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Knowing the causes and treatments of erectile dysfunction requires an in-depth understanding of how erections work and the psychological and physiological factors that bring them about. An erection is part and parcel of the male physiognomy and is caused by increased blood flow through the penis. This increased blood flow is usually caused by either direct contact with the penis or the stimulations of sexual thought. Basically, erections are neurovascular events, which means that the veins, arteries, and nerves all need to function properly for them to occur.

What is Erectile Dysfunction?

Getting an erection is a complex process that involves the peripheral nervous system, the central nervous system, psychological and physiologic factors, vascular (i.e., circulation or blood flow) and hormonal components, as well as local factors within the penis. Erections happen in response to smell, touch, visual or auditory stimuli, any of which may cause the brain to send information to the nerve centers located along the spine’s base. The nerve fibers located here are responsible for the regulation of blood flow before, during and after erections.

Erectile dysfunction or impotence is the inability to get or sustain an erection long enough for the satisfactory completion of sexual activity. It is a subset of sexual dysfunction and can occur if any of the psychological or physiological processes required to get or maintain an erection is disrupted. The factors that cause erectile dysfunction are classified into two: psychological factors and physiological factors.

erectile dysfunction or impotence

Psychological Factors

Some studies show that this is the most common cause of erectile dysfunction, although it usually coexists with other functional or physical causes. Inability to get an erection often produces an emotional and psychological reaction in those affected, and this, in turn, produces a pattern of stress, low self-esteem, and anxiety that further interferes with sexual performance. This is termed “performance anxiety” and should be addressed immediately by your preferred healthcare provider.

Several areas of the brain are involved in sexual behavior, and as such, psychogenic ED may induce the brain to send messages that prevent or inhibit erections. Psychogenic ED may occur due to stressors which cause the release of catecholamines that tighten penile muscles and prevents them from relaxing. Also, feelings such as self-consciousness or nervousness about sex, stress at home or the workplace, troubled feelings or feelings of insecurity about your sexual relationships can contribute to psychogenic ED.

In such cases, successful treatment will include psychotherapy or psychological counseling for both partners. Medications used in the treatment of psychological issues may also cause ED, and it is advised to consult a physician before discontinuing any medication.

Physical Factors

Physiological erectile dysfunction has been linked to a number of factors such as hormonal imbalance, sleep disorders, or simply a matter of age. From the age of 40 and above, most men will experience some form of ED. They will notice that achieving erections will take more time and effort and sustaining it will become more challenging. Hormonal imbalance is another cause of physiological ED especially in men having pituitary gland problems or having excess estrogen in their system, due to obesity. Some of the common causes of physiological ED include the following:

  •    High blood pressure and cholesterol
  •    Metabolic syndrome, multiple sclerosis, and Parkinson’s disease
  •    Diabetes and obesity
  •    Peyronie’s disease and sleep disorders
  •    Alcoholism and substance abuse
  •    Enlarged prostate or prostate cancer treatments
  •    Injuries or surgeries that affect the spinal cord or pelvic area.
  •    Radiation treatments for cancer
  •    Medications such as antihistamines, antidepressants, and prescription drugs that treat prostate, pain, high blood pressure, etc.

If you have one or more of these underlying conditions, treating them may be enough to reverse ED.

One of the common questions asked by men who experience some form of erectile dysfunction is when they should see a healthcare professional. For individuals who experience ED on occasion, for instance, less than 5% of the time, medical attention may not be required. However, if the frequency increases or you experience erection induced pain, you should seek the help of a medical professional.

If you have or suspect that you have erectile dysfunction or issues with your sexual performance, it is best to seek the advice of an experienced healthcare professional. You should choose a medical clinic that employs professional staff with years of experience in treating the causes and symptoms of erectile dysfunction. Whether the cause is physical or psychological, they should have different treatment options that can be tailored to meet your specific needs. They should also have operating hours that suit your schedule, so you don’t have to worry about missing an appointment.

Schedule an appointment with EZCare Clinic’s San Francisco office. We’re open seven days a week from 11 am to 7 pm.


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Introduced to the public by the pharmaceutical manufacturing giant Pfizer in 1998, Viagra is one of the most common and effective treatments for erectile dysfunction. It is also the most widely discussed and controversial pharmaceutical drug to hit the mainstream market in the last three decades. The active ingredient in Viagra is sildenafil citrate, which was originally developed to lower blood pressure.

