Inflatable penile prostheses are implanted during outpatient surgery. Once they are part of a man’s body, they enable him to have an erection whenever he desires. The use of a prosthesis preserves penile sensation, orgasm and ejaculation for most men.
The most commonly used penile implant consists of a pair of inflatable cylinders that are surgically implanted in the erection chambers of the penis. The cylinders are connected through tubing to a reservoir of fluid under the lower abdominal muscles, and to a pump inside the scrotal sac.
To inflate the penile prosthesis, the man compresses the pump a number of times to transfer fluid from the reservoir to the cylinders. This causes the penis to become erect. When inflated, the prosthesis makes the penis stiff and thick, which is very similar to a natural erection.
A penile prosthesis does not change the sensation on the skin of the penis or a man’s ability to achieve orgasm or ejaculate. Pressing on a deflation valve attached to the pump returns the fluid to the reservoir, which returns the penis to a flaccid state.
The surgical procedure is performed through one or two small incisions that are generally well hidden. Other people will be unable to tell that a man has an inflatable penile prosthesis. Complications following surgery are not common, but primarily include infection and mechanical device failure.
Approximately 95% of penile implant surgeries are successful in producing erections that enable men to have sexual intercourse. Moreover, patient satisfaction questionnaires show that up to 90% of men who have undergone penile implants say they would choose the surgery again, and overall satisfaction ratings are higher than those reported by men using oral medication or penile injection therapy.
Each type has its own pros and cons. Discuss your options with your doctor to determine the best treatment for you.
The first step to treating ED is to find the underlying cause. Then the appropriate treatment can begin. There are a number of non-surgical and surgical options that can help a man regain normal sexual function.
What are the differences between erectile dysfunction drugs? About half of men ages 40 to 70 have erectile dysfunction (ED) to some degree, although only one in 10 report a complete inability to have erections. Taking an ED drug produces an erection sufficient to start intercourse in about 70% of otherwise healthy men.
Does it make any difference which of the four drugs for erectile dysfunction you take? “Yes, there can be differences,” says Dr. Louis Liou, chief of urology at Harvard-affiliated Cambridge Health Alliance in Boston. “For new patients, I have them try different ones to see what works best.”
Sildenafil (Viagra) is often the first drug your doctor offers. It’s been on the market longest and its side effects and the medications and foods it interacts with are well known.
But the main challenge to finding the best ED drug for you may turn out to be health insurance rules—not biochemistry. It’s a common practice among insurers to limit the number of pills you can obtain per month. After you hit your limit, the out-of-pocket cost for a single pill can be very high. “The main obstacle in my practice is the cost,” Dr. Liou says. You’ll need to work with your doctor to get the pill you need at a price you can afford.
What erectile dysfunction pills are available?
In addition to Viagra, other ED drugs available in the United States include avanafil (Stendra), tadalafil (Cialis) and vardenafil (Levitra). These all improve blood supply to the penis. In combination with sexual stimulation, the drugs can produce an erection sufficient to initiate and complete intercourse.
There is also a fast-dissolving form of Levitra, called Staxyn, that you put under your tongue.
Viagra
Cialis
Levitra
One ED drug, Cialis, is FDA-approved for use daily in a dose of 2.5 or 5 milligrams. This helps to produce erections on demand and may also help relieve urinary problems, like difficulty starting urination, that result from an enlarged prostate.
How well do ED pills work?
ED drugs produce an erection sufficient for intercourse in about 70% of men. But the results vary quite a bit from one individual to another. A man with nerves or arteries damaged by prostate surgery, diabetes, or cardiovascular disease will not respond as strongly to ED drugs. “There are some men in whom none of these drugs work,” Dr. Liou says.
How quickly do ED pills work?
How soon the drugs start working ranges from 15 to 60 minutes. Neither Viagra nor Levitra will work if you take them after a meal, which blocks their absorption. However, neither Cialis nor Stendra interact with food this way. The onset time determines how soon you can engage in intercourse. Stendra and daily-use Cialis are closest to being an “on demand” erectile drug; using the others requires more planning.
How to use ED pills properly
Dr. Liou says that some men come to him after getting a prescription from their primary care doctors, claiming that the drug doesn’t work. Sometimes it’s because they used it incorrectly. “The biggest misconception is that these drugs are an on/off switch for erections,” Dr. Liou says. But the drugs don’t work well without sexual stimulation. “During that time, you need to be with your partner and have foreplay,” Dr. Liou says. “Don’t take it, do the taxes or the dishes, and then meet at the bedroom thinking you’ll be ready to go. It’s not like that.”
