How Long After Prostate Surgery Can You Have Intercourse

Erectile dysfunction (ED) is the disability to achieve or sustain an erection satisfactory for sexual intercourse.

Every human being occasionally has a problem achieving an erection, and such occurrences are considered normal. Erectile dysfunction (ED) occurs when a human being is

• Never able to achieve an erection

• Achieves erection briefly but non long enough for intercourse

• Achieves constructive erection inconsistently

ED is chosen main if the man has never been able to achieve or sustain an erection.

ED is chosen secondary if it is acquired afterward in life by a man who was previously able to accomplish erections.

Secondary ED is much more common than primary ED.

In the United States, about 50% of men aged 40 to 70 are affected somewhat, and the percent increases with aging. However, ED is non considered a normal part of aging and can be successfully treated at any age.

To achieve an erection, the penis needs an adequate amount of blood flowing in, a slowing of blood flowing out, proper function of nerves leading to and from the penis, adequate amounts of the male person sexual activity hormone testosterone, and sufficient sex drive (libido), and so a disorder of any of these systems may pb to erectile dysfunction (ED).

• Hardening of the arteries (atherosclerosis) that affects the arteries to the penis

Often several factors contribute to ED. For example, a man with a slight decrease in erectile function caused by diabetes or peripheral vascular illness can develop severe ED after starting a new drug or if stress increases.

Atherosclerosis may partially block blood menstruation to the legs (peripheral vascular disease). Usually, arteries to the penis are also blocked, decreasing the amount of claret flow to the penis and causing ED. Diabetes, loftier cholesterol levels, high blood pressure, and smoking contribute to atherosclerosis and therefore to ED.

Sometimes blood leaks out of the veins in the penis too fast, decreasing claret pressure in the penis and thus interfering with achieving or maintaining an erection (called veno-occlusive dysfunction).

Less common nervus disorders that cause ED include spinal cord injury, multiple sclerosis, and stroke. Besides, prolonged pressure on the nerves in the buttocks and genital area (the so-called saddle area), every bit may occur during long-altitude bicycle riding, can cause temporary ED.

Hormonal disturbances (such as abnormally low levels of testosterone) tend to subtract sex activity drive merely can too effect in ED.

What Is Peyronie Disease?

In Peyronie disease, inflammation inside the penis causes scar tissue to class. Because the scar tissue does not enlarge during an erection, the cock penis is curved, making penetration during sexual intercourse hard or incommunicable. The scar tissue may extend into the erectile tissue (corpora cavernosa), causing erectile dysfunction.

Drugs, including alcohol and illicit drugs such as cocaine and amphetamines, can as well cause or contribute to ED.

Sometimes psychologic problems (such equally performance anxiety or low) or factors that decrease a man's energy level (such equally disease, fatigue, or stress) cause or contribute to ED. Erectile dysfunction may exist situational, involving a item identify, time, or partner.

In men with ED, certain symptoms and characteristics are cause for business concern. They include

• Absence of erections during the night or upon enkindling in the morning

• Numbness in the expanse between and around the buttocks and genital area (called the saddle expanse)

• Painful cramping in the muscles of the legs that occurs during physical action but is relieved promptly by rest (claudication)

Although ED may diminish a human's quality of life, information technology is non itself a dangerous status. Still, ED may exist a symptom of a serious medical disorder. Because numbness in the groin or leg can be a sign of spinal string harm, men who suddenly develop such numbness should see a doctor right away. Men who have other warning signs should call their physician and ask how soon they need to be seen and examined.

Doctors ask near

• Drug and alcohol apply

• Smoking history

• History of diabetes

• History of high blood pressure

• History of atherosclerosis

• History of surgery (for example, for prostate enlargement, prostate or rectal cancer, or blood vessel disorders)

• History of injury (for example, a broken pelvic bone or a back injury)

• Symptoms of disorders of the claret vessels (for example, pain in the calves when walking or coolness, numbness, or blue colour of the feet)

• Symptoms of nerve disorders (for instance, numbness, tingling, weakness, incontinence, or falling)

• Symptoms of hormonal disorders (for case, loss of sex bulldoze, increased size of breasts, decreased size of testes, loss of body hair, tremor, changes in weight or ambition, or difficulty tolerating heat or common cold)

• Symptoms of psychologic disorders, specially depression

• Satisfaction with sexual relationships

• Sexual dysfunction (for case, vaginitis or depression) in the man's partner

Even though men may be embarrassed to talk to their doctors about some of these subjects, the information is important in determining the cause of ED.

