Nitroglycerin Gel for ED: Pros, Cons, & Practical Information

About Nitroglycerin Gel for Erectile Dysfunction

Medically reviewed by Matt Coward, MD, FACS — Written by Sara Lindberg on December 16, 2020

This article is a repost which originally appeared on Healthline

Edited for content

Erectile dysfunction (ED) may affect as many as 30 million men in the United States. People with ED experience an inability to get or keep an erection firm enough for sex.

You may be familiar with some of the more common treatments for ED, including lifestyle modifications, oral medications that include phosphodiesterase type 5 inhibitors (PED5 inhibitors), and penis pumps.

But a study published in the Journal of Sexual Medicine also looked at the use of nitroglycerin gel or cream as a topical treatment for ED. Although results look promising, it’s important to note that nitroglycerin gel or cream isn’t approved by the Food and Drug Administration (FDA) to treat ED.

Here’s what you need to know about nitroglycerin as a topical treatment for erectile dysfunction.

What is nitroglycerin?

Nitroglycerin is part of a class called vasodilators, which widen the blood vessels and improve blood flow to allow oxygen-rich blood to reach the heart.

It comes in a variety of forms, including sublingual (under-the-tongue), topical cream or gel, and as a transdermal patch. Nitroglycerin is most often used to prevent angina or attacks of chest pains.

Nitroglycerin for ED

“The idea of treating ED with topical nitroglycerin is not new and was first described in the 1980s,” says Dr. Joseph Brito, a urologist at Yale New Haven Health, Lawrence + Memorial Hospital. Brito is also a member of Healthline’s clinical review network.

In general, Brito says nitroglycerin works by dilating the blood vessels, which is why it’s traditionally used for patients with angina or chest pain due to poor cardiac vessel blood flow.

The concept is the same for ED, although Brito says it may have a dual mechanism of action:

  • It widens blood vessels helps blood flow.
  • It relaxes penile smooth muscle, which in turn compresses penile veins and impedes blood flow out of the penis, which causes rigidity.

How does nitroglycerin gel work?

According to Brito, nitroglycerin gel or cream differs from other ED treatments such as oral medications:

“[Topical nitroglycerin] acts as a nitrogen donor to increase local levels of nitric oxide, which works through molecular signaling (cGMP pathway) to cause this response,” he says.

On the other hand, Brito says PDE5 inhibitors (like tadalafil and sildenafil) work at a later step in the chain by inhibiting the breakdown of cGMP.

Nitroglycerin for ED doesn’t have enough research

That said, Brito points out that nitroglycerin gel or cream is currently not approved by the FDA to treat ED.

Moreover, Brito points out that the American Urological Association guideline on erectile dysfunction published in 2018 didn’t include topical nitroglycerin as a suggested treatment for men with ED.

“Though this therapy was not specifically mentioned, the authors did state ‘the use of these treatments may preclude the use of other treatments known to be effective,’ and felt more research was needed,” he explains.

And there’s another factor to consider: Nitroglycerin cream on the outside of the penis might be transferred to your partner.

Why are people interested nitroglycerin gel for ED?

“Nitroglycerin may have some benefits over standard oral ED medications,” Brito says.

The onset of topical nitroglycerin is between 10 and 20 minutes, which Brito says is better than the quickest acting oral agents, with sildenafil taking at least 30 minutes.

In fact, the 2018 study published in the Journal of Sexual Medicine found that 44 percent of patients saw erection beginning within 5 minutes of application. Seventy percent of the men noticed an erection within 10 minutes.

The randomized, double-blind, placebo-controlled study included 232 men with ED who participated in two 4-week trials. One trial used a 0.2 percent glyceryl trinitrate topical gel before sex, and the other used a placebo gel.

“This may help with spontaneity, which can be an issue for couples using oral agents,” Brito explains.

Another benefit, Brito says, is that unlike other ED treatments like oral agents, nitroglycerin doesn’t need to pass through the gastrointestinal (GI) tract.

“Since absorption of oral agents like sildenafil is strongly affected by food intake, the medications are much more effective when taken on an empty stomach,” he says. This requires more planning and doesn’t always allow for spontaneity.

Where to buy nitroglycerin for ED

Nitroglycerin gel or cream is currently not approved by the FDA to treat ED.

If you have questions about this topical treatment, you need to talk with a doctor who knows your medical history. A prescription is needed for nitroglycerin.

How to take nitroglycerin gel for ED

Nitroglycerin use is managed by your doctor. Don’t use or apply this topical treatment without guidance.

According to the Journal of Sexual Medicine, the concentration studied was 0.2 percent, which Brito says likely explains why the effect was best for men with mild ED.

He also points out that other studies used concentrations of 0.2 to 0.8 percent for patients with more severe ED, who likely needing higher concentrations.

In general, Brito says people prescribed nitroglycerin by their doctor should apply a small amount (pea-sized) to the head of the penis.

Side effects and contraindications

Nitroglycerin is certainly not for everyone. According to a 2018 review, taking nitroglycerin-based medications with certain PDE5 inhibitors like Viagra is contraindicated. Using them together can result in a sudden and serious decrease in blood pressure and potentially death.

According to Brito, some drawbacks of topical nitroglycerin include possible transmission to the partner, which can lead to the partner sharing in side effects, especially low blood pressure. This can lead to headache and nasal congestion.

Other treatments for ED

There are several treatments available for ED, including:

  • oral medications that include PDE5 inhibitors such as sildenafil (Viagra) and tadalafil (Cialis). Other oral medications include vardenafil HCL (Levitra), and avanafil (Stendra)
  • erectile dysfunction pump (penis or vacuum pump)
  • penile injections
  • inflatable penile prosthesis
  • psychotherapy (talk therapy) for emotional or psychological issues related to ED
  • suppositories (Alprostadil)
  • counseling
  • diet modifications
  • exercise
  • stress reduction

The takeaway

Although some research points to the effectiveness of nitroglycerin gel or cream for improving the symptoms of ED, it’s currently not approved by the FDA as a treatment for erectile dysfunction.

