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This review provides a practical, evidence-based guide to the evaluation and management of FSD that is adaptable for clinical practice in Canada. For the purpose of this review, the classification of FSD have been divided into four broad categories: sexual pain, low desire, low arousal, and orgasmic dysfunction.
One trial discussed the effect of 2400 mg of maca for 12 weeks on men with erectile dysfunction using the IIEF-5 score and reported that patients treated with both maca and a placebo observed an increase in erectile function at the end of the treatment period.
Several cardiovascular diseases have been linked with FSD including atherosclerosis, peripheral arterial disease and hypertension, all of which are also pathological conditions associated with aging and erectile dysfunction in men.
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Any alteration in the neuronal pathways coursing from the cerebral cortex, limbic system, and spinal cord to the peripheral nerves may result in erectile dysfunction. Nitric oxide is a key mediator of vasodilation for erections, and the RhoA calcium sensitization pathway is paramount for maintaining flaccidity.