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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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14. Evans JD, Hill SR. A comparison of the available phosphodiesterase-5 inhibitors in the treatment of erectile dysfunction: a focus on avanafil. Patient Preference and Adherence. 2007;9:1159-1164.
Erectile dysfunction medications are effective for many men, but these oral medications may not work for everybody. Our team offers numerous other non-invasive and minimally invasive treatments for improved outcomes. Many of these can achieve results faster,with fewer side effects and a quicker recovery. We also offer placement of inflatable penile prostheses for men who have failed other forms of treatment for erectile dysfunction. .

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The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers.

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Impotence, or erectile dysfunction (ED), is the inability for a man to sustain an erection long enough for normal, satisfying sexual intercourse. To understand the underlying causes of impotence, it helps to know the basics about how an erection develops, along with potential problems that get in the way. Erections begin in the brain with a thought related to sexual desire. Then a chemical message travels from the brain to the penis. Blood flow to the penis increases as blood vessels leading to the reproductive system relax and allow for increased circulation.
SOURCES: Gary Wittert M.D., professor, head of the discipline of medicine, director, Freemasons Foundation Centre for Men's Health, University of Adelaide, and senior consultant endocrinologist, Royal Adelaide Hospital, Australia; David B. Samadi, M.D., chairman, department of urology, chief of robotic surgery, Lenox Hill Hospital, New York; March 28, 2014, Journal of Sexual Medicine Copyright © 2013-2015 HealthDay. All rights reserved. View privacy policy and trust info

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There is some strong evidence that shows that watermelon can treat the ED. Variety of antioxidants are present in watermelon. The main ingredient responsible for treating ED is Citrulline. It is an amino acid in nature and makes your erection harder. It relaxes the blood vessels and improves the blood flow.

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Also, men who have a chronic vitamin B12 deficiency and eat more processed meats and refined grains are more likely to develop ED.

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    Based upon measurements of sildenafil in semen of healthy volunteers 90 minutes after dosing, less than 0.001% of the administered dose may appear in the semen of patients.

    The pulsating waves also trigger a healing response that “wakes-up” dormant stem cells and growth factors in the penis for an overall rejuvenation of male erectile tissue.
    For the 19 subjects who received both VIAGRA and matching placebo, the placebo-subtracted mean maximum decreases from baseline (95% CI) in systolic blood pressure were as follows: Placebo-subtracted mean maximum decrease in systolic blood pressure (mm Hg) VIAGRA 50 mg (95% CI) Supine 9.08 (5.48, 12.68) Standing 11.62 (7.34, 15.90)

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    According to Harvard Health Publishing, some of these wellness habits can include: Losing weight Walking Performing Kegel exercises Improving vascular health Cutting out calorically dense foods Quitting smoking Reducing or eliminating alcohol intake

    For most patients, the recommended dose is 50 milligrams taken approximately one hour before sexual activity.
    Many men cannot take Viagra or Cialis because the drugs cause unpleasant side effects such as migraines, back pain, dyspepsia/nausea, dizziness and skin rash. In addition, men with hypertension, liver/kidney problems, heart disease or men using medications containing nitrate should not take ED drugs since these drugs will increase blood pressure.3

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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.

    Ginkgo biloba. Known primarily as an herbal treatment for cognitive decline, ginkgo has also been used to treat erectile dysfunction -- especially cases caused by the use of certain antidepressant medications. But the evidence isn't very convincing. One 1998 study published in the Journal of Sex & Marital Therapy found that it did work. But a more rigorous study, published in Human Pharmacology in 2002, failed to replicate this finding. "Ginkgo has come out of fashion in the past few years," says Ronald Tamler, MD, assistant professor of medicine and codirector of the men's health program at Mount Sinai Medical Center in New York City. "That's because it doesn't do much. I can say that in my practice, I have not seen ginkgo work -- ever."
    If you’re still experiencing issues, then talk to our providers about how your treatment is going. Our team may have suggestions for correct use, or we may want to explore other options for erectile dysfunction treatment.

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    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.

    Usually you’ll only need a handful of sessions. You may want to include your partner, as well.
    “It’s not like you go into the forest and just eat a leaf,” he says. “You don’t take them right before sex. But there are real natural approaches that work by building up sexual health over time.”

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Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking sildenafil. Talk to your doctor if they last longer than a week or are severe. Feeling sick (nausea)

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Men in generally good health who use terms such as “performance anxiety” usually suffer from stress-induced or substance-induced ED, which is caused by anxiety, distraction or too much drinking of alcoholic beverages. These patients often respond to such drugs as Cialis, Levitra and Viagra, all of which enhance the effects of nitric oxide, a natural chemical in the body that relaxes the penis muscles and increases blood flow.

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14. Hold the syringe between your index and middle fingers and place a thumb on the plunger to inject the entire contents of the syringe. Then take the needle out of your penis.

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