If you have ED or think you may have ED, it’s important that you talk with a doctor about any treatment options. They can talk with you about the range of options, including lifestyle modifications, counseling, oral agents, penis pumps, surgery, and implants.

Getting Back Into Sexual Sync

Getting Back Into Sexual Sync

This article is a repost which originally appeared on WORLDHEALTH.NET

Edited for content

Posted on Nov 30, 2020, 8 p.m.

It’s common for longtime partners to fall into romantic ruts. “You don’t stay newlyweds for life, and there are times when romance and sex get routine and less exciting,” says Dr. Sharon Bober, director of the Sexual Health Program at Harvard-affiliated Dana-Farber Cancer Institute.

What can you do when you and your partner are sexually out of sync? As with most things in life, if you want change, then you must be willing to change.

“This means giving your relationship the attention it needs,” says Dr. Bober. “You can’t leave everything on autopilot and wait for your relationship to eventually return to normal.”

Ups and downs

As couples age, they also face other challenges to intimacy. For instance, sexual drive varies between the sexes and can be more unpredictable.

Women go through menopause, which affects desire and can make sex uncomfortable. Men often deal with erectile dysfunction, which leads to worry about sexual performance and dampens libido.

But there are upsides to this period of life, too. The kids are out of the house, many couples are more financially secure, and they have more time to relax and enjoy each other

The rules of attraction

Couples can get out of sexual sync when one or both partners feel that they are no longer attractive or sexually appealing, even though this is often not the case. “They may falsely believe they are not desirable and that in turn lowers their own feelings of sexuality,” says Dr. Sharon Bober, director of the Sexual Health Program at Harvard’s Dana-Farber Cancer Institute. Make a regular effort to compliment your partner both physically and emotionally, and show that you still want a connection.

Making a new recipe

While erectile dysfunction medication and lubricants can help overcome some of the physical barriers to sex, older couples need to work together to correct an out-of-sync love life.

“There are many strategies that can help get intimacy back in rhythm,” says Dr. Bober. “But it’s like a recipe with multiple ingredients. They work best together.”

Here are some of her suggestions on how to regain romantic rhythm with your partner when sexual drive and interest get out of whack from Harvard Health Publishing:

Restart the romance spark. A satisfying sex life begins outside the bedroom. “Don’t think of your partner as a roommate, but someone you want to bond with,” says Dr. Bober. Try something new together like a hobby or take a class or overnight trip. “Think about how you would woo your partner if you were dating for the first time,” says Dr. Bober.

Plan for intimacy. If motivation is a barrier, set up a sex date. Sometimes you need to make sex happen to get back in the rhythm, similar to scheduling workouts with a trainer. “This way neither partner needs to feel pressured to initiate, but rather together you can plan for and anticipate some romance with each other,” says Dr. Bober.

Find the best time. Energy levels vary throughout the day and night and per person. “Some people like morning romance, and others enjoy it in the evening,” says Dr. Bober. “Couples need to communicate with each other about what time of day is best and try to find a compromise.”

Don’t rush it. Arousal is not as spontaneous as you age. “Put more effort into anticipation and the overall experience of giving and receiving pleasure, which gives both people time for proper arousal and avoids the stress of having to get in the mood quickly,” says Dr. Bober.

Also, make foreplay central to sex. Spend more time hugging, kissing, and exploring each other’s bodies. “Bring back the actions that you found exciting when dating,” says Dr. Bober.

Build from desires. Before and during sex, ask your partner what feels good and what sparks interest. And then share what you like.

“This is a way to build mutual trust,” says Dr. Bober. Besides the physical aspect, desires also could include actions like reading something erotic to each other or watching a sexy movie.

Dr. Bober adds that what really counts is for couples to come together and focus on mutual pleasure.

“For any couple, the key to enhancing desire is communication and connection,” she says. “A little more of both is often great for boosting your sex life.”

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Medications that cause erectile dysfunction

What medications may cause erectile dysfunction?

Several factors can cause or contribute to erectile dysfunction. One example is the medications a person takes. Medicines that affect sex drive, blood flow, and sexual organ function may increase the incidence of erectile dysfunction.

Medically reviewed by Matt Coward, MD, FACS — Written by Rachel Nall, MSN, CRNA on November 11, 2020

This article is a repost which originally appeared on MEDICALNEWSTODAY

Edited for content

Several factors can cause or contribute to erectile dysfunction. One example is the medications a person takes. Medicines that affect sex drive, blood flow, and sexual organ function may increase the incidence of erectile dysfunction.

Erectile dysfunction (ED) is the inability to achieve or maintain an erection. It is a common condition that affects males of all ages and varying levels of health and fitness.

This article lists some medications that may cause or contribute to ED, and outlines some treatment options. Finally, we offer some tips to help prevent ED.

Medications that may cause ED
Certain medications may contribute to ED, although they are not usually the sole cause of the condition.

A person who suspects their ED may be due to a particular medication should talk to their doctor. Where possible, a healthcare professional may recommend changing the dosage or switching medicines.

A person should not stop taking their medications unless their doctor tells them to do so.

Some medications that may contribute to ED are below.

Anti-hypertensives

Anti-hypertensives are prescription medications to help lower blood pressure. They may contribute to ED, though doctors have not yet established why this is the case.

Examples include:

  • beta-blockers, such as metoprolol and atenolol
  • clonidine
  • spironolactone
  • some diuretics, such as hydrochlorothiazide and furosemide

Immunosuppressants

Immunosuppressants reduce the activity of the immune system. A person may take them to help control an autoimmune condition or prevent organ rejection following an organ transplant procedure.

One potential side effect of immunosuppressants is impaired sexual function.

