All these treatments listed above do not provide immediate effect on your body. If you need an instant erection, you should take a look at the topical erection treatment. Targeted delivery has been recently identified as an emerging alternative to orally administered products mainly due to the current concerns of the side effects that may occur from taking prescription drugs. Topical erection treatment presents a preferable delivery method to get an erection that enhances the desired effect directly to the intended site of action while limiting the exposure of the rest of the body to the ingredients.
Don’t give up or blame yourself - you shouldn’t assume that your situation is impossible to improve or that your partner is disappointed in you. Studies show as long as you don’t stop trying to engage your partner sexually, they will still respond positively. If you communicate and stay positive you can work with your partner to get the result you’re looking for.
#2 Physically exhausted. If you’ve been cranking it at the gym, haven’t been sleeping well, or you’ve been working your ass off at your job, getting tangled up with your lover for even more physically demanding activities may not sound ideal. Physical exhaustion has a direct effect on your ability to get aroused. The only fix for this one is to get some rest.
Or, perhaps, since it's been only eight months, it might actually scare you a bit. It can be unsettling when someone falls head over heels. It can be hard to trust that kind of enthusiasm, especially if you've been burned by someone who went from hot-and-heavy to suddenly cold. Even if you're crazy about him, you might need to slow things down a little. Or maybe it's harder for you to say than it is for him — and that's why it rubs you wrong.
Three days after Michael was found to have a dangerously blocked coronary artery, surgeons inserted a stent to prop the artery open. Now he is keen to get more men going to their doctor to be checked up. "When it comes to sex, people keep things to themselves. But this is an easy way to catch heart problems at an early stage and treat them before the worst happens."
inability of the male to achieve or maintain an erection of sufficient rigidity to perform sexual intercourse successfully. An impotent man may produce sufficient numbers of normal spermatozoa; the condition is related to infertility only insofar as it prevents coitus with and impregnation of the female partner. Called also erectile dysfunction. adj., adj im´potent.
Psychological causes include depression, stress and anxiety. Men sometimes worry about getting a new sexual partner pregnant so do make sure you mention contraception. If the relationship is relatively new your partner might be nervous about ‘performing’. If they don’t manage to get an erection, this can add to the tension and pressure the next time and further compound the issue.
Prostate cancer isn’t considered a cause of ED on its own, but radiation treatments, hormone therapy, and surgery to remove the entire prostate gland can lead to difficulty in getting or keeping an erection. Sometimes erectile dysfunction related to prostate cancer treatment is only temporary, but many guys experience ongoing difficulties that need to be addressed by other means.

There are no formal tests to diagnose erectile dysfunction. Some blood tests are generally done to exclude underlying disease, such as hypogonadism and prolactinoma. Impotence is also related to generally poor physical health, poor dietary habits, obesity, and most specifically cardiovascular disease such as coronary artery disease and peripheral vascular disease. Therefore, a thorough physical examination is helpful, in particular the simple search for a previously undetected groin hernia since it can affect sexual functions in men and is easily curable.[11]


The mechanisms by which testosterone plays a role in erectile function are not completely understood. A study evaluating the effect of testosterone on erections in surgically castrated rabbits and control animals, in which the rabbits’ intracavernosal pressures were compared after cavernosal nerve stimulation, determined that castrated rabbits had much lower pressures after stimulation than control rabbits did. [21] Notably, the pressures increased when castrated rabbits received exogenous testosterone replacement.


It is estimated that up to 20 million American men frequently suffer from impotence and that it strikes up to half of all men between the ages of 40 and 70. Doctors used to think that most cases of impotence were psychological in origin, but they now recognize that, at least in older men, physical causes may play a primary role in 60% or more of all cases. In men over the age of 60, the leading cause is atherosclerosis, or narrowing of the arteries, which can restrict the flow of blood to the penis. Injury or disease of the connective tissue, such as Peyronie's disease, may prevent the corpora cavernosa from completely expanding. Damage to the nerves of the penis, from certain types of surgery or neurological conditions, such as Parkinson's disease or multiple sclerosis, may also cause impotence. Men with diabetes are especially at risk for impotence because of their high risk of both atherosclerosis and a nerve disease called diabetic neuropathy.
On the horizon is gene therapy that would deliver genes that produce products or proteins that may not be functioning properly in the penile tissue of men with ED. Replacement of these proteins may result in improvement in erectile function. Experimental animal models have demonstrated improvement in erectile function with gene therapy. Human studies may also demonstrate success with this therapy. Gene therapy may take a long time for regulatory approval and public acceptance.
Instead of the hesitation with which he had accosted the cardinal a quarter of an hour before, there might be read in the eyes of the young king that will against which a struggle might be maintained, and which might be crushed by its own impotence, but which, at least, would preserve, like a wound in the depth of the heart, the remembrance of its defeat.