How long do ED pills last?
The ED drugs break down at different rates in the body. The durations of action range from four hours to more than a day (for Cialis in the higher doses). Each dose should be sufficient to provide a full cycle of intercourse, from erection to climax.
“Will it last through another cycle? It’s not guaranteed,” Dr. Liou says. To have sex more than once a day, Cialis is your best bet.
What are the side effects of ED pills?
The most common side effects of ED drugs, in order of most to least common are headache, flushing, upset stomach, nasal congestion, vision problems, diarrhea, dizziness, and rash. A man who has an erection that lasts four hours or more needs to get to a hospital or risk permanent damage.
None of the ED drugs is safe to take with cardiac drugs called nitrates because it could cause a dangerous drop in blood pressure. Drugs that many men take for urinary symptoms, called alpha blockers, can also lower blood pressure, so take them at least four hours apart from ED drugs. Your doctor may start you on a smaller dose of the ED drug if you already take an alpha blocker or may recommend the alpha blocker tamsulosin (Flomax), which affects blood pressure less.
Heart health and erectile dysfunction
ED is often an early warning sign of underlying cardiovascular disease, such as clogged arteries (atherosclerosis). “It can predate a diagnosis of cardiovascular disease by at least a few years,” Dr. Liou says. We don’t have strong proof yet that starting to live a healthier lifestyle can reverse erectile problems, but it can’t hurt.
ED drugs: How soon they start working and how long they last
The malady formerly known as impotence, erectile dysfunction (ED) is the inability to get or maintain an erection sufficient for satisfying sex. That might include erections that don’t last as long as you want or aren’t as firm as you’d like. ED is very prevalent among American men: Experts estimate that more than 30 million American men have experienced these kinds of erection issues (Nunes, 2012).
What Is the Erectile dysfunction Medications ?
Erectile dysfunction (ED), also called impotence, can affect your quality of life by decreasing your satisfaction from sex. ED can have many causes, both psychological and physical. ED from physical causes is fairly common in men as they age. Medications are available that can help treat ED for many men.
The most well-known ED medications include:
tadalafil (Cialis)
sildenafil (Viagra)
vardenafil (Levitra)
avanafil (Stendra)
These prescription drugs increase the levels of nitric oxide in your blood. Nitric oxide is a vasodilator, meaning it makes your blood vessels widen to help increase the blood flow. These drugs are especially effective at widening the blood vessels in your penis. More blood in your penis makes it much easier for you to get and maintain an erection when you are sexually aroused.
However, these drugs can also cause side some effects. Here are seven of the most common side effects from ED medications.
Headaches
Headaches are the most common side effect associated with ED medications. The sudden change in blood flow from the increased levels of nitric oxide causes the headaches.
This side effect is common with all forms of ED medications, so switching brands won’t necessarily alleviate your symptoms. If you have headaches from your ED drug, talk to your doctor about how to prevent them.
Body aches and pains
Some people have muscle aches and pains throughout their bodies while taking ED medications. Others have reported specific pain in their lower back. If you have these types of pain while taking ED medication, over-the-counter (OTC) pain medication may help.
However, you should talk to your doctor about other possible causes of your pain. Your doctor can help you choose an OTC medication that is safe to take with your ED medications and with any other medications you take.
Digestive system problems
Your ED medication may cause uncomfortable digestive system side effects. The most common are indigestion and diarrhea.
To help relieve minor problems, consider making dietary changes to reduce upset stomach. Drinking water instead of caffeinated beverages, alcohol, or juice may help. If changing your diet doesn’t work, talk to your doctor about OTC remedies that may help.
Dizziness
An increase in nitric oxide can cause some men to become dizzy. The dizziness caused by ED medications is generally mild. However, any dizziness can cause discomfort during everyday activities.
In rare cases, dizziness from ED medications has led to fainting, which can become a serious health issue. You should tell your doctor if you experience dizziness while taking ED medications. If you faint while taking these medications, see your doctor right away.
Vision changes
ED medications can change the way you see things — literally. They can temporarily alter your eyesight and even cause blurry vision. ED medications aren’t recommended if you have had vision loss, or a retinal disorder called retinitis pigmentosa.
