Other factors that “stress” the body can also increase your risk for ED. These include: substance abuse, using marijuana, smoking cigarettes, depression, anxiety and low self esteem. Cigarette smoking — or using nicotine — leads to constricted blood vessels, which has negative effects for sexual health. Other mental/emotional obstacles can cause less desire for sex and decrease testosterone. Several ways to help manage stress include:
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).

Counselling or sex therapy (58% of people find this works for them) –mind-related causes of erectile dysfunction can affect anyone. They are more likely if you experience erectile dysfunction at a younger age. Talking to a counsellor or therapist can help some people overcome erectile dysfunction related to these problems, possibly for good. They can also help you if your erectile dysfunction is causing you stress, as this can make matters worse.
Older men (aged ≥65 years) have higher plasma concentrations of sildenafil compared with younger men (18–45 years), with mean maximum concentration (Cmax) 70% greater in older men and mean area under the curve (AUC) 84% higher compared with the younger age group. Due to age-differences in plasma protein binding, the corresponding increase in free sildenafil plasma concentration was approximately 40%. However, no differences in the safety of any dose of sildenafil were observed in older patients compared with younger men. Therefore, dosage adjustments are not required in elderly patients (Seftel 2003). Sildenafil significantly improves erectile function in elderly patients with erectile dysfunction of broad etiology although efficacy rates may be lower compared with younger men due to the normal aging process and age related risk factor accumulation mentioned before (Rendell et al 1999; Wagner et al 2001; Carson et al 2002).
The phrase “penis exercise” actually refers to exercises known as pelvic floor or Kegel exercises, in which a man focuses on strengthening the muscles that control the flow of urine and ejaculation. These exercises are often recommended to men who are recovering from prostate cancer treatment, have problems with ejaculation, or have a hard time holding their urine, but they do not appear to help erectile dysfunction.
A study published in The American Journal of Cardiology confirmed that aerobic exercises will help you to cure your erectile dysfunction. Erectile dysfunction is most commonly caused by obesity, hypertension, and diabetes, which decrease the blood flow in the penis. Aerobic exercises can and will help you to improve your health in general, improve your blood flow, and ultimately treat your condition.
On the flip side of the coin, helping and inspiring people is my mission. I understand the daily challenges you face regardless of your education, IQ and economic circumstance. I am not a healthcare professional. Simply a lay person who has lived with a Type 1 and Type 2 family member who struggled with their disease. My former Type 1 husband was a role model in how to manage your diabetes, while my intelligent family members were role models on how an invisible disease can be misunderstood, devastating the quality of their life while leaving heart broken family members behind.
Overall health. Certain existing conditions can affect how long Viagra lasts and how well it works for you. Diabetes, nervous system conditions like multiple sclerosis (MS), and heart conditions like atherosclerosis (fat buildup in your blood vessels) can all make Viagra less effective and not last as long. Some kidney conditions may make Viagra last longer because of the condition’s effect on your metabolism.
But, first for those of you who do not know anything on this topic, let’s define erectile dysfunction. Erectile dysfunction is a condition which characterizes itself with the inability to maintain an erection during sexual intercourse. Luckily, although erectile dysfunction is a common condition, this condition seems to be easily treated. You can choose from the variety of natural remedies, including supplements, which claim to increase your stamina, sexual ability, and muscle mass. This article is dedicated to the importance of exercise as a way to treat erectile dysfunction and highlight the best exercises you could use as a part of the treatment. 
I was impressed with the questionnaire to make sure the meds I requested were right for me and the follow up email from the prescribing doctor to see if I needed any support. The meds came promptly, were well packaged and are comfortably in date - I thought they might be very near their sell by date but I was wrong to be suspicious. If I ever need this service again I wouldn't hesitate.
In order to identify truly treatment failures, the physician need to address all the medication, clinician and patient/partner issues that were previously presented. The probability of a misdiagnosis due to incomplete basic diagnostic evaluation from a non-expert physician must also be investigated (Hatzichristou et al 2002). These are patients with hypogonadism or hyperprolactinemia who need specific hormonal manipulation in order to cure erectile dysfunction (Greenstein et al 2005), patients with Peyronie’s disease who need treatment for penile curvature or pain during intercourse, and patients who do not have erectile dysfunction but they experience ejaculatory dysfunction or sensory disturbances.
The number of animals ejaculating within 15 minutes was significantly reduced in 5 mg zinc treated group (one out of eight). However, all intromitted rats ejaculated between 20-30 minutes when observation was continued. Ejaculatory latency was significantly high in this group compared to controls; 711.60 Sec (SEM 85.47) vs. 489.50 Sec (SEM 67.66), P < 0.05. Similarly, they showed a significantly higher frequency of penile thrusting compared to controls; 26.50 (SEM 6.17) vs. 52.80 (SEM 11.28), P < 0.05 [Table 1].
There have been some fishy results on fish oil. It's purported to lower blood pressure, reduce serum triglycerides, decrease the risk of stroke, and ameliorate arthritis. But scientists recently reported that fish oil does something else—it may cause fat to accumulate in the liver and result in nonalcoholic steatohepatitis, a particularly harmful form of fatty liver disease. However, the scientists also found that another type of oil causes the least damage to the liver. Read here to find out more.

