Category: Erectile Dysfunction

The average man who has no physical impediments to erection has anywhere from three to five erections per night, according to MedlinePlus. This is known as nocturnal penile tumescence. Each of these nighttime erections lasts for up to 30 minutes, and most occur during REM (rapid eye movement) sleep.

Not only are these nighttime erections normal, but they also play a key role in the maintenance of healthy erectile function, sort of like exercise undertaken in advance of the big game.

While most men are totally unaware of most of their nocturnal erections, almost all of them have awakened in the morning from time to time to find they have an erection. According to the U.K.’s National Health Service, this is usually the last of a man’s nighttime erections and is known by some as a “morning glory.”

As you probably have witnessed yourself, sensitivity to alcohol varies significantly from one person to another. While most men have a higher tolerance for alcohol than women, there is quite a bit of variation from one man to another.

Moderation is the key, according to Chris Iliades, M.D., who points out in an EverydayHealth.com article that moderation means no more than two drinks a day for a man, according to the Centers for Disease Control and Prevention.

A drink or two, at the most, helps to set the stage for romance, says Iliades, easing inhibitions and producing a warm glow that’s almost guaranteed to enhance the overall experience. However, drink more than that and alcohol’s depressant effects are likely to kick in. You’re likely to find that more than two drinks dampens your mood, decreases sexual desire, and makes it increasingly difficult for you to get and keep an erection.

Perhaps the best-known of all is the so-called stamp test. Buy a roll of inexpensive postage stamps. Before retiring for the night, moisten the stamps and apply them in a continuous ring around the mid-shaft of your penis. If you find upon awakening the next morning that the rings of stamps has been broken, it’s a clear sign that the penis achieved an erection during the night and that there is no serious damage to nerves or blood vessels serving the penis. If the ring of stamps is unbroken, it indicates that no nocturnal erection occurred, which is cause for further testing to see what physical impediments to an erection might be present.

Another self-test is the International Index of Erectile Function, or IIEF. The test consists of several questions, each of which can be answered with one of five or six multiple answers. The questions address recent sexual and erectile experience. Each of the multiple answers has a numerical value assigned to it. After answering all the questions, the numbers of your answers can be totaled to gauge your level of erectile function.

According to HealthLine.com, major pharmaceutical companies have been developing and testing creams that contain alprostadil, a drug already widely used in penile injection therapy to overcome erectile dysfunction. However, as of early 2014, the FDA had not yet approved any of these creams for sale in the United States.

Already available on the Canadian and European markets, Vitaros is a cream formulation of alprostadil that is manufactured by Apricus Biosciences, headquartered in San Diego, California. While acknowledging that the PDE5 inhibitors currently on the market are generally effective in treating erectile dysfunction, Apricus points out that they do have some side effects, such as headache, vision and hearing impairment, and muscle aches, that are generally mild but tend to be more problematic for some users.

Vitaros is applied directly to the penis and produces rapid results, according to Apricus, which notes that the topical cream has been tested for efficacy and safety in more than 3,000 patients.

Yohimbine is an alkaloid chemical found in yohimbe, which is derived from the bark of a West African tree. Before the advent of the PDE5 inhibitors, such as Viagra and Cialis, doctors sometimes prescribed yohimbine hydrochloride as a treatment for erectile dysfunction. Today, the drug is not widely prescribed, because it is not nearly as effective as the newer impotence drugs on the market, according to WebMD.

MayoClinic.com says scientists and medical researchers do not fully understand how yohimbine works. However, it is believed that it stimulates your body to produce more of the chemicals that support erectile function. It works for some men with impotence but has little or no effect for others.

To treat erectile dysfunction, you should take one tablet of 5.4 to 6 milligrams three times daily. This is no miracle pill that can produce an erection within an hour or less. You must take the pills for two to three weeks before seeing any results at all.

While the jury is still out on this question, what evidence there is seems to indicate that marijuana use can compromise erectile function. Two researchers from the University of Ottawa’s Department of Urology undertook a review of the scientific literature on the impact of cannabis use on erectile function.