The physical examination focuses on the genitals and prostate, simply doctors also await for signs of hormonal, nerve, and blood vessel disorders and examine the rectum.

Testing is usually needed. Laboratory tests include the measurement of the level of testosterone in the blood. If the testosterone level is low, doctors measure additional hormones. Depending on the results of the history and physical exam, blood tests may likewise be washed to check for previously unrecognized diabetes, thyroid disorders, and lipid disorders. Usually, these tests provide doctors with enough information to plan treatment.

Occasionally, doctors inject a drug into the penis that stimulates erection then use ultrasonography to appraise claret flow in the arteries and veins of the penis. Rarely, doctors may recommend the use of a habitation monitor that detects and records erections during sleep.

• Handling of underlying causes

• Instruction and counseling

• Oral phosphodiesterase inhibitors

• Sometimes other drugs, mechanical devices, or surgery

Any underlying disorder is treated, and doctors often stop drugs that may be causing erectile dysfunction (ED) or switch the man to a dissimilar drug. However, men should talk with their md before they end taking any drug.

Even ED caused by a physical disorder normally has a psychologic component, then doctors offer reassurance and education (including of the man'southward partner whenever possible). Couples counseling by a qualified sex therapist can assistance improve partner communication, reduce functioning pressure, and resolve interpersonal conflicts that contribute to ED.

Supplemental testosterone can help restore erections in men with depression testosterone levels. These testosterone preparations can be practical daily equally a patch or a gel. Testosterone nasal products and below-the-skin implants are also sometimes recommended. Men with very low testosterone levels may need testosterone injections twice per calendar month.

Noninvasive methods (mechanical devices and drugs) are tried first. Sometimes men must try the method a few times before doctors can make up one's mind whether it is effective. Usually, oral drugs are tried start. Drugs injected into the penis just before intercourse are constructive and often tried second. Although most men prefer drugs to other methods of treating ED, mechanical devices have the advantages of being highly constructive and, because they are free of drug side effects, commonly very safe. Penile implant surgery with an inflatable prosthesis is the last used, but most effective, way to achieve intercourse.

Men who can develop but non sustain an erection may apply a constriction ring. As soon every bit erection occurs, an rubberband band is placed around the base of the penis, helping forbid blood from flowing out and maintaining the firmness of the penis. If the homo cannot develop an erection, a hand-held vacuum erection device can be applied over the penis. This device draws claret into the penis by exerting a gentle vacuum effect, afterwards which the ring is placed on the base of the penis to retain the erection. Bruising of the penis, coldness of the tip of the penis, and lack of spontaneity are some drawbacks to this method. Sometimes a constriction ring and vacuum device are combined with drug therapy.

The primary drugs for ED are oral phosphodiesterase inhibitors. Other drugs include prostaglandins that are injected into the penis or inserted into the urethra. Oral phosphodiesterase inhibitors are used much more often than other drugs because they are unproblematic to use and allow spontaneity in intercourse. Over-the-counter herbal remedies are sold for ED, just they are usually ineffective, incorporate hidden doses of a phosphodiesterase inhibitor, or both. The hidden phosphodiesterase inhibitor may expose the homo to a drug with possible side effects.

Oral phosphodiesterase inhibitors (sildenafil, vardenafil, avanafil, and tadalafil) increment blood menses to the penis. These drugs work in the same way, but differ as to how long the event lasts, their side effects, and their interactions with food. The effect of tadalafil lasts longer than those of the other drugs (upward to 36 hours), which some men prefer.

Nearly phosphodiesterase inhibitors work best when taken on an empty stomach and at to the lowest degree 1 60 minutes before sexual intercourse. Men who are taking nitrates (most often nitroglycerin for the handling of angina simply likewise recreational amyl nitrate ["poppers"]) should not take phosphodiesterase inhibitors because the combination can cause blood force per unit area to drop to unsafe levels. Other temporary side effects of phosphodiesterase inhibitors include flushing, vision abnormalities (including abnormal color perception), and headache. Priapism Persistent Erection Persistent erection (priapism) is a painful, persistent, aberrant erection unaccompanied by sexual desire or excitation. It is nearly common in boys aged five to ten years and in men aged xx to 50... read more than (prolonged erection) develops very rarely and may require emergency medical treatment. In rare instances, men take reported blindness or hearing loss after taking phosphodiesterase inhibitors, merely information technology is non clear whether the phosphodiesterase inhibitors have been the cause.

