Erectile Dysfunction (ED, Impotence)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Can over-the-counter (OTC) and/or natural or home remedies treat erectile dysfunction?

The U.S. FDA (Food and Drug Administration) has a list of 29 OTC products that claim to treat erectile dysfunction. These are recommended to be avoided because many contain harmful ingredients. Other natural or herbal remedies such as DHEA, L-arginine, ginseng, and yohimbe are supplements that have been used but have not been proven to be safe and effective according to some researchers. Before using such compounds, individuals should consult their doctor. Acupuncture, according to some experts, has not been definitively shown to effectively treat erectile dysfunction. Other "home remedies" for reducing ED symptoms include diet changes such as eating blueberries and citrus fruits and drinking red wine.

Is it possible to prevent erectile dysfunction?

Prevention of some of the causes that contribute to the development of erectile dysfunction can decrease the chances of developing the problem. For example, if a person decreases their chances of developing diabetes, heart disease, and hypertension, they will decrease their chances of developing erectile dysfunction. Other things like stopping smoking, eating a healthy diet (heart-healthy with adequate vitamin intake), and exercising daily may also reduce a person's risk.

What is the prognosis for erectile dysfunction?

The prognosis for erectile dysfunction is quite variable among individuals. Some people who seek help (medical and/or psychological) can get very good outcomes, while others may have little or no improvements. For example, about 60% of men treated with appropriate medication report improvement in erectile dysfunction. Those individuals who do not seek help usually do not improve and may develop worsening symptoms. In some individuals who require surgery or other interventions, the prognosis is variable and may depend on how the individual responds to treatments.

What research is being done for erectile dysfunction?

Combination therapy for the treatment of erectile dysfunction has been under investigation. Most of these studies have been small trials, and long-term data regarding their effectiveness and safety are lacking. However, with thorough evaluation and counseling, there may be a use for combination therapy for certain individuals with ED.

Melanocortin receptor agonists are a new set of medications being developed in the field of erectile dysfunction. Their action is on the nervous system rather than the vascular system. PT-141 is a nasal preparation which appears to be effective alone or in combination with PDE5 inhibitors. The main side effects include flushing and nausea. These drugs are currently not approved for commercial use.

REFERENCES:

Diamond, L.E., et al. "Co-administration of Low Doses of Intranasal PT-141, a Melanocortin Receptor Agonist, and Sildenafil to Men with Erectile Dysfunction Results in an Enhanced Erectile Response." Urology 65 (2005): 755.

Ellsworth, P. and E. M. Kirshenbaum. "Current Concepts in the Evaluation and Management of Erectile Dysfunction." eMedicine.com. Nov. 26, 2008.

Kim, E.D. "Erectile Dysfunction Treatment & Management." Medscape. 12 Oct 2015.

United States Food and Drug Administration. "Hidden Risks of Erectile Dysfunction "Treatments" Sold Online." Mar. 23, 2015.

Medically Reviewed by a Doctor on 2/25/2016

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