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02.07.2015
In addition to prescription medications, traditional treatments and lifestyle changes, alternative treatments provide some helpful and beneficial options for men with ED.
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Did you know that best wedding cakes in atlanta has become the most popular topics in this category? Sexual problems as a result of having diabetes can affect both men and women with diabetes. Reduced blood flow and nerve damage to the penis are generally the underlying reasons for erectile dysfunction for men with diabetes. As well as causing neuropathy, another mechanism by which poor blood sugar control can affect erections is by holding back production of nitric oxide. A couple of episodes of not being able to perform sexually may be enough to make a man anxious about having sex and this can be a cause of erectile dysfunction a€” the term doctors use to describe erection problems that happen more than three-quarters of the time. Similarly, stress in a man’s life and other psychological factors, such as depression, can also cause erectile dysfunction.
Medications taken by mouth, such as Viagra (sildenafil), tadalafil and vardenafil, have been shown to be effective in treating erectile dysfunction in men with diabetes. So, there are several successful treatments available to help men with diabetes who are having problems with their erections.A  Remember that erectile dysfunction occurs more often and on average 10-15 years earlier in men with diabetes than in men without diabetes. Just like other women, some women with diabetes may suffer problems with orgasm, but some research shows that if you have diabetes you are no more likely to have these problems than women who don’t have diabetes.
Dryness of the vagina, due to a lack of lubrication or slow lubrication, can lead to painful intercourse for women. Oestrogen creams or pessaries are sometimes prescribed to women going through the menopause or who have had the menopause, because the body slows down its production of oestrogen during and after menopause, leading to vaginal dryness. Whether you’re a man or a woman, when you do have sex, always remember that sex is like any form of exercise a€” your muscles need glucose for energy. In general, much less is known about sexual problems in women and this includes women with diabetes. During periods or menopause, some women’s blood glucose levels may change which means they need to adjust their treatment. Scientific researchers at a hospital in Turkey have recently found that sexual intercourse several times a week may provide an effective way to spontaneously pass kidney stones in male sufferers. Kidney stones occur when salts in the urine separate out and form into solid crystals, which may then block the flow of urine. Very often, the stones will pass of their own accord, especially if they are small in size.
The research, published in Renal & Urology News, was carried out on a sample of 90 men with distal ureteral stones of around the same size in all cases. After two weeks, the results were measured and found to be significantly higher in Group 1 than in the other two groups, at nearly 84% compared to 48% and 35%. Researchers assert that this may be explained by the release of nitrous oxide (NO) that occurs during erection and sexual intercourse (NO has been shown in a number of other studies to cause relaxation of the ureteral muscle). It’s certainly good news to discover that sex might help sufferers, but it is still very important that you seek professional advice.
Although true urologic emergencies are extremely rare, they are a vital part of any emergency physician’s (EP) knowledge base, as delays in treatment lead to permanent damage.
The first step in the management of priapism, regardless of the cause, is always hydration and analgesia. Paraphimosis occurs when the foreskin becomes fixed in the retracted position and cannot be reduced, therefore constricting venous return from the glans. The most common cause of paraphimosis is previous phimosis (fibrosis and constriction of the prepuce distal to the glans preventing retraction).9 This leads to a circular scar, which can then form a tourniquet when the foreskin is retracted, preventing proper venous and lymphatic drainage.
Typically, patients present with edema and pain of the glans and the inability to pull back the retracted foreskin. The primary concerns with regard to treatment of paraphimosis are to relieve any significant pain and prevent further ischemia to the glans. Alternative treatments for paraphimosis, especially popular in Europe, involve creative ways of decreasing the edema to the glans and facilitating reduction. Testicular torsion results from a twisting of the spermatic cord, which impedes blood flow to the testis and impairs venous drainage, resulting in edema, ischemia, and necrosis. The basic pathophysiology behind testicular torsion is a malformation in which the testicle is allowed to rotate more freely around the spermatic cord. The most common presentation is that of acute scrotal pain and swelling, often with a high-riding testicle and an absent cremasteric reflex.
