Hormone-induced ED. Hormonal abnormalities, such as increased prolactin a hormone produced by the anterior pituitary gland , steroid abuse by bodybuilders, too much or too little thyroid hormone, and hormones administered for prostate cancer may cause ED.
Low testosterone can contribute to ED but is rarely the sole factor responsible for ED. Ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration. Lifelong premature ejaculation. With lifelong premature ejaculation, the patient has experienced premature ejaculation since first beginning coitus.
Acquired premature ejaculation. With acquired premature ejaculation, the patient previously had successful coital relationships and only now has developed premature ejaculation. Performance anxiety. Performance anxiety is a form of psychogenic ED, usually caused by stress. Patient medical or sexual history. This may reveal conditions or diseases that lead to impotence and help distinguish among problems with erection, ejaculation, orgasm, or sexual desire.
A problem in the nervous system may be involved if the penis does not respond as expected to certain touching. Secondary sex characteristics, such as hair pattern, can point to hormonal problems, which involve the endocrine system. Laboratory tests. These can include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measurement of testosterone in the blood is often done in men with ED, especially with a history of decreased libido or diabetes.
Psychosocial examination. This is done to help reveal psychological factors that may be affecting performance. The sexual partner may also be interviewed to determine expectations and perceptions encountered during sexual intercourse.
A prescription medication taken orally for the treatment of ED. This drug works best when taken on an empty stomach and many men can get an erection 30 to 60 minutes after taking the medication.
Sexual stimulation is required for sildenafil citrate to have the best efficacy. This drug has a similar chemical structure to sildenafil citrate and works in a similar manner. Studies have indicated that tadalafil citrate stays in the body longer than other medications in its class. Most men who take this medication find that an erection occurs within 4 to 5 hours after taking the pill slow absorption and the effects of the medication may last up to 24 to 36 hours.
Men who are taking medications that contain nitrates, such as nitroglycerin, should NOT use these medications. Taking nitrates with one of these medications can lower blood pressure too much. In addition, men who take tadalafil or vardenfil should use alpha blockers with care and only as instructed by their physician, as they could result in hypotension abnormally low blood pressure. Experts recommend that men have a complete medical history and physical examination to determine the cause of ED.
Men should tell their doctor about all the medications they are taking, including over-the-counter medications. Men with medical conditions that may cause a sustained erection, such as sickle cell anemia, leukemia, or multiple myeloma, or a man who has an abnormally-shaped penis, may not benefit from these medications.
Also, men with liver diseases or a disease of the retina, such as macular degeneration or retinitis pigmentosa, may not be able to take these medications, or may need to take the lowest dosage. These medical treatments should NOT be used by women or children.
Elderly men are especially sensitive to the effects of these medical treatments, which may increase their chance of having side effects.
They also received biofeedback and advice on lifestyle changes. The second group only received advice on lifestyle changes. Men in the first group saw their penile function improve significantly after 3 months of regular pelvic floor muscles exercises.
Men in the second group saw little improvement after 3 months. For the next 3 months, all participants were given at-home exercises to perform. After 6 months in total had elapsed, 40 percent of all participants including some men who had belonged to the second group had regained normal erectile function. A literature review also concluded that pelvic floor exercises were effective at treating both ED and premature ejaculation.
Moderate to vigorous exercise is not only good for your overall health, but also can increase blood flow, possibly helping with ED. Examples include running and swimming. A review of 10 studies examined the effect of aerobic exercise on ED. From their review, investigators concluded that minutes of weekly exercise for 6 months could lead to a decrease in erectile problems. Another study examined physical fitness and testosterone levels in 87 men with ED. Researchers found that testosterone levels were negatively correlated with levels of body fat and abdominal fat.
This suggests that exercise may increase testosterone in addition to reducing body fat. Before you start a new exercise plan, you should always discuss it with your doctor. This is particularly important for people with heart disease or another underlying condition that could be aggravated by vigorous activity. Learn more about exercise and ED.
Yoga can help to relax your mind and body. Since stress or anxiety can cause or contribute to ED, practicing yoga may be an effective way to ease ED symptoms.
In fact, a study of 65 men between 24 and 60 years old found that sexual function increased significantly after a week program of yoga sessions. Discover five yoga poses that could help with ED. ED is often related to problems with blood flow. Maintaining your blood vessel health may be beneficial in both preventing and treating ED. This can be achieved through making certain lifestyle choices, such as eating a healthy diet. Several specific foods, from cocoa to watermelon , may help with ED.
Find out what other foods you may want to add to your grocery cart. Certain herbs and supplements have been shown to treat ED, with varying degrees of success, including:. Horny goat weed and zinc may help as well. Speak with your doctor before buying herbs and supplements, and proceed with caution. Additionally, some supplements, such as yohimbe, are associated with potentially dangerous side effects. Your doctor may be able to recommend reputable brands as well. Get more expert advice on herbs for ED.
Acupuncture is a type of traditional Chinese medicine in which needles are inserted into the skin at specific locations, or acupoints. Acupuncture is believed to work through nerve stimulation, which then has an effect on the release of neurotransmitters.
Studies on its efficacy are limited, and the ones that do exist are often inconclusive. Some evidence from a review indicates that acupuncture may help to treat psychological ED. When choosing an acupuncturist, look for a certified practitioner who uses disposable needles and follows Food and Drug Administration FDA guidelines for needle disposal and sterilization.
Learn more about the use of acupuncture in treating ED. Prostatic massage, a form of massage therapy, may be used for ED. Prostatic massage is often used in combination with other treatments.
During prostatic massage, a practitioner will massage the tissues in and around the groin to promote blood flow to your penis. You may need to undergo a massage several times a week. The length of massage treatment depends on your symptoms.
So far, there have only been limited studies on prostatic massage and its effectiveness. Get tips on finding a practitioner, and more, with the help of this short guide.
Multiple options exist for people looking for natural ways to treat their ED. Try one of the options above or even a combination of them. Remedies like acupuncture and massage can even be paired with Viagra and other traditional medications. Find out more about the effect of lifestyle changes on ED. There are two types of procedures that may be used: implants and vascular surgery.
A penile implant, also referred to as a prosthesis, can be placed in the penis. There are two different types. An inflatable implant allows you to use a pump to make your penis larger, while a malleable implant allows you to adjust the position of your penis manually.
Vascular surgery repairs arteries that may be blocked. This can help to restore adequate blood flow to the penis. Younger men are typically better candidates for this type of procedure. Every surgery has its benefits and drawbacks. Be sure to discuss these with your doctor if you decide to undergo surgery for ED. ED and diabetes can occur together. In fact, the risk of developing ED is approximately 50 percent in men who have diabetes. But why is this? Diabetes affects how your body processes glucose.
There are two major types of diabetes : type 1 diabetes and type 2 diabetes. This sudden influx of blood causes an erection by expanding, straightening and stiffening the penis. Erectile dysfunction impotence is the inability to get and keep an erection firm enough for sex.
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. If you're concerned about erectile dysfunction, talk to your doctor — even if you're embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.
Our caring team of Mayo Clinic experts can help you with your health concerns. Visit Mayo Clinic Men's Health to get started. Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these.
Likewise, stress and mental health concerns can cause or worsen erectile dysfunction. Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction. The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement.
A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:. As you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection. The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions.
For example:. Erectile dysfunction care at Mayo Clinic.
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