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Erectile dysfunction
Classification and external resources
ICD-10 F52.2, N48.4
ICD-9 302.72, 607.84
DiseasesDB 21555
eMedicine med/3023 
MeSH D007172

Erectile dysfunction (ED or (male) impotence) is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings The 2007 version of the ICD is available online at http//wwwwho N00-N39 - Diseases of the Genitourinary system: urinary system (N00-N08 Glomerular diseases Prefixes. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Sexual dysfunction or sexual malfunction (see also Sexual function) is difficulty during any stage of the Sexual act (which includes desire, The erection of the Penis, Clitoris or a Nipple is its enlarged and firm state The penis (plural penises, penes There are various underlying causes, such as cardiovascular leakage and diabetes, many of which are medically treatable. This is an article about the rock music band "Circulatory System" Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc Nerve trauma from prostatectomy surgery can cause chronic erectile dysfunction. A prostatectomy is the Surgical removal of all or part of the Prostate gland.

The causes of erectile dysfunction may be physiological or psychological. Physiology (from Greek grc φύσις physis, "nature origin" and grc -λογία -logia) is the study of the mechanical physical Psychology (from Greek grc ψῡχή psȳkhē, "breath life soul" and grc -λογία -logia) is an Academic and Physiologically, erection is a hydraulic mechanism based upon blood entering and being retained in the penis, and there are various ways in which this can be impeded, most of which are amenable to treatment. For the mechanical technology see Hydraulic machinery and Hydraulic cylinder Hydraulics is a topic of science and Engineering Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells such as nutrients and oxygen—and transports Waste products Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this can often be helped. Thought and thinking are mental forms and Processes respectively ("thought" is both Notably in psychological impotence, there is a very strong placebo effect. Placebo is a substance or procedure a patient accepts as medicine or therapy but which has no specific therapeutic activity

Erectile dysfunction, tied closely as it is to cultural notions of potency, success and masculinity, can have devastating psychological consequences, including feelings of shame, loss or inadequacy; often unnecessary since in most cases the matter can be helped. Shame is variously an affect emotion cognition state or condition loss may refer to A negative difference between retail Price and Cost of production An event in which the team or individual in question There is a strong culture of silence and inability to discuss the matter. The expression conspiracy of silence, or culture of silence, relates to a condition or matter which is known to exist but by tacit communal unspoken consensus is not talked In fact, around 1 in 10 men will experience recurring impotence problems at some point in their lives. [1]

Folk remedies have long been advocated, with some being advertised widely since the 1930s. The introduction of the first pharmacologically-approved remedy for impotence, sildenafil (trade name Viagra), in the 1990s caused a wave of public attention, propelled in part by heavy advertising. Sildenafil citrate, sold as Viagra, Revatio and under various other trade names is a drug used to treat Erectile dysfunction (male impotence

The Latin term impotentia coeundi describes simple inability to insert the penis into the vagina. The vagina (from Latin, literally " Sheath " or " Scabbard " is a fibromuscular tubular tract leading from the Uterus It is now mostly replaced by more precise terms. The study of erectile dysfunction within medicine is covered by andrology, a sub-field within urology. See also Reproductive health Andrology (from Greek grc ἀνήρ anēr, Genitive grc ἀνδρός andros, "man" Urology is the branch of Surgery that focuses on the Urinary tracts of males and females and on the reproductive system of males

Contents

Overview and symptoms

Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. The erection of the Penis, Clitoris or a Nipple is its enlarged and firm state There are several ways that erectile dysfunction is analyzed:

Erection problems are very common. The Sexual Dysfunction Association estimates that 1 in 10 men in the UK have recurring problems with their erections at some point in their life. [1]

