Christine graduated from San Francisco State University with a BA in English Literature. Shortly after she completed a Post Baccalaureate certificate in Pre-health professions and started her journey in healthcare! Christine is currently completing her Master of Science in Health Care Administration at California State University East Bay and will graduate in June of 2018. She has prior experience working and volunteering in various hospital and health care settings including nephrology, post-surgery geriatrics, cardiac electrophysiology, and orthopedics. Christine is excited to be a part of the Lemonaid team and contributing towards their mission of providing accessible health care to all. On her spare time Christine enjoys running, Olympic lifting, and visiting all of the national parks in the United States!

Surgery: If neither drugs nor the vacuum pump works, your doctor may suggest surgery. With surgery, the doctor can place a device in your penis that will cause enough hardness for intercourse. In a few cases, infections may develop after the operation, and the doctor may have to remove the device. Another operation that may help you is rebuilding the blood vessels in the penis to increase blood flow into the penis or decrease blood flow out of the penis. These procedures can help you to get and maintain an erection.

Although women tend to become more around by psychological stimuli, such as fantasies or romance novels, men tend to be more visual creatures, meaning they need to be able to actually see the object of arousal. Obviously, no two people are alike, so this is not a blanket statement, but scientific study after study over the years has shown this to be the norm.

Elise joined Lemonaid because she believes healthcare should be accessible and affordable to everyone! With extensive professional healthcare experience, Elise has spent the last decade as an advocate for the highest quality patient care in specialties like gynecology, internal medicine, and otolaryngology and has excelled in various roles such as office manager, surgery coordinator, and front office coordinator. She feels every patient should be treated with kindness and understanding, and she brings this attitude to work every day. Aside from her medical background, she’s also a professional musician and enjoys living life to the fullest with a smile on her face.
The circulatory system plays a central role in obtaining and sustaining erections. Augmentation of blood flow to the corporal bodies depends on the intravascular pressure in the penile artery. Vascular lesions—typically atherosclerotic, but occasionally fibrotic—and systemic hypotension will limit flow to the corpora. In certain patients, blood flow at rest may be sufficient to obtain an erection but not sufficient to maintain it during intercourse, when the pelvic musculature places greater demands on a compromised blood supply.
The history can be useful in distinguishing organic from psychogenic impotence (Table 187.1). The patient with organic impotence describes problems with erection that progress over months to years. At first, the patient will have partial erections or seemingly firm erections that become flaccid during intercourse. With time, total erectile failure ensues. Organic impotence is constant and nonselective, meaning it is not better or worse with any specific partner or any type of stimulation.