Examples include:

  • sirolimus
  • everolimus
  • tacrolimus
  • cyclosporine

Anti-androgens

Androgens are hormones associated with male characteristics. Anti-androgens block some aspect of these hormones. Doctors may prescribe them for several conditions, such as heartburn or prostate cancer.

Examples of anti-androgens include:

  • ketoconazole
  • flutamide
  • bicalutamide
  • nilutamide
  • enzalutamide

GnRH agonists

Gonadotropin-releasing hormone (GnRH) agonists are a class of medications that doctors sometimes prescribe to treat prostate cancer. They may reduce sexual desire in men.

Examples include:

  • leuprolide (Lupron)
  • goserelin (Zoladex)

Corticosteroids

Corticosteroids are drugs that mimic the effects of certain hormones inside the body. People typically take them to help reduce inflammation.

These drugs can also reduce testosterone levels. This may lead to decreased sexual desire and sexual function in some men.

Examples of corticosteroids include:

  • prednisone
  • prednisolone
  • hydrocortisone

Antidepressants

Antidepressants are medications that doctors may prescribe to treat or prevent the recurrence of clinical depression.

Some antidepressants may inhibit sexual desire, which may affect sexual performance. Others may also delay ejaculation.

Examples of antidepressants that may cause ED include:

  • selective serotonin reuptake inhibitors (Lexapro, Prozac)
  • noradrenaline reuptake inhibitors (Wellbutrin, Zyban)
  • tricyclic antidepressants (Pamelor)

Antipsychotics

Antipsychotics are drugs primarily prescribed for the treatment of psychosis. They may inhibit sexual desire, which may then affect sexual performance.

Examples include:

  • aripiprazole (Ability)
  • olanzapine (Zyprexa)
  • risperidone (Risperdal)

Anti-epileptics

Anti-epileptics are medications that doctors prescribe to help prevent epileptic seizures. They may affect a man’s ability to orgasm.

Examples include:

  • gabapentin (Neurontin)
  • topiramate (Topamax)

Recreational drugs

Aside from medications, some recreational drugs can also affect sexual arousal and performance. Examples include:

  • alcohol
  • hallucinogens
  • narcotics, such as heroin
  • stimulants, such as cocaine and methamphetamines

Drugs to treat opioid addiction may also lead to erectile dysfunction. These drugs include methadone and buprenorphine.

What is ED?

ED is the medical term for when a person has difficulty achieving or maintaining an erection. While this may occur periodically for all males, those with ED experience more frequent and routine episodes.

The ability to achieve and maintain an erection is dependant on several factors, including:

  • sexual arousal
  • sufficient blood flow to the penis
  • nerve sensation

An issue with any of the above factors may lead to ED.

Treatments for ED

A doctor may recommend treatments that can enhance sexual performance while allowing a person to continue taking potentially life-saving or life-extending medications. Some examples are below.

Self-care

Often, ED treatments begin with making changes to a person’s routine. These include:

  • adopting healthful eating habits
  • increasing daily exercise
  • maintaining a healthful weight
  • limiting or avoiding alcohol
  • quitting smoking
  • avoiding using recreational drugs
  • sleeping well

Males who experience mental health issues, such as stress, anxiety, or depression, may also benefit from seeing a mental health professional. These conditions can negatively impact sexual desire and sexual function. As a result, successful treatment may help manage ED.

Medications

A doctor may prescribe one of the following medications to help treat ED.

Phosphodiesterase type-5 inhibitors

Phosphodiesterase type-5 (PDE 5) inhibitors are medications that relax and widen the blood vessels to promote blood flow. The American Urological Association (AUA) recommend that males take PDE 5 inhibitors 1–2 hours before having sex.

Examples of PDE 5 inhibitors include:

  • tadalafil (Cialis)
  • vardenafil (Levitra)
  • avanafil (Stendra)
  • sildenafil citrate (Viagra)

PDE 5 inhibitors are not suitable for people taking nitrates.

Injections

A vasodilator is a medication that helps widen the blood vessels, increasing blood flow.

One potential ED treatment involves injecting the vasodilator directly into the penis or urethra.

Testosterone therapy

According to the AUA, the vast majority of ED cases are due to reduced blood flow to the penis. They add that low testosterone levels may affect a person’s sex drive, but are rarely the cause of ED.

If low testosterone levels contribute to ED, a doctor may consider testosterone therapy (TT). This technique involves regularly administering testosterone in one of the following forms:

  • an injectable medication
  • a gel
  • a patch applied to the skin.

However, the AUA state that TT does not improve erections in males with normal testosterone levels or in those with low testosterone levels who experience ED as their only symptom.

Devices

A vacuum erection device (VED) consists of a plastic tube and a pump. The plastic tube fits over the penis, forming a seal against the body’s skin. Using the pump creates a vacuum around the penis, which causes an erection.

Once the penis is erect, the person slips an elastic ring onto the base of the penis. This retains the blood inside the penis for up to 30 minutes.

According to the AUA, around 75% of males who receive proper training on using a VED can achieve an erection when using these devices.

Surgical treatments

If lifestyle measures and medical treatments are ineffective, doctors may recommend surgical options for ED. These are outlined below.

Penile implant procedure

The main surgical option for ED is inserting a penile implant. This device sits permanently inside the penis, making it rigid enough for a person to have sex.

There are two types of penile implant:

  • Semi-rigid implant: Bendable silicone rods that a person can bend downward for urinating or upward for sex.
  • Inflatable implant: Fluid-filled cylinders attached to a rod inside the scrotum. Using the pump forces fluid into the cylinders, causing the penis to enlarge and stiffen.

Vascular surgery

Vascular surgery for ED helps improve blood flow to the penis. Doctors usually reserve this procedure for younger males with good vascular with ED due to pelvic trauma.