Prevention of some of the causes that contribute to the development of erectile dysfunction can decrease the chances of developing the problem. For example, if a person decreases their chances of developing diabetes, heart disease, and hypertension, they will decrease their chances of developing erectile dysfunction. Other things like stopping smoking, eating a healthy diet (heart healthy with adequate vitamin intake), and exercising daily may reduce a person's risk.

The dorsal artery provides for engorgement of the glans during erection, whereas the bulbourethral artery supplies the bulb and the corpus spongiosum. The cavernous artery effects tumescence of the corpus cavernosum and thus is principally responsible for erection. The cavernous artery gives off many helicine arteries, which supply the trabecular erectile tissue and the sinusoids. These helicine arteries are contracted and tortuous in the flaccid state and become dilated and straight during erection. [9]
To examine what is known about the demographics, etiology, risk factors, pathophysiology, diagnostic assessment, treatments (both generic and cause-specific), and the understanding of their consequences by the public and the medical community, the National Institute of Diabetes and Digestive and Kidney Diseases and the Office of Medical Applications of Research of the National Institutes of Health, in conjunction with the National Institute of Neurological Disorders and Stroke and the National Institute on Aging, convened a consensus development conference on male impotence on December 7-9, 1992. After 1 1/2 days of presentations by experts in the relevant fields involved with male sexual dysfunction and erectile impotence or dysfunction, a consensus panel comprised of representatives from urology, geriatrics, medicine, endocrinology, psychiatry, psychology, nursing, epidemiology, biostatistics, basic sciences, and the public considered the evidence and developed answers to the questions that follow.
Frankly, I sympathize with you: He’s got a bad credit history (and likely a history of making similarly poor financial decisions) and you are anxious to pay this debt back before anything else, to the extent that you’re “basically” spending your whole paycheck on debt. Should he be paying more right now? Maybe he should pay more — but, then again, maybe it’s not all or nothing: Maybe you could compromise.
Erection is a vascular event. The penis becomes rigid when blood flow to the corpora cavernosa increases sixfold and venous outflow is physiologically impeded. Penile perfusion is governed by three organ systems—the neurologic, circulatory, and endocrinologic systems—each necessary for potency. The neurologic system accounts for vasodilation and venoconstriction of the corporal blood vessels so that blood is shunted to the erectile tissues; the circulatory system provides adequate blood flow to the hypogastric-cavernous bed, a distal branch off the internal iliac vessels; and the endocrine system, mediated by testosterone, plays a permissive role through mechanisms that have yet to be elucidated.

In a prospective study from the Prostate Cancer Prevention Trial database, Thompson et al reported that men presenting with ED had a significantly higher chance of developing a cardiovascular event over a 7-year follow-up period. [55] The hazard ratio was 1.45, which is in the range of risk associated with current smoking or a family history of MI.


#2 Physically exhausted. If you’ve been cranking it at the gym, haven’t been sleeping well, or you’ve been working your ass off at your job, getting tangled up with your lover for even more physically demanding activities may not sound ideal. Physical exhaustion has a direct effect on your ability to get aroused. The only fix for this one is to get some rest.

My boyfriend, 25, can't get hard anymore!! He WANTS to have sex, but he just won't get hard, when just about a month ago he would get hard just by looking at me. We have been together for six months, and I'm starting to think he might be bored of me or that I'm the problem. He says it's not me at all. Our relationship is great, but I don't know what to do. Please help!!
Estimates of the prevalence of impotence depend on the definition employed for this condition. For the purposes of this consensus development conference statement, impotence is defined as male erectile dysfunction, that is, the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Erectile performance has been characterized by the degree of dysfunction, and estimates of prevalence (the number of men with the condition) vary depending on the definition of erectile dysfunction used.
Constriction of the trabecular smooth muscle and helicine arteries induced by sympathetic innervation makes the penis flaccid, with blood pressure in the cavernosal sinuses of the penis near venous pressure. Acetylcholine is thought to decrease sympathetic tone. This may be important in a permissive sense for adequate trabecular smooth muscle relaxation and consequent effective action of other mediators in achieving sufficient inflow of blood into the lacunar spaces. When the trabecular smooth muscle relaxes and helicine arteries dilate in response to parasympathetic stimulation and decreased sympathetic tone, increased blood flow fills the cavernous spaces, increasing the pressure within these spaces so that the penis becomes erect. As the venules are compressed against the tunica albuginea, penile pressure approaches arterial pressure, causing rigidity. Once this state is achieved, arterial inflow is reduced to a level that matches venous outflow.
While impotence may be the presenting symptom of vascular disease, in neurologic disease impotence generally occurs in the setting of an obvious nervous system disorder, typically in patients known to have spinal cord pathology or neuropathy. Impotent patients should be questioned about decreased genital sensation, which would suggest diabetic, alcoholic, or other forms of neuropathy; weakness, which may accompany multiple sclerosis or spinal cord tumors; and back pain, bowel, and bladder symptoms, which raise concern for cauda equina syndrome. A careful drug history is important in the evaluation of impotence. Drugs that cause impotence (Table 187.3) generally do so by interfering with neurotransmission.
Neurologic impotence is suggested by the absence of sensation in the sacral dermatomes when tested by pinprick, or by neurologic abnormalities elsewhere. The bulbocavernosus reflex may be assumed to be present if anal sphincter tone is normal on rectal examination. If there is doubt, the reflex can be tested by pinching the glans penis and assessing sphincter contraction during the rectal examination.
The first line and by far the most common treatment today is with the prescription drug sildenafil citrate, sold under the brand name Viagra. An estimated 20 million prescriptions for the pill have been filled since it was approved by the FDA in March 1998. It is also the most effective treatment with a success rate of more than 60%. The drug boosts levels of a substance called cyclic GMP, which is responsible for widening the blood vessels of the penis. In clinical studies, Viagra produced headaches in 16% of men who took it, and other side effects included flushing, indigestion, and stuffy nose.
Some may use alcohol as a way to get into the mood and overcome some of the nerves associated with having sex, but too much of a good thing can actually backfire. In fact, having a long history of alcohol abuse may lead to long-term erectile dysfunction. As many as 70 percent of men with chronic erectile dysfunction also have a history of alcohol abuse.
First realize that this is normal, and just because it happened once does not mean it will happen again (but freaking out about it could make it happen again). Then Skyler tells people to completely ditch the idea that sex is a goal-oriented act with orgasm being the big finish. Instead, take a pleasure-oriented mentality where various sex acts are done because they feel good — not because it's part of series of steps to get you to climax. This helps take away some of the anxiety, because when you're not so focused on the performance, it's not that big of a deal if there's a little bit of stage fright, she says. There's plenty of other things you can do while hanging out with a non-erect penis!

