by the condition because it is often underreported, but it is estimated that about half of men over 40 in Canada have frequent problems achieving or maintaining an erection. The number of men suffering from erectile dysfunction increases with age, but it is not considered a normal part of aging. The majority of cases can be successfully treated.
ED has been for long time considered a problem mainly related to psychological conditions and distress. Accordingly, until phosphodiesterase type 5 inhibitors (PDE5i) were introduced, psychoanalysis and cognitive-behavioural therapy were the only option for ED. In the last few decades, ED has been recognized as a clinical consequence of several different organic diseases and the importance of vascular health in erectile function has been so emphasized that ED is now considered not only the result of vascular impairment, but also a harbinger of forthcoming cardiovascular (CV) events (17). Despite the increasing attention of research towards organic mechanisms and conditions leading to ED, it is now known that considering this symptom as entirely due to organic disorders, is as imprecise as considering it only secondary to psychological conditions. In fact, this pathogenetic dichotomy is now obsolete (1,18,19), because it is now known that ED is a multidimensional disorder deriving from the interaction of different components related to organic conditions, relational context and psychological status (20,21). Even when only one of these components is involved in the initial development of erectile impairment, eventually the other ones will appear, thus further worsening ED (21-23). The multidimensional nature of ED is still not fully accepted by health care professionals when dealing with young patients. In fact, complaints of ED in young men is often underestimated and attributed to transient and self-limiting psychological conditions, such as performance anxiety. Young patients are often reassured without any further medical investigations, including physical exam. However, organic disorders, as well as relational and psychological or psychiatric conditions, can be meaningful in determining ED in younger men. In a population of subjects seeking medical care at the Sexual Medicine and Andrology Unit of the University of Florence for sexual dysfunction, the first tertile of age (n=1,873 subjects) represents younger subjects (18–44 years). Pathogenetic components of ED in our sample are investigated by the Structured Interview on Erectile Dysfunction (SIEDY), a structured interview including 13 questions, whose answers, organized in a Likert scale, provide three scales, one for the organic subdomain [(SIEDY Scale 1); (22)], one for the relational subdomain [(SIEDY Scale 2); (23)] and one for the intrapsychic subdomain [(SIEDY Scale 3); (21)]. According to these scale scores, organic, relational and intrapsychic conditions are all significant risk factors for ED in younger patients of our population (Figure 2).
Malleable implants usually consist of paired rods, inserted surgically into each of the corpora cavernosa. The rods are stiff, and to have an erection, one bends them up and then when finished with intercourse one bends them down. They do not change in length or width. The malleable implants are the least mechanical and thus have the lowest risk of malfunction. However, also have the least "normal appearance."
Erectile dysfunction, or ED, is the inability to achieve or sustain an erection suitable for sexual activity. Causes vary and include: adverse side effects to certain medications, chronic illnesses such as diabetes and heart disease, poor blood flow to the penis, low testosterone, physical trauma, mental health issues, alcohol and/or drug abuse or misuse, and fatigue.
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Some men try to talk themselves into attraction; they think, “She’s hot” instead of asking themselves “Am I attracted to her?” External beauty does not equal internal erotic energy and is rarely enough to create real chemistry or sexual desire. If you are trying to have sex with someone who you are not really feeling the chemistry with, it is time to confront the issue directly.
Some men say certain alternative medicines taken by mouth can help them get and maintain an erection. However, not all “natural” medicines or supplements are safe. Combinations of certain prescribed and alternative medicines could cause major health problems. To help ensure coordinated and safe care, discuss your use of alternative medicines, including use of vitamin and mineral supplements, with a health care professional. Also, never order a medicine online without talking with your doctor.