A complete loss of vision or changes that don’t go away can signify a more serious issue with your ED medication. Seek emergency medical care if you experience these symptoms.
Flushes
Flushes are temporary periods of redness of the skin. Flushes usually develop on your face and may also spread to parts of your body. Flushes can be mild, like blotchy skin, or severe, like rashes. Although the appearance may make you uncomfortable, flushes typically aren’t harmful.
Flushes from ED medications may get worse when you:
eat hot or spicy foods
drink alcohol
are outside in warm temperatures
Congestion and runny nose
Congestion or a runny or stuffy nose can be a common symptom of ED medications. In most cases, these side effects go away without treatment. Talk to your doctor if they persist.
Recognizing uncommon, severe side effects
Minor side effects are common when taking ED medication. Still, there are a few side effects that aren’t as common, and some can even be dangerous. Severe side effects of ED medications can include:
priapism (erections that last longer than 4 hours)
sudden changes in hearing
vision loss
Contact your doctor immediately if you have any of these severe side effects.
Certain men are more at risk of these side effects than others. This may be because of other conditions they have or other medications they take.
Serious side effects of ED medication
Go to the emergency room immediately if you experience any of the following symptoms or side effects:
Chest pain
Shortness of breath
Severe headaches
Fainting
Erections that last longer than four hours
Visual changes (like loss of sight)
Or anything out of the ordinary—even lightheadedness
If you notice any severe or prolonged symptoms at all, contact a healthcare provider immediately. It doesn’t matter how rare a side effect is if you’re the one experiencing it.
When discussing ED treatment with your doctor, it’s important to tell them about all drugs that you take and other health conditions you have. If ED drugs aren’t right for you, your doctor may suggest other treatment options, such as surgery or vacuum pumps.
Erectile dysfunction (ED) is the inability to get and keep an erection firm enough for sexual intercourse. Estimates suggest that one of every 10 men will suffer from ED at some point during his lifetime. It is important to understand that in most cases, ED is a symptom of another, underlying problem. ED is not considered normal at any age, and may be associated with other problems that interfere with sexual intercourse, such as lack of desire and problems with orgasm and ejaculation.
How common is erectile dysfunction?
Approximately one in 10 adult males will suffer from ED on a long-term basis.
Many men do experience occasional failure to achieve erection, which can occur for a variety of reasons, such as drinking too much alcohol, stress, relationship problems, or from being extremely tired.
The failure to get an erection less than 20% of the time is not unusual and typically does not require treatment. However, the failure to achieve an erection more than 50% of the time generally means that there is a problem and treatment is needed.
ED does not have to be a part of getting older. While it is true that some older men may need more stimulation, they should still be able to achieve an erection and enjoy intercourse.
Erectile dysfunction or ED May be Caused by following Health Conditions [1]
An erection occurs when blood flows into the corpora cavernosa (erection bodies) and gets trapped there. If the blood has problems getting to or staying in those erection bodies, you may have erectile dysfunction.
There are many potential causes for erectile dysfunction, such as these conditions/circumstances:
Vascular conditions:
High blood pressure
Elevated cholesterol
Cardiovascular disease
Diabetes
Trauma:
Spinal cord injury
Pelvis injury
Neurologic disease:
Stroke
Parkinson’s disease
Alzheimer’s disease
Radiation to the pelvis for cancer
Endocrine:
Hypogonadism (low testosterone)
Hyperprolactinemia (high prolactin levels)
Pelvis surgery:
Radical prostatectomy (a surgical procedure for the partial or complete removal of the prostate)
Surgeries for rectal cancer or bladder cancer
Medication side effects:
Antidepressants
Antihypertensives (high blood pressure medicine)
Antiandrogens (testosterone blockers)
Antiarrhythmics (heart rhythm medicine)
Alcohol
Cigarette smoking
Cocaine and marijuana
What medications could cause erectile dysfunction (ED)?
Erectile dysfunction (ED) is a common side effect of a number of prescription drugs. While these medications may treat a disease or condition, in doing so they can affect a man’s hormones, nerves or blood circulation, resulting in ED or increasing the risk of ED.
If you experience ED and think that it may be a result of the medication you are using, do not stop taking the medication. If the problem persists, contact your doctor and he or she may be able to prescribe a different medication. Common medications that may list ED as a potential side effect include:
Diuretics (pills that cause increase urine flow).
Antihypertensives (high blood pressure drugs).