Their review, published in the April 2011 issue of “Journal of Sexual Medicine,” acknowledged that while some studies showed that marijuana use can enhance erectile function, other studies showed the opposite.

The researchers cited, in particular, recent animal and human studies that showed potential links between marijuana use and sexual health, noting that cannabis may have “peripheral antagonizing effects on erectile function by stimulating specific receptors in the cavernous tissue.” Cavernous tissue fills with blood and expands to create an erection. The researchers urged additional clinical studies in an attempt to definitively determine exactly how marijuana use affects erectile function.

Once again, that old truism about what’s good for the heart is good for the penis comes into play. Just as your heart needs a strong blood flow to operate optimally, your penis must have a strong blood flow to achieve and maintain an erection.

This means that anything that tends to compromise healthy circulation throughout the body is almost certainly going to have an adverse effect on both cardiac and penile function. And smoking definitely can lead to erectile dysfunction, according to WebMD, which points out that the risk of ED increases based on how much you smoke.

In September 2011 Time magazine reported on a study that involved 65 sexually active male smokers who wanted to kick the habit and were willing to have their erections periodically evaluated in the laboratory. Enrolled in an eight-week smoking cessation program that used nicotine patches to wean them off their habit, 20 of the men reported that they had ED at the start of the study. By the time the program, 15 of these men no longer suffered erectile problems.

Many people tend to think of Obamacare and the coverage it provides in very monolithic terms, as if the government itself were the insurer for all the health plans offered under the Affordable Care Act. In fact, health insurance plans under Obamacare must all provide a certain set of services for policyholders and all are required to cover prescription medicines. But each of the private insurers offering an ACA-qualified plan can have its own formulary, or list of prescription medicines that are available and at what copays.

Going back to your original question, treatment of erectile dysfunction involves diagnostic services, which can usually be obtained from your personal doctor or a specialist such as a urologist. With copays based on the plan you choose — bronze to platinum — such doctor visits are covered. As are other diagnostic services from laboratories.

When it comes to treatment for erectile dysfunction, some plans may include one or more of the popular PDE5 inhibitors as a preferred medication on their formulary of prescription drugs. This means that insurance will pay the bulk of the price of the medication, and you will contribute only a small copay. But the only way to find out which drugs are covered is to start shopping for an ACA-qualified health plan, taking care to see which medications are listed as preferred under each plan.

There is no quick and easy answer to this question, according to WebMD, which suggests that you consult with your insurance provider to determine if the form of treatment you’re considering is covered under your health insurance plan. Generally speaking, however, most insurance plans will cover at least some of the cost of treatment of documented medical conditions that are shown to be causing erectile dysfunction.

However, WebMD says your health insurance plan probably won’t cover sex therapy or medications that have not yet been approved by the FDA.

Medicare Part D provides coverage of the vast majority of the prescription medications taken by Americans over the age of 65. However, the Center for Medicare & Medicaid Services (CMS) says Part D coverage explicitly excludes “drugs when used for treatment of sexual or erectile dysfunction, unless such agents are used to treat a condition, other than sexual or erectile dysfunction, for which the agents have been approved by the FDA.” However, Medicare does cover vacuum erectile systems, known as “penis pumps,” under the prosthetic benefit provided under Medicare’s Part B.

Having high blood pressure can deliver a double-whammy to your erectile function, often resulting in a persistent inability to achieve and maintain an erection.

Over time, high blood pressure causes damage to the linings of your blood vessels. Arteries gradually harden and narrow, a phenomenon known as atherosclerosis, according to MayoClinic.com. Atherosclerosis results in diminished blood flow to the penis, making it more difficult or even impossible to achieve an erection. High blood pressure can also reduce your level of sexual desire and interfere with ejaculation.

Because high blood pressure, left untreated, can lead to a heart attack or stroke, most patients with hypertension are prescribed medications to lower blood pressure. Therein lies the second half of the double-whammy as many of these medications in and of themselves can cause ED. Among all anti-hypertensive drugs, the ones most likely to cause ED are thiazides, which are diuretics, followed closely by beta-blockers, according to MedlinePlus. Alpha-blockers are less likely to impede erectile function.