After two hours of zinc treatment, male rats were individually caged and kept for 15 minutes for adaptation. One estrous (receptive) and one diestrous (nonreceptive) female were introduced to each cage and the duration of physical contact with each female was recorded for 15 minutes. Partner preference index (PPI) was calculated as the difference between the time spent with estrous female and diestrous female. Positive indices indicate their positive sexual interest.
Both patients and partners report higher levels of satisfaction (assessed with the Erectile Dysfunction Inventory of Treatment Satisfaction [EDITS] questionnaire) after sildenafil treatment relative to placebo (Lewis et al 2001). Patients receiving sildenafil had significantly higher scores (73.6 ± 3.2) than did those receiving placebo (48.4 ± 3.2, p<0.001). The scores on the partner version of the EDITS were also significantly higher among the partners of men who received sildenafil (63.9 ± 8.1) than among the partners of those who received placebo (33.3 ± 7.5, p<0.001). A high level of treatment satisfaction (65%) reported in another clinical practice study (assessed by 5-item scale) (Jarow et al 1999). Treatment satisfaction was correlated with ED severity (41% in severe, 78% in moderate, and 100% in mild ED) and etiology (56% in neurologic causes, 58% in diabetes, 35% in radical prostatectomy, 89% in psychogenic causes, and 86% in vasculogenic causes). However, no particular characteristic predicted absolute failure with sildenafil. Sildenafil also improved all aspects of health-related quality of life (assessed by SF-36 or Q13 and Q14 of the IIEF) in general ED population or subgroups such as spinal cord injuries (Hultling et al 2000; Giuliano et al 2001; Fujisawa et al 2002). Significant improvements in self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction after treatment of ED with sildenafil were reported by Althof and colleagues (2006) using the self-esteem and relationship questionnaire (SEAR) in a cross-cultural double-blind, placebo controlled, flexible dose study (Althof et al 2006; Cappelleri et al 2006). Treatment satisfaction is also maintained through time (Figure (Figure3)3) (Carson et al 2002).
As we mentioned before, there are a lot of treatment options that you could use to treat a condition as erectile dysfunction. A lot of the men diagnosed with erectile dysfunction decide to try some of the natural remedies before they refer to some of the top men enhancement pills. Exercise is one of the most commonly recommended ways as a natural remedy for erectile dysfunction. We all know that exercising has a lot of different beneficial effects on our bodies so why not use it as a part of the treatment for this condition?
Data on partner satisfaction support the patients’ satisfaction. For the partners of sildenafil-treated patients, 74% (younger than 65 years) and 67% (65 years or older) were satisfied with the treatment compared with the partners of placebo-treated patients (35% and 22% respectively) (Montorsi and Althof 2004). Satisfaction defined as EDITS score of greater than 50. The quality of partnership as perceived by both the men and their female partners is significantly better in ED patients treated with sildenafil than in untreated controls (Muller et al 2001). More than 90% of partners reported satisfaction with treatment in an open prospective study of men with ED receiving sildenafil for 10 weeks (Gil et al 2001).
A variety of personal habits and lifestyle choices have been linked to ED. In some ways, this is a good thing, since habits can be broken and choices reconsidered. What's more, many of the lifestyle factors that contribute to sexual problems are ones that affect overall health and well-being, both physical and mental. Addressing these factors, therefore, can have benefits beyond improving erectile dysfunction.
Saying zinc is essential for our physiology is an understatement due to the numerous processes this element has involvement in. It is believed that zinc plays a crucial role in the activation of over 300 enzymes in the human body and unfortunately, deficiencies in this element are quite common . It is currently estimated that about 17.2 percent of the global population is at risk for insufficient zinc intake . When zinc is deficient, patients at younger ages are more sensitive to physiological alterations. Young patients still in puberty can expect to see slower growth in gonadal organs (sex organs) and have stunned growth, which can reduce sex hormones overall and predispose patients to sexual dysfunction. As adults, there seems to be a link between low zinc levels and sexual dysfunction. Zinc is also essential in our immune system and any deficiency essentially shuts off half of our only protection against pathogens. These patients will contract sicknesses easily and have some chronic conditions that could also cause erectile dysfunction.  Thankfully, most staple foods in the Western diet have naturally high levels of zinc. Some of the most robust foods include low-fat beef, ground beef, dark meat in poultry, egg yolks and some types of cheeses .