Unintended Side Effect During Clinical Trials

Pharmaceutical scientists in the U.K were trying to create a drug for the treatment of high blood pressure and heart failure. The drug was meant to affect pertinent enzymes within the walls of the blood vessels that controlled the signaling of nitric oxide. During clinical trials, many patients began to mention improved erections as a side effect of the drug. This led to the development of the drug for use in the treatment of erection difficulties.

Relaxes Blood Vessels Around the Penile Area

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Viagra helps to treat erectile dysfunction in men who have issues achieving or maintaining an erection. It functions by relaxing blood vessels around the penile area, allowing for easier and increased blood flow to the penis. It improves erectile response in men who are sexually stimulated and does not initiate sexual stimulation by itself. When a man is sexually stimulated (through smell, touch, visual or auditory stimuli), the body’s nervous system releases nitric oxide present in the penis’ erectile tissue.

Helps to Prevent the Degradation of cGMP

The nitric oxide causes the stimulation of an enzyme, which in turn produces cGMP (cyclic guanosine monophosphate). The cGMP causes the dilation of arteries in the penile area and causes blood to flow to the erectile tissues thereby resulting in an erection. Erectile dysfunction occurs when cGMP is degraded before sexual satisfaction is achieved. Viagra works by preventing the degradation of cGMP and allowing for the continuous flow of blood to the arteries and erectile tissues.

Treatment of Pulmonary Arterial Hypertension

Aside from being an important and very effective treatment for erectile dysfunction, Viagra could also be used in the treatment of other health conditions. One such promising application of Viagra is the treatment of PAH (pulmonary arterial hypertension), a life-threatening and potentially deadly lung and heart condition. Studies show that Viagra significantly decreases the symptoms of PAH through the relaxation of blood vessels in the patient’s lungs, thus preventing constriction that leads to hypoxia and pulmonary hypertension. If left untreated, PAH could lead to right-sided heart failure. There are numerous cases where Viagra was used to successfully treat premature babies born with PAH.

Treatment of Congestive Heart Failure

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Viagra also improves the symptoms of men diagnosed with CHF (congestive heart failure) since it helps to lower blood pressure and heart rate during physical exertions like exercise and sexual activities. Studies show that over 65% of patients suffering from CHF also have erectile dysfunction. Most of these patients believe that the medications used in treating CHF adversely affect their sexual performance and as a result, they stop taking them. Viagra encourages such patients to continue their medications while it takes care of erectile dysfunction.

Symptomatic Relief from BPH

Viagra could also provide relief from some urinary tract symptoms usually associated with BPH (benign prostatic hyperplasia), which is a non-cancerous enlargement of the prostate gland. BPH usually occurs when the prostate gland is undergoing its second phase of growth and this growth period may begin to interfere with the normal functioning of the male urinary system. Reports from the Urology Care Foundation show that nearly 50% of men between 51- 60 and over 90% of those above 80 suffer from BPH. Although it is non-cancerous, BPH shows some of the symptoms associated with prostate cancer and can only be diagnosed by an experienced healthcare professional.

Increases Chances of Fertility

Studies conducted in Nevada by the Sher Institute for Reproductive Medicine show that Viagra could dramatically increase chances of fertility in certain groups of women. The study suggested that it aids fertility by increasing the flow of blood to the patient’s uterus.

Finding a Clinic That Provides Viagra

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It’s imperative that you find a clinic with qualified physicians who have experience in treating men with Viagra. Find a clinic with a professional staff and a division that specializes in men’s health. You should also choose a clinic that provides convenient appointments or walk-in availability. If you would like to get a Viagra prescription in San Francisco, schedule your appointment with EZCare Clinic by calling (415) 966-0848 or walk in from 11 am to 7 pm.


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Women are not the only ones who deal with negative consequences and symptoms of getting older and imbalanced hormones. Men can deal with a lack of energy, less enjoyment in the bedroom, faster weight gain, loss of strength and muscle, and simply not being able to accomplish what they could just a few short years before from a decreased production of hormones.

Most of these ill-gotten symptoms are a result of the lessened production of testosterone that happens naturally through aging. This process is called andropause and it starts as early as age 30 for men. Around this age, testosterone production can begin to lessen by 2% each year.