Patients with both ED and cardiovascular disease who receive treatment with an oral PDE5 inhibitor require education regarding what to do if anginal episodes develop while the drug is in their system. Such education includes stressing the importance of alerting emergency care providers to the presence of the drug so that nitrate treatment is avoided.
Since endothelial dysfunction, CVD and ED are closely associated in epidemiological studies, the question for clinicians is whether to recommend the man presenting with ED undergo a cardiovascular (CV) evaluation. Clearly, based on numerous studies, ED can be considered at least a ‘marker’ for possible further vascular disease or CVD.15 In their report, Vlachopoulos and coworkers make the point that the man presenting with ED, the clinician, is offered an opportunity to attempt to improve the health of the man by addressing lifestyle modification, and consider further vascular evaluation owing to the clear relationship between endothelial dysfunction, ED and CVD.19
Recently, the US Food and Drug Administration (FDA) has issued a safety announcement regarding TRT. In part it reads ‘The benefit and safety of these medications have not been established. We are also requiring these manufacturers to add information to the labeling about a possible increased risk of heart attacks and strokes in patients taking testosterone.’37
This is similar to magnetic resonance imaging. Magnetic resonance angiography uses magnetic fields and radio waves to provide detailed images of the blood vessels. Doctors may inject a "contrast agent" into the patient's bloodstream that causes vascular tissues to stand out against other tissues. The contrast agent provides for enhanced information regarding blood supply and vascular anomalies.
The Massachusetts Male Aging Study (MMAS) documented an inverse correlation between ED risk and high-density lipoprotein (HDL) cholesterol levels but did not identify any effect from elevated total cholesterol levels. [15] Another study involving male subjects aged 45-54 years found a correlation with abnormal HDL cholesterol levels but also found a correlation with elevated total cholesterol levels. The MMAS included a preponderance of older men.
Stress is another factor that can be a cause or effect of ED. If you're stressed at work, at home, and in your relationships, it's going to take a toll on your sexual function. Your mind is elsewhere, and relaxing when you finally make it between the sheets is a long shot. Now you’re stressed because you can’t get it up (talk about the ultimate catch-22), so you're stuck in this sad, frustrating cycle. “ED really affects the psyche of a guy, regardless of the etiology, Gittens says. “If you have a problem getting an erection one night, you’re probably going to be anxious and worried your partner might see you as less of a man the next time you try to get an erection.” There's a pill that will help with this, and it's not promoted on television with middle-aged men in sports cars. It's a damn chill pill.
Alprostadil may also be administered into the urethral opening of the penis. In MUSE (medical urethral system for erection), the man inserts a thin tube the width of a vermicelli noodle into his urethral opening and presses down on a plunger to deliver a tiny pellet containing alprostadil into his penis. The drug takes about 10 minutes to work and the erection lasts about an hour. The main side effect is a sensation of pain and burning in the urethra, which can last about five to 15 minutes.
Tadalafil should not be used with alpha-blockers (except Flomax), medicines used to treat high blood pressure, and benign prostate hypertrophy (BPH) because the combination of tadalafil and an alpha-blocker may lower the blood pressure greatly and lead to dizziness and fainting. Examples of alpha-blockers include tamsulosin (Flomax), terazosin (Hytrin), doxazosin (Cardura), alfuzosin (Uroxatral), and prazosin (Minipress). Tamsulosin (Flomax) is the only alpha-blocker that patients can use safely with tadalafil. When tadalafil (20 mg) was given to healthy men taking 0.4 mg of Flomax daily, there was no significant decrease in blood pressure and so patients on this dose of tamsulosin (Flomax) can be prescribed tadalafil. The only alpha-blocker not tested with tadalafil is alfuzosin (Uroxatral), and no recommendations can be made regarding the interaction between the two.
Stiffy Solution: The good news is, almost all of these conditions can be successfully treated if you catch them early on. And since erectile problems may be the first side effect your dude has experienced, seeking medical treatment for his erectile problems may be the thing to get him into a doctor's office. So if your dude is a well-rested, non-drinking, non-smoking, paragon of relaxation who suddenly can't get wood, urge him to talk to his doctor — his misbehaving penis may actually be communicating something way more important than "Not tonight, honey."
Your like a lot of posters in forums. You make crazy statement's and weather you know it or not, your totaly wrong. Im 56 and my wife is 37. We have a good sex life and are always going at it when we can. I pity peeps like you and fig your kind of logic helps you deal with your inadequate performance. Get help or live alone and leave the keyboard alone.

