#6 It’s performance anxiety. Many men suffer from performance anxiety, and that’s another reason you can’t get hard. Simply put, you’re too nervous to get your dick up. And that’s okay, it happens! This is likely to happen if you haven’t had sex in a while or if you’re starting up with a new partner. Sex is supposed to be fun, but worrying over your prowess between the sheets can make sex the exact opposite of what’s it’s supposed to be. [Read: 13 ways to overcome sexual anxiety and perform]
Impotence can have emotional causes but most often it is due to a physical problem. The physical causes of impotence include diseases (such as diabetes and hypertension), injuries (such as from prostate surgery), side-effects of drugs (such as the protease inhibitors used in HIV therapy), and disorders (such as atherosclerosis) that impair blood flow in the penis. Impotence is treatable in all age groups. Treatments include psychotherapy, vacuum devices, surgery and, most often today, drug therapy.

In fact, one common reason many younger men visit their doctor is to get erectile dysfunction medication. Often, men with erectile dysfunction suffer with diabetes or heart disease, or may be sedentary or obese, but they don’t realize the impact of these health conditions on sexual function. Along with erectile dysfunction treatment, the doctor may recommend managing the illness, being more physically active, or losing weight.
For example, many men with diabetes mellitus may develop erectile dysfunction during their young and middle adult years. Physicians, diabetes educators, and patients and their families are sometimes unaware of this potential complication. Whatever the causal factors, discomfort of patients and health care providers in discussing sexual issues becomes a barrier to pursuing treatment.
While studies are limited, it has been shown that male sexual dysfunction can also negatively impact the sexual function of female partners. A study comparing the sexual function of women with partners with erectile dysfunction to those without showed that sexual arousal, lubrication, orgasm, satisfaction, pain and total score were significantly lower in those who had partners with erectile dysfunction. Later in that study, a large proportion of the men with erectile dysfunction underwent treatment. Following treatment, sexual arousal, lubrication, orgasm, satisfaction and pain were all significantly increased. It was concluded that female sexual function is impacted by male erection status, which may improve following treatment of male sexual dysfunction.
So here’s something that’s really fascinating. Healthy eating is a way to reduce anxiety and stress. Now how, you may be asking, right? Well, think about it. We live in a world where there are so many variables and where we don’t have control over our lives. But now, with healthy eating, we have control over what goes into our body. And now having that control empowers us to be even healthier, to be more directive in what we do. And certainly, that begins then to reduce the anxiety and the stress. So all in one, you have a healthier body, but certainly a healthier mind.
The motivation and expectations of the patient and his partner and education of both are critical in determining which therapy is chosen and in optimizing its outcome. If single therapy is ineffective, combining two or more forms of therapy may be useful. Penile prostheses should be placed only after patients have been carefully screened and informed. Vascular surgery should be undertaken only in the setting of clinical investigation and extensive clinical experience. With any form of therapy for erectile dysfunction, long-term followup by health professionals is required to assist the patient and his partner with adjustment to the therapeutic intervention. This is particularly true for intracavernosal injection and vacuum constriction therapies. Followup should include continued patient education and support in therapy, careful determination of reasons for cessation of therapy if this occurs, and provision of other options if earlier therapies are unsuccessful.
#3 - Maxoderm ranked 69 out of 100. Maxoderm is the revolutionary topical Male Enhancement System discovered by thousands to help treat erectile function, improve erection quality and firmness. Maxoderm's topical formula goes to work fast increasing pleasure immediately. The very first time you use Maxoderm you're going to experience an intense warming sensation which feels great. However, in order to achieve the greatest possible results, it's recommended to use Maxoderm up to 12 weeks approximately 4-6 applications per week.
The rumors are true. Having too much to drink can interfere with a man’s ability to have an erection. According to Everyday Health, alcohol is a depressant. This means that, along with dampening your ability to think, speak, and move efficiently, it can also dampen mood, decrease sexual desire, and make it difficult for a man to achieve erection or reach an orgasm. This is because alcohol decreases blood flow to the penis. That not only may reduce a man’s ability to have an erection, but even if he is lucky enough to get it hard, alcohol can reduce the intensity of his orgasm.