Antihistamines.
Antidepressants.
Parkinson’s disease drugs.
Antiarrhythmics (drug for irregular heart action).
Tranquilizers.
Muscle relaxants.
Nonsteroidal anti-inflammatory drugs.
Histamine H2-receptor antagonists.
Hormones.
Chemotherapy medications.
Prostate cancer drugs.
Anti-seizure medications.
Other substances or drugs that can cause or lead to ED include these recreational and frequently abused drugs:
Alcohol.
Amphetamines.
Barbiturates.
Cocaine.
Marijuana.
Methadone.
Nicotine.
Opiates.
These drugs not only affect and often suppress the central nervous system, but can also cause serious damage to the blood vessels, leading to permanent ED.
Diabetes & ED
Half of men with diabetes will experience ED within 10 years of their diagnosis. High blood sugar levels can damage the nerves that control sexual stimulation. They can also damage the blood vessels needed to provide adequate blood flow to the penis in order to have and maintain an erection.
While oral medications are a common first step for therapy, they only tend to work in about 50 percent of men with diabetes. Diabetic men are more likely to move on to other treatment options, such as the pump, penile injection therapy, and penile implants. However, the penile implant has the highest satisfaction rate of all treatment options.
ED & Heart Disease
Erectile dysfunction can be a warning sign of current or future heart disease sometimes. In fact, ED can precede coronary artery disease in almost 70 percent of cases.
When you have heart disease, or coronary artery disease (blocked blood vessels), it will affect the tiny arteries in your penis sooner. Many times, we will refer you to a cardiologist to determine if you have cardiovascular disease that is causing your ED.
Improving your heart health can help lower your risk for ED. You can start by:
increasing physical activity,
quitting tobacco products,
losing weight, and
consuming a healthy, well-balanced diet.
Prostate Cancer & ED
Erectile dysfunction is a potential complication following prostate cancer treatments. The nerves that control an erection lie very close to the prostate and may be injured during treatment. However, some men may regain their previous level of erectile function with nerve-sparing procedures. But it may take up to a year while some men may never recover their ability to have a natural erection.
Radiation for prostate cancer can cause ED symptoms to appear gradually, usually within two to three years after treatment. If you are experiencing ED after undergoing prostate cancer treatment, you can get a healthy sex life back. We can help you choose the best treatment options for you.
What prescription drugs may cause erectile dysfunction?
Erectile dysfunction (ED) is a common side effect of a number of prescription drugs. While these medications may treat a disease or condition, in doing so they can affect a man’s hormones, nerves or blood circulation. The result may be ED or an increase in the risk of ED.
If you have ED and think that it may be a result of the medication you are using, do not stop taking the medication. If the problem persists, contact your doctor and he or she may be able to prescribe a different medication. Common medications that may list ED as a potential side effect include:
Diuretics (pills that cause an increase in urine flow).
Antihypertensives (medication for high blood pressure).
Antihistamines.
Antidepressants.
Parkinson’s disease drugs.
Antiarrhythmics (medication for irregular heart action).
Tranquilizers.
Muscle relaxants.
Non-steroidal anti-inflammatory drugs.
Histamine H2-receptor antagonists.
Hormones.
Chemotherapy medications.
Prostate cancer drugs.
Anti-seizure medications.
What other substances or drugs may cause erectile dysfunction?
opioids and Pain Medications
Other substances or drugs that can cause or lead to ED include these recreational and frequently abused drugs:
Alcohol.
Amphetamines.
Barbiturates.
Cocaine.
Marijuana.
Methadone.
Nicotine.
Opiates.
Aside from the well-known complications that the use and abuse of these drugs can cause, ED is not often mentioned. However, use of these drugs is a risk factor for ED. These drugs not only affect and often times slow down the central nervous system, but can also cause serious damage to the blood vessels, leading to permanent ED.
What is the connection of Erectile Dysfunction and the Heart?
Erectile dysfunction (ED) is when you are unable to get or keep an erection suitable for sexual intercourse or another chosen sexual activity. The most common cause of ED is a lack of blood supply to the penis. The lining of the blood vessels (arteries) that supply blood to the penis is called the endothelium (pronounced en- do- thee- lee- um).
This controls the speed with which blood enters the penis. If the endothelium does not work properly, blood can not enter fast enough or stay there long enough to get a firm erection that lasts sufficient time for satisfactory sexual intercourse (see our factsheet ‘Erectile dysfunction’).
