![japan gay massage part 14 japan gay massage part 14](https://i.pinimg.com/736x/9a/d6/7f/9ad67f751d3c2780e36516e33ccafc1a.jpg)
That’s because ED is often due to atherosclerosis-the same artery-clogging process that usually precedes heart attacks and strokes. In some studies, ED is like the canary in a coal mine for a future heart attack. More and more, erectile dysfunction is being viewed as a systemic medical problem. Morgentaler says, “how are you going to make him do better on testosterone?” A logical approach In other words, for these men the Viagra worked so well that there was little room for improvement. The researchers speculate that Viagra may supercharge the process that creates erections beyond the point at which testosterone could add anything more. Matthew Spitzer, the lead author of the study, which was published in the Annals of Internal Medicine. “One of the central findings of the study is that sildenafil works extremely well,” says Dr. Erections, desire for sex (libido), and sexual activity were the same in both groups.
![japan gay massage part 14 japan gay massage part 14](https://www.sasapost.com/wp-content/uploads/header-5120x.jpg)
Half took Viagra and used a daily testosterone gel, while the other half took Viagra and used a placebo gel.Īdding testosterone to Viagra didn’t make a difference. Does this make a difference? To find out, a team of researchers based at Boston University Medical School conducted a study involving 140 men with low testosterone. Men with ED who also test low for testosterone may be offered a hormone boost, frequently in the form of a rub-on gel applied daily, in addition to an ED drug. But like testosterone, they don’t work for about 30% of men who try one. That’s because they tend to work more reliably than testosterone, and the response is usually quicker. Today, one of these drugs is usually the first treatment a primary care doctor recommends for erectile complaints-not testosterone. Several competitors have since leapt into this lucrative market: tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra). They enhance blood flow to the spongy tissues in the penis, which creates an erection. The current ED medications belong to a class of drugs known as PDE-5 inhibitors. Also, men with low testosterone and symptoms may experience extra benefits of testosterone replacement, such as more “pep” and more desire for sex in the first place. One potential advantage to the “testosterone first” approach is that could make it unnecessary to take a pill in the anticipation of a sexual encounter. “Improved doesn’t always mean adequate, though, so, it is not unusual to add sildenafil or a similar medication if a man still is not satisfied with quality of his erection with testosterone therapy alone.” Morgentaler, the author of Testosterone for Life. At the clinic, “our first choice for men who have low testosterone and erection problems is to give them testosterone and not sildenafil,” says Dr. Morgentaler is also the founder and director of Men’s Health Boston, which treats many men with low testosterone. Abraham Morgentaler, an associate clinical professor of urology at Harvard-affiliated Beth Israel Deaconess Medical Center.ĭr. “It’s well established that testosterone by itself, for men with sexual dysfunction that includes erectile dysfunction, can improve erections in the majority of men who take it,” says Dr. But it is an option on the table for men with low testosterone. And boosting testosterone doesn’t always improve erections. Many doctors won’t consider prescribing testosterone unless certain other symptoms are also present, such as decreased desire for sex (libido) and fatigue. Some men with erectile problems have perfectly normal amounts of testosterone. To be sure, getting more of this hormone isn’t a universal solution for ED. Testosterone is central in the male sexual response, including the desire for sex and the mechanics of triggering an erection. Testosterone first?īefore Viagra appeared on the scene in 1998 and transformed the treatment of erectile dysfunction, testosterone was an important medical therapy for it. But is an erectile dysfunction (ED) drug like sildenafil (Viagra) or its competitors always the best place to start? That’s an open question, especially among men with low levels of testosterone. Thanks to an aging population and a lot of direct-to-consumer advertising, many American men of a certain age know to ask about the “little blue pill” or similar medications if they develop erectile difficulties. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Please note the date each article was posted or last reviewed. ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content.