Consistent with its known effects on the nitric oxide/cGMP pathway [see CLINICAL PHARMACOLOGY], VIAGRA was shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are using nitric oxide donors such as organic nitrates or organic nitrites in any form either regularly and/or intermittently is therefore contraindicated.
Arginine: It's found naturally in food, and it relaxes blood vessels and is used to treat heart problems. Doctors think it boosts circulation to the penis, but Espinosa says he doesn’t recommend it much because the body metabolizes it so quickly. “You need a lot and you need to take it frequently for it to work,” he says.
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He urged men with concerns about sexual dysfunction to discuss it with their doctor. “For men with as yet untreated hypertension, older medications (beta blockers and diuretics) are not ideal and should be used only if absolutely indicated,” he said.
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In addition, a study published in the Journal of Sex and Marital Therapy showed that the use of L-arginine and pycnogenol supplement helped a number of men ages 25 to 45 years old. The ED sufferers achieve normal erections without any side effects.
Being overweight can bring many health problems, including type 2 diabetes, which can cause nerve damage throughout the body. If the diabetes affects the nerves that supply the penis, ED can result.
It’s important to discuss your plans with your doctor before you try a natural or alternative approach.
The Prostate Cancer Prevention Trial was a landmark study by Thompson et al that prospectively assessed the time to developing CVD after the diagnosis of ED. There were 4247 men with no ED at study entry; 2420 developed incident ED (defined as the first report of ED of any grade) over 5 years. Those men that developed ED had a 1.45-fold higher probability of experiencing a CV event compared with men who did not develop ED.27
This comes from the fruit of a small palm tree and has been used to treat symptoms in men with enlarged prostate gland like difficulty urinating. Most experts recommend Saw Palmetto to treat ED caused by an enlarged prostate.
Beck RO, Betts CD, Fowler CJ (1994) Genito-urinary dysfunction in multiple system atrophy: clinical features and treatment in 62 cases. J Urol 151:1336–1341.
The penile implant allows men to achieve an erection through an implanted device. These devices can be effective in restoring sexual activity for a man and his partner. At Yale Medicine, our doctors have specialized experience with placing the penile prosthesis.
Because a man’s brain, heart, nerves, muscles, emotions, and more all factor into his ability to get an erection, many things can cause ED. This includes: DiabetesHeart diseaseHigh blood pressureMetabolic syndromeObesityLow testosteroneStress and anxietyDepressionRelationship challenges
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In some cases, ED may simply be as a result of stress. Exercise is a good stress reliever and allows you to maintain a healthy lifestyle. You don’t have to engage is a serious workout, a simple daily walk routine is enough. For men who are obese, sexual performance may be affected by the weight and therefore, exercising will do you some good.
If your doctor doesn't take your problem seriously, ask to be referred to a specialist. Don't let yourself be fobbed off with comments like "What do you expect at your age?"
22. Shindel AW, Lue TF. Sexual Dysfunction in Diabetes. Endotext. June 8, 2021. www.ncbi.nlm.nih.gov/books/NBK279101/. Accessed March 22, 2022.
Believe it or not, some cases of erectile dysfunction stem from penile injuries that occur during sex. Taking your time and avoiding certain positions can help. It may be uncomfortable, but consider talking to your doctor about what to do and, more importantly, what not to do.