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Some studies have shown that male circumcision may result in an increased risk of impotence,[13][14] while others have found no such effect,[15][16][17] and another found the opposite.[18] Ninety-three percent of men with both erectile dysfunction and coronary artery disease reported symptoms of erectile dysfunction one to three years before experiencing angina, with two years the average time. "It is essential that healthcare clinicians get that message across." In a few cases there is a vascular problem which can be treated surgically. To get the most benefit, you should exercise at least 20 to 30 minutes, preferably on most days of the week. Current studies suggest that at least five times a week is best. If you are a beginner, exercise for a few minutes each day and build up to 30 minutes. Originally, alprostadil was used to treat neonates with congenital heart defects. In order to treat this condition, alprostadil has to be directly injected into the heart region. 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