Erectile Dysfunction

TREATMENT

The first thing your doctor will do is to make sure you’re getting the right treatment for any health conditions that could be causing or worsening your erectile dysfunction.

Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. Your doctor can explain the risks and benefits of each treatment and will consider your preferences. Your partner’s preferences also might play a role in your treatment choices.

Your doctor will consider your particular situation to determine which treatment might work best. These medications might not fix your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you.

Oral medications are a successful erectile dysfunction treatment for many men. They include:

  • Sildenafil (Viagra)
  • Tadalafil (Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Avanafil (Stendra)

All four medications enhance the effects of nitric oxide — a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.

Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing men to function normally. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in men who get normal erections.

The medications vary in dosage, how long they work and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset.

Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, discuss them with you doctor here at MHI.

Medications for erectile dysfunction might not work or may be dangerous if you:

  • take nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin (Minitran, Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Dilatrate-SR, Isordil)
  • have very low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension)
  • have severe liver disease
  • have kidney disease that requires dialysis

Other medications for erectile dysfunction include:

  • Penile self-injection. With this method, you use a fine needle to inject medication (Caverject Impulse, Edex, TriMix) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include Papaverine, Alprostadil and Phentolamine.

Each injection generally produces an erection that lasts about an hour. Because the needle used is very, very fine, pain from the injection site is usually minor. Side effects can include bleeding from the injection, prolonged erection (priapism) and formation of fibrous tissue at the injection site.

  • Testosterone replacement. Some men have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In the case of documented low testosterone, testosterone replacement therapy might be recommended as the first step.

Other treatments included external and internal penile pumps, penile implants and blood vessel surgery. If discussion is indicated for these treatments, information is available on our website and through your doctor.

A New Therapy

There is also a new research validated technique offered at the Men’s Health Institute using Low Intensity Shock Wave Therapy to improve the blood flow to the penis for men with erectile dysfunction. Speak with your doctors about all of these options.