Impotence (also known as an erectile dysfunction) is a disease that affects 1 in 10 male patients. Impotence, also called erectile dysfunction, is the persistent inability to achieve or maintain an erection long enough to have sexual intercourse.
The only symptom of impotence is the inability to achieve or maintain an erection long enough to have sexual intercourse. The main factors that trigger erectile dysfunction can be either physical or psychological.
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Erectile dysfunction (ED) is also known as impotence that interferes with male sexual intercourse. ED has the tendency to occur at any age but it is more common in elderly men and uncommon among the young. Normal male reproductive system functions depend on a healthy nervous system to carry nervous impulses or messages, healthy arteries in and near copora cavernosa and healthy smooth muscles and fibrous tissues as well as appropriate levels of nitric oxide. Diabetes mellitus- ED is said to arise 10-15 years earlier in men suffering from diabetes than the ones who do not. Hypertension (high blood pressure)- It is not clearly known how hypertension contributes to ED.
Cardiovascular diseases- atherosclerosis is the most common cardiovascular disease in the U.S. Smoking cigarettes- this will worsen atherosclerosis which will increase the risk of developing ED.
Nerve and spinal cord damage- this can cause ED due to damage sustained to the nerves in the pelvis and the spinal cord.
Substance abuse- ED can develop due to marijuana, heroin, cocaine, crystal meth, alcohol abuse and methamphetamines.
Depression and anxiety disorders- It is proved that psychological disorders can lead to ED. Liver function tests and liver enzymes- Cirrhosis, a severe liver disease, lead to hormonal imbalance and gonad dysfunction. Total testosterone levels- Blood samples to test the level of testosterone is obtained early morning, before 8 a.m. Other hormone levels (LH, prolactin, cortisol)- these measurements provide further clues to the causes of poor levels of testosterone and ED problems.
PSA levels- PSA or the prostrate specific antigen levels in blood is important to rule out prostrate cancer before the patient undergoes treatment for testosterone as this hormone can worsen prostrate cancer. Other blood tests- other tests may be performed that  will indicate zinc deficiency, hemochromatosis, lupus, scleroderma, cancers, sickle cell anaemia , etc.
A psychosocial examination will take the form of an interview and questionnaire which may give the medical doctor clues and factors that are contributing to ED. Certain lifestyle improvements will not only improve an individual’s general health but also contribute in preventing ED.
Some studies conducted reported that men who had changed certain lifestyle habits have had much better success with oral medicines. Testosterone treatment can improve both libido and ED in patients who suffer from hypogonadism. Patients who require testosterone treatment,  aged 40 years and above, should first undergo a digital examination of the prostate, breast examination and PSA level detection prior to the treatment to rule out breast and prostate cancers.
It is important to note that there are certain medications that are available that can alter or disrupt gonadal function. However, there are certain side effects that can be experienced in those undergoing this therapy. Combination therapy has been analysed and studied many times by researchers for the treatment of ED.
A newer medication  which is being developed for ED has taken the form of melanocortin receptor agonists. Moreover, several other medications are being researched and studied that will effectively treat ED. Erectile dysfunction (ED) is also known as impotence that interferes with male sexual intercourse.
The causes of this condition may be from health problems like prostate problems, severe trauma or injury in the genital area, and vascular problems.
Some of these men say that they grew tired of it since they consume almost all of their energy seeking for treatment that would work best for them. Some known facts about how to improve erectile dysfunction is to first seek a doctor’s help. Second, maintaining a healthy lifestyle is said to be effective in improving this condition.
There may be other options like 5 Hour Potency Male Enhancement for men to try regarding ways on how to improve erectile dysfunction. While there are many things that are exciting about retirement and living the life of a senior citizen prostrate issues is nothing to be happy about. For those who suffer from Arthritis pain, the thought of anything that will offer relief sounds like a good idea. Supplements are on the market that are advertised to solve almost every ailment and health problem. The problems of a enlarged prostate gland as most men age can be a source of embarrassment. Circumcision is a surgical procedure in which the foreskin (also known as the prepuce) is cut from the penis. Phimosis is a condition where the foreskin is constricted and cannot be pulled back over the head of the penis (glans). However, note that during childhood (until about 5 years old) the foreskin can usually not be pulled back over the glans, because the glans and foreskin have not yet separated.