Male Sexual Worries: Trends in the Post-Viagra Age

Male Sexual Worries: Trends in the Post-Viagra Age

TOPICS:Urology

By European Association of Urology July 18, 2020

This article is a repost which originally appeared on SciTechDaily

Edited for content

Trends in reasons for visiting a the San Raffaele sexual health clinic. Credit: This diagram appears with the permission of the authors and the International Journal of Impotence Research. The EAU thanks the authors, and the journal for their cooperation.

Scientists report a change in why men seek help for sexual problems, with fewer men complaining about impotence (erectile dysfunction) and premature ejaculation, and more men, especially younger men, complaining about low sexual desire and curvature of the penis (Peyronie’s disease).

Presenting the work at the European Association of Urology (virtual) Congress, after recent acceptance for publication, research leader Dr. Paolo Capogrosso (San Raffaele Hospital, Milan, Italy) said:

“Over a 10 year period we have seen a real change in what concerns men when they attend sexual health clinics. This is probably driven by greater openness, and men now accepting that many sexual problems can be treated, rather than being something they don’t want to talk about.”

The success of erectile dysfunction treatments such as Viagra and Cialis, and the availability of new treatments, means that men facing sexual problems have now have treatments for sexual problems which weren’t available a generation ago. Now researchers at San Raffaele Hospital in Milan have studied why men come to sexual health clinics, and how this has changed over a 10-year period.

In what is believed to be the first research of its kind, the scientists questioned 3244 male visitors to the San Raffaele Hospital Sexual Health Clinic in Milan over a 10 year period (2009 to 2019), and classified the main reason for the visit. They found that the number of patients visiting with erectile dysfunction problems increased from 2009 to 2013, then started to decrease.

There were comparatively few patients complaining of low sex drive or Peyronie’s disease in 2009, but complaints about both of these conditions grow from 2009 to the end of the study. In 2019 men were around 30% more likely to report Peyronie’s disease than in 2009, and around 32% more likely to report low sexual desire.

The amount of men complaining of premature ejaculation dropped by around 6% over the 10-year period. The average age of first attendance at the clinical also dropped, from a mean of 61 to 53 years.

“Erectile dysfunction is still the main reason for attending the clinic, but this number is dropping, whereas around 35% of men attending the clinic now complain of Peyronie’s disease, and that number has shown steady growth,” said Paolo Capogrosso. “Our patients are also getting younger, which may reflect a generational change in attitude to sexual problems.”

Dr. Capogrosso continued “We need to be clear about what these figures mean. They do not indicate any change in the prevalence of these conditions, what they show is why men came to the clinic. In other words, it shows what they are concerned about. The changes probably also reflect the availability of treatments; as treatments for sexual conditions have become available over the last few years, men are less likely to suffer in silence.”

These are results from a single centre, so they need to be confirmed by more inclusive studies. “Nevertheless there seems to be a growing awareness of conditions such as Peyronie’s disease, with articles appearing in the popular press*. In addition, we know that the awareness of this condition is increasing in the USA and elsewhere, so this may be a general trend,**” said Dr. Capogrosso.

Commenting, Dr Mikkel Fode (Associate Professor of Urology at University of Copenhagen), said:

“Although these data are somewhat preliminary as they stem from single institution they are interesting because they allow us to formulate several hypotheses. For example the drop in men presenting with erectile dysfunction may mean that family physicians are becoming more comfortable addressing this issue and that the patients are never referred to specialized centers. Likewise, the simultaneous drop in age at presentation and increase in Peyronie’s disease and low sex drive could indicate that both men and their partners are becoming more mindful to optimizing their sex lives. I will be very interesting to see if these trends are also present in other centers around the world.”

Dr. Fode was not involved in this work, this is an independent comment.

References:

* “Trends in reported male sexual dysfunction over the past decade: an evolving landscape” by Edoardo Pozzi, Paolo Capogrosso, Luca Boeri, Walter Cazzaniga, Rayan Matloob, Eugenio Ventimiglia, Davide Oreggia, Nicolò Schifano, Luigi Candela, Costantino Abbate, Francesco Montorsi and Andrea Salonia, 1 July 2020, International Journal of Impotence Research.

** “The Prevalence of Peyronie’s Disease in the United States: A Population-Based Study” by Mark Stuntz, Anna Perlaky, Franka des Vignes, Tassos Kyriakides and Dan Glass, 23 February 2016, PLOS ONE.
DOI: 10.1371/journal.pone.0150157
PMCID: PMC4764365

PRP for Erectile Dysfunction: Research, Benefits, and Risks

Can PRP Treat Erectile Dysfunction? Research, Benefits, and Side Effects

Medically reviewed by Kevin O. Hwang, MD, MPH — Written by Daniel Yetman on March 6, 2020

This article is a repost which originally appeared on Healthline

Edited for content

What is PRP?

Platelet-rich plasma (PRP) is a component of blood that’s thought to promote healing and tissue generation. PRP therapy is used to treat tendon or muscle injuries, stimulate hair growth, and speed recovery from surgery.

It’s also used as an experimental or alternative treatment option for:

  • erectile dysfunction (ED)
  • Peyronie’s disease
  • penis enlargement
  • sexual performance

There’s currently little research on the effectiveness of PRP for ED. In this article, we’re going to break down what scientists have found so far. We’ll also look at alternative treatment options and potential side effects of PRP therapy.

How does it work?

Your blood is made of four different components: red blood cells, white blood cells, plasma, and platelets.

Plasma is the liquid part of your blood and makes up about half of its volume. Platelets are critical for helping your blood clot after an injury. They also contain proteins called growth factors that help speed up healing.

The theoretical benefit of PRP for ED is to make the tissue and blood vessels in the penis healthier.

To prepare PRP, a medical professional takes a small sample of your blood and spins it in a machine called a centrifuge. The centrifuge separates the plasma and platelets from the other parts of your blood.