The observation that TRT enhances the efficacy of PDE5 inhibitors in hypogonadal men taking these therapies with suboptimal response to the PDE5 inhibitors alone has been reported.33 In addition, investigators have demonstrated that TRT in hypogonadal men can improve erectile function even without the benefit of PDE5 inhibitors.33 In addition, guidelines for managing ED in hypogonadal men by the European Association of Urology recommend controlling the man to a eugonadal state prior to initiation of PDE5 inhibitor therapy.36 Testosterone measurement consists of a serum specimen which should be ideally obtained in the morning because of the normal diurnal variation of testosterone which is at its peak in the morning. Since TRT is relatively safe, and men can potentially see an improvement in erectile function, it seems prudent to consider this issue when presented with a patient suffering from ED.
In patients who either fail to respond to first or second-line therapy, or are not interested in the conservative therapies, penile prosthesis implantation is available. Malleable and rigid implants were available for many years, but in 1973 the world of penile prosthetics took a giant leap forward with the advent of the inflatable penile implant. Most implants done nowadays are of the inflatable variety. Adverse events including malfunction and infection are rare, and patient satisfaction is very high.45
Nearly every primary care physician, internist and geriatrician now understand that many older men retain an interest in sexual activity as they age. Some primary care physicians think that sexual potency in older men is the norm, and that if it is lacking, it is ‘all in the head.’ This viewpoint has not been supported by current literature. The Massachusetts Male Aging Study (MMAS) found that 52% of men between 40 and 70 years old reported having some form of erectile dysfunction (ED).1 The reality is that ED is a natural part of ageing and that the prevalence increases with age. In the MMAS, they found that roughly 50% of men at 50 years old, 60% of men at 60 years old and 70% of men at 70 years old had ED. Thus, nearly all men who live long enough should develop ED. The myths that surround the problems of impotence or ED confound the attempts of patients to receive treatment and the attempts of physicians to help them.1
The research found that most of the men were overcoming erectile dysfunction naturally. The remission rate of those with erectile dysfunction was 29% which is high. This shows that many of these factors affecting men are actionable providing them an opportunity to do something about their condition. "Even when medication to help with erectile function is required it is likely to be considerably more effective if lifestyle factors are also addressed says Dr. Sean Martin lead author of the research paper.
A man needs to try the medicine at least four times before he concludes that it doesn’t work for him. It is unlikely that a man with diabetes who has other medical problems such as high blood pressure, is taking multiple medicines, and has not had sexual intercourse for several years will be able to have an erection adequate for intercourse the first time he takes a pill. Most men need to try the medicine several times before they have the desired results.
Oysters are also a great source of zinc, with just 3 ounces providing 493% of your recommended daily intake. In fact, oysters are so rich in zinc that eating too much can cause an accidental zinc overdose, so just be wary of this. Bear in mind as well that oysters are a common source of food poisoning, and they are also very high in cholesterol – might be best to stick to your nuts and seeds!
Since 1998, when sildenafil (brand name Viagra) first came on the market, oral therapy has been successfully used to treat erectile dysfunction in many men with diabetes. (Sildenafil was followed in 2003 by the drugs tadalafil [Cialis], vardenafil [Levitra] and avanafil [Stendra], which work in much the same way.) Some 50% of men with Type 1 diabetes who try the drugs report improved erections, and some 60% men with Type 2 diabetes do, too. However, that leaves a large percentage of men with diabetes and erectile dysfunction who do not respond to therapy with one of these pills. This article takes a look at what can be done to treat those men who do not respond to oral therapy.
Handful of things can cause erectile dysfunction, but healthy vitamins supply for erection will make your sex life very soothing and romantic. Healthy blood vessels are necessary for good circulation, as blood is pumped around the body to carry nutrients to the cells. Vitamins can help the blood vessels to dilate or open so blood can fill the manhood.
Over 18 million American men over 20 years old suffer from erectile dysfunction, a condition characterized by the inability to keep an erection. It’s a complex disorder brought on by a number of factors, but it’s almost always devastating for the man it affects — causing him to lose confidence in himself and different aspects of his life. The stress it causes can deteriorate relationships and lead to lost productivity at work. Health problems aren’t uncommon either. But there’s good news in all the bad; a new study finds exercise may be a simple way to get things going under the sheets again.