In the past, nuclear scintigraphy had been used to distinguish between testicular torsion, epidydimitis, and torsion of the appendix. Time is of the essence in attempting to salvage an ischemic testicle, as salvage rates rely heavily on a speedy diagnosis (Figure 3).
In most instances, surgical repair is the best and most appropriate treatment for testicular torsion.
Fournier’s gangrene is a necrotizing fasciitis of the perineum which can quickly spread to the skin of the entire scrotum and penis.
In Fournier’s gangrene, 50–60% of infections stem from a gastrointestinal (GI) or genitourinary (GU) source. The process begins locally with infection in the skin and spreads down the fascial plane where inflammation, ischemia, and necrosis result. Hyperbaric oxygen (HBO) has traditionally been used as adjunctive therapy for Fournier’s, although randomized controlled trials of effectiveness are lacking. Address for Correspondence: Chad Kessler, MD, FACEP, Department of Emergency Medicine, Jesse Brown VA Hospital, 820 S. The "P-spot" or the "male G-spot," are parts of the sexual response cycle in males and is a key contributor to the male orgasm. Some men might felt embarrassed, especially younger males, because they ejaculate during Prostate Massage. Men’s Sexual Age While 30-yr old men can expect to live for 50 more years and stay sexually active for 35 of those years.
Please note: If you have a promotional code you'll be prompted to enter it prior to confirming your order. If you subscribe to any of our print newsletters and have never activated your online account, please activate your account below for online access. When it comes to preventing and treating high blood pressure, one often-overlooked strategy is managing stress.
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Both of which will support, guide, and inspire you toward the best possible health outcomes for you and your family. The good news is that often there are treatments that can help you if you are suffering from diabetes-related sex problems.
This can be caused by many factors like being tired, stressed, and depressed or drinking too much alcohol.
Often men with diabetes who have the condition also have other complications related to nerve damage or blood circulation problems, such as high blood pressure, high cholesterol or heart disease.
Bringing blood glucose back under control again may sometimes restore a man’s sex drive. If you are having sexual problems that may or may not be related to your diabetes, see your doctor a€” there may be some simple things you can do to improve the situation.
Women who suffer from poor blood glucose control are more susceptible to vaginal yeast infections, because the yeasts flourish in high sugar environments. If you get recurrent thrush infections, it may be that your partner is carrying the yeast and re-infecting you during sex.


Decreased sexual desire can be due to many factors, but one which does relates to women with diabetes is widely fluctuating blood glucose levels. The main sexual problems that women deal with are vaginal dryness, a decrease in sexual desire, pain during sex and trouble having an orgasm.
You need to talk to your doctor about the strategies that will best suit you and your lifestyle. Finding out as much as you can and the treatments available will bring positive results and improve your sense of well being. They can also cause severe pain and lead to infection, although some people may have no symptoms.
Kidney stone treatments may include pain relief, Tamsulosin (Flomax) medication, endoscopic removal, shockwave therapy, or surgery for large stones or severe cases. Stone expulsion also happened much more quickly – at 10 days for Group 1 compared to 16.5 and 18 days for Groups 2 and 3 respectively. The researchers concluded that for men with kidney stones of 6mm in size or smaller who have sexual partners, sexual intercourse at least three times per week may assist with the spontaneous passing of kidney stones.
If you suspect you may have kidney stones, speak to a kidney stone specialist to discuss treatment options and management. The four urologic emergencies discussed are priapism, paraphimosis, testicular torsion, and Fournier’s gangrene. Low-flow priapism, or ischemic priapism, results from decreased venous and lymphatic drainage of the corpus cavernosum. Drugs of abuse, such as alcohol and cocaine, are important contributors to priapism, especially in heavy users.2Blood pressure medications such as hydralazine, prazosin, and calcium channel blockers are common causes. Generally, high-flow priapism patients will have a recent history of perineal trauma, often times a straddle injury. Sickle-cell priapism should be treated in the same manner as other ischemic priapisms with supplemental oxygen, analgesia and hydration. Phosphodiesterase 5 (PDE5), a molecular effector, has been implicated in recurrent priapism.