Despite the proven long-term efficacy of PDE5i, it has been suggested that tachyphylaxis to this therapy may develop. Long-term treatment with PDE5i and excessive cGMP accumulation may up-regulate PDE5 (El-Galley et al 2001). Such hypothesis however, has not been proven in the existing clinical trials with chronic PDE5i therapy (Behr-Roussel et al 2005; Musicki et al 2005). Currently, there are no evidence-based data to support tachyphylaxis in patients treated with sildenafil or any other PDE5i.
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.
But in this case, zinc is much harder to absorb. This explains a decrease in testosterone levels in vegetarians. Slippery jack mushrooms, button mushrooms, beef liver, and fish are also rich in zinc. They are followed by breadstuffs, egg yolk, rabbit, chicken, beans, tea, and cocoa. In addition, zinc is found in onions, garlic, and rice. And a very small amount of zinc is available in fruits, vegetables, and milk.
If you’ve been to the health food store lately, you’ve seen shelves lined with vitamins and “organic” supplements, each claiming to boost immunity, revitalize organ function, or “promote health.” And it’s working. Supplements are currently a $30 billion industry in the US, with more than 90,000 products on the market, and vitamin use is on the rise. In fact, a recent survey in Journal of American Medicine Association showed that “52% of US adults reported use of at least 1 supplement product.”

Alpha adrenergic antagonists are commonly used drugs in patients with BPH-related LUTS. Although the adverse event profile of sildenafil is not worsened by a background of anti-hypertensive medicines, even when the patient is on multiple antihypertensive agents, it appears to have some interaction with alpha blockers, which may result in clinically significant orthostatic hypotension under some conditions (Kostis et al 2005). This is most likely to occur in patients treated with doxazosin (a long-acting alpha blocker). Today, alpha blockers are no longer considered a contraindication for sildenafil, but precautions in the use of these drugs are listed. Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of sildenafil. Therefore, patients should be stable on alpha-blocker therapy prior to initiating sildenafil. Treatment with sildenafil must be initiated at the lowest recommended dose, while it should be taken 3–4 h apart from antihypertensive administration.

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.


