Erectile dysfunction is a common occurrence in men with diabetes. The incidence of erectile dysfunction increases progressively with age, from 5% in men age 20 to 75% in men over age 65. The cause of erectile dysfunction in men with diabetes is usually related to a decrease in the blood supply to the penis as well as to injury to the nerves that are responsible for the erection mechanism. A decrease in testosterone production has also been identified as the cause in some men with diabetes.

Although the term ‘treatment failure’ to oral drugs is widely used, there is no precise definition of what exactly means. Treatment failure may be due to medication, clinician and patient issues (Table ​(Table3).3). Based on these issues a definition of a non-responder to oral pharmacotherapy is proposed: “an inadequate erectile response after at least 4 attempts of the highest tolerated drug dose in accordance with manufacturer’s guidelines with respect to timing relative to meals, alcohol ingestion, use of concomitant medications, and adequate sexual stimulation/arousal” (Carson et al 2004).
Are you reading article after article wondering how to put a stop to erectile dysfunction? There is no shame in suffering from erectile dysfunction, being as common condition as it is, erectile dysfunction is one of the leading health problems in men. The researchers suggest that every man will suffer from erectile dysfunction at some point of their life. So, if you have been wandering the Internet with the hope of finding out about the ways you could use to cure your condition, or if you want to get informed about the topic of erectile dysfunction, you are in the right place.

Physical exercises are only one part of overcoming sexual dysfunctions. If you're serious about restoring full control sexually then you need to understand which of your current thoughts and actions are causing your failure. After you understand how your problem works, THEN you can apply the correct thought and action sequence to stay in control sexually!


The Medline (Pubmed) electronic database was searched (from June 1972 to November 2010) for systematic reviews that evaluated the effects of therapeutic exercise on ED. The key words and search terms used to develop the search strategy for each of these databases included: exercise therapy, aerobic exercise, therapeutic exercise, rehabilitation exercise, impotence and erectile dysfunction. In addition, the electronic searches were supplemented by checking the reference lists of any relevant identified articles.
Your brain runs on procedures, so you need to apply the correct thought and action sequence to specifically address the problem you are facing. For example, Kegels are one of the most commonly recommended treatments for premature ejaculation. While Kegels (PC exercises) are a good exercise to strengthen the muscles which support your penis, when done during sex Kegels can cause a man to ejaculate early. This is because Kegels increase blood flow which leads to an increased awareness of sensation. This is exactly what you don't want if you suffer from premature ejaculation!

For the study, data was collected from more than 800 randomly selected Australian men, 35 to 80 years old at the beginning of the study, with follow-up five years later. Sexual desire was assessed using a standard questionnaire that addressed interest in engaging with another person in sexual activity, interest in engaging in sexual behavior by oneself, and no interest in sexual intimacy.
"For men who are unwilling or unable to self-inject alprostadil, the FDA has approved this dissolvable pellet that can be inserted directly into the urethra, the opening of the penis," says Dr. Feloney. MUSE, with an inspiring name that actually stands for medicated urethral system for erection, will trigger an erection in about 10 minutes that may last as long as an hour. Using MUSE to treat ED can result in somewhat unpleasant side effects, however — including an aching sensation, burning, redness, and minor bleeding.