With aging, particularly when combined with an unhealthy lifestyle, the arteries become narrowed and damaged by a process known as atherosclerosis, which is similar to a pipe furring up. The link between ED and disease of the coronary arteries (those that supply the heart) is that they share the same endothelium, so atherosclerosis in the penile arteries is also likely to be present in the coronary arteries.
This is why up to two-thirds of men with coronary artery disease (CAD) also have ED. The problem is that over half the men with ED may have CAD they don’t know about. Finding and treating atherosclerosis early can help stop it from getting worse, so this is important.
Atherosclerosis (narrowing) of an artery
Can ED come before CAD?
Yes! The arteries in the penis are smaller in diameter (1-2mm) than the coronary arteries (3-4mm). This means that while atherosclerosis in the coronary arteries may not currently be causing any heart problems, the same disease in the smaller penile arteries causes them to become narrowed earlier, leading to ED.
It takes longer for the bigger coronary arteries to be affected by the narrowing process, but if it is allowed to continue, a man with ED and no heart complaint may develop a heart complaint within 3-5 years of his ED starting. This is why the penis has been described as ‘the window to the hearts of man’. It means ED can help identify someone at future risk of a heart attack, giving us a chance to prevent it from occurring by lowering cholesterol and treating high blood pressure. The early detection and treatment of diabetes is also important.
What are the risk factors for ED and CAD?
They are the same. High blood pressure, raised cholesterol, cigarette smoking, obesity, diabetes, physical inactivity, low testosterone, depression and stress. So it is easy to see why ED and CAD often occur together – it is really a matter of which comes first.
What if you have ED and no sign of CAD?
It is very important to see your GP to assess your health and see if you have any of the risk factors described above. Lifestyle issues are important. Losing weight if needed, eating a healthy Mediterranean-style diet and increasing physical activity are the easiest changes to make, and these will benefit both ED and CAD (see our factsheets ‘Body Mass Index (BMI)’ and ‘The Mediterranean diet’).
By reducing your risk factors for ED and CAD, you reduce your chances of a serious health problem in the future. You may have had your ED successfully treated by tablets given to you by a friend or bought online, but getting your erection back without a check on the heart is asking for trouble.
Are Clogged Arteries To Blame For Erectile Dysfunction?
A growing body of scientific evidence supports the fact that erectile dysfunction can be caused by a clog or multiple clogs in the penile arteries. As most men know, an erection is produced when arousal causes blood flow to enter the penis through the penile arteries as they widen and allow blood to flow into the network of vessels that travel through the stomach and lead into the penis. The result is swelling which is commonly known as an erection.
But in a man with a blockage in the penile arteries, blood cannot move into the penis the way it would for an otherwise healthy man. The result would be either a partial erection or no erection at all.
The Chicken or the Egg: Clogged Arteries Cause ED
It is true that clogged arteries can cause ED but it is also equally true that clogged arteries in the penis can be a symptom of heart disease which means clogged arteries in the rest of the body. According to Harvard Health they are a warning signal of heart disease.
The path to erectile dysfunction often starts at the heart, which pumps blood through arteries to all areas of the body. Erectile dysfunction often occurs when these pathways are blocked by plaque, a condition known as atherosclerosis. So, clogged arteries can cause ED.
Cholesterol builds up on vessel walls, which causes them to narrow and slow down blood flow. If left untreated, flow can come to a screeching halt. Clogged arteries can cause ED and this condition can also cause angina, heart attacks, strokes, and claudication (pain in the legs with walking). In some cases, erectile dysfunction could be a warning sign that a heart attack or stroke may happen down the road.
Atherosclerosis and Erectile Dysfunction
Atherosclerosis is commonly defined as the hardening of the arteries responsible for pushing blood to various regions throughout the body. As healthy arteries are an essential part of daily health, individual who do develop atherosclerosis may be at a risk for a variety of potentially harmful conditions, one of which is erectile dysfunction.
Men who suffer from atherosclerosis may notice that it is increasingly difficult to develop and sustain an erection. The arousal process may take substantially longer than it has previously, and the strength and quality of an erection will most likely be noticeably reduced. Additionally, men may find that their erections subside quickly, leaving them a very little window of opportunity in which they can engage in sexual intercourse.
The presence of erectile dysfunction in a man’s life can be heartbreaking. And in the most literal sense it can mean that his physical heart is experiencing a lower level of performance.