The resulting PRP mixture has a much higher concentration of platelets than regular blood. Once the PRP is developed, it’s injected into your penis. This is called the Priapus Shot, or P-Shot.

The P-Shot is a quick procedure, and you’ll likely be able to leave the clinic in about an hour. You also don’t have to do anything to prepare in advance for the procedure.

What does the research say?

Many clinics offering PRP for ED claim that it’s effective, but there’s limited scientific evidence to support their claims. Using PRP for ED is experimental, and its effectiveness is still under review.

A 2020 review looked at all the research available to date on PRP therapy for male sexual dysfunction. The review looked at three animal studies and two human studies for ED. The studies didn’t report any major adverse reactions to PRP therapy.

The researchers concluded that PRP has the potential to be a useful treatment option for ED. However, it’s important to keep in mind that the studies had small sample sizes, and there weren’t adequate comparison groups.

More research is needed to understand the benefits of PRP treatment. The current evidence is mostly anecdotal.

How does PRP compare to other ED treatments?

At this time, it isn’t clear if undergoing PRP therapy will help improve symptoms of ED. Traditional treatment options might be a better alternative until more research is available.

Many people with ED have success with traditional treatment options, which usually target the underlying cause of ED. Your doctor can evaluate you for potential causes of ED, such as heart disease, high cholesterol, or diabetes, and recommend the best treatment option for you.

Common ED treatments include:

  • Medications. ED medications allow the blood vessels in the penis to relax and increase blood flow.
  • Lifestyle changes. Becoming more physically active, eating a healthier diet, and quitting smoking all have the potential to improve ED.
  • Talk therapy. Talk therapies might help improve ED if it’s a result of psychological causes, such as anxiety, stress, or relationship problems.
  • Targeting underlying conditions. ED is often caused by an underlying condition, such as high blood pressure, obesity, and heart disease. Treating these conditions has the potential to improve erection quality.
How much does PRP cost?

Few insurance plans currently cover PRP because it’s still considered an experimental treatment. The cost of the P-Shot can range widely among clinics. According to the Hormone Zone, the P-Shot procedure costs about $1,900. However, some clinics may charge up to $2,200 for treatment.

According to the 2018 Plastic Surgery Statistics Report, the average doctor fee for a PRP procedure was $683, not including facility and instrument cost.

Finding a doctor

If you’re interested in having PRP treatment for ED, talk to your doctor. They can answer your questions about PRP and refer you to a specialist who performs the treatment. Globally, there are at least 683 registered clinics that can administer PRP for ED.

PRP is usually performed by a doctor or surgeon. However, laws on who can perform the treatment may vary between countries.

When looking for somebody to perform PRP, check their medical credentials to make sure they’re licensed by a medical board before you make an appointment.

If possible, you may also want to speak to one of their previous clients to see if they were happy with their results.

Risks and side effects

The 2020 review mentioned earlier found no major adverse effects in the study participants. However, researchers can’t say whether or not PRP is a safe treatment for ED until more research comes out.

As of now, there have been few clinical trials, and the sample sizes have been too small to make any conclusions.

PRP is unlikely to cause an allergic reaction since the substance being injected is coming from your body. However, as with any type of injection, there’s always a risk of complications, such as:

  • infection
  • nerve damage
  • pain, including pain at the injection site
  • tissue damage
  • bruising
Takeaway

PRP therapy is still an experimental treatment. At this time, it isn’t clear if PRP can help treat ED. The procedure is relatively expensive and isn’t covered by most insurance companies.

Early research looks promising, but until studies with large sample sizes and control groups come out, you may want to stick with traditional ED treatments.

If you’re having trouble getting an erection, it’s a good idea to talk to your doctor. They can test you for underlying medical conditions that may be causing ED and recommend an appropriate treatment.

The 10 tips to keep your penis healthy from more sex to exercising it

TIP TOP The 10 tips to keep your penis healthy from more sex to exercising it

Gemma Mullin, Digital Health Reporter
1 Mar 2020, 9:21

This article is a repost which originally appeared on THE SUN

Edited for content

WHEN it comes to talking about matters down below, it can be a pretty sensitive topic.

Most of us prefer to keep discussions about our privates, well, private.

But keeping your todger in good working order is important – especially as you get older.

Research shows that looking after your member can reduce your risk of erectile dysfunction and prostate cancer.

It’ll also help you enjoy a long and happy sex life well into the future.

Not sure where to start?

Here, male sexual health expert Kerri Middleton, from Bathmate, reveals her top tips to keep your penis healthy…

1. Workout

You’ll be pleased to know that the number one tip is to use the tool you’ve been gifted with.

A study by Harvard University found that blokes who ejaculate more frequently — upwards of 21 times per month — have a 33 per cent lower risk of developing prostate cancer.

Men who have sex at least once a week are less likely to suffer erectile dysfunction than those who roll in the hay less often.

A Finnish study has shown that the more you use it, the better your erections will be.

And don’t worry if you’re going through a dry patch – masturbation counts, too.

But it’s not just your penis that you need to work out to keep performing at your best – it’s your entire body.

Plenty of evidence links a sedentary lifestyle with erectile dysfunction, so if you want to improve staying power be sure to enjoy plenty of aerobic exercise.

Running and swimming are the best for penile health.

2. Let go of stress

Leave your stress at work and minimise stressful situations in your home life to keep your member strong.

Excess adrenaline is released into the bloodstream when you’re in a state of worry, causing your blood vessels — including the ones in your penis — to contract.

There are plenty of methods you can use to ease tension and unwind, from meditation to laughter or pumping iron, all of which can help with performance.

3. Cut down on booze

One way many people choose to relieve stress after a hard day’s work is hitting the bottle.

However, if you want to enjoy a healthy sex life long into the future, alcohol can seriously scupper your desire.