It is important that you exercise, not only to combat ED but also to maintain your general health. Any aerobic exercise such as running, cycling or swimming will be great for improving your overall health and fitness. These kinds of exercise improves your cardiovascular health, which is important to help you treat your ED. You may also find it helpful to review your general lifestyle and reduce factors which could be contributing to your ED, such as smoking, drinking alcohol and eating unhealthy foods.
if you are taking sildenafil to treat erectile dysfunction, tell your doctor if you have ever been advised by a healthcare professional to avoid sexual activity for medical reasons or if you have ever experienced chest pain during sexual activity. Sexual activity may be a strain on your heart, especially if you have heart disease. If you experience chest pain, dizziness, or nausea during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.
Adequate daily magnesium intake is slightly lower for younger men than for those in their 30s and older. The University of Maryland Medical Center recommends 400 mg daily for men between the ages of 19 and 30, and 420 mg per day for men 31 and older. While these levels are a good general guideline, you should check with your doctor to determine the proper dosage for a daily magnesium supplement, particularly if you’re using magnesium to help treat or prevent erectile problems.
Surgery for erectile dysfunction is usually considered only after all other options have failed. The two surgical options include the insertion of a semi-rigid rod or the implantation of a three-piece inflatable prosthesis. Penile prosthesis implantation has low infection, complication, and malfunction rates. However, since placement of an implant requires permanent injury to the erectile tissue of the penis, implant treatment is considered irreversible.
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.
Andrew McCullough, MD, associate professor of clinical urology and director, male sexual health program, New York University Langone Medical Center. Lecturer: Auxillium. Research grant: Pfizer. Data safety monitoring board: Pfizer. Consultant: Slate Pharmaceuticals. Clinical trials: Warner Chilcott, Vivus, Lilly, Bayer-GSK, ICOS, Timm, Schering Plough, Aeterna.
In the 14 years or so since Viagra was introduced in 1998, the number of men diagnosed with erectile dysfunction (ED) has increased by a whopping 250 percent. Men are realizing more and more that they’re not alone and that they have options. Aside from pills like Viagra, Levitra, and Cialis, for example, there are surgical, therapeutic, even do-it-yourself treatments that can bring back that lovin’ feeling. "Some older ED treatments are actually being used more than ever, especially for men who can't take the pill," says Michael Feloney, MD, a urologist at the Nebraska Medical Center in Omaha. Read on to find out about nine common remedies for ED, plus the truth about which ones live up to the hype and which fall flat.
Several new studies have proven not only the cardiovascular safety of sildenafil, but have also suggested that sildenafil may have a cardioprotective role. PDE5A inhibition by sildenafil blunts systolic responses to beta-adrenergic stimulation suggesting a possible role in modifying stimulated cardiac function (Borlaug et al 2005). Chronic inhibition of cGMP phosphodiesterase 5A by sildenafil prevents and reverses cardiac hypertrophy (Takimoto et al 2005). Finally, sildenafil is the only PDE5i that improved arterial oxygenation in patients with pulmonary hypertension (Ghofrani et al 2004) and it has been recently approved in doses of 20 mg and 40 mg, taking every 8 h life-long by patients with pulmonary hypertension (Galie et al 2005).
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).
The nitric oxide stimulates an enzyme that produces something called a messenger cyclic guanosine monophosphate (cGMP). The cGMP relaxes the smooth muscle cells. One result of this is that the arteries in your penis dilate and the blood can flow into your penis more easily. Another result is that the erectile tissue itself fills with blood. Both of these process result in an erection. Viagra works by maintaining the level of cGMP in the smooth muscle cells.

If you suffer from premature ejaculation, erectile dysfunction or are unable to reach orgasm, it’s important that you reach a higher level of fitness than you currently have. This is also a requirement for you to become a healthier human being. These best exercises to improve sexual function are aimed at redeveloping your groups of muscles directly involved in the sexual act. Increasing the health of your sex muscles can naturally increase blood flow and can lead to improving your sexual performance.