The inability to achieve or sustain a sufficiently firm penile erection (tumescence) to allow normal vaginal sexual intercourse. The great majority of cases are not caused by organic disease and most men experience occasional periods of impotence. It is often related to anxiety about performance and is usually readily corrected by simple counselling methods which prescribe sensual massage but forbid coitus. Organic impotence may be caused by DIABETES, MULTIPLE SCLEROSIS, spinal cord disorders and heart disease. Many cases can be helped by the drug SILDENAFIL (Viagra).
Vacuum constriction devices may be effective at generating and maintaining erections in many patients with erectile dysfunction and these appear to have a low incidence of side effects. As with intracavernosal injection therapy, there is a significant rate of patient dropout with these devices, and the reasons for this phenomenon are unclear. The devices are difficult for some patients to use, and this is especially so in those with impaired manual dexterity. Also, these devices may impair ejaculation, which can then cause some discomfort. Patients and their partners sometimes are bothered by the lack of spontaneity in sexual relations that may occur with this procedure. The patient is sometimes also bothered by the general discomfort that can occur while using these devices. Partner involvement in training with these devices may be important for successful outcome, especially in regard to establishing a mutually satisfying level of sexual activity.
Psychotherapy, marital counseling, or sex therapy may be helpful in treating cases of impotence that have psychological or emotional causes. A range of other treatments exists for cases of impotence that arise from purely physiological causes. These treatments include vacuum devices, penile injections, and penile implants. These mechanical or physically invasive approaches have largely been superseded, however, by the drug sildenafil citrate (trade name Viagra), which is taken in pill form. This drug works by enhancing the effects of nitric oxide, a chemical that, upon sexual stimulation, is normally released to widen the blood vessels supplying the penis. The increased flow of blood through those vessels into certain tissues in the penis causes an erection. See also sexual dysfunction.
Picture the scene. You get home from the bar with your date. You both decided to leave a little early, after only two drinks, because the chemistry was really there and both of you wanted to cut to the chase and get intimate. To discover each other's bodies. To eat of the fruits of passion. In short, to have sex. You stick the key in the lock, swing the door open, and invite her into your beautiful place. OK, well it might not be exactly beautiful. It might be a bit of a mess, frankly. But you don't let that ruin the moment. You turn around and passionately kiss her. How the two of you make it to your bedroom with some clothing still on is anybody's guess. You jump on the bed and hurriedly strip. God — can't this go any faster, you wonder? 

One thing you need to know.  When you are experiencing anxiety, you get a stress response.  You can read more about this here.  A stress response is what you automatically feel, say, if a fight broke out near you.  Your body gets ready to protect itself.  During a stress response, blood is diverted away from less important areas to help your heart beat faster.


Patients receiving penile prostheses should be instructed in the operation of the prosthesis before surgery and again in the postoperative period. The prosthesis usually is not activated until approximately 6 weeks after surgery, so as to allow the edema and pain to subside. The prosthesis is checked in the office before the patient begins to use it.
When we say it’s a barometer of men’s health, it’s a signal. It’s an indicator that things may be right or not. And so when a man develops an erectile problem– and we’re talking about something that is occurring over time. It’s not something that just occurred overnight. When it occurs overnight, it’s more often than not a psychogenic, an anxiety reaction.
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