In his research, Dr. Faysal Yafi, Director of the Men’s Health Services at the UCI Health Center for Urological Care, found that there is a connection between erectile dysfunction and heart disease.
Atherosclerosis, which can cause a penile blood clot, can develop from a variety of risk factors. These include:
Diabetes
Smoking
Alcohol abuse
High blood pressure
Certain medications (such as thiazide diuretics)
High levels of LDL cholesterol
Obesity
Low testosterone
Advanced age
Family history of the condition
How to Improve Blood Flow to the Penis
As a man interested in being at your best, you are not one to accept defeat when victory can be as close as the next move. You know that poor circulation in the penis can cause ED, but you also know that there are specific actions you can take to reduce your risk of heart disease which produces the clogs that can cause your ED. Here is a list of steps you can take to unclog penile arteries:
Quit Smoking. Smoking is on the decline but if you are one of the holdouts your smoking habit is likely not doing you any favors in the bedroom. And stopping can help reduce your risk of ED, which is what can happen when arteries in the penis constrict.
Reduce Your Blood Pressure. There are many ways to do this and the lifestyle changes in this list will help unclog penile arteries. But if you are living a stress-filled life now might be the time to take up some new hobbies that provide relaxation and connection with nature.
Communicate with Your Partner. Set aside some time every day to communicate with your partner about whatever is going on in your life. If you are feeling stress in any area of your life, being able to talk about it openly and honestly will reduce the potential negative effects of whatever may be going wrong.
Lose Weight. Your weight may not be affecting your performance now, but combined with other risk factors it may be only a matter of time; losing weight can help unclog penile arteries.
Manage Your Diabetes. Diabetes affects a lot of things in your body including your circulation. You don’t have to cure your diabetes to improve blood flow and reduce the risk of erectile dysfunction.
Improve Your Eating Habits. Focus on fresh ingredients and limit over processed and chemical laden foods. A sensible diet packed with leafy greens and multi colored vegetables, lean proteins, and healthy oils can become your best friend.
Reduce Inflammation. Inflammation of any kind can negatively impact one’s health.
Check Your Testosterone. A healthy testosterone level is key to healthy erections and many of the items on this list support healthy testosterone levels.
Move Your Body. A solid exercise regimen will improve your overall health, give you more energy and be an aide in reducing inflammation which can help unclog penile arteries.
Get Enough Sleep. Sleep is not just a time to disconnect from the world. It is the time when your body works to repair and replenish itself to set you up for success tomorrow.
What You Need To Know If Your ED Is Caused By a Clog
First, you are not alone. Over 50 percent of American men between the ages of 40 and 70 will experience mild, moderate, or severe erectile dysfunction in their lifetime. It’s pretty clear that atherosclerosis can cause erectile dysfunction. Atherosclerosis by itself accounts for 50-60 percent of ED cases in men over the age of 60. On a related note, experts estimate that 35 to 50 percent of diabetics experience ED.
Second, contrary to popular perception, ED doesn’t just affect older men. One in four men who sought help at an outpatient clinic for the condition were under the age of 40, nearly half of whom had severe symptoms. While these men in some ways appeared healthier than their older counterparts – less weight, more testosterone, fewer medications – they also smoked or used illegal drugs more regularly. Perhaps of most concern is the fact that a majority of men, regardless of age, do not seek treatment for erectile dysfunction.
Third, there is a non-invasive treatment that is ideal for clog caused ED. It’s called GAINSWave® and it offers a unique solution that can achieve impressive results. This simple in-office procedure uses low-intensity acoustic soundwaves to break up plaque and stimulate the release of growth factors, which can lead to the development of new blood vessels in the penis.
The procedure also awakens dormant stem cells and encourages blood flow, an essential component for normal erectile function. GAINSWave is an effective alternative for men who seek to address ED or simply improve their overall sexual performance.
The man who is committed to upping his game recognizes that a clog can cause ED and he takes action to unclog his penile arteries.
The Early Warning Signs
The best way to judge whether or not an individual is at risk for either atherosclerosis or endothelium damage is to observe their lifestyle habits and men who have high cholesterol, smoke regularly, have diabetes or are obese have a significantly higher risk of developing these conditions than those who do not.