Pathophysiology

Penile erection is managed by two different mechanisms. The first one is the reflex erection, which is achieved by directly touching the penile shaft. The second is the psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. The limbic system, or Paleomammalian brain is a term for a set of brain structures including the Hippocampus and Amygdala and anterior thalamic nuclei and a limbic The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain In both conditions, an intact neural system is required for a successful and complete erection. Stimulation of penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. The nervous system is a Network of specialized cells that communicate information about an animal's surroundings and itself Nitric oxide or nitrogen monoxide is a Chemical compound with Chemical formula N[[Oxygen O]] Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy erectile system. Testosterone is a Steroid hormone from the Androgen group In mammals testosterone is primarily secreted in the testes of males and the Ovaries The testicle (from Latin testiculus, diminutive of testis, meaning "witness" virility plural testes) is the male The pituitary gland, or hypophysis, is an Endocrine gland about the size of a Pea. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood supply or psychological problems. Restriction of blood flow can arise from impaired endothelial function due to the usual causes associated with coronary artery disease, but can also be caused by prolonged exposure to bright light. The endothelium is the thin layer of cells that line the interior surface of Blood vessels forming an interface between circulating Blood in the Coronary artery disease (CAD (or atherosclerotic Heart disease) is the end result of the accumulation of atheromatous plaques within the walls Over-illumination is the presence of lighting intensity ( Illuminance) beyond that required for a specified activity

Causes

A few causes of impotence may be iatrogenic (medically caused). The terms iatrogenesis and iatrogenic artifact refer to adverse effects or complications caused by or resulting from medical treatment or advice Various antihypertensives (medications intended to control high blood pressure) and some drugs that modify central nervous system response may inhibit erection by denying blood supply or by altering nerve activity. Antihypertensives are a class of drugs that are used in Medicine and Pharmacology to treat Hypertension (high blood pressure Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the Blood pressure is chronically elevated In Vertebrates the central nervous system ( CNS) is the part of the Nervous system which is enclosed in the Meninges.

Surgical intervention for a number of different conditions may remove anatomical structures necessary to erection, damage nerves, or impair blood supply. Complete removal of the prostate gland or external beam radiotherapy of the gland are common causes of impotence; both are treatments for prostate cancer. Some studies have shown that male circumcision may result in an increased risk of impotence,[11][12] while others have found no such effect,[13][14][15] and another found the opposite. Male circumcision is the removal of some or all of the Foreskin (prepuce from the Penis. [16]

Excessive alcohol use has long been recognised as one cause of impotence, leading to the euphemism "brewer's droop," or "whiskey dick;" Shakespeare made light of this phenomenon in Macbeth. In Chemistry, an alcohol is any Organic compound in which a Hydroxyl group ( - O[[hydrogen H]]) is bound to a Carbon Brewing is the production of Alcoholic beverage and Alcohol fuel through fermentation. Whisky (uisge-beatha or whiskey (uisce beatha or fuisce) refers to a broad category of Alcoholic beverages that are distilled from fermented William Shakespeare ( baptised Macbeth is among the best-known of William Shakespeare 's plays, and is his shortest tragedy, believed to have been written some time between

A study in 2002 found that ED can also be associated with bicycling. The number of hours on a bike and/or the pressure on the penis from the saddle of an upright bicycle is directly related to erectile dysfunction. [17]

Diagnosis

Medical diagnosis

There are no formal tests to diagnose erectile dysfunction. Some blood tests are generally done to exclude underlying disease, such as diabetes, hypogonadism and prolactinoma. A blood test is a laboratory analysis performed on a Blood sample that is usually extracted from a Vein in the arm using a needle, or via Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc Hypogonadism is a medical term for a defect of the Reproductive system that results in lack of function of the Gonads ( ovaries or testes) A prolactinoma is a Benign Tumor ( Adenoma) of the Pituitary gland that produces a Hormone called Prolactin. Impotence is also related to generally poor physical health, poor dietary habits, obesity, and most specifically cardiovascular disease such as coronary artery disease and peripheral vascular disease. Obesity is a condition in which excess Body fat has accumulated to such an extent that health may be negatively affected Cardiovascular disease or cardiovascular diseases refers to the class of diseases that involve the Heart or Blood vessels ( arteries and Coronary artery disease (CAD (or atherosclerotic Heart disease) is the end result of the accumulation of atheromatous plaques within the walls Peripheral vascular disease (PVD also known as peripheral artery disease (PAD or peripheral artery occlusive disease (PAOD is a collator for all Diseases

A useful and simple way to distinguish between physiological and psychological impotence is to determine whether the patient ever has an erection. If never, the problem is likely to be physiological; if sometimes (however rarely), it could be physiological or psychological. The current diagnostic and statistical manual of mental diseases (DSM-IV) has included a listing for impotence. The Diagnostic and Statistical Manual of Mental Disorders' ( DSM) is published by the American Psychiatric Association