Binge and heavy drinking causes nerve and liver damage and can affect the careful balance of male sex hormones.

Even in the short term, alcohol curbs sensitivity and decreases reaction time, leaving you less able to perform.

4. Ditch cigarettes

It’s no secret that cigarettes harm your blood vessels and have a negative impact on your heart health.

Remember that your heart is the ultimate titan, pumping blood throughout your body — including your penis.

Nicotine also makes your blood vessels contract and can stifle blood flow down below.

5. Drink plenty of water

Water keeps everything flowing, especially the plasma and blood cells that make your member stand to attention.

If you’re dehydrated, the blood simply doesn’t flow as well as it should.

So, if you’re worried, up your daily intake of straight H2O to the recommended amount of eight glasses per day.

6. DON’T skip coffee

It’s a little-known fact that coffee consumption and healthy erections are linked.

Drinking coffee is said to speed up the metabolism and get the heart rate going in a healthy way, contributing to blood flow and a healthy member.

Caffeine also causes the arteries in your penis to relax, promoting blood flow to the nether regions.

A study found that drinking two to three cups a day has a particularly positive effect on blokes who are carrying a few extra pounds.

Keeping your penis in good health shouldn’t be a strain.

All of the components required to lead a healthy lifestyle contribute to blood flow, sperm count and testosterone levels and help fight disease.

Get into a mindset where looking after yourself is a priority, and the rest will follow.

7. Get a good night’s sleep

It’s all too easy in our busy society to allow sleep to fall by the wayside.

Between working, playing, relaxing and chatting, there’s barely enough hours in the day.

Still, rest is one of the most vital components of a healthy lifestyle.

Not getting enough sleep is connected to several health issues that contribute to downstairs disappointment such as high blood pressure, diabetes and obesity.

8. Eat well

We all know how important diet is to our overall health, but not many men realise how vital it is to eat the right diet for your penis.

The fuel you put in your body won’t only help erections – it also improves sperm count, sex drive and even affects your risk of prostate cancer.

The foods to avoid:

  • Anything deep-fried
  • Processed meats like bacon
  • Soy
  • Fizzy drinks
  • Sugar
  • Refined carbohydrates like white bread and breakfast cereals

The best foods to eat include tomatoes, salmon, olive oil and oysters.

Another type of food associated with male sexual health is anything spicy.

A French study has found that men who consume more spicy foods have higher testosterone levels than those who shy away from them.

Serrano peppers increase testosterone levels by reducing the amount the kidneys flush out while capsaicin releases chemicals that increase your heart rate, mimic arousal and kickstart your libido.

9. Check cholesterol levels

Not being able to get it up becomes more of an issue the older you get — but it doesn’t have to.

The reason age is tied into loss of erectile function is because as we age, we tend to put less effort into leading a healthy lifestyle.

High cholesterol narrows the blood vessels, which is the leading cause of erectile dysfunction.

Keeping fit, eating healthily and avoiding cigarettes and alcohol are the ideal ways to lower cholesterol.

10. Keep blood pressure in check

Like high cholesterol, high blood pressure is a sign of poor heart health.

It can cause thickening of the arteries, which restricts blood flow and can cause problems with your penis.

Losing weight and enjoying regular cardiovascular exercise, along with avoiding refined carbs and salty food, will naturally lower your blood pressure.

#SexColumn: Men can lose their sex drive too

#SexColumn: Men can lose their sex drive too

Sep 25, 2020

By Sharon Gordon

This article is a repost which originally appeared on IOL

Edited for content

Every joke I’ve ever heard about lack of libido or not wanting to have sex has had a woman as the brunt. In reality many women report that their partners are more often than not the cause for a drop in sexual activity.

Men can also feel asexual, not enjoy sex and find themselves in a slump. The difference is nobody will admit to it or discuss it.

So let’s talk about the top 10 things that can kill your sex drive and your penis. Doctors often refer to ED (erectile dysfunction) as the first signs of early death. I don’t want to be alarmist but the penis and its ability to be erect is a fantastic gauge for health.

ED is the first sign that you may have one of the big three chronic conditions; hypertension, cardiac problems or diabetes. They are easy to diagnose and treatable and yet many men ignore the signs because they are reluctant to admit that their erections are not what they used to be.

One of the big drug companies talk about the 5 finger erection. Hold your hand out in front of you, fingers outstretched, thumb facing up and pinkie finger to the floor. It is the perfect explanation of erections through the ages. The thumb indicates the strength and height of a young adolescent male and the pinkie that of an older male. No cause for concern, as long as the penis is still hard.

It’s when the penis can no longer obtain an erection that you should see your doctor. A real doctor, not some quack that is going to just prescribe ways to achieve and erection. You should be treating the cause and not just the symptom.

There are other reasons why your erection isn’t what it should be. I’ve already alluded to diabetes. Sugar affects testosterone production, making it harder to get an erection. So slow down on eating all those sweets and chocolates.

Inadequate sleep also affects testosterone levels and in turn your erection. I know that this year has shot stress levels through the roof, affecting everything from sleep to nutrition. Be aware of it and if necessary get help. Exercise and mediation can help but drugs may be necessary in acute cases.

Which brings me to exercise. Too much exercise, especially running and cycling could be doing more harm than good. British Columbia University did a study that alleges that more than 64km per week can drop testosterone levels by 17%.

I wonder if erections were stronger during the lockdown when alcohol was not available for sale. Alcohol consumption has a major impact on erections and inability to orgasm. Alcohol also affects testosterone levels.

I keep going on about the hormone testosterone. This is the libido driving hormone and without it your sex drive will tank. Men often lack enough testosterone. It is a simple blood test and is very easily treated. So if you feel something is off, get it tested. I know so many men who would rather bite the bullet than spend an hour at the doctor and get it sorted.

