Erectile dysfunction is a self-reported condition by the patients and the results of different treatment modalities are also self-evaluated (Hatzimouratidis and Hatzichristou 2005). Recent data on ED treatment outcome have shown that many patients discontinue treatment, despite the availability of efficacious pharmacotherapies, because doctors fail to inform patients properly and to ensure continuity in care, as well as to be routinely involved in asking patients about their needs and expectations (Mulhall et al 1999; Hatzichristou et al 2005). Althof (2002) described several causes that may contribute, including the length of time the couple were asexual before seeking treatment, the man’s approach to resuming a sexual life with his partner, the female partner’s physical and emotional readiness to resume lovemaking, the meaning for each partner of using a medical intervention to enable intercourse and the quality of the nonsexual aspects of the relationship. It becomes apparent that patients’ needs and expectations vary widely and the treatment approach should always be individualized according to their preference for information and involvement in the decision-making process. Patient satisfaction is a complex issue that depends not only on therapeutic outcomes in terms of efficacy and adverse events or complications but also on expectations from treatment and relationship dynamics.
Sildenafil, vardenafil and tadalafil increase the amount of nitric oxide in your body. Your body contains nitric oxide naturally, which is a gas that relaxes blood vessels. Medications to treat erectile dysfunction relax blood vessels in a man’s penis to help obtain and maintain an erection. Some medications that treat high blood pressure, high cholesterol and heart disease also relax your blood vessels. If you take niacin while you also take medications to treat erectile dysfunction, your blood pressure could drop drastically. You could faint or develop other health problems.
Most studies related to male infertility show a clear concise relationship between zinc and ed. During a study some young men were given a diet which included very little amounts of zinc and thus they developed a zinc deficiency. When testosterone levels were measured after 20 weeks of low-zinc diet it was found that the level of the hormone had drastically reduced. The study also found that in elderly men, with an increase in the uptake of zinc, testosterone levels nearly doubled.
Also to be considered, patients were not using PDE5 inhibitors during the study period. Therefore it wasn’t determined whether the combined use with niacin can enhance the response of PDE5 inhibitors. Another limitation on the study results was the exclusion of the partner’s assessments. This would help to provide a more comprehensive assessment of the efficacy of niacin.
Energy-boosting goji berries have been used for thousands of years in Chinese medicine to help increase energy and enhance the release of hormones.”Goji is also beneficial for increasing blood flow, which helps to oxygenate all of the cells and tissues of the body, including the sex organs,” says celebrity nutritionist Dr. Lindsey Duncan. “Which increases libido—that’s why they call goji the ‘Viagra of China.'”

Dr. Niket Sonpal is the Associate Program Director of the Internal Medicine Residency at Brookdale Hospital Medical Center in Brooklyn and an Associate Professor at Touro College of Osteopathic Medicine. He's a practicing Gastroenterologist and Hepatologist with a focus on Men's and Women's Health, and a regular contributor to Women's health, Shape and Prevention Magazine.
Erectile dysfunction is obviously a frustrating health condition caused from different types of physical body problems. This may cause struggle with the self-esteem for both the man as a patient and his life partner. Luckily, individuals may take various supplements in the form of vitamins to deal with the root cause leading to the problem of erectile dysfunction. In this article, we will discuss about the role of Vitamin B3, known scientifically as Niacin to overcome the condition of erectile dysfunction among men.
Some studies have shown Levitra to be more suitable for men suffering from diabetes. Other treatments include Caverject ('Alprostadil'), which is a medication injected directly into the penis and MUSE (another form of 'Alprostadil'), which is a pellet inserted into the urethra. These may be of use for men who have to take Nitrates and are therefore unable to take the PDE5 inhibitors.
Begot, I., Peixoto, T. C. A., Gonzaga, L. R. A., Bolzan, D. W., Papa, V., Carvalho, A. C. C., ... & Guizilini, S. (2015, March 1). A Home-Based Walking Program Improves Erectile Dysfunction in Men With an Acute Myocardial Infarction. The American Journal of Cardiology, 115(5), 5741-575. Retrieved from http://www.ajconline.org/article/S0002-9149(14)02270-X/abstract
Counselling – erectile dysfunction can be caused by stress and anxiety and so seeking professional help from a counsellor can help relieve the symptoms. Life-changing issues or just everyday stress from work or home life can be enough to cause erectile dysfunction. Talking with a counsellor can help and it may also help to include your partner in these sessions as well. Counselling can help you last longer long-term if it works.
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.