Clinical Tests Used to Diagnose ED

Duplex ultrasound
Duplex ultrasound is used to evaluate blood flow, venous leak, signs of atherosclerosis, and scarring or calcification of erectile tissue. Duplex ultrasonography (more commonly but less correctly known as duplex ultrasound) is a form of Medical ultrasonography that incorporates two elements1 B-mode Injecting prostaglandin, a hormone-like stimulator produced in the body, induces erection. A prostaglandin is any member of a group of Lipid compounds that are derived enzymatically from Fatty acids and have important functions in the Animal body Ultrasound is then used to see vascular dilation and measure penile blood pressure. Blood pressure is also the title of a short story by Damon Runyan in Guys and Dolls and Other Stories Measurements are compared to those taken when the penis is flaccid.
Penile nerves function
Tests such as the bulbocavernosus reflex test are used to determine if there is sufficient nerve sensation in the penis. The physician squeezes the glans (head) of the penis, which immediately causes the anus to contract if nerve function is normal. A physician measures the latency between squeeze and contraction by observing the anal sphincter or by feeling it with a gloved finger inserted past the anus. Specific nerve tests are used in patients with suspected nerve damage as a result of diabetes or nerve disease.
Nocturnal penile tumescence (NPT)
It is normal for a man to have five to six erections during sleep, especially during rapid eye movement (REM). Their absence may indicate a problem with nerve function or blood supply in the penis. There are two methods for measuring changes in penile rigidity and circumference during nocturnal erection: snap gauge and strain gauge. (It should be noted that a significant proportion of men who have no sexual dysfunction nonetheless do not have regular nocturnal erections. Thus presence of NPT tends to signify physically functional systems, but absence of NPT may be ambiguous and not rule out either cause. )
Penile biothesiometry
This test uses electromagnetic vibration to evaluate sensitivity and nerve function in the glans and shaft of the penis. A decreased perception of vibration may indicate nerve damage in the pelvic area, which can lead to impotence.
Penile Angiogram
Invasive test - allows visualization of the circulation in the penis and is used during the repair of a priapism. Angiography or arteriography is a Medical imaging technique in which an X-ray image is taken to visualize the inside or lumen, of blood vessels Priapism (πριαπισμός is a potentially harmful and painful medical condition in which the erect Penis does not return to its flaccid state despite
Dynamic Infusion Cavernosometry
(Abbreviated DICC) technique in which fluid is pumped into the penis at a known rate and pressure. It gives a measurement of the vascular pressure in the corpus cavernosum during an erection. To do this test, a vasodilator like prostaglandin E-1 is injected to measure the rate of infusion required to get a rigid erection and to help find how severe the venous leak is. A prostaglandin is any member of a group of Lipid compounds that are derived enzymatically from Fatty acids and have important functions in the Animal body Venous leakage - An Erection is produced when blood to the penis compress the veins in the Corpora cavernosa so the blood cannot leave
Corpus Cavernosometry
Cavernosography measurement of the vascular pressure in the corpus cavernosum. Saline is infused under pressure into the corpus cavernosum with a butterfly needle, and the flow rate needed to maintain an erection indicates the degree of venous leakage. The leaking veins responsible may be visualised by infusing a mixture of saline and x ray contrast medium and performing a cavernosogram. [18]
Digital Subtraction Angiography
In DSA, the images are acquired digitally. The computer creates a mask from lower-contrast x-rays of the same area and digitally isolates the blood vessels (this is done manually through darkroom masking with traditional angiography).
Magnetic resonance angiography (MRA)
This is similar to magnetic resonance imaging. Magnetic resonance angiography uses magnetic fields and radio waves to provide detailed images of the blood vessels. Doctors may inject a "contrast agent" into the patient's bloodstream that causes vascular tissues to stand out against other tissues. The contrast agent provides for enhanced information regarding blood supply and vascular anomalies. Aside from the IV used to introduce the contrast material into the bloodstream, magnetic resonance angiography is noninvasive and painless.

