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About one-third of cases of infertility are caused by male factors alone. A combination of male and female factors causes about one-third of cases. Learn to use stress management techniques and coping mechanisms, such as deep breathing or guided imagery. Keep a positive attitude. Believe in yourself. 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. The type of birth control you choose depends on your needs. Some people only need to prevent pregnancy. Other people may also want to protect themselves or their partners from diseases that can be passed by having sex. These diseases are called sexually transmitted infections (STIs). Some STIs include acquired immunodeficiency syndrome (AIDS), chlamydia, human papillomavirus (HPV), herpes, genital warts and syphilis. Penile pain (11 to 32 percent) and minor urethral discomfort are the most common reported adverse effects of transurethral administration, with dizziness (2 percent) and symptomatic hypotension (3 percent) being the most serious.16 As with transcavernosal alprostadil, the transurethral form of the drug is contraindicated in patients with an abnormally formed penis, those having conditions that predispose them to priapism, those with a known hypersensitivity to alprostadil and those who have been advised for medical reasons to avoid sexual intercourse. Because it is a smooth muscle relaxant, transurethral alprostadil should not be used during sexual intercourse with a pregnant woman.16 Its causes remain a mystery, Vorona said, but some evidence suggests it's related to reduced levels of iron and the neurotransmitter known as dopamine in the brain. Those who have the neurological disorder complain of an almost irresistible urge to move their legs. Lifetime Piling Up If you have erectile dysfunction (ED), you may experience many emotions, including anger and resentment. While this is understandable, you shouldn't "shut out" your partner while dealing with the problem. Your partner is also affected by your condition. Not only is good communication essential to successful diagnosis and treatment, it can help your partner understand what you are going through. McCullough adds, "If you put it in the context of a physical problem and not a sexual one, most men will be less likely to 'shut down' or shut you out." While some men would rather go the treatment route alone, others might welcome the support of their partner, so be certain to make the offer to go with him, and then let your man decide. Men with organic ED can be treated with one or more of the various available therapies. However, if they have lost confidence in their ability to obtain and maintain an erection suitable for penetration, a few words of encouragement from their physician can be of great help. A. This device consists of two silicone rods that can easily be bent or straightened. Once surgically implanted in the corpora cavernosa, a man will have a permanent erection. Bending the rods so that the penis is close to the body conceals it, while straightening the organ with one or two fingers immediately readies it for intercourse. A serum thyroid-stimulating hormone evaluation is appropriate in select patients. Evaluating the patient for diabetes with a hemoglobin A1c measurement is a useful screening test. where to buy viagra canada Yohimbine No surgery required Feeling so self-conscious that you can't enjoy sex In fact, many medications have ED as a side effect, but “hypertensive drugs are classically the worst,” says Nehra. However, he emphasizes, you don’t have to endure this side effect. Talk to your urologist about medications that will counter ED without affecting your blood pressure meds. The development of future medical options will emphasize the restoration of physiologic function. A better understanding of the molecular biology of ED will allow the development of new classes of agents. Research involving gene therapy is beginning to show promise. Duplex ultrasound is used to evaluate blood flow, venous leak, signs of atherosclerosis, and scarring or calcification of erectile tissue. Injecting prostaglandin, a hormone-like stimulator produced in the body, induces erection. Ultrasound is then used to see vascular dilation and measure penile blood pressure. Measurements are compared to those taken when the penis is flaccid.