Alprostadil (the prostaglandin PGE1) alone or in combination with papaverine and phentolamine may be directly injected into the side of the penis using a very thin needle, causing a suitable erection in most men. Alprostadil suppository may be inserted into the urethra using a straw-like applicator. These therapies may crusade priapism and penile pain. Usually, the doctor guides the man to administer the drug himself during an function visit. After this, men may give themselves these drugs at home. Alprostadil suppository may be combined with an oral phosphodiesterase inhibitor for men in whom oral drugs are non effective.

For some men, drug therapy is not effective or adequate. In these men, surgery to implant a penile prosthesis may exist washed. Prostheses can take the form of rigid silicone rods or hydraulically operated devices that tin be inflated and deflated. Both involve the risks of full general anesthesia, infection, and prosthetic malfunction.

Although erectile dysfunction (ED) does increment with aging, it need not be accepted as a normal office of aging. Rather, because older men are more likely to take medical conditions that affect the blood vessels they are also more than likely to have ED. Many older couples engage in satisfying sex without erections or intercourse and may not cull to seek treatment. Nevertheless, treatment of ED tin be advisable for older men.

• ED commonly results from psychologic, nervous system, or blood vessel disorders, from injury, or from the side effects of some drugs or surgery.

• When considering the causes, doctors consider psychologic and interpersonal factors.

• Testosterone therapy may assistance restore erectile role in men with low serum testosterone levels and ED, but a low testosterone level is not a common cause of ED.

• Most men with ED may be successfully treated with an oral phosphodiesterase inhibitor such as sildenafil, vardenafil, avanafil, or tadalafil.

• Most men who practise not respond to therapy with oral phosphodiesterase inhibitors can accomplish erections with injections of alprostadil, either lone or combined with an oral phosphodiesterase inhibitor.

• Vacuum erection devices and penile prosthesis surgery are effective treatments for men with severe ED.

Generic Name	Select Brand Names
atenolol	TENORMIN
carvedilol	COREG
metoprolol	LOPRESSOR, TOPROL-XL
propranolol	INDERAL
clonidine	CATAPRES
furosemide	LASIX
hydrochlorothiazide	MICROZIDE
chlorthalidone	No US brand name
methyldopa	No The states make name
spironolactone	ALDACTONE
terazosin	No United states make proper noun
doxazosin	CARDURA
tamsulosin	FLOMAX
silodosin	RAPAFLO
finasteride	PROPECIA, PROSCAR
dutasteride	AVODART
leuprolide	LUPRON
goserelin	ZOLADEX
bicalutamide	CASODEX
ketoconazole	NIZORAL
alprazolam	XANAX
chlordiazepoxide	LIBRIUM
diazepam	VALIUM
lorazepam	ATIVAN
phenelzine	NARDIL
selegiline	ELDEPRYL
tranylcypromine	PARNATE
codeine	No Usa brand name
hydromorphone	DILAUDID
methadone	DOLOPHINE
morphine	DURAMORPH PF, MS CONTIN
oxycodone	OXYCONTIN
citalopram	CELEXA
escitalopram	LEXAPRO
fluoxetine	PROZAC, SARAFEM
paroxetine	PAXIL
sertraline	ZOLOFT
amitriptyline	No US brand proper noun
desipramine	NORPRAMIN
imipramine	TOFRANIL
nortriptyline	PAMELOR
megestrol	MEGACE
cimetidine	TAGAMET HB
estrogens	PREMARIN
testosterone	DELATESTRYL
sildenafil	VIAGRA
vardenafil	LEVITRA
avanafil	STENDRA
tadalafil	CIALIS
nitroglycerin	NITRO-DUR
alprostadil	CAVERJECT, EDEX, MUSE
papaverine	No US make name
phentolamine	ORAVERSE

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Source: https://www.merckmanuals.com/home/men-s-health-issues/sexual-dysfunction-in-men/erectile-dysfunction-ed

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