Without immediate treatment this causes edema, induration, ischemia, and eventually necrosis of the glans. Another significant cause of paraphimosis is iatrogenic, when medical staff fails to reduce the foreskin after urethral catheterization or genital exam. Diagnosis is usually straightforward as the stricture caused by the prepuce of the non-retractable foreskin and the resulting edema is easily visualized (Figure 1). The first concept is based on applying a high concentration of sugar to the outside of the glans in order to osmotically draw water out and reduce swelling.
Testicular torsion has a bimodal age distribution with the first peak at age 1–2 years old and the second higher peak in adolescence. Treatment consists of emergent surgery to detorse the affected testicle and attach it properly to the scrotal wall. However, there is new research focused on the post-surgical setting looking at medical treatments that may limit reperfusion injury and help preserve testicular function. Immunocompromised patients, especially diabetics and alcoholics, with or without trauma or instrumentation are at significant risk. A plain radiograph or CT may demonstrate air in the perineal tissues.1 Although diagnosis is straightforward when the lesions are found (Figure 4), failure to examine the genitals, especially in the elderly or obtunded patient, can result in misdiagnosis. Studies preformed as recently as 2005 have failed to show a significant difference in morbidity or mortality associated with hyperbaric oxygen. However, the difficulty in differentiating these emergencies from more common conditions and the need for quick, decisive action, require that EPs be vigilant and knowledgeable. It is located adjacent to the rectum, and can be stimulated manually using finger or massager. Basically a prostate massage or prostate milking serves as a stimulation to the prostate gland that help to relieve the tension of the prostate nerves and might signal the brain stem to re-adjust inflammatory and enhance immune responses for men suffering from Chronic Prostatitis, pelvic pain and Premature Ejaculation. Excessive anxiety can resulted in contraction of the abdominal muscle, muscles around the prostate, and rectal muscle that would tear muscle fibers resulted in unwanted lesions and rectal bleeding. Some severe sexually exhausted men can not attain orgasm unless their prostate also stimulated through Prostate Massage or receptive anal sex.
Make sure you have smooth out your fingernails, so there are no rough, sharp, or jagged edges. Due to privacy reason, many men decided to use prostate massager to massage their prostate for both pleasure and release the pus. Try Shaoling Cannabis Detoxification & Erection Panacea to boost liver function for expel out toxins out of your body. We had taken this picture from the net that we think would be probably the most representative pics for chicco high chair chevron.
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We had taken this image from the web that we think would be one of the most representative photos for exile vilify face reddit. Some medications may also cause erectile dysfunction, such medications for high blood pressure, depression or stomach ulcers. Erectile dysfunction that starts off having a physical cause can often acquire a psychological component to it as a man becomes worried about his performance. Injection into the penis with the medication Caverject (alprostadil) is also another treatment for erectile dysfunction. The problem is easily remedied by using a water soluble personal lubricant which should provide relief from discomfort during sex. Whether diabetes affects these problems is unclear although women who find it hard to come to terms with having diabetes are more likely to report sexual problems. Group 1 was assigned to have sexual intercourse three to four times per week, while the other two groups were provided with Tamsulosin medication or standard medical therapies. An overview is given for each, including causes, pathophysiology, diagnosis, treatment, and new developments.
Highflow priapism is less likely to be ischemic and is most often caused by a traumatic arterial laceration. Psychiatric medications, also notorious for causing priapism, include trazodone, chlorpromazine, thioridazine, and other selective serotonin re-uptake inhibitors (SSRIs). These patients usually seek treatment later in the course as they do not typically experience intense pain, as opposed to low-flow patients.1 The definitive distinction between high- and low-flow states can also be made by penile blood gas, aspirated from the corpus cavernosum. If there is immediate recurrence after aspiration, the next step is a surgical shunt between the corpora spongiosa and cavernosum.
Thus, it is usually non-emergent and can be observed before deciding upon invasive treatment. PDE5 is important in breaking down nitric oxide and restoring normal blood flow to the penis after an erection.
Allergic reactions, trauma, and hair tourniquets can all have similar presentations to paraphimosis. A penile nerve block or ice can often minimize patient discomfort and lead to a successful decompression. Torsion is fairly uncommon in adults over 40.5 Speed of diagnosis and time to treatment is vital in preserving patients’ testes and fertility.
