Straight, No Chaser: The Treatment of Erectile Dysfunction

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Well, here’s what many of you’ve been awaiting.  Assuming the preventative efforts I mentioned didn’t work for you, there are several different treatment approaches. If there’s an underlying medical cause, then treatment of that cause is not only a good way to relieve erectile dysfunction (ED), but it’s a good way to get healthy and avoid other complications from the primary disease. Today, I’ll review different treatment strategies your primary care physician or urologist may discuss or recommend to you for treatment.

The medications

A first consideration is to be wary of (any) medications via mail order. The same level of testing, scrutiny and quality control just doesn’t exist to the same degree as do medications obtained through a pharmacy. Reports abound of people receiving expired or weak formulations of the pills, as well as fake or hazardous substitutes of the pills they thought they were receiving. Engage at your own risk.

Now, regarding those medications you know all too well by name and brand (e.g. Levitra, Cialis and Viagra), there’s no special ‘magic’ to them. They all are variations of the same theme, physiologically relaxing muscles in the penis, resulting in increased blood flow to it.  Unfortunately, that’s not the entire story with these medications.  ED medications all lower blood pressure throughout the body, and that increased blood to the penis is coming at the expense of decreased blood flow elsewhere (This is called a ‘steal syndrome’.).  If you’re otherwise unhealthy, and your redirecting blood that was needed in the heart or brain, you could end up with a heart attack or stroke while taking these meds.  Therefore, this leads to two very important cautions regarding ED meds.  You shouldn’t start them without discussing with a physician first (to determine “…if you’re healthy enough to have sex”, as the commercials say), and secondly, don’t keep the fact that you’re taking them a secret (to your significant other, and especially to any physician you come across if you’re sick).  These medications could be the cause of whatever medical issue has you in an emergency room. They could also be contributors to life-threatening adverse effects if you’re being treated for something else with a medication that interacts with the ED med you’re taking but didn’t bother to mention to the emergency physician.  This is why ED medications generally aren’t given to men also on medications for high blood pressure, an enlarged prostate, blood thinners or certain other heart diseases (e.g. angina).

There are actually even more intricate medications used to treat ED.  Taking testosterone injections is an increasing means of addressing low hormone levels.  Additional injections directly into the penis or inserting a suppository into the penis itself are additional, effective treatment methods.  You’d be given these options by your urologist if necessary.

The counseling

If your ED is due  to anxiety, stress or other psychologically generated reasons, psychotherapy (possibly with your partner) may be of incredible assistance.  If you pursue this option, you and your partner must be prepared to be patient and to work through a variety of issues and possible approaches.

Surgery and additional methods

  • If you’ve ever seen an Austin Powers movie, you’re familiar with (well at least the jokes about) penis pumps.  These are real things, and involve placing a hollow tube over the penis and creating a vacuum to pull blood to the penis via a pump.  A tension ring is placed about the base of the penis to maintain the erection during intercourse.
  • Actual vascular surgery to repair damaged arteries may be indicated in certain cases.
  • Penile implants are an additional option.  Inflatable rods are placed into the sides of the penis.  These rods are simply inflated when needed.

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If you think some of this is a bit much, it may or may not be, depending on if you’re the one suffering.  As I usually conclude, prevention would have been a much better course of action.  Hopefully if that’s not the case, you’ve understood the information provided well enough to have an informed conversation with your physician.  Good luck, and I welcome your comments and/or questions.

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