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Red Ginseng — One small randomized trial found evidence that red ginseng may offer modest improvements in ED symptoms (as compared with placebo). A meta-anaylsis published in the British Journal of Clinical Pharmacology states, “Traditionally red ginseng has been used to restore and enhance normal well-being, and is often referred to as an adaptogenic….Possible mechanisms of action of red ginseng include hormonal effects similar to those of testosterone. Others have postulated that red ginseng might induce relaxation of the smooth muscles.”  (5)
Hunter Wessells, chairman of urology at the University of Washington School of Medicine, says, “Exercise has a set of potential effects that are not strictly related to weight loss.” A recent Italian study in the Journal of Sexual Medicine found that exercise plus a PDE-5 inhibitor drug like sildenafil (Viagra) worked much better than the drug alone. Another Italian report showed that exercise was a major contributor to sexual function and blood vessel condition.
Penile erection is a hemodynamic process involving increased arterial inflow and restricted venous outflow, coordinated with corpus cavernosum and penile arterial smooth muscle relaxation. Any problem in this mechanism results in ED, and its etiology is generally multifactorial (6). Diabetes, hypertension, high serum cholesterol level, peripheral vascular disease and cardiac problems are significantly found together with ED (7). However, vascular reasons predominate in the etiology of ED and it frequently appears along with atherosclerosis (7). It is known that atherosclerotic lesions prevent blood flow into cavernosal tissues resulting in ED (8).
You may know horny goat weed from its omnipresence behind the counter at your local convenience store, but this traditional Chinese formula is less sketchy than it sounds. Used for centuries to treat low libido and erectile dysfunction, the herb’s potential efficacy was show in a 2010 study published in the Journal of Sexual Medicine. Researchers who fed the supplement to rats found they had improved erectile function; another study showed that the supplement can block a natural chemical that wilts erections. (Just be warned: Viagra was found to be 80 times more powerful.)
For many patients, when I mention there is an another option to Viagra and other PDE-5 Inhibitors, their eyes light up, quickly followed by a nervous look as they find that it requires an injection to their penis or inserting something directly into their urethra. At this point, to not completely turn off the patient, I do try to get some information in to help them make a decision.
The Scenario: Driven by an urge to be the best he can be, a friend who does not have erectile dysfunction is pre-gaming for sex by taking Viagra recreationally. He maintains that the erections he sports while taking it are fuller, harder, and more long lasting than the ones he produces naturally and help overcome a slew of obstacles that can bedevil his boner including too much booze, cocaine, performance anxiety, and the fact that he's long past the days when a stiff breeze would be enough to provoke a thumping erection. He's also been known to take it when he's not necessarily in the mood for sex but doesn't want to disappoint a horny partner.
They found that men who exercised the most were also the most likely to have higher scores in sexual function. Specifically, those who expended 18 METS, or metabolic equivalents, per week were most likely to enjoy sex. METS is a physiological measurement that denotes the amount of energy a person spends on a specific activity, as well as the intensity of it. According to the researchers, 18 METS was equal to about two hours of strenuous exercise like running or swimming, 3.5 hours of moderate-intensity exercise, or six hours of light exercise.   

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).
At his last visit, Mr. Jones was prescribed Imdur (isosorbide mononitrate) to help with his heart condition. Reading through the notes, it looks like the Imdur worked. He was feeling better, so much better that he wanted to start having sex with his wife again. And here was the problem: Mr. Jone’s doctor had renewed his Cialis prescription. Quickly, I went from a moment of elation to consternation.
Older age. A man’s risk increases past the age of 40, as age is the variable most strongly associated with impotence. This is due to changing hormones, higher risk for heart problems and those affecting circulation, and decreased sexual desire that often occurs with increasing age. For example, based on findings from the National Health and Social Life Survey, it’s been found that “men between 50–60 years old are more than 3 times as likely to experience erection problems and to report low sexual desire compared to men aged 18 to 29 years.” (3)
Fortunately, Ron Hansen didn't have to go that far. He has become used to injecting himself with Alprostadil, which produces a firmer erection than he experienced with Viagra, and one that lasts at least 30 minutes. It also doesn't cause the headaches associated with Viagra. Hanson occasionally uses the suppositories, though they take longer to work.

The association of CVD and ED was noted in 1997 as one analysed the results of the MMAS. In this landmark study, 1709 men aged 40–70 years were enrolled between 1987 and 1989. A follow-up some 10 years later revealed a striking relationship between ED and CVD. In this study, it became clear that the risk factors for ED were very similar to those of CVD, such as diabetes mellitus, smoking and dyslipidaemia.18
Research has even found possible links to frequent ejaculation and a lower risk of prostate cancer. In one study of 32,000 men published in 2016 in the journal European Urology, for example, men who ejaculated at least 21 times per month while in their 20s were less likely to be diagnosed with prostate cancer than those who ejaculated four to seven times per month. And men who ejaculated more often in their 40s were 22 percent less likely to get a prostate cancer diagnosis.