Temporary Treatments
Although the development of atherosclerosis cannot be reversed, a variety of pharmaceutical products can be used to dramatically slow the progress of this condition. That being said, the most valuable tool at any man’s disposal for countering the unwanted effects of atherosclerosis is simple lifestyle adjustments. It is absolutely imperative that men engaging in high-risk behavior change their lifestyle immediately in order to ensure that they do not place themselves further in harm’s way.
As stated previously, men who believe they may be suffering from atherosclerosis are advised to discuss these problems with their doctors immediately in order to ensure the real cause of low sexual stamina so that they have the information they need to effectively combat this illness. Good luck!
Treating clogged arteries
Doctors can prescribe medicines to treat atherosclerosis. These include:
antiplatelet medication, such as aspirin or clopidogrel, to reduce blood clotting
anticoagulants, such as warfarin or heparin, to thin the blood
cholesterol-lowering medicines, such as statins
blood pressure medicines
Sometimes, a doctor needs to perform surgery for atherosclerosis. This may include balloon angioplasty or a stent to open a blocked artery. Healthcare professionals can treat angina with a coronary artery bypass. The doctor grafts a piece of a healthy vein to an area above the blockage to allow blood to flow.
Penile implants are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. Penile implants are typically recommended after other treatments for ED fail.
There are two main types of penile implants, semirigid and inflatable. Each type of penile implant works differently and has various pros and cons.
The placement of penile implants requires surgery. Before choosing penile implants, make sure you understand what surgery involves, including possible risks, complications and follow-up care.
Talk with your doctor about whether surgery is right for you. A urologist performs surgery at a surgical center or hospital to
implant a device to make the penis erect
rebuild arteries to increase blood flow to the penis
Penile Implant
Implanted devices. Implanted devices, known as prostheses, can help many men with ED have an erection. Implants are typically placed by a urologist. The two types of devices are
inflatable implants, which make your penis longer and wider using a pump in the scrotum
malleable implants, which are rods that allow you to manually adjust the position of your penis
You usually can leave the hospital the day of or day after the surgery. You should be able to use the implant 4 to 6 weeks after the surgery.
Once you have either implant, you must use the device to get an erection. Possible problems with implants include breaking and infection.
Why penile implants is done ?
For most men, erectile dysfunction can be successfully treated with medications or use of a penis pump (vacuum constriction device). You might consider penile implants if you aren’t a candidate for other treatments or you can’t get an erection sufficient for sexual activity by using other methods.
Penile implants can also be used to treat severe cases of a condition that causes scarring inside the penis, leading to curved, painful erections (Peyronie’s disease).
Penile implants aren’t for everyone. Your doctor might caution against penile implants if you have:
ED that’s situational, the result of a relationship conflict or potentially reversible
An infection, such as a pulmonary infection or urinary tract infection
Diabetes that isn’t well-controlled
Keep in mind that while penile implants allow men to get an erection, they don’t increase sexual desire or sensation. Most penile implants also won’t make your penis any larger than it naturally is at the time of surgery. In fact, your erect penis might be slightly shorter than it used to be.
Types of penile implants
There are two main types of penile implants:
Inflatable implants. Inflatable devices, the most common type of penile implant used, can be inflated to create an erection and deflated at other times. Three-piece inflatable implants use a fluid-filled reservoir implanted under the abdominal wall, a pump and a release valve placed inside the scrotum, and two inflatable cylinders inside the penis.To achieve an erection, you pump the fluid from the reservoir into the cylinders. Afterward, you release the valve inside the scrotum to drain the fluid back into the reservoir. The two-piece model works in a similar way, but the fluid reservoir is part of the pump implanted in the scrotum.
Semirigid rods. Semirigid devices are always firm. The penis can be bent away from the body for sexual activity and toward the body for concealment.A positionable penile implant is a semirigid device with a central series of segments held together with a spring on each end. It can maintain upward and downward positions better than other semirigid rods can.
Other special designs can fit a shortened penis, or one that’s larger than average. Some inflatable penile implants are also available with antibiotic coatings, which might help reduce the risk of infection.
Comparing implant types
When choosing which type of penile implant is right for you, consider your personal preference and your medical history. Your doctor might suggest one type of design over another based on your age, risk of infection, and health conditions, injuries or medical treatments you’ve had in the past.