For obvious reasons, ED can be a sensitive subject, one that until relatively recently men were more likely to try to hide than to deal with. Fortunately, a deeper understanding of the variety of causes of erectile dysfunction has led to medications, therapies, and other treatments that can be more individualized and more likely to be effective—and more open discussion about addressing the concern.
However, our friend is not in fact some sort of unthinking, unfeeling sex bot and as such is going to have his resolve softened by a number of external factors such as the ones mentioned above. As Kerner says, Viagra can help with the non-physical hurdles in between him and a prize winning hard-on, and it's probably not going to do him any serious or permanent damage.
The prolongation of ejaculatory latency may be beneficial when present with unimpaired arousability, penile erection and sex vigor. The ejaculatory latency can also be prolonged due to some disorders in the neuroendocrine or reproductive system.[24] But the duration of zinc supplementation in our study was only two weeks which is not long enough to have an impact on the neuroendocrine or reproductive system.
So what’s the problem? Well, if you really listen to the advertisements on television for erectile dysfunction (ED) medications, ignoring the blue tinted jazz from Viagra or the bathtubs in the sunset from Cialis, you may have heard the line “Do not take if you take nitrates for chest pain, as it may cause an unsafe drop in blood pressure.” You see Viagra, Cialis, and Levitra belong to the same drug class called Phosphodiesterase 5 Inhibitors (abbreviated as PDE-5 inhibitors), and they all share the same interaction with nitrates. Many patients wonder how bad can a ‘drop in blood pressure’ be. The answer, as we learned after Viagra came out, is this reaction could lead to heart attack in patients and potentially cause death, leading to a black box warning for the whole class of drugs like Viagra.
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 Erectile Dysfunction and its etiology is generally multifactorial. This study is aimed at determining the objective outcome of aerobic training in the management of Erectile Dysfunction of arterogenic origin using Meta analysis.
Hello everyone my name is john Scott,i was heartbroken because i had very small penis, not nice to satisfy a woman, i had so many relationship called off because of my situation, i have used so many product which i found online but none could offer me the help i searched for. i saw some few comments about this specialist called Dr Austin and decided to email him on DRaustinenlargementhome
One of the keys to addressing erectile dysfunction is improving the functioning of the endothelium, which is the inner lining of blood vessels. Wayne Hellstrom, MD, urology professor at Tulane University School of Medicine says keeping endothelium healthy can help you improve erectile functioning. Cardio training helps with this, as does resistance training. Adding weight training to cardio training increases muscle mass and bone strength helps your balance and stability (which can help prevent injuries) and can help lower blood pressure as well. Improved muscle definition can also be great for self-esteem, and that can’t hurt.
Lower urinary tract symptoms (LUTS) are independent risk factors for sexual dysfunction in older men (Rosen et al 2003). A possible role for PDE5i in the treatment of LUTS has been presented (McVary 2005). Sairam and colleagues (2002) showed that ED treatment with sildenafil improved both sexual function scores (based on IIEF) and LUTS and urinary scores correlated strongly with sexual function scores at 3 months. Mulhall and colleagues (2006), in a group of ED patients treated with sildenafil, similarly noticed that 60% of men improved their IPSS score, and 35% had at least a 4-point improvement in their score. If ongoing clinical research proves these preliminary data, it will open the avenue for innovative therapeutic approaches.
3. Testosterone replacement. Before oral medications like Viagra, testosterone was routinely used to treat erectile dysfunction as it is central in the male sexual response, including the desire for sex and the process of getting an erection. Testosterone can be administered in a number of ways, for example orally, by means of an injection, skin patch, or subcutaneous (under the skin) pellet. 