The tunica vaginalis normally attaches the superior pole of the testes to the posterior scrotum, fixing it in place.
This procedure is also done on the unaffected testicle as malformations which contribute to testicular torsion are often bilateral.23 When suspicion of torsion is high, the only appropriate step is immediate surgical consultation to save as much tissue as possible. The list of proposed medications is exhaustive with more than 40 researched agents, usually investigated in rats. Additionally, the infection is most aggressive when both aerobic and anaerobic bacteria are involved.3 The most commonly cultured organisms include E.
Moreover, in one study, the author showed that patients required an average of six treatments at $600–$1300 each.33 A small trial in 2008 from a regional burn center with expertise in HBO echoed these findings and was also not able to show improved outcome.
For priapism the major difficulty lies in differentiating high-flow from low-flow states as low-flow requires more immediate treatment. Choosing the right prostate massager might be a daunting task, since your friend is not able to share this information with you.
It usually becomes inflamed because of an infection or an obstruction in the digestive tract.
It’s important to always tell your doctor about any medications you may be taking for other conditions. Women with poorly controlled diabetes are more likely to have frequent bouts of thrush (yeast infection). Preventive measures including reduction of dietary salt intake, maintaining good hydration, and getting prompt treatments for urinary tract infections. The focus for priapism is on diagnosis and distinguishing high-flow from low-flow forms, as the latter requires emergent treatment.


The main complication of priapism is erectile dysfunction, especially in recurrent ischemic priapism, due to inflammation and fibrosis of the corpus cavernosum. In addition, drugs which limit the fibrotic response in priapism, and therefore limit potential erectile dysfunction, are being studied. When considering paraphimosis, it is important to distinguish between various infections and strictures of the penis.
The glans should be compressed to reduce the edema during the attempt to replace the foreskin.
Torsion of these structures causes local hemorrhage, which often presents with a bluish discoloration on the skin.
These tests are used only when history and physical provide equivocal findings.5 No one sign or symptom establishes the diagnosis of torsion.
While waiting for surgical intervention, manual detorsion of the testicle by using a medial to lateral rotation or “dialing out” can be attempted. The most frequently discussed medications include allopurinol, melatonin, N-acetylcysteine, zinc aspartate, and caffeic acid phenethyl ester (CAPE).
For paraphimosis, it is important to understand the various methods of reduction: manual with analgesia, dorsal slit procedure, and circumcision. They have advocated the use of the Prostate Massage as a way to drain out and wringing out the built-up pus and dead prostate cell.
If untreated, an infected appendix can burst and spread the infection throughout the abdominal cavity and into the bloodstream. It is intended for general informational purposes only and does not address individual circumstances.
Both men and women with diabetes may also lose their sexual desire when their blood glucose levels are high.
For paraphimosis, we describe various methods of relieving the stricture, from manual reduction to surgery in extreme cases.
Notably, antioxidants are being investigated as a possible treatment, although effectiveness has not been established.2,7,8 The theory is that antioxidants will relieve some of the post-ischemic reperfusion injury, thus limiting cavernosal fibrosis and muscle damage. To clarify, balanitis is an infection of the glans only, whereas balanoposthitis is an infection of the glans and the foreskin. If the foreskin cannot be reduced within a few attempts this effort should be terminated so as not to cause more irritation and swelling.
At this time, there are no randomized controlled studies documenting the efficacy of this procedure, and evidence exists only in case reports. The presence of localized tenderness over the superior pole of the testis along with this “blue dot sign” is highly suggestive of appendiceal torsion. If a perirectal source is suspected, proctoscopy may be revealing.5 It is also important to elicit a history of perineal trauma, as even superficial scratches or burns can be the initiating event. Such drainage can be effectively shrinking the prostate gland and allowing the prostate gland to re-circulate with new blood and nutrients. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. For testicular torsion, the most important factor in salvaging the testicle is decreasing time to treatment.
