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Research is mixed on the effectiveness of acupuncture as an erectile dysfunction cure, but one study published in November 2013 in the Journal of Alternative and Complementary Medicine found that acupuncture can be beneficial for men experiencing erectile dysfunction as a side effect of antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs).

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These findings suggest that patients who present with ED and CV risk factors should be evaluated for silent CVD and should undergo a thorough CV evaluation.
How common is impotence? According to findings from several studies, including “The Massachusetts Male Aging Study,” overall prevalence for men between 40–70 years old is around 52 percent (or around 30 percent of all men between 18–60 years old). That’s right — nearly half of all men over 40 experience erectile dysfunction symptoms at some point. Not surprisingly, research demonstrates that impotence is increasingly prevalent with age. Around 40 percent of men in their 40s experience sexual dysfunction. Up to 70 percent of men in their 70s experience ED. (1) Every year more than 617,000 new cases of impotence occur in the United States alone. .

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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.
The usual dose is 40mg – two 20mg tablets, taken once a day. These tablets are large, so take the tablets one after the other.

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Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
20. Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol. 2018;200(2):423-432.

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Your physician team will work with your primary care physician, as well as your cardiologist, if ED is related to a heart problem. Providers may also recommend lifestyle changes, changing your prescribed medications or seeking mental health counseling to help treat the underlying causes of ED.

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Management of EDOptimal management of ED involves shared decision-making between the patient, his partner, and the treating clinician.6 Underlying disease states and risk factors should be identified and treated or minimized.5 Contributing medications should be discontinued, or the dose should be reduced.5 A variety of nonpharmacologic and pharmacologic treatment options may be considered for ED treatment. Generally, oral medications are trialed first, and more invasive options are reserved for those who fail to respond to initial therapy.5,6

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    Most men will experience some form of impotence in their lifetime, and the likelihood of developing symptoms increases with age and declining health.

    ED can be seen as the result of an interruption - either medicinal, physical or psychological - of the natural process which causes an erection when sexual excitement is felt.
    Erectile dysfunction or ED (also known as impotence) is when a man cannot achieve or sustain an erection for sexual intercourse. This can be: a total inability, inconsistent ability, or a tendency to sustain only brief erections.

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    GAINSWave™ is a new ED treatment that utilizes pulsed acoustic waves, known in Europe as shockwave therapy, to address the cause of poor sexual performance in men – decreased and insufficient blood flow.

    Doumanian, Leo MD, associate professor of clinical urology at Keck School of Medicine at the University of Southern California.
    Many men are unhappy with their ability to get or maintain an erection, but only 5% of these men seek help. This is because most men, in general, are unwilling to discuss their sex life, even when it is going well.

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    Stendra also acts quicker in the body than others — 15 minutes is all it typically takes before the drug acts to help you.

    While ED medication works for most patients, there are other treatment options. These include external vacuum devices that draw blood into the penis and injections that men administer themselves to dilate the arteries of the penis and allow blood to flow in. Another option is penile implants, which Dr. Walker calls the “gold standard” for men who cannot tolerate the drugs and for whom other treatments fail. Flexible cylinders are embedded in the penis. The man pumps fluid into them from a reservoir when he wants to perform sexually.
    Surgery provides the only true cure, but men typically want to explore other, less invasive options first.

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They also have different onsets of action with Viagra, sildenafil, Levitra and Cialis being active within 30-60 mins but the newest medication to be introduced, Spedra, as its name would suggest, can be active in as little as 15 mins, and therefore is the quickest to have an affect.

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There are contraindications for each drug (i.e., reasons why a person should not try to use it). Men with certain liver, kidney, or cardiovascular conditions may not be able to take ED medications safely. Men taking nitrates and alpha-blockers to treat hypertension may need to find other ways to treat their ED. Other health conditions could make PDE-5 medications unsafe for men.

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