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PSA levels: PSA (prostate specific antigen) blood levels and prostate examination to exclude prostate cancer is important before starting testosterone treatment since testosterone can aggravate prostate cancer. best place to buy generic viagra online buy viagra online no prescription
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Treating an underlying cause - For example, treating depression, anxiety, changing medication, cutting back on drinking lots of alcohol, or treating certain hormonal conditions may cure the associated ED. What Is Inhibited Sexual Desire? Inhibited desire, or loss of libido, refers to a decrease in desire for, or interest in sexual activity. Reduced libido can result from physical or psychological factors. It has been associated with low levels of the hormone testosterone. It also may be caused by psychological problems, such as anxiety and depression; medical illnesses, such as diabetes and high blood pressure; certain medications, including some antidepressants; and relationship difficulties. Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but often can be helped. Notably in psychological impotence, there is a strong response to placebo treatment. Erectile dysfunction, tied closely as it is about ideas of physical well being, can have severe psychological consequences. Modern drug therapy for ED made a significant advance in 1983, when British physiologist Giles Brindley, Ph.D. dropped his trousers and demonstrated to a shocked Urodynamics Society audience his papaverine-induced erection. The drug Brindley injected into his penis was a non-specific vasodilator, an alpha-blocking agent, and the mechanism of action was clearly corporal smooth muscle relaxation. The effect that Brindley discovered established the fundamentals for the later development of specific, safe, orally effective drug therapies.[better source needed][better source needed] viagra online singapore buy viagra
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Prostaglandin E1 injection test is sometimes performed to determine the penile blood flow. Prostaglandin is directly injected into the corpora cavernosa in order to cause dilation of blood vessels and promote blood flow into the penis. If erection ensues, it confirms normal or adequate blood flow to the penis. This can also provide information about possible therapeutic options.