Treatment

Treatment depends on the cause. Testosterone supplements may be used for cases due to hormonal deficiency. However, the cause is more usually lack of adequate penile blood supply as a result of damage to inner walls of blood vessels. This damage is more frequent in older men, and often associated with disease, in particular diabetes. A disease is an abnormal condition of an organism that impairs bodily functions and can be deadly Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc

Treatments (with the exception of testosterone supplementation, where effective) work on a temporary basis: they enable an erection to be attained and maintained long enough for intercourse, but do not permanently improve the underlying condition. There are different treatments available:[19]

Oral treatment

3 different tablets are currently available from the doctor and these work when there is sexual stimulation. Depending on the treatment, it will need to be taken 20 minutes to 1 hour before sex and the period of time over which it works can vary between 3 hours and up to 36 hours.

Alprostadil

This can be injected into the penis or inserted using a special applicator - usually just before sexual intercourse. Alprostadil is the pharmaceutical name for Prostaglandin E1 It is used as a drug in the treatment of Erectile dysfunction and has Vasodilatory

Alprostadil has also bcome available in some countries as a topical cream (under the brand name Befar),[20] and preliminary studies have shown a clinical efficacy of up to 83%. [21] It has an onset of action of 10-15 minutes and its effects can last over 4 hours.

Vacuum pumps

These work by drawing blood into the penis and are also used just before sexual intercourse.

Hormone treatment

It is rare, but some men receive hormones for their erection problem. This does depend on the cause of the problem as well as other factors.

Surgery

Often, as a last resort if other treatments have failed, the most common procedure is prosthetic implants which involves the insertion of artificial rods into the penis. [22]

Counselling

Counselling is often a consideration, both where a psychological cause is suspected or must be ruled out, or to assist in management of any distress.

ED can in many cases be treated by drugs taken orally, injected, or as penile suppositories. These drugs increase the efficacy of NO, which dilates the blood vessels of corpora cavernosa. When oral drugs or suppositories fail, injections into the erectile tissue of the penile shaft are extremely effective but occasionally cause priapism. When pharmacological methods fail, a purpose-designed external vacuum pump can be used to attain erection, with a separate compression ring fitted to the penis to maintain it. These pumps should be distinguished from other "penis pumps" (supplied without compression rings) which, rather than being used for temporary treatment of impotence, are claimed to increase penis length if used frequently, or vibrate as an aid to masturbation. Masturbation refers to Sexual stimulation especially of one's own genitals ( self masturbation) and often to the point of Orgasm, which

More drastically, inflatable or rigid penile implants may be fitted surgically. Implants are irreversible and costly.

All these mechanical methods are based on simple principles of hydraulics and mechanics and are quite reliable, but have their disadvantages.

In a few cases there is a vascular problem which can be treated surgically.

Uncontroversial treatments

PDE5 Inhibitors
The cyclic nucleotide phosphodiesterases constitute a group of enzymes that catalyse the hydrolysis of the cyclic nucleotides cyclic AMP and cyclic GMP. They exist in different molecular forms and are unevenly distributed throughout the body. These multiple forms or subtypes of phosphodiesterase were initially isolated from rat brain by Uzunov and Weiss in 1972[23] and were soon afterwards shown to be selectively inhibited by a variety of drugs in brain and other tissues. [24][25] The potential for selective phosphodisterase inhibitors to be used as therapeutic agents was predicted as early as 1977 by Weiss and Hait. [26] This prediction has now come to pass in a variety of fields, one of which is in the pharmacological treatment of erectile dysfunction.

One of the forms of phophodiesterase is termed PDE5. The prescription PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are prescription drugs which are taken orally. A phosphodiesterase type 5 inhibitor, often shortened to PDE5 inhibitor, is a drug used to block the degradative action of Phosphodiesterase type 5 on Sildenafil citrate, sold as Viagra, Revatio and under various other trade names is a drug used to treat Erectile dysfunction (male impotence Vardenafil ( INN) is a PDE5 inhibitor used for treating impotence ( Erectile dysfunction) that is sold under the trade name Levitra ( Bayer Tadalafil is an orally administered drug for treating impotence ( Erectile dysfunction) that initially was developed by the Biotechnology company ICOS They work by blocking the action of PDE5, which causes cGMP to degrade. cGMP-specific phosphodiesterase type 5 is an Enzyme ( from the Phosphodiesterase class Cyclic guanosine monophosphate ( cGMP) is a Cyclic nucleotide derived from Guanosine triphosphate (GTP CGMP specific phosphodiesterase type 5 causes the smooth muscle of the arteries in the penis to relax, allowing the corpus cavernosum to fill with blood.