Paraphimosis is a rare condition in which the foreskin gets stuck in its retracted position, that is, after the foreskin is pulled back over the glans of the penis, it cannot be replaced to its usual position. Circumcision cannot be performed for some men and boys (whose parents may wish to have them circumcised for non-medical reasons), for example because their penis is abnormally shaped. Circumcision should not be performed without a qualified health professional and a sanitary environment. Circumcision is usually performed for non-medical reasons, and thus the timing of circumcision usually depends on the motivation for the procedure. When a circumcision is indicated for medical reasons, the circumcision will typically be performed during adulthood, following the onset of sexual activity. Before performing circumcision, a doctor will ask someone to sign a form to indicate that they agree to the circumcision procedure.
Before asking a man or parents to sign a consent form, the doctor will provide up to date, scientific information about the health risks and benefits associated with circumcision.
Men who are being circumcised should also be aware that that wound healing following circumcision typically takes six weeks and complete abstinence from all forms of sexual arousal is necessary in that period to avoid an erection. Before surgery begins, the genital area will be thoroughly cleaned using a surgical scrub preparation, but the pubic hair will not be cut or shaved. Newborn babies have traditionally been circumcised without anaesthesia, due to the incorrect belief that newborn babies do not feel pain during circumcision because they do not cry.
Dorsal penile nerve block: an anaesthetic which is applied to the nerve which controls feeling in the penis.
Caudal epidural block: an anaesthetic which is injected directly into the spine and affects the whole body.
Combining these anaesthetics with painkillers like paracetamol before and after the operation, provides the most effective pain relief. In Australia, circumcision of babies older than six months and boys is generally performed under general anaesthetic, with a regional block (i.e.
The glans and foreskin are separated to fully expose the coronal groove (the ridge that defines the glans of the penis).


Following the procedure a dressing which goes around the penis is not applied, as the glans may become damaged if it swells while there is a bandage around it.
There are a range of specific methods of circumcision which are usually named after the specialist surgical equipment used for the procedure. The Plastibell method is a circumcision method used to circumcise babies, in which a plastic device known as a Plastibell is used.
Once the correct size bell has been selected, the foreskin is retracted and a device known as a haemostat, which controls bleeding, is placed on each side of the foreskin. Research has shown that the older the boy at the time of circumcision, the longer the Plastibell takes to fall off. Minor complications also commonly arise following Plastibell circumcision and the most common complication is when the Plastibell becomes wedged into the penis (known as impaction) and fails to fall off spontaneously. The Gomco circumcision procedure uses tools called the Gomco bell and clamp, to assist with the surgical procedure. Once a slit has been made in the foreskin on the upper side of the penis, a Gomco bell of the correct size is placed over the glans and the foreskin is drawn over the bell. There are a range of techniques used for circumcising adult men, including the dorsal slit method and the sleeve method. The dorsal slit technique is recommended when circumcision is indicated for phimosis or paraphimosis. Accurate statistics about complications of circumcision are limited, however estimates suggest that 1-5% of circumcised males experience, typically minor, complications. Changes in sexual function, however the direction of the change is controversial, with some studies reporting greater sexual dysfunction in circumcised men and others reporting reduced sexual dysfunction in circumcised men.
Death has also been reported as a result of bleeding or systemic infection following circumcision. Antibiotic cream can be applied to the circumcision wound and application will provide protection against infection and lubrication to prevent the wound sticking to the baby’s nappies. Following circumcision, men should wear loose fitting briefs and clean the wound daily for 5-7 days. Men must avoid any kind of sexual arousal for six weeks following the surgery, as an erection is likely to interfere with the wound healing process.
About myVMCVirtual Medical Centre is Australia’s leading source for trustworthy medical information written by health professionals based on Australian guidelines.
Please be aware that we do not give advice on your individual medical condition, if you want advice please see your treating physician. If the physical consultation reveals that the testicles are smaller than normal, the doctor may recommend testing the testosterone serum dosage. There are two options, one being the psychological treatment and the other being medication. ED is quite different from other conditions such as decreased libido and other dysfunctions of the male reproductive system. Firstly, the elderly are likely to develop heart attacks, cardiovascular diseases, strokes, diabetes mellitus, high blood pressure, etc which are risk factors associated with ED. It may be due to the earlier onset and the severity of developing atherosclerosis due to diabetes mellitus. It has been discovered that hypertension is linked to low nitric oxide production by the arteries of the body.
Alcohol abuse can cause nerve damage, atrophy of the testicles and low levels testosterone.
These medications include the ones used to treat high blood pressure, antihistamines, antidepressants, tranquilizers and appetite suppressants. Problems in the nervous system may be detected due to the insensitivity of the penis to touching.
