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A review of 46 articles on phosphodiesterase type 5 inhibitor abuse was published in the journal Current Drug Abuse Reviews in 2011. One reason cited for abuse was easy access to ED drugs. A search for Internet drug stores found over six million hits at 7,000 Internet pharmacies. Only 4 percent of the sites were in proper compliance, according to the Verified Internet Pharmacy Practice Sites program.

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A medical professional, such as a doctor or urologist, can officially diagnose ED. To do so, they will assess your medical and sexual history and conduct mental and physical health exams.
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Surgery provides the only true cure, but men typically want to explore other, less invasive options first.
Tomatoes and Pink Grapefruit contain phytonutrient known as Lycopene. Lycopene is excellent for the circulation of blood and sexual problems. Mixing lycopene with oily foods including, olive oil and avocados enhances the absorption of lycopene.

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https://www.koreascience.or.kr/article/JAKO200311922122275.page Randomised Controlled Trial of Pelvic Floor Muscle Exercises and Manometric Biofeedback for Erectile Dysfunction. (2004).
Erythrocytosis has been noted in men on TRT, and should be monitored every 6–12 months depending upon the patients’ response to changes in haematocrit levels. For mild elevations, the dosage of testosterone can be decreased or the interval of using the medication can be increased. With the haematocrit greater than 50%, decisions to temporarily discontinue the medication or periodic phlebotomy may be indicated.38

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90% of men with impotence (erectile dysfunction) have at least one underlying physical cause for their problem

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    What Is Erectile Dysfunction (ED)? Symptoms, Causes, Diagnosis, Treatment, and PreventionBy Julie Lynn MarksNovember 24, 2020

    Acupuncture. Though acupuncture has been used to treat male sexual problems for centuries, the scientific evidence to support its use for erectile dysfunction is equivocal at best. In 2009, South Korean scientists conducted a systematic review of studies on acupuncture for ED. They found major design flaws in all of the studies, concluding that "the evidence is insufficient to suggest that acupuncture is an effective intervention for treating ED." QUESTION Erectile dysfunction (ED) is… See Answer
    What causes ED? There are many causes of impotence both medical and psychological. Often, age is a predominant factor in erectile dysfunction; however, your chronological age is not solely responsible for ED’s development. Men over the age of 40 typically experience ED as the result of inadequate blood flow to the penis, most often due to the narrowing of blood vessels. This can arise due to many causes including:

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    Hearing: Cases of sudden decrease or loss of hearing have been reported postmarketing in temporal association with the use of PDE5 inhibitors, including VIAGRA. In some of the cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events. In many cases, medical follow-up information was limited. It is not possible to determine whether these reported events are related directly to the use of VIAGRA, to the patient's underlying risk factors for hearing loss, a combination of these factors, or to other factors [see WARNINGS AND PRECAUTIONS and PATIENT INFORMATION].

    Bleeding at the injection site — This usually results in a black and blue patch on the skin that disappears in a few days. This occurs when you don’t put enough pressure on the injection site after removing the needle or from puncturing a skin vein.
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    Avanafil (Stendra)Sildenafil (Viagra)Tadalafil (Cialis)Vardenafil (Levitra, Staxyn)

    But if you don’t have ED, you don't need them. If you are concerned about ED, talk with your doctor -- searching for Viagra on the Internet can have disastrous consequences.
    This is especially important for erections. When a man is sexually stimulated, his penis fills with blood. This blood gives him the firmness he needs for sexual activity. Once he ejaculates, the blood flows out of the penis and back into the rest of his body.

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    Viagra is in a class of medicines known as phosphodiesterase (PDE) inhibitors. It works by increasing blood flow to the penis.

    If you think you or someone else may have overdosed on: Viagra (Sildenafil (Injection)), call your doctor or the Poison Control center
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Ask your doctor if you are healthy enough to use Viagra or the other ED drugs. Make sure you know the side effects. Tell your doctor about any other drugs you take. Drug interactions are possible with lots of common drugs including drugs for blood pressure, angina, blood thinners, and seizures.

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If you have failed to penetrate the erectile tissues after injection, you will feel a burning sensation. This should go away within an hour and no erection will result.

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Even in healthy men, testosterone levels often begin falling sharply around age 50. Every year after age 40, a man's testosterone level typically falls about 1.3%.

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