(Specific devices are mentioned for information only; mention should not be taken as endorsement).

Dopamine Receptor Agonist
Inflatable implant
Rigid implant
Surgical treatment of certain cases

Controversial and unapproved treatments

Naltrexone
Drug used for treating drug addicts can have some success in patients with inhibited sexual desire.
Bremelanotide
The experimental drug bremelanotide (formerly PT-141) does not act on the vascular system like the former compounds but allegedly increases sexual desire and drive in males as well as females. Bremelanotide (formerly PT-141 is a compound developed for use in treating Sexual dysfunction in both men ( Erectile dysfunction or impotence and women ( It is applied as a nasal spray. Bremelanotide allegedly works by activating melanocortin receptors in the brain. Melanocortins are a group of Pituitary Peptide hormones that include adrenocorticotropin ( ACTH) and the alpha beta and gamma Melanocyte-stimulating In Biochemistry, a receptor is a Protein molecule embedded in either the Plasma membrane or Cytoplasm of a cell to which a mobile signaling It is currently in Phase IIb trials.
Melanotan II
Like bremelanotide the experimental drug Melanotan II does not act on the vascular system either but increases libido. Note this article describes both melanotan and melanotan II although their names are similar they have different chemical and biological properties Libido in its common usage means Sexual desire however more technical definitions such as those found in the work of Carl Jung, are more general referring to libido Melanotan II works by activating melanocortin receptors in the brain. Melanocortins are a group of Pituitary Peptide hormones that include adrenocorticotropin ( ACTH) and the alpha beta and gamma Melanocyte-stimulating In Biochemistry, a receptor is a Protein molecule embedded in either the Plasma membrane or Cytoplasm of a cell to which a mobile signaling
hMaxi-K
hMaxi-K is a form of gene therapy using a plasmid vector that expresses the hSlo gene, that encodes the alpha-subunit of the Maxi-K channel. Gene therapy is the insertion of Genes into an individual's cells and tissues to treat a Disease, and Hereditary diseases in which a A plasmid is an extra-chromosomal DNA molecule separate from the chromosomal DNA which is capable of replicating independently of the chromosomal DNA BK channels, also called Maxi-K or slo1, are Ion channels which conduct Calcium (Ca2+ and Potassium (K+ ions It has undergone phase I safety trials. [27]
Ginseng
A double-blind study appears to show evidence that ginseng is better than placebo:[1] see the ginseng article for more details. The blind method is a part of the Scientific method, used to prevent research outcomes from being influenced by either the Placebo effect or the Observer Ginseng refers to species within Panax, a genus of 11 species of slow-growing Perennial plants with fleshy roots in the family Araliaceae. Ginseng refers to species within Panax, a genus of 11 species of slow-growing Perennial plants with fleshy roots in the family Araliaceae.
Enzyte
Enzyte is a product that has been advertised by saturation coverage on television channels such as CourtTV. truTV is an American Cable Television network owned by Time Warner through its subsidiary Turner Broadcasting. However, the Center for Science in the Public Interest (CSPI) has filed a complaint with the Federal Trade Commission (FTC) about Enzyte for deceptive advertising. The Center for Science in the Public Interest ( CSPI) is a non-profit watchdog and Consumer advocacy group headquartered in Washington D The Federal Trade Commission ( FTC) is an independent agency of the United States government, established in 1914 by the Federal Trade Commission Act It is manufactured by Berkeley Nutritionals, which is alleged to be the subject of an investigation by the Attorney General of Ohio and the defendant in class-action lawsuits. Ohio ( is a Midwestern state of the United States. As part of the Great Lakes region, Ohio has long been a cultural and geographical crossroads