As previously mentioned, medications used to treat hypertension, depression and high lipid levels are some of the common medications that can lead to ED. However, testosterone treatment alone to treat ED in hypogonadism patients is insufficient. Despite the fact that there are no exact values of testosterone that define hypogonadism, a value or level lower than 250 nano grams per decilitre are said to be low and levels higher than 350 nano grams per decilitre are said to be normal.
Some of these medication include seizure medication, long-acting opiate pain medications, thiazide diuretics, antipsychotic medications as well as oral steroids. Common side effects include local irritations, breast tissue enlargement, prostate enlargement, aggravation of certain cancers (prostrate and breast cancer), depression, elevated red blood cell (RBC) count and aggravation of congestive heart failure. ED is quite common where an estimated 30 million males in the United States alone are said to be affected.
Doctors say that there may be possible options like 5 Hour Potency Male Enhancement in treating this condition but the range is not that wide compared to other common conditions like hypertension. Bringing this problem to a doctor’s attention may be hard since men are not that open when it comes to conversing about this problem but is still found to be the best way to treat this condition. According to research, habits that result to blood flow restriction in the body will also affect the blood flow towards the genitals causing ED.
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However, there are a number of conditions affecting the genitals of adult men which circumcision is sometimes used to treat. This condition can be treated with medication, but men who fail to respond to these medications are usually circumcised. Erections during the wound healing phase can be painful and interfere with the healing process.
That belief has since been demonstrated incorrect by scientific studies, and almost all circumcisions are now performed whilst the patient is under anaesthesia. The above steps therefore vary slightly depending on which method of circumcision is chosen. Complications of this type occurred in 6.1% of procedures in one study, and were more common in older boys. The bell has a long handle, which is placed through a hole in the base plate of the clamp during the procedure. The procedure is carried out as described above, and no specialist circumcision equipment is used. It differs from the procedure described above, in that the foreskin is removed from its retracted position (i.e.
While most reports of death are from places where circumcision is performed in unsanitary conditions by non-medical practitioners, a number of recent deaths in developed countries have also occurred. Parents should also check the ring and return to the clinic if it slips out of position or if there are signs of infection or bleeding. In the period immediately following circumcision this may cause some discomfort because the stitches are pulled when the penis becomes erect. Boys will be boys: traditional Xhosa male circumcision, HIV and sexual socialisation in Contemporary South Africa. Impotence refers to the inability to use the penis for intercourse, even if the desire and opportunity are present.
Through this test, the doctor can determine whether the erectile dysfunction is caused by a hormonal dysfunction or not. Drug treatment based on Sidenafil citrate (better known as Viagra) is one of the most popular. Population studies carried out in the Netherlands discovered that some degree of ED took place in 20% of men aged 40-54 and 50% of men aged 70-78.


Atherosclerosis is characterised by the narrowing of the arteries which will result in less delivery of blood to the make genitalia which will concurrently lead to ED. Hormonal problems can be identified by small testicles, lack of facial hair and enlarged breasts known as gynecosmastia. Thyroid hormone levels are also routinely checked for hypothyroidism and hyperthyroidism conditions.
In the case of medications for hypertension, three different classes of anti-hypertensive medications are available. Thus, patients who are diagnosed with breast or prostate cancers or even the ones suspected of having them should not go ahead with this treatment. In addition, if any result of this test show levels between these figures, can be considered or labelled indeterminate.
As a result, TRTs are only prescribed to men with symptoms of ED and men who have a testosterone level less than 200 nano grams per decilitre.
Thus, significant data regarding their productiveness and their safety are lacking. Nevertheless, with extensive evaluation, research and counselling, combination therapy may be regarded as one of the prime therapies for certain patients with ED. This is when a man does not have full control over his erections wherein he is not able to maintain or get an erection no matter what methods are used to arouse him. Also, men who only started to have sex when they were around their thirties, or never tried masturbating or getting an erection while they were young were said to be at higher risks of developing ED as they age. Since having an erection needs normal blood flow, eating food which are high in fiber and low in salt may help regain and maintain the health of the genitals.
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Prostavar is one of the many supplements advertised to help with the most common prostate issues experienced by aging males.
The doctor will also examine the man’s penis to ensure he has no conditions which contraindicate circumcision.
Circumcision can be performed with either general (whole body), local (circumcision site only) or regional (entire genital system) anaesthesia.