PDE5 inhibitors, the primary second-line therapy, have been the mainstay of ED treatment since the release of sildenafil (Viagra) in 1998, with the subsequent development of many others, and still more in the development stage. These medications do improve erectile quality for the majority of men, and they work by enhancing blood flow in the corpora cavernosa. These medications are generally used on demand and need to be taken about an hour before sexual intimacy. Tadalafil (Cialis) is longer acting and does come in a daily preparation potentially eliminating the ‘on-demand’ need. The daily dosing of tadalafil, 2.5–5 mg\day, has also been approved by the FDA for treatment of symptoms of BPH.41 PDE5 inhibitors are contraindicated in men taking nitrates, but otherwise PDE5 inhibitors are very safe and effective. When PDE5 inhibitors are coadministered with nitrates, pronounced systemic vasodilation and severe hypotension are possible. Many patients with ED are elderly and have the same risk factors as patients with CAD, so these drug combinations are commonly considered or encountered in clinical practice.42
Diabetes is a well-recognized risk factor for ED. A systematic review and meta-analysis found that the prevalence of ED was 37.5% in type 1 diabetes, 66.3% in type 2 diabetes, and 52.5% in diabetes overall—a rate approximately 3.5 times higher than that in controls. [39]  The etiology of ED in diabetic men probably involves both vascular and neurogenic mechanisms. Evidence indicates that establishing good glycemic control can minimize this risk.
The time the dose should be taken and how long the effects last depend on the medication used. The most common side effect of these medications is a headache. However, there is a potential for certain dangerous drug interactions. Anyone prescribed this medication must let his doctor know about any medications he's on, and especially if he's taking nitrates (e.g., nitroglycerin spray, nitroglycerin pills, or nitroglycerin patch) for heart problems.
Quitting smoking, exercising regularly, losing excess weight, curtailing excessive alcohol consumption, controlling hypertension, and optimizing blood glucose levels in patients with diabetes are not only important for maintaining good health but also may improve or even prevent progression of erectile dysfunction. It is unclear if such lifestyle changes can reverse erectile dysfunction. However, lifestyle improvements may prevent progression of the erectile dysfunction. Some studies suggest that men who have made lifestyle improvements experience increased rates of success with oral medications.
The common PDE5 inhibitor drugs approved in the United States are sildenafil (Viagra), vardenafil (Levitra and Staxyn, the generic form), tadalafil (Cialis), or avanafil (Stendra). All of the currently approved PDE5 inhibitors work in the same way. They differ in the number of available doses, how quickly they work and last in your system, the dosing, and to some extent in the side effects. However, they generally share the same indications and contraindications. Currently, tadalafil is the only medication that patients can take on a daily basis and is approved for the treatment of both ED and BPH (benign enlargement of the prostate).
Injection of vasodilator substances into the corpora of the penis has provided a new therapeutic technique for a variety of causes of erectile dysfunction. The most effective and well-studied agents are papaverine, phentolamine, and prostaglandin E[sub 1]. These have been used either singly or in combination. Use of these agents occasionally causes priapism (inappropriately persistent erections). This appears to have been seen most commonly with papaverine. Priapism is treated with adrenergic agents, which can cause life-threatening hypertension in patients receiving monoamine oxidase inhibitors. Use of the penile vasodilators also can be problematic in patients who cannot tolerate transient hypotension, those with severe psychiatric disease, those with poor manual dexterity, those with poor vision, and those receiving anticoagulant therapy. Liver function tests should be obtained in those being treated with papaverine alone. Prostaglandin E[sub 1] can be used together with papaverine and phentolamine to decrease the incidence of side effects such as pain, penile corporal fibrosis, fibrotic nodules, hypotension, and priapism. Further study of the efficacy of multitherapy versus monotherapy and of the relative complications and safety of each approach is indicated. Although these agents have not received FDA approval for this indication, they are in widespread clinical use. Patients treated with these agents should give full informed consent. There is a high rate of patient dropout, often early in the treatment. Whether this is related to side effects, lack of spontaneity in sexual relations, or general loss of interest is unclear. Patient education and followup support might improve compliance and lessen the dropout rate. However, the reasons for the high dropout rate need to be determined and quantified.
The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