Enzyte is a supplement that claims to increase the male libido or frequency of erections of the penis. Libido in its common usage means Sexual desire however more technical definitions such as those found in the work of Carl Jung, are more general referring to libido The penis (plural penises, penes Commercials for Enzyte are shown regularly on television. Television ( TV) is a widely used Telecommunication medium for sending ( Broadcasting) and receiving moving Images, either monochromatic These commercials feature a man named Bob who never stops smiling, apparently because he had taken Enzyte and improved the size of his sex organs. The commercials are riddled with symbolic phallic imagery, e. The word phallus can refer to an erect Penis, or to an object shaped like a penis g. golf clubs, remarkably tall glasses of iced tea, and a hose spraying barely a trickle of water (carried by someone who doesn't use Enzyte).
The effectiveness of Enzyte is in dispute. Some medical professionals in fact advise against taking Enzyte, saying that it can lead to damage. The Center for Science in the Public Interest have urged the Federal Trade Commission to disallow further television advertising for Enzyte due to a lack of proper studies supporting claims. The Center for Science in the Public Interest ( CSPI) is a non-profit watchdog and Consumer advocacy group headquartered in Washington D The Federal Trade Commission ( FTC) is an independent agency of the United States government, established in 1914 by the Federal Trade Commission Act Advertising is a form of Communication that typically attempts to persuade potential Customers to Purchase or to consume more of a particular Brand Enzyte maker Berkeley Premium Nutraceuticals, Inc. , is currently under a class action lawsuit for false advertising. In Law, a class action or a representative action is a form of Lawsuit where a large group of people collectively bring a claim to court False advertising is the use of false or misleading statements in Advertising.
Enzyte is said to contain: Tribulus terrestris; Yohimbe Extract; Niacin; Epimedium; Avena sativa; zinc oxide; maca; Muira Pauma; Ginkgo biloba; L-Arginine; Saw Palmetto. Tribulus terrestris is a Flowering plant in the family Zygophyllaceae, native to warm temperate and tropical regions of the Old World Niacin, also known as vitamin B3, is a water-soluble vitamin which prevents the deficiency disease Pellagra. Epimedium, also known as Barrenwort, Bishop's Hat, Fairy Wings, Horny Goat Weed, or Yin Yang Huo (淫羊藿 is a Oats redirects here It may mean either the common cereal oat discussed here or any cultivated or wild species of the Genus Avena. Zinc oxide is a Chemical compound with the formula ZnO It is nearly insoluble in water but soluble in Acids and Bases It occurs Ginkgo ( Ginkgo biloba; in Chinese 銀杏 Pinyin romanization yín xìng) frequently misspelled as "Gingko" and also known Arginine (abbreviated as Arg or R) is an α- Amino acid. The L-form is one of the 20 most common natural amino acids Serenoa repens, the saw palmetto, is the sole Species currently classified in the Genus Serenoa. Other ingredients: gelatin, rice bran, oat fiber, magnesium stearate, silicon dioxide.
Herbal and other alternative treatments
These are generally ineffective when tested blind, but may be useful for their psychological (placebo) effect: if a good result is expected, any highly praised, and often expensive, treatment can be effective. Reputable drugs can also benefit from the same effect. This is especially useful if blindfolded, as it helps to clear the mind of anxiety issues.
Prelox
Prelox is a Proprietary mix/combination of naturally occurring ingredients, L-arginine aspartate and Pycnogenol. In double blind tests carried out by Dr. Steven Lamm at New York University School of Medicine, 81. 1% of men overall judged Prelox to be effective in improving their ability to engage in sexual activity. [28] Whilst the supplements should be taken daily, the manufacturers claim that it brings the spontaneity back into ones' love life; unlike other products which must be remembered to be taken a fixed time before sexual activity.

