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Psychological factors include feelings of nervousness related to sex; feelings of inadequacy, stress at work or home, and a troubled relationship with your partner may contribute to psychological issues hindering normal sexual function. Performance anxiety is a common problem that results from depression and anxiety related to sexual performance. Those who suffer from “performance anxiety” should discuss their feelings with their physician.
A. Many men and their partners don't like the device because the erection it produces is not "normal." Some pump users complain that their penis feels numb, or that it becomes discolored, misshapen, and cold to the touch. Many couples complain about the interruption of intimacy it brings to lovemaking. Also, some men complain that the constriction ring at the base of the penis causes mild discomfort upon ejaculation or varying degrees of ejaculation impairment.
The most common form of management in current practice is the use of one of the oral PDE-5 inhibitors. If one agent does not work adequately at its maximum dosage, another agent should be tried. Trying these medications 3-4 times is sometimes necessary before concluding that the therapy is ineffective. Men who have a vascular-leak (venous leak) phenomenon may need a constriction device placed at the base of the penis to maintain the erection, which may be effective by itself or in combination with a PDE-5 inhibitor. In selected cases, combination therapy with one of the PDE-5 inhibitors plus Yohimbine, MUSE, or intracavernosal injections can be tried. Although some men have taken two different PDE-5 inhibitors simultaneously, no evidence suggests any benefit and the risk of significant adverse effects is greatly enhanced. However, the use of both a shorter-acting agent and a longer-acting agent is not unreasonable at appropriate times and intervals as long as they are not taken together.
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Before you are given any of these tests, your doctor will explain what is involved. If you have any questions, do not hesitate to ask your doctor.
"It's relatively common in men with diabetes and various forms of vascular disease, or men who've previously had infections -- usually infections of a penile prosthesis," Sharlip said. "There are men who have such severe fibrosis that nothing can be done to restore their natural erection function, other than to implant a surgical prosthesis," he added.
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It is not uncommon for men with ED to feel angry, frustrated, sad, or even unsure of them self. Such feelings, if not dealt with, can eventually lead to depression.
ED usually has a physical cause.
Another study, this one published in the American Journal of Epidemiology, found that male smokers in their 40s were more likely to experience erectile difficulties than older nonsmoking males. The risk of erectile dysfunction was nearly doubled for smoking men in their 40s compared to nonsmokers in their 50s.
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