Any type of injury to the back, legs, buttocks, groin, penis, or testicles. May be difficult to conceal 3 Istituto Oncologico Veneto, 35128 Padua, Italy A psychosocial examination, using an interview and a questionnaire, reveals psychological factors. A man's sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse. Psychogenic Nocturnal erections; sudden onset; history of depression; anhedonia; poor relationship with partner; anxiety; life crisis Sad or withdrawn affect; tearful; psychomotor retardation Nocturnal penile tumescence (stamp test; Snap-Gauge) A. It works for 70 to 80 percent of all men suffering from ED, with highest success rates in men with non-vascular causes of ED (psychogenic, hormonal, neurogenic). After undergoing a radical prostatectomy, some men experience pain and burning when injecting the medicine, (alprostadil). Only 1 to 5 percent of men have this reaction, but it's enough to prevent them from using the drug again. Drug Therapy While these medications work for many people with erectile dysfunction, they don't work for everyone. It is also important to know that not everyone is a suitable candidate for these drugs. If these issues are true in your case, there are other options to consider. How Well Do Vacuum Constriction Devices Work? Curb your vices. If scientific evidence and public service announcements haven't convinced you to stop smoking or abusing drugs, maybe a desire to avoid erectile dysfunction will. * The ability to get erections on demand, whenever you want. Get it up and keep it up! The survey did not ask volunteers if a doctor had diagnosed either of the disorders, only about related symptoms, which is a weakness, said Dr. Thomas Pollm?cher, the director of mental health at Ingolstadt Hospital, Germany. Hypogonadism (which leads to lower testosterone levels) If you can't keep your blood sugar or your blood pressure under control, you can get erectile dysfunction. It's important that you take your medicines for these problems just the way your doctor tells you. Very limited effectiveness Q. Is it difficult to persuade a man to inject his penis? Warning How should sildenafil (Viagra) be administered? Viagra Canadian Pharmacy JAMA 1993, 270:83-90. PubMed Abstract Sildenafil (Viagra) was the first oral phosphodiesterase type 5 (PDE5) inhibitor approved by the FDA in the United States for the treatment of erectile dysfunction (it is not approved for women). Sildenafil inhibits PDE5, which is an enzyme that destroys cGMP. By inhibiting the destruction of cGMP by PDE5, sildenafil allows cGMP to accumulate. The cGMP in turn prolongs relaxation of the smooth muscle of the corpora cavernosa. Relaxation of the corpora cavernosa smooth muscle allows blood to flow into the penis resulting in increased engorgement of the penis. In short, sildenafil increases blood flow into the penis and decreases blood flow out of the penis.