If you have low blood pressure, heart disease, take medicines for heart disease or for high blood pressure, you shouldn’t use our service. If you take the medicines we prescribe you'll be at greater risk of serious side effects such as severe dizziness, fainting, heart attack, and stroke. Read the package insert that comes with the medicine for a full list of side effects and warnings.
Penile implants: This treatment involves permanent implantation of flexible rods or similar devices into the penis. Simple versions have the disadvantage of giving the user a permanent erection. The latest (and most expensive) device consists of inflatable rods activated by a tiny pump and switch in the scrotum. Squeezing the scrotum stiffens the penis, whether the person is aroused or not. The penis itself remains flaccid, however, so the diameter and length are usually less than a natural erection, and hardness is lacking, although it's sufficient for intercourse.
The liver is the largest gland and organ in the body. There are a variety of liver diseases caused by liver inflammation, scarring of the liver, infection of the liver, gallstones, cancer, toxins, genetic diseases, and blood flow problems. Symptoms of liver disease generally do not occur until the liver disease is advanced. Some symptoms of liver disease include jaundice, nausea and vomiting, easy bruising, bleeding excessively, fatigue, weakness, weight loss, shortness of breath, leg swelling, impotence, and confusion. Treatment of diseases of the liver depends on the cause.
The risk of impotence increases with age. It is four-fold higher in men in their 60s compared with those in their 40s according to a study published in the Journal of Urology (2000;163:460-463). Men with less education are also more likely to experience impotence, perhaps because they tend to have less healthy lifestyles, eat a less healthy diet, drink more and exercise less. Physical exercise tends to lessen the risk of impotence.
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.
The cost to you for ED drug therapy varies considerably, depending on the pharmacy price, prescription co-pays, and your level of health plan coverage. Nationally, the out-of-pocket cost per pill ranges from approximately $15 to $20. Even if private insurance covers it, you may be limited to four doses per month. Here are a few things you can do to contain costs:
Hypogonadism may be suggested by the patient's general appearance. If testosterone deficiency antedates puberty, as in Klinefelter's syndrome, eunuchoid proportions—defined as an arm span 5 cm or more in excess of height, or a sole-to-pubis length exceeding crown-to-pubis length by more than 2 cm—may be present. In postpubertal males whose testosterone levels are markedly depressed, the secondary sexual characteristics may become atrophic. Testicles less than 4 cm in length or a prostate gland that is smaller than expected may be the only clues on physical examination to a pituitary tumor with secondary hypogonadism.
Low-intensity extracorporeal shock wave therapy has been proposed as a new non-invasive treatment for erectile dysfunction caused by problems with blood vessels. Shock wave therapy machines are now available in some medical practices in Australia. Although there is some evidence that it may help a proportion of men with erectile dysfunction, more research is needed before clear recommendations on its use can be made.
The key to this line is to act chill. An occasional soft dick ain’t no thang. But if you get angry, throw off the sheets, and stomp around the apartment while your partner sits in bed watching a grown man throw a temper tantrum, it becomes a thang. Throw out an apology to cover your bases, and then let it go. Once again for the guys in the back: Women understand about not always being able to get wet. And we really understand about not being able to get off every time. One in three women has trouble reaching orgasm during sex. I get that it’s not the exact same thing, but we’re empathetic. A good rule of thumb for almost all insecurities is the less of a big deal you make about something, the less others will.

Because there's no word better than "love," where do you go from "I love you"? I really, really love you? I love you so much? With a cherry on top? Ugh. Pretty soon, you're in Hallmark territory, quoting bad pop lyrics. Since "I love you" is as good as it gets, maybe you feel you've peaked. You might be wondering: Is this it? Do you just say the same thing, over and over, for the rest of your days? "I love you" can be scary when it seems to be a plateau and the end of something. But that's bullshit. Hopefully, "I love you" is just the beginning.
Let’s admit that not “talking about anything that could possibly be uncomfortable” is a sure-fire recipe for total disaster. Maybe you’re exaggerating, but if he can’t deal with anything even slightly difficult, then that is a bigger problem than pillow talk. Think about how exactly it would affect everything else in your relationship. He can’t choose not to deal. When good things are happening, it’s a shame he can’t say "I love you0". But when hard things happen, he can’t just say: "Um, pass."
Your question reminds me of this brilliant Louis CK bit from his special Hilarious, in which he talks about a guy who said his appetizer was amazing. "Really? You were amazed by a basket of chicken wings? What if Jesus comes down from the sky and makes love to you all night long and leaves the new living lord in your belly? What are you going to call that? You used amazing on a basket of chicken wings! You've limited yourself verbally to a shit life."

Impotence is a common problem among men and is characterized by the consistent inability to sustain an erection sufficient for sexual intercourse or the inability to achieve ejaculation, or both. Erectile dysfunction can vary. It can involve a total inability to achieve an erection or ejaculation, an inconsistent ability to do so, or a tendency to sustain only very brief erections.
ED usually has something physical behind it, particularly in older men. But psychological factors can be a factor in many cases of ED. Experts say stress, depression, poor self-esteem, and performance anxiety can short-circuit the process that leads to an erection. These factors can also make the problem worse in men whose ED stems from something physical.
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