Most older men suffer not ED but erection dissatisfaction. Starting around age 50 (often earlier among smokers and/or diabetics), erections change. In some men, the process is gradual, in others, it happens more quickly. Either way, older men lose the ability to raise erections solely from sexual fantasies. Direct fondling of the penis becomes necessary. When erections appear, they rise more slowly and do not become as firm as they were during men’s thirties and forties. And minor distractions may cause wilting—the doorbell or an ambulance siren. These changes alarm many men, who jump to the conclusion that they must have ED. If you can still raise erection durings masturbation, you don’t. What you have is erection dissatisfaction.
Half of all men between the ages of 40 and 70 will experience erectile dysfunction. While the problem doesn't cause heart disease, the two often occur together – study after study has shown that men with ED are dramatically more likely to develop heart disease and have a heart attack or stroke. One German study from 2010 found men with erectile dysfunction are twice as likely to die within the next two years as those without, prompting some experts to call the phenomenon "the canary in the trousers".
It is important that all erectile dysfunction is reported to your doctor, as sometimes it can be an indicator of something physically wrong with you that has to be treated. Also, your doctor is in the best position to find the reason for your erectile dysfunction. Routine questions and tests will provide a guide to the cause and allow your doctor to decide what kind of treatment you might need to deal with it. This may involve referral to a specialist. Detailed information can be found at the website of the Impotence Association – www.sda.uk.net

More recent estimates suggest that the number of U.S. men with erectile dysfunction may more likely be near 10-20 million. Inclusion of individuals with partial erectile dysfunction increases the estimate to about 30 million. The majority of these individuals will be older than 65 years of age. The prevalence of erectile dysfunction has been found to be associated with age. A prevalence of about 5 percent is observed at age 40, increasing to 15-25 percent at age 65 and older. One-third of older men receiving medical care at a Department of Veterans' Affairs ambulatory clinic admitted to problems with erectile function.
How’s this for a win-win: The more sex you have, the less likely you are to suffer from erectile dysfunction, according to a 2008 study published in The American Journal of Medicine. Men aged 55-75 who reported having sex less than once per week had twice the incidence of erectile dysfunction (there were 79 cases of ED per 1,000) as men who have sex once a week (32 cases of ED per 1,000). But if you really want to up your odds, shoot for three times per week (only 16 cases of ED per 1,000). Can you really argue with science, or a perscription to have more sex?
Whenever I am prescribing a medication to a patient, I’m always asking myself, what can the patient do before requiring the medication? What changes do they have to make in order to reduce the amount of medication or preclude their even needing it? So a good candidate is somebody who has an understanding of a healthy lifestyle, about physical activity, about sleep, about nutrition, alcohol, smoking. So patients, individuals, have to do their share before they’re a candidate for anything. All right?
For more information please refer to the erectile dysfunction article. There are also other causes of problems in bed like enlarged prostate, or you may be interested in general male enhancement. This is not the subject we are talking about. The main purpose of this review is to let you know how to get an erection when you need it. We will take a look at the products and techniques that will help you get an instant erection on demand. Face it, if you want to take total control of a woman, you just can't let concerns about your performance disrupt the thrill and momentum of spontaneous, passionate sex. You want to know without a doubt that you'll be as hard and as hot and as enduring as you ever dreamed. And you want it now. Now means instant erection when you need it.
A good indicator that "everything is in working order" and that it is probably a psychological cause is if a “morning erection” is still experienced. Feelings like fear, anger, distress and anxiety cause part of the nervous system to come into play which directly blocks the action of another part of the system involved in creating an erection. This is a natural reaction – our ancestors would find it more difficult to run from a predator with an erection in the way!
The rumors are true. Having too much to drink can interfere with a man’s ability to have an erection. According to Everyday Health, alcohol is a depressant. This means that, along with dampening your ability to think, speak, and move efficiently, it can also dampen mood, decrease sexual desire, and make it difficult for a man to achieve erection or reach an orgasm. This is because alcohol decreases blood flow to the penis. That not only may reduce a man’s ability to have an erection, but even if he is lucky enough to get it hard, alcohol can reduce the intensity of his orgasm.

