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Diabetes mellitus: Erectile dysfunction tends to develop 10-15 years earlier in diabetic men than among nondiabetic men. In a population study of men with type I diabetes for more than 10 years, erectile dysfunction was reported by 55% of men 50-60 years of age. The increased risk of erectile dysfunction among men with diabetes mellitus may be due to the earlier onset and greater severity of atherosclerosis that narrows the arteries and thereby reduces the delivery of blood to the penis. When insufficient blood is delivered to the penis, it is not possible to achieve an erection. Diabetes mellitus also causes erectile dysfunction by damaging both sensory and autonomic nerves, a condition called diabetic neuropathy. Smoking cigarettes, obesity, poor control of blood glucose levels, and having diabetes mellitus for a long time further increase the risk of erectile dysfunction in diabetes. In addition to atherosclerosis and/or neuropathy causing ED in diabetes, many men with diabetes also develop a myopathy (muscle disease) as their cause of ED in which the compliance of the muscles in the corpora cavernosa is decreased, and clinically this presents as an inability to maintain the erection. here you can buy viagra buy viagra Cardiovascular diseases: The most common cause of cardiovascular diseases in the United States is atherosclerosis, the narrowing and hardening of arteries that reduces blood flow. Atherosclerosis typically affects arteries throughout the body and is aggravated by hypertension, high blood cholesterol levels, cigarette smoking, and diabetes mellitus. When coronary arteries (arteries that supply blood to the heart muscle) are narrowed by atherosclerosis, heart attacks and angina occur. When cerebral arteries (arteries that supply blood to the brain) are narrowed by atherosclerosis, strokes occur. Similarly, when arteries to the penis and the pelvic organs are narrowed by atherosclerosis, insufficient blood is delivered to the penis to achieve an erection. There is a close correlation between the severity of atherosclerosis in the coronary arteries and erectile dysfunction. For example, men with more severe coronary artery atherosclerosis also tend to have more erectile dysfunction than men with mild or no coronary artery atherosclerosis. Some doctors suggest that men with new onset erectile dysfunction should be evaluated for silent coronary artery diseases (advanced coronary artery atherosclerosis that has not yet caused angina or heart attacks). cialis drugstore cialis online Online a drugstore - you can always buy viagra from us buy viagra What Should I Do If I Am Having Problems Achieving/Maintaining an Erection? If you suspect you may have erectile dysfunction, see your doctor. He or she can perform a variety of tests to identify what is causing your problem and refer you to a specialist if needed. Once the cause is identified, there are several treatments to consider. 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.[33] 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.[34][better source needed][35][better source needed]