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During the physical examination, signs of hypogonadism, such as gynecomastia or the loss of axillary and pubic hair, should be noted.4 The genital examination should include an evaluation of the size and consistency of the testes. The penis should be examined for any fibrosis and plaques indicative of Peyronie's disease.8 Finally, the bulbocavernosus and cremasteric reflexes should be assessed to eliminate a neurologic cause of the erectile dysfunction. The bulbocavernosus reflex is elicited by squeezing the glans penis while observing for contraction of the external anal sphincter. This may be visualized or felt during a digital rectal examination.
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A. Some men who undergo a radical prostatectomy with one or both neurovascular bundles spared still can't achieve an erection after being injected. The nerves could play a role here but for some it has more to do with the fact that they might have anatomic variations in blood supply to the penis. Somehow blood supply has been compromised during a normal prostatectomy and this contributes to their ED. Complicate this with other risk factors, such as partial nerve injury or diabetes, and an erection can become very difficult to achieve.
In fact, many medications have ED as a side effect, but “hypertensive drugs are classically the worst,” says Nehra. However, he emphasizes, you don’t have to endure this side effect. Talk to your urologist about medications that will counter ED without affecting your blood pressure meds.
Vardenafil is generally well tolerated with only mild side effects. These side effects include headache, flushing, nasal congestion, dyspepsia, body aches, dizziness, nausea, and increased blood levels of the muscle enzyme creatine kinase.
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The mean IIEF GS at Visit 1 was 25.7 (median 22, range 5 – 64), at Visit 3, 56.9 (median 62, range 7 – 73) and at Visit 4, 59.3 (median 60, range 18 – 73). The respective mean IIEF EDS was 8.2 (median 6, range 0 – 28), 23.5 (median 27, range 1 – 30) and 25.2 (median 25, range 6 – 30). There was no correlation between age and response to Viagra, although older men had relatively lower IIEF scores.
67 percent of women rate their partner's penis size as average
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Many men achieve stronger erections by injecting drugs into the penis, causing it to become engorged with blood. Drugs such as papaverine hydrochloride, phentolamine, and alprostadil (marketed as Caverject) widen blood vessels. These drugs may create unwanted side effects, however, including persistent erection (known as priapism) and scarring. Nitroglycerin, a muscle relaxant, can sometimes enhance erection when rubbed on the penis.
Just as girls and women are bombarded with the message that thin is better, popular media also reinforces the notion that bigger is better when it comes to the size of a man's penis. In our culture, penis size is equated with sexual power and masculinity. But does size really matter?
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Though a human application is a ways off, researchers say the technique could one day be used to treat severe erectile dysfunction in men.
In one randomized, double-blind, placebo-controlled, multi-center clinical trial conducted in China (5), 157 ED patients aged 26 to 75 with various etiologies (psychogenic, organic, and a combination of both), had an average ED history of 5 years. They all received treatment of Befar® or a placebo for 4 weeks. After the 4-week period, the Befar® patients improved their ability to have and maintain their erections by 68%. The same patients also improved the frequency and strength of their erections by 75%.
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According to Orr, Men must consult with a licensed physician before using any medication, but in my experience, using an injection for impotence is just a tiny pinch. The benefits far outweigh any inconvenience. I wish I hadnt waited so long to learn about it.
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"If you're a man who needs Viagra on your 30's or 40's," Adams added, "you don't need Viagra, you need to clean up your diet and start exercising!"
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Restriction of blood flow caused by a vascular disease can occur because of a buildup of cholesterol and other substances that may block blood vessels. It also is known that blood vessels open more widely (relax) or close down to become narrower (constrict), possibly due to signals from cells called endothelial cells that are located inside the lining of these blood vessels. These signals can result in the restriction of blood flow to certain organs even without the vessels' necessarily being clogged by any material. When endothelial function is impaired, constriction that is similar to plugged blood vessels may result. This could be one explanation why ED is so often associated with vascular disease.
Organic nitrates in any form are contraindicated when used regularly or intermittently because they potentiate hypotensive effects of nitrates; if nitrate administration is necessary, at least 48 h should elapse after the last dose of tadalafil
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Neurologic Spinal cord injury; nerve injury (prostate surgery); stroke; peripheral neuropathy; incontinence; multiple sclerosis; Parkinson's disease Motor or sensory deficits; aphasia; gait abnormality; abnormal bulbocavernosus reflex; tremor
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