Antioxidants  boost nitric oxide production and prevent NO breakdown. Ascorbic acid has direct effects on the bioactivity of NO, and augments NO production in a variety of body processes. The effects are actually synergistic with Vitamin E. Both vitamins are not usually measured, and a reasonable dose of Vitamin C is 500 to 1,000 mg daily. Vitamin E supplementation should be limited to <400 IU per day because of potential adverse long-term health effects of higher doses.
Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.
Test was terminated after 15 minutes of observation or after ejaculation (whichever occurred first). Ejaculatory latencies were taken as 15 minutes when animals showed intromissions but failed to ejaculate during the test period. After analyzing the results, the following tests were performed with the group that indicated significantly positive effects compared to the controls:
Sildenafil is a highly selective inhibitor of PDE type 5 (Boolell et al 1996; Gbekor et al 2002). It enhances NO-mediated relaxation of human corpus cavernosum in vitro (Ballard et al 1998; Stief et al 1998; Gemalmaz et al 2001). Sildenafil, by inhibiting phosphodiesterase, increases the intracellular concentrations of cyclic guanosine 3’,5’ monophosphate (cGMP), causing an amplification of the endogenous NO-cGMP signaling pathway.
Sildenafil is a highly effective treatment associated with a good safety and tolerability profile in men with ED. It is also effective in several subpopulations although efficacy is lower in the so called difficult-to-treat subpopulations such as patients with diabetes mellitus or after radical prostatectomy, including men in older age groups. Sildenafil significantly improves satisfaction and quality of life for both patients and partners. Furthermore, new data from basic and clinical research suggest a possible role in the future for several other chronic conditions.

You may be wondering why alprostadil can’t just be applied directly to the penis as a topical agent instead of directly injecting/inserting it. A study conducted in 2006 in 1732 patients using a topical formulation did demonstrate some efficacy (though less than Caverject or Muse). Common side effects were burning sensation (for both men and women) though this was relatively low, with only 2.7% of subjects stopping its use. Currently, drug manufacturer Apricus Biosciences is looking to bring this formulation, named Vitaros, to market in the US (it is available in Europe at this time) but progress with regulatory approval has been slow. When and if this formulation makes it to the US market, it may be preferred by men who cannot take PDE-5 inhibitors.
Magnesium helps regulate levels of calcium, zinc, and other vitamins and minerals. It also helps the body produce energy and contributes to proper organ function. Most people don’t develop a genuine magnesium deficiency, even if they don’t get enough of the mineral in their diets, according to the University of Maryland Medical Center. A true magnesium deficiency, however, may increase the risk of erectile dysfunction.
Cai, T., Verze, P., Massenio, P., Tiscione, D., Malossini, G., Cormio, L. ... Mirone, V. (2016, August 12). Rhodiola rosea, folic acid, zinc and biotin (EndEP®) is able to improve ejaculatory control in patients affected by lifelong premature ejaculation: Results from a phase I II study. Experimental and Therapeutic Medicine, 12(4), 2083-2087. Retrieved from https://www.spandidos-publications.com/10.3892/etm.2016.3595
But you really do not need any medications like I-Arginine and others to solve your erection problems. Many researches suggest that if you try natural solutions and home remedies rather than going for medications, you will have a healthy and satisfying sex. These vitamins and supplements with surely  help in treating  your ED (erectile dysfunction) and other penis related problems.
The substance that gives hot peppers their kick can also give you some kick in the pants: Studies have associated the natural chemical with increased testosterone levels. In animal studies, capsaicin has also shown to increase the size of sex organs, while simultaneously decreasing belly fat. A 2014 study from France also found that men who ate more spicy food had higher testosterone levels than those who ate less. You can consume capsaicin via peppers, chili powder or a cayenne supplement.
Move a muscle, but we're not talking about your biceps. A strong pelvic floor enhances rigidity during erections and helps keep blood from leaving the penis by pressing on a key vein. In a British trial, three months of twice-daily sets of Kegel exercises (which strengthen these muscles), combined with biofeedback and advice on lifestyle changes — quitting smoking, losing weight, limiting alcohol — worked far better than just advice on lifestyle changes.
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