Other treatment methods

Zinc

Zinc is known to help prevent the conversion of testosterone to estradiol, and testosterone is essential for proper erectile function and the synthesis of sperm (testosterone deficiency is a primary contributor in many cases of erectile dysfunction). Estradiol (17β-estradiol (also oestradiol) is a Sex hormone. [29][30][31][32][33] Moreover, zinc levels have been found to be significantly reduced in both chronic bacterial prostatitis (CBP) and non-bacterial prostatitis (NBP). Prostatitis is an Inflammation of the Prostate gland in men A prostatitis diagnosis is assigned at 8% of all urologist and 1% of all primary care physician visits Many doctors and nutritionalists recommend zinc for prostate or erectile problems. [34][35][36]

Zinc is best taken in lozenge form, as in tablet form the zinc is difficult to absorb, and can irritate the stomach lining. Applications Modal logic In Modal logic, the lozenge expresses the possibility of the following expression [37]

History

The earliest attempts at treating erectile dysfunction date back to Muslim physicians and pharmacists in the medieval Islamic world. They were the first to prescribe medication for the treatment of this problem, and they developed several methods of therapy for this issue, including a single-drug therapy method where a drug was prescribed and a "combination method of either a drug or food. Medication, also referred to as medicine, can be loosely defined as any substance intended for use in the diagnosis cure mitigation treatment or prevention of disease Therapy (in Greek: θεραπεία) or treatment, is the attempted Remediation of a health problem usually following a Diagnosis A drug, broadly speaking is any chemical substance that when absorbed into the body Food is any substance usually composed primarily of Carbohydrates Fats water and/or Proteins that can be eaten or drunk by an " Most of these drugs were oral medication, though a few patients were also treated through topical and transurethral means. In Medicine, a topical Medication is applied to body surfaces such as the Skin or Mucous membranes for example the Vagina Transurethral resection of the prostate (also known as TURP, plural TURPs and as a transurethral prostatic resection TUPR) is a urological operation Erectile dysfunctions were being treated with tested drugs in the Islamic world since the 9th century until the 16th century by a number of Muslim physicians and pharmacists, including Muhammad ibn Zakarīya Rāzi, Thabit bin Qurra, Ibn Al-Jazzar, Avicenna (The Canon of Medicine), Averroes, Ibn al-Baitar, and Ibn al-Nafis (The Comprehensive Book on Medicine). For the episode of the American television series The Office, see " Drug Testing " (836 in Harran, Mesopotamia &ndash February 18, 901 in Baghdad) was an Arab astronomer, mathematician Abu Ja'far Ahmad bin Abi Khalid Ibn al-Jazzar Al-Qayrawani (circa 898-980 ( أبو جعفر أحمد بن أبي خالد بن الجزار القيرواني) was a 10th century TemplateInfobox Muslim scholars --> ( Persian /ابو علی الحسین ابن عبدالله ابن سینا (born The Canon of Medicine ( Arabic: القانون في الطب Al-Qanun fi al-Tibb " The Law of Medicine " Persian Abū 'l-Walīd Muḥammad ibn Aḥmad ibn Rushd (Arabicأبو الوليد محمد بن احمد بن رشد better known just as Ibn Rushd (ابن رشد and in European Abu Muhammad Abdallah Ibn Ahmad Ibn al-Baitar Dhiya al-Din al-Malaqi (ابن البيطار (d TemplateInfobox Muslim scholars --> Ala al-Din Abu al-Hassan Ali ibn Abi-Hazm al-Qarshi al-Dimashqi ( [38]

Dr. John R. Brinkley initiated a boom in male impotence cures in the US in the 1920s and 1930s. John Romulus Brinkley (later John Richard Brinkley; born on July 8, 1885; died May 26, 1942) was a controversial American Medical His radio programs recommended expensive goat gland implants and "mercurochrome" injections as the path to restored male virility, including operations by surgeon Serge Voronoff. Serge Abrahamovitch Voronoff (Сергей Абрамович Воронов c After the Kansas State Medical Board revoked his medical license and the Federal Radio Commission refused to renew his radio license (both in 1930), Brinkley moved his operations just over the Texas border to Mexico where he opened a medical clinic and broadcast advertisements into the US from a border blaster radio station. The Federal Radio Commission ( FRC) was a government body that regulated Radio use in the United States from its creation in 1927 until its replacement A border blaster is a licensed commercial Radio station that transmits at very high power from one nation to another

Surgeons began providing patients with inflatable penile implants in the 1970s. Penis enlargement procedures (sometimes euphemistically referred to as "male enhancement procedures" in spam email and television advertisements are techniques

Modern drug therapy for ED made a significant advance in 1983 when British physiologist Giles Brindley, Ph. D. dropped his trousers and demonstrated to a shocked American Urological Association audience his phentolamine-induced erection. The drug Brindley injected into his penis was a non-specific vasodilator, an alpha-blocking agent, and the mechanism of action was clearly corporal smooth muscle relaxation. The effect that Brindley discovered established the fundamentals for the later development of specific, safe, orally-effective drug therapies. [39]

Reference: Helgason ÁR, Adolfsson J, Dickman P, Arver S, Fredrikson M, Göthberg M, Steineck G. Sexual desire, erection, orgasm and ejaculatory functions and their importance to elderly Swedish men: A population-based study. Age and Ageing. 1996:25:285-291. [2]

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External links

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Dictionary

erectile dysfunction

-noun

  1. The inability of a man to obtain or sustain an erection. Abbreviation: ED
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