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In prescribing sildenafil, a doctor considers the age, general health status, and other medication(s) the patient is taking. The usual starting dose for most men is 50 mg, however, the doctor may increase or decrease the dose depending on side effects and effectiveness. The maximum recommended dose is 100 mg every 24 hours, however, many men will need 100 mg of sildenafil for optimal effectiveness, and some doctors are recommending 100 mg as the starting dose.
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Objective: To analyze the prevalence and risk factors for erectile dysfunction (ED) in Italy in a cross-sectional study.
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Surgical intervention for a number of different conditions may remove anatomical structures necessary to erection, damage nerves, or impair blood supply. Complete removal of the prostate gland or external beam radiotherapy of the gland are common causes of impotence; both are treatments for prostate cancer. Some studies have shown that male circumcision may result in an increased risk of impotence, while others have found no such effect, and another found the opposite.
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Sex therapy is unlikely to work if a man drops out of treatment after only one or two sessions.
Erectile dysfunction, commonly referred to as ED, is the inability to achieve and sustain an erection suitable for sexual intercourse. This condition is not considered normal at any age and is different from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.
Reality: Although ED is most common in men 65 and older, it can occur at any age. Statistics show that the majority of men experience erectile problems at some point in their lives, and 10 percent of the entire male population has persistent ED, according to the American Medical Association. Because diseases such as diabetes and heart disease interfere with blood flow and increase the incidence of developing ED, men who develop these conditions, no matter how young they may be, are more likely to experience erectile dysfunction.
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Penile Injection Therapy Backgrounder - Penile injection therapy was discovered fortuitously. In 1980, the French physician Ronald Virag reported that during penile surgery, he inadvertently injected an anesthetized patient in the wrong part of the penis with papaverine - a substance derived from the opium poppy. The resulting relaxation of the smooth muscle of the penile arterial walls created an unexpected two-hour erection. This mistake prompted serious research into the use of injectable medications to relieve ED. Around the same time, Giles Brindley, a British physiologist and research scientist, discovered that injecting the drug phenoxybenzamine into the corpora cavernosa of the penis could produce an erection within minutes. At a meeting in Paris in 1984, New York urologist Dr. Adrian Zorgniotti presented his first case studies of self-injection utilizing a combination of papaverine and phentolamine. The latter drug blocks the action of neurotransmitters that cause vasoconstriction, causing the smooth muscles of the penis to relax. Two years later, Japanese researchers presented evidence that injecting the drug prostaglandin E-1 produced powerful erections. Slowly, news of the favorable results with the injectable medication began to spread within the small international community of urologists who were treating ED. Most began utilizing all three (papaverine, phentolamine, and prostaglandin E-1) in what was referred to as "trimix."
Psychogenic Nocturnal erections; sudden onset; history of depression; anhedonia; poor relationship with partner; anxiety; life crisis Sad or withdrawn affect; tearful; psychomotor retardation Nocturnal penile tumescence (stamp test; Snap-Gauge)
Common causes of ED include diseases that affect blood flow, such as atherosclerosis (hardening of the arteries); nerve diseases, psychological factors, such as stress, depression, and performance anxiety; and injury to the penis. Chronic illness, certain medications and a condition called Peyronie's disease (scar tissue in the penis) can also cause ED.
Pills containing norgestimate or drospirenone (for example, YasminŽ) were associated with a nearly six-fold extra risk. And pills containing cyproterone (for instance, DianeŽ), had nearly a seven times greater risk.
If you have difficulty having or keeping an erection more than 25% of the time, it is considered a problem.
Whether you're already taking the birth control pill or the birth control patch (or you're considering using either), and have concerns about the risks, speak to your doctor about other contraceptive options so you can make the best decision for your lifestyle and overall health.
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Implants are usually used for men in whom other therapies have failed or in those who require penile reconstructions. Men who have had a radical prostatectomy for prostate cancer and in whom a nerve-sparing procedure was not performed or was not successful often do not respond to oral PDE-5 inhibitors, and these men are good candidates for an implant. The same is true for men treated with radiation therapy, although more of these men tend to respond to oral agents. Additionally, some patients experience increased sexual satisfaction with the combined use of an implant and an oral PD5 inhibitor.
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