“Even before any human clinical trials were done, severe sexual dysfunction was a foreseeable consequence of taking finasteride or dutasteride,” Dr. Steven Belknap, research assistant professor of dermatology and medicine at Northwestern and lead author of the study, told Healthline. “If there was meaningful assessment of persistent sexual dysfunction in humans during the clinical development of the these drugs, this does not appear to have been reported in the medical literature, the FPI, or other publicly accessible sources.”
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.
Several classes of prescription drugs contribute to sexual dysfunction in men and women (Table 1).1-3 Patients who develop drug-induced sexual dysfunction are more likely to be non-adherent. This has been found with antihypertensives4 and antipsychotics5. The literature has emphasised male sexual problems with less data available on female or couple problems.

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.
Yes. Stress definitely can cause erectile dysfunction (ED). It may become an issue with a new relationship or when challenges at work become overwhelming. These issues can interfere with “erotic focus” or “awareness of sensory experience.” Basically, it can take someone out of “the moment” making maintaining an erection a challenge. In fact, while stress is a common cause of erectile dysfunction in those under the age of 40, it can be responsible for ED at any age. Also, while younger men are more likely to have a psychological reason for their ED, physical reasons cannot be excluded. Nevertheless, in younger men the causes are often related to stress, depression, extreme anxiety, or some other disruption in their emotional state. Young men may have physical reasons that cause ED, including issues like abnormal hormone production, trauma that affects the blood vessels of the penis, Peyronie’s disease that causes a bend in the penis, neurological conditions that affect the transmission of signals that result in erections, drug or alcohol use, or the use of medications as simple as antihistamines. Also, in men under the age of 40, ED can be an early sign that vascular disease is beginning to affect them. An erection is an indicator of a man’s general health. It is always worth exploring the possible physical issues that could be at work. Nevertheless, in the younger population stress and depression are not uncommon causes of ED.
Medications used in the treatment of other medical disorders may cause erectile dysfunction. If you think erectile dysfunction is caused by a medication, talk with your doctor about drugs that might not cause this side effect. Do not just stop taking a prescribed medication before talking with your health care provider. Common medications associated with erectile dysfunction are:
Erectile dysfunction (previously called impotence) is the inability to get or maintain an erection that is sufficient to ensure satisfactory sex for both partners. This problem can cause significant distress for couples. Fortunately more and more men of all ages are seeking help, and treatment for ED has advanced rapidly. The enormous demand for “anti-impotence” drugs suggests that erection problems may be more common than was previously thought. Find out more about the causes and treatment of erectile dysfunction here.
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.
Erectile dysfunction can be embarrassing and difficult to talk about for some men. Many men may feel like they need to hide their diagnosis from their partner. "Failure to communicate openly about erectile dysfunction can result in both partners drawing away from the relationship," warns Feloney. Remember that your partner is also affected by your problem; being open and honest is the best way to decrease fear and anxiety. Discuss options for achieving sexual satisfaction together, and be positive — most erectile dysfunction problems can be treated.

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.


Your health our health. And you don’t have to stop taking life-saving medication to treat ED. Talk to your doctor to see if you can alter the medication that’s causing your ED toIf you’re experiencing ED.  A frank discussion can lead to alternative medications or treatments, and a better discussion about ED. Just remember that you should never stop taking a prescription medication without the supervision of a doctor.
Other hormone levels: Measurement of other hormones beside testosterone (luteinizing hormone [LH], prolactin level, and cortisol level) may provide clues to other underlying causes of testosterone deficiency and erectile problems, such as pituitary disease or adrenal gland abnormalities. Doctors may check thyroid levels in some individuals as both hypothyroidism (low thyroid function) and hyperthyroidism (overactive thyroid function) can contribute to erectile dysfunction.
Difficulty maintaining an erection happens from time to time and often has no underlying causes. It’s very common and doesn’t always mean that anything is wrong. Sometimes all it takes is trying new things with your partner(s) and focusing on ways to help sex work for you. Focusing on past experiences of losing erections can increase feelings of anxiety.
Not enough info for you? No problem. Nerd out on all the causes of erectile dysfunction with research from the most trusted sources on the interwebs. If you have any questions or you think we missed something important, leave a comment or book a consultation with one of these trained professionals and we’ll get you on the way to a healthier manhood.
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