Needle punctures into the inflamed portion of the penis to remove blood can help decrease the size of the glans and help facilitate manual reduction as well. Early appendiceal torsion may be differentiated by history and exam from testicular torsion, but as it progresses, swelling obscures the blue dot sign and makes point tenderness of the superior pole more difficult to appreciate.18 Moreover, epidydimitis is more common after puberty (due to sexual activity) and torsion of the appendage is more common in prepubertal boys. With high clinical suspicion, an EP should never wait for a confirmatory test to consult with an urologist. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site.
This is accomplished through experience and understanding which signs and symptoms strongly suggest it, so that time-consuming tests are avoided. Color duplex ultrasonography may also be used to differentiate the two by visualizing flow patterns. If these measures fail, a urologist should be consulted to perform a dorsal slit procedure. Therefore, although these procedures are safe, they should be attempted only after reduction with penile block alone fails and the patient wishes to avoid dorsal slit procedure or circumcision.
Lastly, in Fournier’s gangrene, a thorough physical exam, especially in the elderly and immunocompromised, can lead to diagnosis and prompt treatment of this potentially fatal infection. A dorsal slit procedure entails incising the fibrotic ring of the prepuce to relieve the constriction and reduce the foreskin.
Another method to decrease swelling that can be effective up to 90% of the time is to soak the penis in a glove full of ice for five minutes before attempting manual reduction.13 It should be noted that sufficient evidence does not exist for any of these treatments of paraphimosis. Absent cremasteric reflex is the most sensitive sign of testicular torsion with two retrospective studies20,21 showing 100% sensitivity for testicular torsion in boys older than 30 months.22 Urinalysis showing pyuria and leukocytosis suggests epidydimitis as do urinary symptoms such as dysuria, urgency, and frequency. In order to decrease permanent tissue damage, reduce infertility and save lives, a vigilant EP will always be mindful of these four non-traumatic urologic emergencies. While aggressive medical and surgical therapy will improve chances of survival and outcome, it is vital for the emergency department (ED) physician to diagnose Fournier’s.
Further symptoms such as nausea and vomiting are more common in testicular torsion than in appendiceal torsion or epidydimitis.
It often presents in the elderly, immunocompromised, or those with depressed mental status.
Poor LibidoThere are several forms of male sexual dysfunction, including poor libido and problems with ejaculation. The goal of this paper is to arm EPs with information to recognize urological emergencies and intervene quickly to preserve tissue, fertility, and life. The percentage of complete ED increases from 5% to 15% as age increases from 40 to 70 years.
Also, ED may be more common in Hispanic men and in those with a history of diabetes, obesity, smoking, and hypertension. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes. Among men with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes. Other conditions that may cause ED include cardiovascular disease, atherosclerosis (hardening of the arteries), kidney disease, and multiple sclerosis. Smoking, excessive drinking, and drug abuse may damage the blood vessels and reduce blood flow to the penis. In some cases, the nerve damage is permanent, and the patient will require treatment to achieve an erection. Men should talk with their doctor if they suspect a prescription or over-the-counter drug may be causing erectile problems.
Experts say stress, depression, poor self-esteem, and performance anxiety can short-circuit the process that leads to an erection.
This area between the anus and scrotum contains arteries and nerves vital to sexual arousal. The doctor will conduct a complete physical exam to uncover signs such as poor circulation or nerve trouble. Measuring testosterone levels can determine whether there is a hormonal imbalance, which is often linked to decreased desire.
One study suggests ED is a strong predictor of heart attack, stroke, and death from cardiovascular disease. The researchers say all men diagnosed with ED should be evaluated for cardiovascular disease. Giving up smoking, losing weight, and exercising more often can help by improving blood flow. They're generally taken 30-60 minutes before sexual activity and should not be used more than once a day. Cialis can be taken up to 36 hours before sexual activity and also comes in a lower, daily dose. Drugs approved for this purpose work by widening the blood vessels, causing the penis to become engorged with blood. Good candidates are typically younger men whose blockage stems from an injury to the crotch or pelvis.
When an erection is desired, the man uses a pump to fill the cylinders with pressurized fluid.
A therapist can teach the man and his partner techniques to reduce performance anxiety and improve intimacy.



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