Erectile Dysfunction (ED, Impotence) (cont.)

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What is the treatment for erectile dysfunction?

The treatment of erectile dysfunction depends upon the underlying cause and will be individualized by the health care professional for each patient.

If the underlying problem causing erectile dysfunction is due to low testosterone levels in the body, androgen (male hormone) replacement therapy may be indicated. These medications can be injected into a muscle, applied as a gel on the skin, or provided by a transdermal patch. Testosterone preparations taken by mouth tend not to work.

There is often a stepwise approach to treatment beginning with medications by mouth. Phosphodiesterase inhibitor medications include sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis), and avanafil (Stendra).

These medications are very effective at helping with erectile dysfunction. Your doctor will need to review your medical history and other medications you are taking to make sure they are appropriate for you.

Should these medications fail, penile injections with prostaglandins or the use of a pellet placed inside the urethra of the penis may be considered with or without the above mentioned medications by mouth.

Other therapies are available:

  • Vacuum devices are used to draw blood into the penis. Then, a constricting ring placed at the base of the penis prevents the backflow of blood.
  • Two surgery options are available. The first involves the placement of semirigid rods into the penis. These bendable rods allow for placement of the penis into a position appropriate for intercourse. The second implant is an inflatable device that helps control penis size and rigidity.
  • Because erectile dysfunction is relatively common and because many patients show a reluctance to have frank discussions with their health care professional, many over-the-counter medications, vitamins, supplements, and alternative therapies have been marketed directly to the consumer.
    • Flaxseed, arginine, zinc, vitamin C, vitamin E, and bioflavonoids are just some of the herbal medications recommended for erectile dysfunction. None are FDA approved nor are there medical studies demonstrating their effectiveness.
    • DHEA may be effective for erectile dysfunction but it is not recommended for patients whose erectile dysfunction is associated with diabetes or other nerve disorders. Its safety for human use is not certain. Herbal remedies that suggest they increase testosterone levels in the body have not yet been proven to be effective.
    • Acupuncture may be an alternative therapy that has been shown to benefit patients with erectile dysfunction.
Medically Reviewed by a Doctor on 4/3/2014

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