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]
I am 60 & have erection problems for 20 plus years. Factors for me include heavy smoking for 30 years, overweight, bad eating habits,many medications that claim " may cause sexual side effects ", extreme anxiety, circumcision, & stressful relationships. E.D. has been a big part of relationships ending. Masturbation is now my only recourse & that is many times unsuccessful Also have tried all of the E.D. medications with no success.Stress has been the biggest factor for inability to achieve an erection for me. An inventory of male erogenous zones is key. Many males are shy about trying what works for me with is extreme nipple play. That allows orgasm for me 90 percent of the time. Even at my age daily orgasms are welcome in me life. As far as knowing how to care for the older ladies, it is a learning process as to which I have been a good student. Pleasing a lady even without intercourse is very much possible.
Prostaglandins (alprostadil): Alprostadil can be injected into the penis or inserted as a pellet through the urethra. It causes an erection without sexual stimulation that usually lasts about 60 minutes. The danger with this method is that too high a dose can cause priapism, an erection that won't go away. This condition requires immediate medical attention as it can cause serious bruising, bleeding, pain and permanent penile damage. Once the doctor is sure of the right dose, the man can self-inject at home.
Currently, there are no therapies that cure erectile dysfunction. However, a number of effective therapies are available that allow an individual to have an erection when desired. Depending on the cause of the erectile dysfunction, certain therapies may be more effective than others. Although there is limited data on lifestyle modification, intuitively, decreasing risk factors for erectile dysfunction may help prevent progression of disease.
Psychological Causes of ED – Between 10% and 20% of ED cases have a psychological cause. Because arousal starts in the brain, psychological issues can be a significant contributing factor to erectile dysfunction. Mental health conditions like depression or anxiety can negatively impact your libido, making it more difficult for you to become aroused.
Vacuum devices for ED, also called pumps, offer an alternative to medication. The penis is placed inside a cylinder. A pump draws air out of the cylinder, creating a partial vacuum around the penis. This causes it to fill with blood, leading to an erection. An elastic band worn around the base of the penis maintains the erection during intercourse.
It is necessary to identify the causes of worry and try to remove these. They could include concern about personal relationships, work, family problems, health or even sexual “performance” with a new or old partner. It is often said that the brain is the biggest sex organ of them all – if it is too busy with other things, it will not be involved in arousal and the erection that follows.
Fact is, almost all men experience erection problems from time to time. Sometimes it's a temporary condition that will go away with just power of mind or little treatment. But unfortunately in many cases it may be an ongoing problem. Whatever it is, if you don't want to eventually destroy your self esteem and harm relationship with your lover, immediate treatment is required.
It appears that testosterone has NOS-independent pathways as well. In one study, castrated rats were implanted with testosterone pellets and then divided into a group that received an NOS inhibitor (L-nitro-L-arginine methyl ester [L-NAME]) and a control group that received no enzyme. [24] The castrated rats that were given testosterone pellets and L-NAME still had partial erections, a result suggesting the presence of a pathway independent of NOS activity.
If PDE-5 inhibitors are not suitable or don’t work, other therapies include injections into the base of the penis, which cause flow of blood into the penis and a fairly immediate erection that lasts around an hour. The drugs injected are alprostadil (Caverject and Erectile dysfunctionex) and Invicorp (VIP and phentolamine). Alprostadil may also be inserted as a gel into the opening of the penis. This is not suitable if your partner is pregnant.
The trouble is, most people don't know that sexual dysfunction can be a warning sign of something more serious. Dr Graham Jackson, a cardiologist and the chairman of the Sexual Advice Association, would like to change that. "People aren't aware of the underlying causes of their problems because they feel well otherwise," he says. "They'll say, 'It's my age' or 'I'm nervous because I'm in a new relationship.' But every man with erectile dysfunction should have their heart and blood pressure checked."
Since no two men are alike, the best ED treatment plan will depend on what’s causing your problem. That’s why you need to put aside your embarrassment and make an appointment to visit with see a qualified doctor who specializes in helping guys get back to enjoying their time with their spouses or partners to the fullest. You’ll be relieved to talk to someone who understands and has solutions.
There are treatments available to help you to get and maintain an erection. In addition, making healthy changes to your lifestyle could help with impotence. Switching to a healthier balanced diet, taking more exercise and cutting down on or giving up alcohol and cigarettes could help you to see an improvement in sexual function. If you think that the problem may be related to stress or anxiety, counselling can also help.