Luckily, men suffering from andropause can benefit from testosterone replacement therapy that can either help replace or rebalance their testosterone levels. Here are some of the negative consequences of andropause and what you need to know about testosterone replacement therapy.

Testosterone Replacement Therapy- EzCareClinic

Negative Consequences of Andropause

There are multiple negative consequences of andropause and they can all lead to a decreased sense of self-esteem and enjoyment in life.

Decreased bone density: A decrease in testosterone as well as estrogen leads to a decrease in bone density. This bone-thinning can lead to serious conditions such as osteoporosis. Osteoporosis causes bones to become brittle which can lead to fractures. Serious fractures such as hip fractures can lead to a rapid decline in health and even death. Over a third of men who have Osteoporosis and experience a hip fracture, as a result, die within a year of that hip fracture.

Mood swings and depression: Irritable Male Syndrome (IMS) is a condition caused by decreased levels of testosterone. This can cause men to feel depressed, irritable, highly expressive, anxious, angry, frustrated, and defensive.

Decreased energy: Some of the mood swings and irritableness experienced by men suffering from andropause could be because of decreased energy. Decreased energy and increased fatigue can cause men to feel depression, night sweats, and insomnia, weight gain and heart disease.

Decreased libido and erectile dysfunction: An extreme decrease in an interest in sex and even erectile dysfunction can be a result of andropause. Suffering from these over an extended period of time can lead to a decrease in self-esteem and issues in personal relationships.

In addition to using testosterone replacement therapy to help with these negative consequences listed above, a change in diet, physical exercise and lifestyle can also aid in the relief of these symptoms.

Benefits of Testosterone Replacement Therapy in San Francisco

All of the negative consequences of andropause can be fixed with testosterone replacement therapy. Some of the benefits of testosterone replacement therapy include but are not limited to:

  • Increase bone mass
  • Increase lean muscle
  • Helps to eliminate cellulite
  • Helps to build muscle and burn fat
  • Boosts libido and sperm production
  • Can improve your mental state; concentration, memory, and focus
  • Can lower bad cholesterol levels
  • Improves red blood cell count
  • Improves energy
  • Increases self-esteem and confidence
  • Allows you to get back to enjoying life

How Testosterone Replacement Therapy Works

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There are a variety of ways in which men can take testosterone replacement therapy. Testosterone supplements can come in the form of a gel, tablet, mouth patch, injections, implants and more.

Here’s a more in-depth review of some of the ways in which testosterone can be delivered through the body:

Gel Delivery – Testosterone in the form of gel is a simple yet effective way to get this hormone in your body. You simply apply the gel to the upper and lower parts of your body and the gel releases the hormone in your body over the course of 24 hours. This method of delivery can be repeated for as long as you need it to. It usually takes about 4 months of continuous use before the gel is able to raise your testosterone levels to the amount needed to feel normal.

Mouth Patch – The mouth patch sticks to your gums and delivers a dose of testosterone through your mucous membranes in your mouth. This type of patch provides testosterone over the course of a 12-hour period after which, it will have to be replaced. This type of testosterone therapy takes about 12 weeks before testosterone levels are considered normal again. This type of therapy can also be repeated for as long as you need it.

Injections – With injections, your doctor will inject testosterone into your muscle tissues every 2-4 weeks. Through this type of transmission, testosterone is slowly released into your bloodstream and maintains a steady level of testosterone in your body until your next injection.

Implants – Implants, just like injections are used for slow and continuous releases of testosterone into the bloodstream. Unlike injections, implants are injected into the soft tissue every four to six months.

Transdermal Delivery – Transdermal delivery is a patch that you put on your skin; usually on your thigh or upper body. The patch is to be replaced daily. This type of transmission delivers testosterone over the course of 24 hours and patients can achieve a normal level of testosterone in as little as 27 days.

As you can see there are multiple reasons why you should consider testosterone replacement therapy if you are suffering from low testosterone levels. In addition to feeling vibrant once again, there are also multitudes of ways in which you can take testosterone making therapy a discreet and painless solution.

If you are unsure of your testosterone levels or if you just want to see how testosterone therapy can help you, come by our walk-in clinic in San Francisco and speak with one of our qualified professionals.

In addition to hormone replacement therapy, we also provide comprehensive health services such as weight loss programs, exercise programs, smoking cessation programs and mental health services. We can help custom tailor a plan just for you! Contact HRT Clinic today.


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