A nationwide MDLinx survey found that 91% of primary care physicians said that traditional Chinese medicine, or Oriental medicine, is at least somewhat effective. Indeed, more than 3 in 4 PCPs reported that they've prescribed or referred patients for acupuncture. Also, as many as 36% of respondents have prescribed traditional Chinese herbal medicines, our study found. Maybe 36% doesn't seem like a lot, but perhaps some physicians have prescribed herbal medicines or their derivatives without even realizing it—such as the malaria drug developed from a common herb through Nobel Prize-winning research. Read this to learn more.
Consequently, taking other steps to reduce inflammation might also heal ED. Ask your doctor about going on a low-cost anti-inflammatory medicine like salsalate, which has been shown to help diabetes in some studies. Also, make sure your dental health is good. A large Chinese study found that gum disease was strongly correlated with ED in men with diabetes. That doesn’t prove that gum disease causes ED, but it is a major cause of system-wide inflammation, which won’t do your blood vessels any good.
The bottom line is that nearly all men with diabetes who wish to have an erection adequate for sexual intercourse can do so with the therapies currently available. And with commitment and communication, the experience of erectile dysfunction can be changed from a potential personal tragedy to an opportunity for greater emotional intimacy in a couple.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
General health. If you have liver or kidney problems, Viagra’s effects could last for longer, although it might not be safe to take Viagra with these conditions. The reason it lasts longer is because the tablet will take longer to be broken down by your body, this means there is a bigger risk of having more serious side effects. You must always mention these conditions during a doctor assessment for Viagra treatment
A drug called Alprostadil, either alone or sometimes in conjunction with others such as papaverine and/or phentolamine, can be injected directly into the penis to dilate the arteries, experts say. The drug produces an erection in about 10 minutes that can last up to an hour. But there are several disadvantages, says Teresa Beam, MD, a urologist with the Grey Clinic. Some patients are averse to using a needle, which is why many men abandon the therapy. Those who give it a try may experience pain at the injection site or priapism (a painful erection lasting too long).
Since endothelial dysfunction, CVD and ED are closely associated in epidemiological studies, the question for clinicians is whether to recommend the man presenting with ED undergo a cardiovascular (CV) evaluation. Clearly, based on numerous studies, ED can be considered at least a ‘marker’ for possible further vascular disease or CVD.15 In their report, Vlachopoulos and coworkers make the point that the man presenting with ED, the clinician, is offered an opportunity to attempt to improve the health of the man by addressing lifestyle modification, and consider further vascular evaluation owing to the clear relationship between endothelial dysfunction, ED and CVD.19
What if we look at erectile dysfunction as something that can be addressed as a condition other than a “pill for every ill”. What if we actually look at a nutrient level that directly correlates to a medical condition and follow the science to give a directive on its recommendation? Well it turns out taking a simple zinc supplement won’t help 100% of the time, but it certainly helps some of the time.
In a double-blind, placebo-controlled study, sildenafil (50 mg–100 mg) taken every night for 9 months, starting 1 month after nerve sparing radical prostatectomy was associated with recovery of spontaneous erections in 27% of patients compared with 4% of patients taking placebo (Padma-Nathan et al 2003). Schwartz and colleagues (2004), in a study of 40 potent volunteers with prostate cancer who underwent RRP, showed that sildenafil administration every other night for 6 months, substantially increases corporal smooth muscle content. The most promising prophylactic role of sildenafil is clearly the preservation of the smooth muscle of the corpora cavernosa.
Penile implants - are generally used if physical damage (like an accident) makes the anatomical parts needed for an erection not work. These are inserted by surgery and can provide a permanent treatment choice if others fail to work. The implants can be semi-rigid or inflatable. They can be pretty expensive and are not usually available on the NHS.
Intermountain Healthcare is a Utah-based, not-for-profit system of 23 hospitals, a Medical Group with more than 1,600 physicians and advanced practice clinicians at about 180 clinics, a health plans division called SelectHealth, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and in efficient healthcare delivery.
Ginkgo Biloba increased nitric oxide in one study by nearly 13% and decreased endothelin-1 a potent vasoconstricting peptide produced by endothelial cells by almost 6% increasing the NO/ET-1 ratio by approximately 20%. These three factors: increasing nitric oxide decreasing ET-1 and increasing in the NO/ET-1 ratio had a synergistic effect with increased vasodilation.