If you are spending too much time indoors you ay also be lowering testosterone production. You do need Vitamin D for production to happen. So why not take yourself out for a day in the outdoors. I have recently discovered that in and around Johannesburg there is plenty to do.

I have some bad news for the lactose intolerant and vegans. Harvard Medical School alleges a direct connection between Soy intake and erectile dysfunction. So if you have recently changed your diet to soy based foods and have been experiencing erectile issues, try cutting out the soy.

Every one of these causes can be addressed and I am by no means suggesting that these are the only causes for your penis not working as well as it should. My absolute opinion is that if it’s not working as well as it should seek medical assistance. There is no reason to be ashamed or embarrassed. Most women have their breasts and vaginas examined annually to ensure continued sexual health and men should get into the habit of doing the same.

In the interim, while you are sorting out the causes there are some adult toys that can help out in the play department. Penis pumps can help draw blood into the penis and thus help with a better erection. Once blood is in the penis use a simple cock ring to keep the blood there for the duration of play. Remove it before it becomes uncomfortable and no longer than 20 minutes.

For a little extra vooma, use a vibrating cock ring. You will maintain your erection and become a vibrator in one go. If your erection doesn’t work at all anymore, you can use a hollow strap on. The penis is placed inside the strap on and is then used to pleasure your partner the same way an erection would. Also remember that your mouth and hands can offer just as much pleasure when used correctly.

Keto diet found to boost sperm count and quality in obese men – Insider

The keto weight loss diet could help boost sperm count and quality, according to 2 case reports

Gabby Landsverk
Sep 10, 2020, 6:00 PM

This article is a repost which originally appeared on Insider

Edited for content

  • Two new case reports suggest a keto weight loss diet could benefit sperm count and quality in obese men.
  • Two patients who lost 20 to 60 pounds on the diet saw dramatic improvements in their sperm samples.
  • This is backed by evidence that keto can boost sexual health, but other healthy eating plans like a Mediterranean or DASH diet are also linked to improvements.

There’s new evidence that the high-fat, low carb keto diet might have benefits for reproductive health.

In new case reports, two men with obesity who lost weight on a very low calorie keto diet saw significant improvements in both sperm count and quality, according to research from the Universidade de São Paulo, Brazil, presented at the 2020 European and International Obesity Congress,

In the first case, the patient lost nearly 60 pounds in the three-month dieting period, dropping his body fat percentage from 42% to 34%. Subsequently, his sperm quality improved by nearly 100%, based on the percentage of motile sperm in a test sample. His testosterone levels also more than doubled.

The second case report was of a patient who lost less weight, 20 pounds in three months, dropping from 26% to 21% body fat. His sperm quality also improved, but he saw even more significant benefits to sperm count, with over 100 million more sperm tested in the final sample, an increase of nearly 30%. Interestingly, his testosterone levels decreased slightly.

These results were based on the dieting plan called Pronokal, a highly-studied commercial weight loss method launched in Spain in 2004, which differs from traditional keto in that it’s both low-carb (fewer than 50 grams a day) but also limited to 800 calories a day.

Two patients is hardly a large enough sample size to draw broader conclusions about keto and sperm count. But existing evidence supports the notion that low-carb diets could have benefits for sexual health, as increasing fat consumption appears to support healthy sperm levels.

Previous research has also linked higher levels of dietary fat intake to increased testosterone.

You may not need a strict diet to improve sexual health

One caveat to these findings is that extremely restrictive diets can have side effects, particularly in the long term, and very low calorie diets in particular should only be done with medical supervision.

It’s also not only the keto diet specifically that’s linked to better sperm count, quality, and other measures of fertility. There’s evidence healthy dietary changes of any sort can boost sexual health.

The Mediterranean diet, for instance, has been linked to improvements in erectile dysfunction. In a 2004 study, a healthy diet and exercise program helped improve erectile dysfunction in obese men.

A 2019 study found eating processed foods was linked to poor sperm count, while eating more fish and veggies was linked to better sperm count, which is also related to sex drive and overall sexual function.

The DASH diet, which limits red meat and full-fat dairy in favor of fruits, veggies and whole grains, is also linked to higher sperm count, according to research.

That suggests that the benefits may be less related to any one dietary pattern, such as keto, and more about improvements to overall health that affect every area of the body.

 

Men: Ageing and Sexual Health Myths

Men: Ageing and Sexual Health Myths

[email protected] (healthxchange.sg)
Health Xchange4 September 2020

This article is a repost which originally appeared on Yahoo SG

In conjunction with World Sexual Health Day (4 Sep 2020), the departments of Psychiatry and Urology from Singapore General Hospital (SGH), a member of the SingHealth group, help dispel common myths about male ageing and sexual health.

Top 5 myths on male ageing and sexual health

Myth 1: Is something wrong with me as my friends don’t seem to have complaints about their erections?

Fact: Every man’s erection becomes weaker with age. However, men with medical conditions like diabetes, hypertension and high cholesterol may experience erectile dysfunction earlier in their lives.

Myth 2: A short penis is not good for sex.

Fact: Many men have this misconception that good sex requires a long penis. Procedures to lengthen the penis are merely cosmetic and do not enhance erection. In fact, they may even impair erections in some cases! (Alprazolam)

Myth 3: Is not being able to have multiple erections a problem?

Fact: Most men do not have multiple erections. After ejaculation, the penis will have a refractory period whereby it cannot become erect.

Myth 4: Using erection drugs will improve my sex life.

Fact: Erection drugs do not increase sex drive. They increase blood flow in the penis, allowing erections to be stronger and more rigid.

Myth 5: It is possible to die from taking erection drugs.

Fact: Deaths from erection drugs are very rare and they happen when the drugs are taken without medical supervision. Victims may also have underlying medical conditions like heart problems. When taken properly under medical supervision, erection drugs are actually very safe.​

Treatment for erectile dysfunction

The most common treatment for erectile dysfunction is taking drugs such as Viagra, Levitra or Cialis under medical supervision. The most drastic treatment is a surgical procedure which involves inserting a penile implant.