Prostate problems are most common in older men, but it’s never too early to start looking after your prostate! Problems such as BPH (enlarged prostate) and prostatitis can cause unpleasant symptoms such as frequent urination, weak urine stream, difficulty urinating and sudden urges to urinate, which can really get in the way of daily life and interrupt sleep.

Non-drug approaches to rehab include using a vacuum constriction device. This is a plastic cone that you place over the penis, then pump out the air inside to create a vacuum. The vacuum draws blood into the penis. For intercourse, an elastic band is slid over the penis to keep the blood in. But for rehab, you don’t use the band; the idea is just to keep the erection for 10 to 15 minutes, or as long as possible. According to San Diego Sexual Medicine, doing this three times a week can help restore normal sexual function. This can be combined with a PDE-5 inhibitor.


3. Testosterone replacement. Before oral medications like Viagra, testosterone was routinely used to treat erectile dysfunction as it is central in the male sexual response, including the desire for sex and the process of getting an erection. Testosterone can be administered in a number of ways, for example orally, by means of an injection, skin patch, or subcutaneous (under the skin) pellet. 

If you can't take one of these oral medications, your physician may have you try Caverject (alprostadil for injection), a hormone that you inject into your penis using a fine needle, or Muse (alprostadil urogenital), a tiny suppository that you insert into the tip of the penis. Both of these will bring on an erection within five to 15 minutes without sexual stimulation.
Impotence, or erectile dysfunction (ED), is the inability for a man to sustain an erection long enough for normal, satisfying sexual intercourse.  To understand the underlying causes of impotence, it helps to know the basics about how an erection develops, along with potential problems that get in the way. Erections begin in the brain with a thought related to sexual desire. Then a chemical message travels from the brain to the penis. Blood flow to the penis increases as blood vessels leading to the reproductive system relax and allow for increased circulation.
The availability of phosphodiesterase type 5 inhibitors (PDE5i) has resulted in increasing numbers of patients seeking medical help for erectile function problems, but has also altered dramatically the medical management of ED (Hatzichristou and Pescatori 2001; Lewis et al 2001; Steers et al 2001). More physicians are treating ED, especially in the primary care setting, including minimal patient work-up and prescription of PDE5i due to their proven efficacy and safety profile. The management of ED by non-specialists includes minimal patient work-up and prescription of exclusively first-line treatment options in most cases, mainly due to the lack of time and background knowledge (Hatzichristou 2002). Sildenafil was the first available PDE5i that revolutionized ED treatment (Goldstein et al 1998). More than 30 million of men are treated worldwide with sildenafil accompanied by vast experience and research with more than 2600 papers published in Medline as of July 2006. Furthermore, new data suggest that sildenafil has beneficial effects in several chronic conditions. It has been recently approved for the treatment of idiopathic pulmonary hypertension (Galie et al 2005), and numerous articles have suggested that PDE5i may improve endothelial function (Katz et al 2000; Desouza et al 2002; Halcox et al 2002; Vlachopoulos et al 2003; Vlachopoulos et al 2004; Gori et al 2005; Hirata et al 2005). PDE5i have been also suggested to be beneficial for patients with premature ejaculation (Abdel-Hamid 2004). However, clinical studies have shown controversial results so far (Salonia et al 2002; Chen et al 2003; Atan et al 2006) and it remains uncertain, whether PDE5i act on the physiologic process of ejaculation, or indirectly, improving erectile function and therefore, reducing performance anxiety in men with ED.
Clinical trials and post marketing data of sildenafil demonstrated no increase in myocardial infarction rates in patients that received these agents as part of either double blind, placebo controlled trials or open label studies or compared to expected rates in aged matched populations of men (Boshier et al 2004). Sildenafil does not adversely affect total exercise time or time to ischemia during exercise testing in men with stable angina. In fact, it may actually improve exercise tests. Sildenafil does not alter cardiac contractility, cardiac output or myocardial oxygen consumption based on evidence reviewed to date (Gillies et al 2002; Vlachopoulos et al 2003; Kukreja et al 2004; Webster et al 2004).
The search criteria identified 210 studies from 1972 to 2010; on inserting randomized controlled trials only 26 studies were identified out of which only 5 met the inclusion criteria and 21 studies did not meet the inclusion criteria, hence, were excluded. Five (18, 24–27) randomized controlled trials (RCTs) met the inclusion criteria; studies involved the use of aerobic exercise in the management of ED, the IIEF was the assessment tool for ED and also involved control groups. A total of 385 subjects were involved: Lamina et al (25), n=43; Lamina et al (26), n=43; Esposito et al (18), n= 110; Kalka et al (27), n= 129; Maio, Saraed and Marchiori (24), n= 60.
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).
In a study with human subjects, Kruger et al. have reported that acute changes in the normal physiological levels of PRL led to a significantly prolonged ejaculatory latency, but minor reductions of sexual drive and function.[19] Although zinc induced elevation of PRL was not an acute effect, findings similar to the human study (prolongation of ejaculation and mild reduction of libido index with medium dose of zinc) were observed in this study. However, the prolongation of ejaculatory latency may not be merely due to effects of elevated PRL because elevated PRL levels are known to be associated with the negative aspects of sexual activities (decreased sexual desire and frequency of sexual intercourse).[20]
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The problem with this though is that there are a lot of websites that are claiming to have a specific exercise technique or perhaps very effective male enhancement products that can guarantee erectile dysfunction. Be careful not to fall for a male enhancement scam. Even though erectile dysfunction may be stressful or difficult to discuss about, there are proven and safe methods that can help you in dealing with it.
Aside from pelvic floor exercises, it has been found out that aerobic exercises also work in treating erectile dysfunction. This condition is often caused by problems related to blood flow to the penis. Diabetes, obesity, vascular disease as well as high cholesterol may affect blood flow. This results to erectile dysfunction. By adding some aerobic exercises to your routine, you can significantly enhance your overall male sexual health and may even remove the problem totally in the long run.
Dear David and Aisha, I am a 39-year-old married man who has had type 1 diabetes for 22 years. My A1C levels run around 7.5%. About six years ago, I started having trouble with erections. Now they are very rare, even with ED pills. I know you say that there is more to sex than intercourse, and my wife and I still enjoy ourselves however we can. But we both miss the erections.
Impotence, also called erectile dysfunction (ED), can be a very frustrating problem. Some men are able to achieve an erection but are not able to maintain one. Others are not able to achieve one at all. Causes of impotence can be both physiological (affecting mostly the body and organs) or psychological (affecting the mind). Luckily, there are natural remedies for impotence you can try.

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.

This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.


Take note that you may not be able to complete a series of about 10 kegel exercises on your first try. This is just fine. Just do what you can, and gradually work on more kegel exercises until you reach 10 to 20 kegels, up to three times in a day. When performing these exercises, avoid holding your breath, or pushing your stomach, thigh muscles, or buttocks in. It would be helpful if you relax after every count of five. You may also challenge yourself by alternating between long and short squeezes.
You can also consider using a cock ring or penis ring if you are able to get an erection but have trouble maintaining it.  Cock rings work by trapping the blood inside your penis so it remains harder for longer.  You can purchase one in a sex store or online for about $5 and you put in on over your penis and testicles when you are half hard and keep it on until you are finished with sex.  It’s a great cheap fix for erectile issues.
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