The Gomco circumcision procedure is the most popular technique for baby circumcision in the US. The bell is drawn up into the clamp until the open end, surrounded by foreskin, is fitted in the opening. All parents should take their child back to the clinic where they were circumcised once the ring has separated, or after two weeks if the ring has not separated at that time. Other factors, such as marital conflict, depression, or the existence of other sexual orientations may contribute to the onset of the disease as well. Another diagnostic method is the international index of erectile function: this is a questionnaire with 15 questions that the patient must answer.
ED is said to be under diagnosed due the reluctance of some men not wanting to discuss ED with doctors as they don’t feel comfortable or due to embarrassment.
The National Ambulatory Medical Care Survey in 1999 found out that 1,520,000 men visited a health care professional concerning ED. Diabetes mellitus can cause ED due to the damage of the nervous system, both the sensory and autonomic nerves.
Furthermore, measuring the bio available testosterone levels is a better indicator than measuring total testosterone levels specially in men who are obese and men who suffer from liver diseases.
Angiograms are sometimes performed (very rare) in cases where vascular surgery may be thought to be advantageous.
These medications lower the blood pressure which include beta-blockers, calcium channel blockers, diuretics to increase volume of urine, ACE inhibitors (angiotensin converting enzyme inhibitors and ARBs (angiotensin receptor blockers).
This therapy is administered, in the United States, as topical, injectable and transbuccal (placing inside the mouth, between the cheek and upper gum) testosterone. This preparation happens to be effective on its own or in combination with PDE5 inhibitors.
The common causes that pertain to ED are ageing, high blood pressure, smoking cigarettes  atherosclerosis, diabetes mellitus, side effects of medications, nerve damage, spinal cord damage, excessive consumption of alcohol or other substance abuse (heroine, marijuana,etc) and low levels of the male hormone, testosterone. Around 1% of boys will be affected by recurring balanoposthitis infections, and circumcision is usually done in these recurrent cases.
In adult males, the condition is most prominent in elderly men, and particularly those who have used a catheter at some stage in their life. Plastibells come in a range of sizes, and the doctor will select a bell which is the correct size for the baby being circumcised.
Complications of Plastibell impaction are also more likely if the wrong size Plastibell is used.
Circumcisions performed using the Gomco clamp are typically quick and easy surgical procedures which result in very little bleeding.
Based on the patients’ answerss, the pjysician can determine the severity of impotence. Diminished arterial pulses in the legs or by listening to the sound of blood flowing through narrowed arteries with a stethoscopes are some of the techniques used to diagnose reduced blood flow as a result of atherosclerosis.
Anti-hypertensive medications can be prescribed alone or in combination in order to bring down or control blood pressure.
The condition may also affect adults and circumcision is also used to treat men with balanoposthitis. Doctors will usually try to manipulate the foreskin back over the glans, while the individual is under anaesthetic. Adult men who have not been circumcised in their youth may also decide at any time to circumcise, for religious or personal reasons (e.g. Male circumcision and risk of syphilis, chancroidand genital herpes: a systematic review and meta-analysis. Disorders responsible for most cases of impotence are diabetes, atherosclerosis, vascular disease (either blocked arteries or obstructed penis valves), spinal cord injuries, multiple sclerosis or hormonal disorders. In some cases, an ultrasound procedure that measures blood flow to the penis can also be used. In general, those who have a history of prostate cancer do not receive hormone injections or pills, because male hormones may increase the cancerous cell growth. In addition, smoking cigarettes, obesity, diabetes mellitus, etc also lead to increase risk of developing ED. The different classes of anti-hypertensive medications render different effects on erectile function. Treatments of ED include psychotherapy, appropriate lifestyle changes, oral PDE5 inhibitors, intraurethral medications, intracavernosal injections, vacuum devices, surgery, etc. Another type of investigation, called angiography, can help detect the presence of a blocked blood vessel in the penis. In addition,  patient should consult their medical doctors and work toward avoiding medications that may lead to ED.
The angiography is a special X-ray procedure that uses the injection of a contrast substance in order to enhance the image. Other anti-hypertensive medications namely calcium channel blockers and ACE inhibitors are not known to cause ED.
Currently, new research and developmental methods are undertaken to find more effective and efficient therapies to treat ED.
If the doctor suspects that one of the administered medication could be the cause of impotence, he can replace that particular medication with something similar. Therefore, particular attention should be employed in finding the correct anti-hypertensive medication to avoid ED.



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