Similar results were presented by other studies. Incorrect administration accounted for 81% of sildenafil failures referred by primary care physicians (Atiemo et al 2003). Reasons included administration after heavy meals, lack of sexual stimulation, short timing to intercourse, and too few attempts for intercourse. The authors were able to salvage 41.5% of nonresponders after reeducation as measured by the General Assessment Question (GAG) and Sexual Health Inventory for Men (SHIM) scores. Gruenwald and colleagues (2006) showed that counseling and dose adjustment were directly influential in achieving an excellent response to a second trial of sildenafil in patients with ED who had previously failed treatment with the drug, and obviated their needing to seek more invasive measures. In this study, 38% of the included patients did not receive any explanations or counseling whatsoever from the prescribing physician. After proper instruction, erectile function domain scores increased significantly and overall 23.6% of the patients had a normal IIEF EF domain score (≥26) at the end of the study.
A glass of pomegranate juice a day keeps the oncologist away? Such may be the case if further evidence confirms a recent investigation of the pomegranate's ability to inhibit breast cancer cells. Previous studies have shown that pomegranate juice disrupts metastasis of breast and prostate cancers, but in a new study, researchers found that phytochemicals in pomegranate extract altered breast cancer stem cells, inhibiting cell growth and differentiation. Does this warrant more investigation? Find out here.
The efficacy of sildenafil in almost every subgroup of patients with ED is more than established. Response rates in elderly men (≥65 years) are comparable with general population regardless of age (Wagner et al 2001). No differences in response rates were demonstrated in ethnic groups (Young et al 2002). In type 1 diabetic patients, 66.6% reported improved erections (GAQ) and 63% reported successful intercourse attempts compared with 28.6% and 33% by those taking placebo, respectively (Stuckey et al 2003). In another multicenter, randomized, double-blind, placebo-controlled, flexible dose-escalation study in diabetic patients, 56% of patients reported improved erections and 61% reported at least 1 successful intercourse attempt compared with 10% and 22% in the placebo group, respectively (Rendell et al 1999). Diabetic patients are one of the most difficult to treat subgroups (Behrend et al 2005). In patients after bilateral nerve-sparing radical prostatectomy, 76% responded to sildenafil (defined as successful vaginal intercourse) (Raina et al 2004). A favorable response to sildenafil in patients with ischemic heart disease (GEQ and IIEF Q3 and Q4) who were receiving b-blockers and/or angiotensin-converting enzyme inhibitors and/or calcium channel blockers has been observed (Olsson and Persson 2001). Similar results presented in patients with hypertension (taking different or multiple antihypertensive drugs). High efficacy rates presented in patients on chronic dialysis for renal failure (lower doses and longer intervals between treatments are usually required) (Chen et al 2001; Mahon et al 2005), after renal transplantation (Prieto Castro et al 2001; Sharma et al 2006), in spinal cord injuries (Derry et al 2002; Deforge et al 2006) and patients with depression (treated with selective serotonin reuptake inhibitors [SSRIs] or not) (Seidman et al 2001; Nurnberg et al 2002) or patients treated with antipsychotic agents (Gopalakrishnan et al 2006).
This scenario raises a key concern for us (and should for you as well) about what is recommended to treat erectile dysfunction. I performed a quick Google search on kegels as treatment for the pelvic floor, and found hundreds of websites instructing men to perform kegels to ameliorate erectile dysfunction, have longer and stronger erections – a quick and easy fix. I found a few sites instructing men to perform anywhere from 50-100 repetitions per day (insanity). I discovered a new book called Male Pelvic Fitness, a “user manual to your man parts
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I would think the 25% is just an average. Some men never have a problem with erections. Some healthy men in their 60's never have a problem with their erections -- no Viagra needed at all, thank you. And, no, it is NOT completely associated with age. In fact, many men in their 40's and even younger, are already dealing with ED, especially if they smoke, are obese, don't exercise, or are addicted to porn, among other things. In fact, even men in their 20's and 30's can have these problems.
In the end, open and honest communication with your therapist will yield the best course of action. If you do decide to try pelvic floor PT, a comprehensive evaluation will determine what exactly is going on with your muscles. They may be tight and weak or they could have poor coordination. So my advice for those suffering from erectile dysfunction is this: before you try kegels, make an appointment with your pelvic floor therapist.
He and his co-investigators studied 76 men who had erectile dysfunction for at least six months. Group 1 took 50 mg of Viagra nightly at bedtime. Group 2 took 50-100 mg of Viagra when they wanted, presumably before sexual intercourse. The investigators also followed a third group of men with erectile dysfunction who received no treatment. The men were an average of 47 years old.
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.