Do you recommend a medical specialist, such as a urologist, an endocrinologist, a psychiatrist, or a sex therapist? Why or why not? The type of birth control you choose depends on your needs. Some people only need to prevent pregnancy. Other people may also want to protect themselves or their partners from diseases that can be passed by having sex. These diseases are called sexually transmitted infections (STIs). Some STIs include acquired immunodeficiency syndrome (AIDS), chlamydia, human papillomavirus (HPV), herpes, genital warts and syphilis. Numerous factors can disrupt the normal physiologic mechanisms involved in erection (Table 1). Most cases of erectile dysfunction were thought to be psychologically based, but it is now understood that most have an organic cause, especially in older patients. In about 40% of men over 50 years old, the primary cause of erectile dysfunction is related to atherosclerotic disease.20 In this respect, risk factors are similar to those of cardiovascular disease. However, erectile dysfunction may also be related to psychological, neurological, hormonal, pharmacological and end-organ (penile) factors. Fast Delivery Viagra canadian pharmacy viagra for sale In fact, many medications have ED as a side effect, but “hypertensive drugs are classically the worst,” says Nehra. However, he emphasizes, you don’t have to endure this side effect. Talk to your urologist about medications that will counter ED without affecting your blood pressure meds.