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.
In many of these cases, a discussion between the physician, the man with erectile dysfunction, and possibly his partner can help to resolve the issues leading to treatment failure. For men who experience severe side effects, can’t take the drugs for other reasons (such as taking medicines such as nitroglycerin), or don’t respond in spite of further education on the correct use of the drugs, there are other treatment options that can help most men remain sexually active.
Because cholesterol is a building block for testosterone, drugs that interfere with cholesterol production can lower levels of this hormone (Journal of Sexual Medicine, April, 2010). French and Dutch researchers have reported that decreased libido and erectile dysfunction may be associated with statin-type drugs (British Journal of Clinical Pharmacology, Sept. 2004; Drug Safety, July, 2009).
Derived from the bark of a West African evergreen tree, yohimbe was the go-to ‘script for a wonky willy prior to the advent of wonder drugs like Viagra, Walker says. “Yohimbe enhances sexual performance both by blocking certain neurotransmitters in the brain and by increasing the release of nitric oxide in the cavernosal nerves of the penis,” he explains. And it pairs well with other erection-friendly tablets: A 2010 study in the Iranian Journal of Psychiatry found that a combination of yohimbe and L-arginine successfully helps guys get it up. However, yohimbe also has a handful of side effects, including elevated blood pressure and anxiety, so definitely talk to your doctor before you start on the supp.
For men who do find themselves suffering from ED, the knee-jerk reaction can be to reach for the Viagra but – while ED tablets are an excellent solution in the short term – there are other treatment options to consider incorporating into your lifestyle on a long-term basis, one of the most straightforward being exercise. Below you’ll find four great ways that exercise may help to treat erectile dysfunction.
"Sexual relations are not only an important part of people's wellbeing. From a clinical point of view, the inability of some men to perform sexually can also be linked to a range of other health problems, many of which can be debilitating or potentially fatal," says Professor Gary Wittert, Head of the Discipline of Medicine at the University of Adelaide and Director of the University's Freemasons Foundation Centre for Men's Health.
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.
For centuries, men have tried all sorts of natural remedies for erectile dysfunction (ED) -- the repeated inability to get or maintain an erection firm enough for sexual intercourse. But do they really work? It is simply not scientifically known at this point. Furthermore, you take these remedies at your own risk, because their safety profiles have not been established. What follows are commentaries by experts and reviews in the field of alternative treatments that are available over the counter for erectile dysfunction and impotence.
Participants in this study gradually increased their daily intake of niacin from 250 mg to 3,000 mg over 36 weeks. Nine of the 23 people who were taking immediate-release niacin withdrew from the study early because of facial flushing, fatigue, or skin discoloration. Eighteen of the 23 who were taking 3,000 mg daily of sustained-release niacin dropped out due to upset stomachs, fatigue, or abnormal liver function tests. All of these side effects disappeared once the participants stopped taking the vitamin. Additional cause for concern comes from other reports suggesting that high doses of sustained-release niacin can cause jaundice and liver failure.
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This no.1 penis strengthening exercise is essential for helping to correct erectile dysfunction problems and can lead to mind-blowing orgasms. The download instructions (see link above) also contain important information regarding a common mistake that men make, especially when doing Kegel exercises. Kegel Exercises are not the best treatment for premature ejaculation! However, a slight modification to a common Kegel exercise can make it become more beneficial in overcoming PE and ED. See the above instructions for detailed explanation.

Some medical self-help books make niacin sound like a panacea for health-conscious people with rising cholesterol levels and shrinking budgets. Because this B vitamin is cheap and sold over-the-counter at drug and health food stores, people see no reason to check with the doctor before tossing back a handful of pills. What they may not know is that the high doses (1,500-3,000 mg) needed to lower cholesterol levels can cause serious complications. (As a dietary supplement, 10-20 mg is usually recommended). To add to the confusion, niacin comes in two forms: immediate- and sustained-release preparations.
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).
Long-term effectiveness of sildenafil was assessed in 3 open-label, flexible-dose (25 mg to 100 mg) studies. After 12 months of treatment (3 years in one study) or at the time of discontinuation, patients were asked if they were satisfied with the effect of the medication on erections, and if the treatment improved their ability to engage in sexual activity. Satisfaction and improvement in ability to engage in sexual activity reported in 96% and 99% of patients respectively. Of the 11% of patients who discontinued treatment, 2% discontinued for treatment-related reasons (1.6% for insufficient response, 0.4% for adverse events). These satisfaction rates maintained for 3 years in one study. Over the 3-year period, 32% of patients discontinued treatment. Only 6.7% of discontinuations were treatment related (5.7% for insufficient response, 1% for treatment-related adverse events). The remaining 25.3% of patients discontinued for reasons not related to treatment (eg, non–treatment-related adverse events, lost to follow-up evaluation, withdrawn consent, and protocol violations). Most patients were receiving 100 mg sildenafil doses (88% at 3 years) (Carson et al 2002). Similar efficacy rates for sildenafil were reported in clinical practice setting. An improvement in ability to achieve erections was reported by 68% and 71% of patients with ED (Marks et al 1999; McMahon et al 2000). Success with sildenafil, defined as 75% successful intercourse, was reported by 82% of patients with 77% being successful at every attempt (Guay et al 2001).
Size matters, so get slim and stay slim. A trim waistline is one good defense — a man with a 42-inch waist is 50% more likely to have ED than one with a 32-inch waist. Losing weight can help fight erectile dysfunction, so getting to a healthy weight and staying there is another good strategy for avoiding or fixing ED. Obesity raises risks for vascular disease and diabetes, two major causes of ED. And excess fat interferes with several hormones that may be part of the problem as well.
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