Is your erectile dysfunction due to psychological (stress, relationship problems, etc.) or physical factors? Your doctor may ask if you note erections at night or in the early morning. Men have involuntary erections in the early morning and during REM sleep (a stage in the sleep cycle with rapid eye movements). Men with psychogenic erectile dysfunction (erectile dysfunction due to psychological factors such as stress and anxiety rather than physical factors) usually maintain these involuntary erections. Men with physical causes of erectile dysfunction (for example, atherosclerosis, smoking, and diabetes) usually do not have these involuntary erections. Men with psychogenic erectile dysfunction may relate the onset of problems to a "stressor," such as failed relationship. Your doctor may suggest a test to determine if you have erections during sleep, which may suggest that there may be a psychological cause of the erectile dysfunction.
Disclaimer : Any and all information, images and written material included on ErectileDysfunction.com, which will hereafter be referred to as “Content” is to be used only for informational and educational purposes. Content is not intended to diagnose or treat any medical ailments or problems, and in no case should it ever take the place of proper and immediate medical attention. Never substitute this website, or any other, for an appointment with your physician. ErectileDysfunction.com is not associated with any other company, including those companies owning or representing medications, treatment methods or other products that are mentioned within the Content of the website. - See more at: www.erectiledysfunction.com
Injection of vasodilator substances into the corpora of the penis has provided a new therapeutic technique for a variety of causes of erectile dysfunction. The most effective and well-studied agents are papaverine, phentolamine, and prostaglandin E[sub 1]. These have been used either singly or in combination. Use of these agents occasionally causes priapism (inappropriately persistent erections). This appears to have been seen most commonly with papaverine. Priapism is treated with adrenergic agents, which can cause life-threatening hypertension in patients receiving monoamine oxidase inhibitors. Use of the penile vasodilators also can be problematic in patients who cannot tolerate transient hypotension, those with severe psychiatric disease, those with poor manual dexterity, those with poor vision, and those receiving anticoagulant therapy. Liver function tests should be obtained in those being treated with papaverine alone. Prostaglandin E[sub 1] can be used together with papaverine and phentolamine to decrease the incidence of side effects such as pain, penile corporal fibrosis, fibrotic nodules, hypotension, and priapism. Further study of the efficacy of multitherapy versus monotherapy and of the relative complications and safety of each approach is indicated. Although these agents have not received FDA approval for this indication, they are in widespread clinical use. Patients treated with these agents should give full informed consent. There is a high rate of patient dropout, often early in the treatment. Whether this is related to side effects, lack of spontaneity in sexual relations, or general loss of interest is unclear. Patient education and followup support might improve compliance and lessen the dropout rate. However, the reasons for the high dropout rate need to be determined and quantified.
Willful and capricious – erections are funny things. When you're a young man, they seem to pop up at the most inappropriate moments (and the only thing between you and embarrassment is a carefully placed notebook). As you get older, however, they go the other way, and fail to appear on demand no matter how much you try. The sad thing is, my patients often equate this with a loss of masculinity.
ED can be caused by either physical and/or psychological factors like stress, anxiety, or depression. Importantly, ED can be the first sign of heart or other health conditions, including cardiovascular disease and diabetes. We offer the optional order of a lab test to investigate whether you might have more serious underlying health problems. Our doctors can order investigative labs in all the states we operate in apart from AZ, NY, NJ and RI. You’ll need to go to a Quest Diagnostics center to have these tests done. When we get the test results back, we can help you understand what they mean.

How soon the drugs start working ranges from 15 to 60 minutes. Neither Viagra nor Levitra will work if you take them after a meal, which blocks their absorption. However, neither Cialis nor Stendra interact with food this way. The onset time determines how soon you can engage in intercourse. Stendra and daily-use Cialis are closest to being an "on demand" erectile drug; using the others requires more planning.


While erectile dysfunction can occur at any age, the risk of developing erectile dysfunction increases with age. According to the Massachusetts Male Aging Study, the prevalence of erectile dysfunction was 52% in men 40-70 years of age. The prevalence of complete erectile dysfunction increases from 5% at 40 years of age to 15% among men 70 years of age and older.
Three forms of penile prostheses are available for patients who fail with or refuse other forms of therapy: semirigid, malleable, and inflatable. The effectiveness, complications, and acceptability vary among the three types of prostheses, with the main problems being mechanical failure, infection, and erosions. Silicone particle shedding has been reported, including migration to regional lymph nodes; however, no clinically identifiable problems have been reported as a result of the silicone particles. There is a risk of the need for reoperation with all devices. Although the inflatable prostheses may yield a more physiologically natural appearance, they have had a higher rate of failure requiring reoperation. Men with diabetes mellitus, spinal cord injuries, or urinary tract infections have an increased risk of prosthesis-associated infection. This form of treatment may not be appropriate in patients with severe penile corporal fibrosis, or severe medical illness. Circumcision may be required for patients with phimosis and balanitis.

Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).


