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ED can result from health problems, emotional issues, or from both.

Some known risk factors are: Being over age 50 Having high blood sugar (Diabetes) Having high blood pressure Having cardiovascular disease Having high cholesterol Smoking Using drugs or drinking too much alcohol Being obese Lacking exercise.

Even though ED becomes more common as men age, growing old is not always going to cause ED.

ED can be an early sign of a more serious health problem. Finding and treating the reason for ED is a vital first step.

ED happens when: There is not enough blood flows into the penis Many health issues can reduce blood flow into the penis, such as hardened arteries, heart disease, high blood sugar (Diabetes) and smoking. The penis cannot trap blood during an erection If blood does not stay in the penis, a man cannot keep an erection.

Nerve signals from the brain or spinal cord do not reach the penis Certain diseases, injury or surgery in the pelvic area can harm nerves to the penis. Diabetes can cause small vessel disease or nerve damage to the penis Cancer treatments near the pelvis can affect the penis' functionality Surgery and or radiation for cancers in the lower abdomen or pelvis can cause ED.

Treating prostate, colon-rectal or bladder cancer often leaves men with ED. Cancer survivors should see a Urologist for sexual health concerns.

Drugs used to treat other health problems can negatively impact erections Patients should talk about drug side effects with their primary care doctors. Normal sex needs the mind and body working together.

Emotional or relationship problems can cause or worsen ED. Some emotional issues that can cause ED are: Depression Anxiety Relationship conflicts Stress at home or work Stress from social, cultural or religious conflicts Worry about sex performance. Finding the cause of your ED will help direct your treatment options. Diagnosing ED starts with your health care provider asking questions about your heart and vascular health and your erection problem. Your provider may also give you a physical exam, order lab tests or refer you to a Urologist.

Your doctor will ask you questions about your health history and lifestyle.

It is of great value to share facts about drugs you take, or if you smoke or how much alcohol you drink.

He/she will ask about recent stressors in your life. Speak openly with your doctor, so he/she can help you find the best choices for treatment. Questions about your health: What prescription drugs, over-the-counter drugs or supplements do you take?

Have you had surgery or radiation therapy in the pelvic area? Do you have other health problems (treated or untreated)?

Knowing about your history of ED will help your health provider learn if your problems are because of your desire for sex, erection function, ejaculation, or orgasm (climax). Some of these questions may seem private or even embarrassing.

However, be assured that your doctor is a professional and your honest answers will help find the cause and best treatment for you.

Questions about your ED symptoms: How long have you had these symptoms?

Do you wake up in the morning or during the night with an erection? Do your erections change at different times, like when going in a partner, during stimulation by mouth, or with masturbation? Do you have problems with ejaculation or orgasm (climax)? How is this problem changing the way you enjoy sex? Do you have painful with erections, feel a lump or bump in the penis or have penile curvature?

These are signs of Peyronie's Disease which can be treated but calls for an expert in urology to assess and manage.

Your health care provider may ask you questions about depression or anxiety. He or she may ask about problems in your relationship with a partner. Some health care providers may also ask if they may talk to your sex partner.

Are you often under a lot of stress, or has something recently upset you?

Do you have any anxiety, depression or other mental health issues?

Examination focusing on your genitals (penis and testicles) is often done to check for ED. Based on your age and risk factors, the exam may also focus on your heart and blood system: heart, peripheral pulses and blood pressure. Based on your age and family history your doctor may do a rectal exam to check the prostate.

Most patients do not need a lot of testing before starting treatment. Your health care provider may order blood


and collect a urine sample to look for health problems that cause ED.

Questionnaires are often used by health experts to rate your ability to initiate and keep erections, gauge your satisfaction with sex and help identify any problems with orgasm.

For some men with ED, specialized testing may be needed to guide treatment or re-assess you after a treatment fails. Blood work to check Testosterone and other male hormones Blood work to measure blood sugar (Diabetes) Ultrasonography (penile Doppler) to check blood flow A shot into the penis with a vascular stimulant to cause an erection Pelvic x-rays like arteriography, MRI or CT scanning are rarely needed to check ED unless there is history of trauma or cancer Nocturnal penile tumescence (NPT), an overnight test to check for sleep erection. The treatment for ED starts with taking care of your heart and vascular health.

Your doctor may point out ‘risk factors' that can be changed or improved. You may be asked to change certain food habits, stop smoking, increase workouts or stop using drugs or alcohol. You medicine shoppe sildenafil may be offered alternatives to the drugs you take. (Never stop or change prescription drugs without first talking to your health care provider.) Your health care provider may also suggest treating emotional problems.

These could stem from relationship conflicts, medicine shoppe sildenafil life's stressors, depression or anxiety from past problems with ED (performance anxiety). The treatments below are available to treat ED directly. Most of the medicine shoppe sildenafil best-known treatments for ED work well and are safe. Still, it helps to ask your health


provider about side effects that could result from each option: Oral drugs or pills known as phosphodiesterase type-5 inhibitors are most often prescribed in the U.S.

for ED (Viagra, Cialis, Levitra, Stendra) Testosterone Therapy (when low testosterone is detected in blood testing) Penile Injections (ICI, intracavernosal Alprostadil) Intraurethral medication (IU, Alprostadil) Vacuum Erection Devices Penile Implants Surgery to bypass penile artery damage for some younger men with a history of severe pelvic trauma. Penile vascular surgery is not recommended for older men with hardened arteries. Oral Drugs (PDE5 inhibitors) Drugs known as PDE type-5 inhibitors increase penile blood flow. These medicine shoppe sildenafil are the only oral agents approved in the U.S.

by the Food and Drug Administration for the treatment of ED. Viagra ® (sildenafil citrate) Levitra ® (vardenafil HCl) Cialis ® (tadalafil) Stendra ® (avanafil) For best results, men with ED take these pills about an hour or two before having sex. The drugs require normal nerve function to the penis. PDE5 inhibitors improve on normal erectile responses helping blood flow into the penis. About 7 out of 10 men do well and have better erections. Response rates are lower for Diabetics and cancer patients.

If you are taking nitrates for your heart, you SHOULD NOT take any PDE5 inhibitors. Always speak with your health care provider before using a PDE5 inhibitor to learn how it might affect your health. Most often, the side effects of PDE5 inhibitors are mild and medicine shoppe sildenafil often last just a short time. The most common side effects are: Headache Stuffy nose Facial flushing Muscle aches Indigestion.

In rare cases, the drug Viagra ® can cause blue-green shading to vision that lasts for a short time.

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