Reduced libido caused by a lack of testosterone can be confirmed with a blood test and treated with testosterone supplements. The treatment can be given in an oral form or via a series of injections, with regular follow-ups to ensure that the patient’s testosterone is replaced adequately and safely.

Prevention is better than treatment

That is why it is important to maintain a well-balanced lifestyle – physically, emotionally and financially – as it is the first step towards graceful ageing and a healthy sex life.

If you have any chronic medical problems such as diabetes, hypertension, hyperlipidaemia and depression, they need to be managed well so as to prevent long-term complications.

Experts warn against drug and alcohol abuse as these have a toxic effect on the nervous system, damaging nerves that are critical to sexual desire. Smoking causes early atherosclerosis (which leads to premature erectile dysfunction and is also associated with heart attacks, strokes and many cancers) and should be avoided.

Exercising regularly will also help improve your self image (which increases desire and boosts sexual hormones) and promote healthy blood vessels (which means delaying the onset of erectile dysfunction).

On the emotional front, focus on relationships with important people in your life and let go of past grievances. Also, be mentally and financially prepared for retirement. If one enters the golden years possessing financial stability, companionship and meaningful hobbies, one will be well equipped to lead a more fulfilling life in the later years.

 

Common Causes of Impotence

Common Causes of Impotence

By Sara Ryding, B.Sc.

Reviewed by Emily Henderson, B.Sc.

This article is a repost which originally appeared on NEWS MEDICAL

Edited for content

Impotence, which is also known as erectile dysfunction, is the inability to get and maintain an erection for intercourse. While the occasional issue with impotence is not considered rare or cause for concern, persistent issues can cause severe stress and be a sign of an underlying health issue. The causes of impotence can include physical and psychological sources.

Impotence and sexual arousal

The processes around sexual arousal are complex and can be difficult to distinguish. For males, the sexual arousal process involves the brain, hormones, emotions, nerves, muscles, and blood vessels to achieve an erection.

As such, impotence can stem from any of these areas or a combination of them. For example, impotence caused by blood vessel issues can be worsened by subsequent stress and mental health concerns.

Physical causes of impotence

Vascular causes of impotence are among the most common causes of impotence. In some cases, impotence can be a symptom of progression towards cardiovascular disease. For example, impotence is common in people with atherosclerosis and can later progress into heart disease. If the veins are unable to close during an erection, this can cause impotence as it hinders the erection from being maintained. This is called veno-occlusive dysfunction.

Veno-occlusive dysfunction can be caused by the development of venous channels that drain blood from the corpora cavernosa where blood would otherwise be trapped during health erections. Veno-occlusive dysfunction can also be caused by deleterious alterations to the tunica albuginea, which would otherwise be responsible for stopping blood from leaving the penis. These alterations can occur as a result of old age, diabetes, or Peyronie’s disease. Other causes include traumatic injury, alterations to muscles around the area, and shunts that are acquired during certain surgery.

Neurological issues are another physical cause of impotence. This can occur as a result of diseases, such as Parkinson’s or Alzheimer’s disease, or due to trauma and injury. These can cause impotence by both decreasing libidos and by inhibiting the onset of an erection. In the event of spinal cord injury, the effect on impotence can depend on the nature, location, and extent of the injury. Similarly, neurological issues can be the cause of impotence in old age as sensory stimuli abate with age.

There is some evidence that hormonal issues can cause impotence. A deficiency in androgen, a hormone needed for male sexual characteristics and sex drive, can lower nocturnal erections and decrease libido. However, there is also evidence that erections in response to sexual stimulation still occur in patients with decreased hormonal activity, meaning androgen is not essential.

Psychological causes of impotence

Psychological issues were previously believed to be the main cause of impotence, and it is still considered a common cause of impotence. If the onset of impotence is sudden, this might indicate that the cause is psychological rather than physical.

Psychological issues can range from serious mental disorders, such as schizophrenia, to issues in the relationship with whom impotence occurs. The brain is a starting point for sexual arousal, and issues at this stage can be detrimental to the onset of an erection.

Mental health issues such as depression have a particularly strong link to impotence. This can be due to a lack of libido, performance anxiety, or persistent loss of interest and enjoyment. In schizophrenic people, lowered libido is the main cause of impotence. Some drugs to treat schizophrenia can increase libido, but there can still be persistent issues with erections and orgasms.

Risk factors of impotence

While the causes of impotence can be physical and psychological, there are certain lifestyle and medical factors that can increase the risk of these causes. For example, using tobacco can restrict blood flow the veins and arteries and can thus, over time, lead to vasculature issues which lead to impotence.

Age is one of the biggest risk factors in impotence. Impotence occurs in around 20-40% of older men. Studies have found that the risk of impotence rises by 10% every year in men aged 40-70 years old. The reasons for this are numerous: the penis becomes less sensitive to stimulation, hormone levels decrease, cardiovascular issues become more common, and libido naturally decreases with age.

Other risk factors include obesity, injuries that damage nerves or arteries that are involved in erections, persistent drinking, or alcoholism. Impotence can be avoided by sometimes making changes to lifestyle, such as reducing drinking and smoking but may sometimes need focused treatment. Other times, medical treatments such as radiation treatment or prostate surgery can be risk factors for impotence and may be needed to save the patient’s life.

Sources

  • Mayo Clinic. 2020. Erectile Dysfunction – Symptoms and Causes. [online] Available at: <https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776> [Accessed 26 August 2020].
  • Lue, T., 2000. Erectile Dysfunction. New England Journal of Medicine, 342(24), pp. 1802-1813.
  • Wyllie, M., 2005. The underlying pathophysiology and causes of erectile dysfunction. Clinical Cornerstone, 7(1), pp. 19-26.