So what can you do to help things along a little?  Well, chances are it may sort itself out as you settle in to your relationship. But if it keeps happening and you see a future in the relationship, you need to talk about it, or it will soon become the elephant in the bedroom. Pick a time with no distractions and where nobody can overhear you. Tell them that you care about them and that you don’t need to rush things sexually. This can take the pressure off the need to perform. 
The surgery for placement of a penile prosthesis is typically an outpatient surgery. Doctors often perform a penile prosthesis through a single incision, and all of the components are hidden under the skin. Health care professionals often give patients antibiotics at the time of surgery and often after the surgery to decrease the risk of developing an infection. Depending on your health history, a health care provider may leave a catheter in your penis to drain your bladder overnight.

Her remark was entirely destructive of poetry, since it was to the effect that poetry had nothing whatever to do with her; all her friends spent their lives in making up phrases, she said; all his feeling was an illusion, and next moment, as if to taunt him with his impotence, she had sunk into one of those dreamy states which took no account whatever of his existence.


Jump up ^ Reepmeyer JC, Woodruff JT (2007). "Use of liquid chromatography-mass spectrometry and a chemical cleavage reaction for the structure elucidation of a new sildenafil analogue detected as an adulterant in an herbal dietary supplement". Journal of Pharmaceutical and Biomedical Analysis. 44 (4): 887–93. doi:10.1016/j.jpba.2007.04.011. PMID 17532168.
In this study, ED proceeded CVD in almost 70% of cases. Similarly, many men with ED have been found to have pre-existing CVD. A study by Vlachopoulos et al evaluated the incidence of asymptomatic CVD in 50 men with ED.22 These authors found that 19% of men with ED had asymptomatic CVD. Similarly, Mulhall and colleagues found that 20% of men presenting with ED and vascular insufficiency on penile duplex had asymptomatic CVD.23
You’ve heard of—and probably experienced—the numbing effect alcohol has on your mind, body, and (unfortunately) penis. If you fail to rise to the occasion on a regular basis and you're drinking has gone from occassional weekend binge to a Monday through Friday ordeal, consider cutting back—way back. Heavy drinking proportionately increases your risk of ED, according to research from the Indian Journal of Psychiatry.
Between 10 and 88% of patients diagnosed with cancer experience sexual problems following diagnosis and treatment. The prevalence varies according to the location and type of cancer, and the treatment modalities used. Sexuality may be affected by chemotherapy, alterations in body image due to weight change, hair loss or surgical disfigurement, hormonal changes, and cancer treatments that directly affect the pelvic region.
Factors that mediate contraction in the penis include noradrenaline, endothelin-1, neuropeptide Y, prostanoids, angiotensin II, and others not yet identified. Factors that mediate relaxation include acetylcholine, nitric oxide (NO), vasoactive intestinal polypeptide, pituitary adenylyl cyclase–activating peptide, calcitonin gene–related peptide, adrenomedullin, adenosine triphosphate, and adenosine prostanoids.
It's definitely possible that your boner isn't cooperating because it's not really thrilled to be there. Maybe you're not sure about this partner, you're worried about pregnancy or STIs, you're not feeling comfortable with an unfamiliar hookup, or you typically need some other kind of stimulus to get in the mood. It's always worth checking in with yourself to see if one of these factors might be holding you back in bed, says Skyler. If you have a hunch that it's because you're doing something you don't want to do (or you're not doing something you do want to do) pay attention to that hunch.
If you just got off solo, you might have to wait before you can hop into bed with your partner, says Dr. Brahmbhatt. It might have something to do with a spike in the hormone prolactin after you orgasm, according to a study published in the International Journal of Impotence Research. This hormone has been linked to difficulties maintaining an erection or even ejaculating.
In patients who either fail to respond to first or second-line therapy, or are not interested in the conservative therapies, penile prosthesis implantation is available. Malleable and rigid implants were available for many years, but in 1973 the world of penile prosthetics took a giant leap forward with the advent of the inflatable penile implant. Most implants done nowadays are of the inflatable variety. Adverse events including malfunction and infection are rare, and patient satisfaction is very high.45
Pills such as Viagra® are the most common ED treatment, but they don’t work for everyone. Some guys find they cause bothersome headaches or persistent stomach troubles. Some have serious side effects such as chest pain and vision or hearing changes. Others don’t respond to the medication at all. And still others don’t like having to wait for the pill to take effect.
×