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The physical examination can reveal clues for physical causes of erectile dysfunction. For example, if the penis does not respond as expected to touching, a problem in the nervous system may be the cause. Small testicles, lack of facial hair, and enlarged breasts (gynecomastia) can point to hormonal problems such as hypogonadism with low testosterone levels. A reduced flow of blood as a result of atherosclerosis can sometimes be diagnosed by finding diminished arterial pulses in the legs or listening with a stethoscope for bruits (the sound of blood flowing through narrowed arteries). Unusual characteristics of the penis itself could suggest the root of the erectile dysfunction, for example, bending of the penis with painful erection could be the result of Peyronie's disease. Particular attention is paid to any underlying risk factors for erectile dysfunction. Erectile dysfunction, heart disease and other vascular diseases: Although ED can be caused by various conditions, about 7 in 10 cases are due to narrowing of the small arteries in the penis. This causes reduced blood flow to the penis. This is the same problem that can occur in other blood vessels. For example, narrowing of the blood vessels in the heart (the coronary arteries) is a cause of angina and other heart problems. Narrowing of blood vessels to the brain is a risk factor for having a stroke. Narrowing of blood vessels in the legs can cause peripheral vascular disease. viagra purchase online
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buy cialis online Can Sexual Problems Be Prevented? While sexual problems cannot be prevented, dealing with the underlying causes of the dysfunction can help you better understand and cope with the problem when it occurs. There are some things you can do to help maintain good sexual function: Follow your doctor's treatment plan for any medical/health conditions. Limit your alcohol intake. Quit smoking. Deal with any emotional or psychological issues such as stress, depression, and anxiety. Get treatment as needed. Increase communication with your partner.