In other cases, men who habitually use alcohol or other drugs may experience similar results. Alcohol is a depressant to the central nervous system. This means that a little bit might be able to lighten the mood, but too much can basically shut down all communication between the brain and the penis. When this happens, no amount of will or stimulation will result in an erection. Other drugs can also affect the body’s ability to achieve an erection, including heroin and MDMA, otherwise known as ecstasy.
You should talk to your doctor about possible treatments. You may want to talk to other patients who have had the treatment planned for you. You also may want to seek a second doctor's opinion about surgery before making your decision. You may find it difficult to talk to your doctor about impotence. You will want to find a doctor who treats this condition and will help you feel comfortable talking about the problem and choosing the best treatment. You can also get more information by contacting your local National Kidney Foundation affiliate.
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.
Both ED and low testosterone (hypogonadism) increase with age. The incidence of the latter is 40% in men aged 45 years and older. [15] Testosterone is known to be important in mood, cognition, vitality, bone health, and muscle and fat composition. It also plays a key role in sexual dysfunction (eg, low libido, poor erection quality, ejaculatory or orgasmic dysfunction, reduced spontaneous erections, or reduced sexual activity). [16]
The percentage of men who engage in some form of sexual activity decreases from 73% for men aged 57–64 years to 26% for men aged 75–85 years.3 For some men, this constitutes a problem, but for others it does not. The aetiology for this decline in sexual activity is multifactorial and is in part due to the fact that most of the female partners undergo menopause at 52 years of age with a significant decline in their libido and desire to engage in sexual activity. A study by Lindau and colleagues3 that examined sexuality in older Americans showed that 50% of the men in a probability sample of more than 3000 US adults reported at least one bothersome sexual problem and 33% had at least two such problems.3 This article will review the normal changes that occur with ageing, factors that influence these changes, individual variations and perspectives, and the available treatment options for ED and androgen deficiency.
This process comprises a variety of physical aspects with important psychological and behavioral overtones. In analyzing the material presented and discussed at this conference, this consensus statement addresses issues of male erectile dysfunction, as implied by the term "impotence." However, it should be recognized that desire, orgasmic capability, and ejaculatory capacity may be intact even in the presence of erectile dysfunction or may be deficient to some extent and contribute to the sense of inadequate sexual function.
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.
Some men should not take PDE5 inhibitors. They can cause hypotension (abnormally low blood pressure that can lead to fainting and even shock) when given to patients who are taking nitrates (medications taken for heart disease). Therefore, patients taking nitrates daily should not take any of the PDE5 inhibitors. Nitrates relieve angina (chest pain due to insufficient blood supply to the heart muscle because of narrowing of the coronary arteries); these include nitroglycerine tablets, patches, ointments, sprays, and pastes, as well as isosorbide dinitrate and isosorbide mononitrate. Other nitrates such as amyl nitrate and butyl nitrate also are in some recreational drugs called "poppers."
I’m going to share a secret with you. I understand that for men it’s a big (well, perhaps flaccid and at least momentarily small) deal when you can’t get hard. However, in most instances, women don’t give a fuck. We’re understanding creatures who (ahem) know a thing or two about not being able to get off every time. To ease the awkwardness, here are a few go-to phrases to drop when you just can’t get it up.
My name is John and i am happy today,because it has been a long time since i have this problem of weak erection and premature ejaculation,hope was lost because i cant even penetrate or erect,and a man that those not erect is not a man,but now i erect and i can now have sex any time any day,i was cured by a Doctor OLUMBA,so if you want to be strong and erect again you can contact him @ Email.drolumbaayi@gmail.com or call him @ +2347068002488.
In a randomized double-blind, parallel, placebo-controlled trial, sildenafil plus testosterone was not superior to sildenafil plus placebo in improving erectile function in men with ED and low testosterone levels. [19] The objective of the study was to determine whether the addition of testosterone to sildenafil therapy improves erectile response in men with ED and low testosterone levels.
The trouble is, most people don't know that sexual dysfunction can be a warning sign of something more serious. Dr Graham Jackson, a cardiologist and the chairman of the Sexual Advice Association, would like to change that. "People aren't aware of the underlying causes of their problems because they feel well otherwise," he says. "They'll say, 'It's my age' or 'I'm nervous because I'm in a new relationship.' But every man with erectile dysfunction should have their heart and blood pressure checked."
This may be the oldest excuse in the book as a reason not to have safe sex, but research has confirmed that condoms may interfere with some men’s ability to have and hold an erection. For example, a 2006 study found that, over a three-month period, about 37 percent of men lost at least one erection when putting on a condom, or during sex with a condom, SexualHealth.com reported.

Exercise and lifestyle modifications may improve erectile function. Weight loss may help by decreasing inflammation, increasing testosterone, and improving self-esteem. Patients should be educated to increase activity, reduce weight, and stop smoking, as these efforts can improve or restore erectile function in men without comorbidities. Precise glycemic control in diabetic patients and pharmacologic treatment of hypertension may be important in preventing or reducing sexual dysfunction. [49]

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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