Your prescriber will determine the right approach for your goals
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NICE-aligned management typically involves: Addressing modifiable risk factors (smoking cessation, weight loss, increased physical activity, alcohol reduction) Optimising management of underlying conditions (diabetes, hypertension, depression) Trial of PDE5 inhibitor therapy Referral to specialist services (urology/andrology) if first-line treatments fail or where structural/neurological/endocrine causes are suspected Consideration of psychosexual therapy where appropriate Men should be reassured that ED is a medical condition with effective treatments, and seeking help through proper channels ensures safety, appropriate investigation of underlying causes, and access to evidence-based therapies
By I/M use only
This is why everyone is talking about QWO (a.k.a
Low serum vitamin B12 concentrations in people using metformin are associated with hyperhomocysteinemia [48], a higher incidence of neuropathy [49,50], and worse neuropathy scores [51]