Type of penile implant
Pros
Cons
Three-piece inflatable
Creates the most natural, rigid erection
Provides flaccidity when deflated
Has more parts that could malfunction than does any other implant
Requires a reservoir inside the abdomen
Two-piece inflatable
Provides flaccidity when deflated
Is mechanically more complicated than is a semirigid implant
Provides less firm erections than does a three-piece implant
Semirigid rod
Has a low chance of malfunction due to the small number of parts
Is easy to use for those with limited mental or manual dexterity
Results in a penis that is always slightly rigid
Puts constant pressure on the inside of the penis, which can cause injury
Can be difficult to conceal under clothing
Before penile implant surgery you might also need to:
Avoid certain medications. Your doctor might recommend that you temporarily stop taking aspirin and anti-inflammatory drugs, which can increase your risk of bleeding.
Arrange for a ride home. Ask your doctor when you’ll be able to go home after surgery. Penile implant surgery typically involves an overnight stay.
Limit food and liquids. Don’t eat or drink anything after midnight before your surgery, or follow specific instructions from your doctor.
What you can expect
Before the procedure
Penile implant surgery is usually done at a surgery center or hospital. Your doctor might give you medication to make you unconscious during the surgery (general anesthesia) or medication that blocks pain in the lower part of your body (spinal anesthesia).
Your doctor will give you IV antibiotics to help prevent infection. The surgery site will also be shaved immediately before surgery to reduce the risk of infection.
During surgery
A tube (catheter) might be inserted into your bladder via your penis to collect urine at some point during surgery. Your surgeon will make an incision below the head of the penis, at the base of the penis or in the lower abdomen.
Next, your surgeon will stretch the spongy tissue in the penis that would normally fill with blood during an erection. This tissue is inside each of the two hollow chambers called the corpora cavernosa.
Your surgeon will choose the correct size implant and place the implant cylinders inside your penis. All sizes are customized to your exact body measurements.
If your doctor is implanting a two-piece inflatable device, a pump and valve are placed inside the scrotum. For a three-piece device, your doctor will also implant a fluid reservoir under the abdominal wall through an internal incision.
Once the device is in place, your surgeon will sew the incisions closed. Penile implant surgery usually takes 45 minutes to an hour.
After surgery
After penile implant surgery, you’ll likely need to take medications to ease pain. Mild pain might persist for several weeks. You might also need to take antibiotics for one week to prevent infection.
Your doctor might recommend keeping your penis up on your lower abdomen and pointing toward your bellybutton during the healing process to prevent downward curvature.
Your doctor will provide specific instructions about when you can resume normal activities. Most men can resume strenuous physical activity and sexual activity about four to six weeks after surgery. You’ll likely need to return to your doctor to have your stitches removed in about two weeks.
At this point, your doctor might recommend fully inflating and deflating inflatable penile implants twice a day to give you practice using them and stretch the area surrounding the cylinders.
Risks of penile implants
Risks of penile implant surgery include:
Infection. As with any surgery, infection is possible. You might be at an increased risk of infection if you have a spinal cord injury or diabetes.
Implant problems. New penile implant designs are reliable, but in rare cases the implants might malfunction. Surgery is necessary to remove, repair or replace a broken implant.
Internal erosion or adhesion. In some cases, an implant might stick to the skin inside the penis or wear away the skin from inside the penis. Rarely, an implant breaks through the skin. These problems are sometimes linked to an infection.
Treating an infection
Infections after penile implant surgery typically occur in the first few weeks or possibly years later. Early infections can cause swelling of the scrotum, pus buildup and fever. Later infections might involve persistent or recurrent long-term pain.
Surgery to remove the implant is likely necessary to treat an infection. Replacing a penile implant can be complicated and can lead to a buildup of scar tissue and a decrease in penis length.
How you prepare for penile implants
Initially, you’ll talk to your doctor or a urologist about penile implants. During your visit, your doctor will likely:
Review your medical history. Be prepared to answer questions about current and past medical conditions, especially your experience with ED. Talk about any medications you’re taking or have taken recently, as well as any surgeries you’ve had.
Do a physical exam. To make sure penile implants are the best options for you, your doctor will do a physical exam, including a complete urologic exam. Your doctor will confirm the presence and nature of ED, and make sure that your ED can’t be treated in another way.He or she will also try to determine whether there’s any reason that penile implant surgery is likely to cause complications. Your doctor will also examine your ability to use your hands, since some penile implants require greater manual dexterity than others.
Discuss your expectations. Make sure you understand what the procedure involves and the type of penile implant that suits you best. It’s also important to know that the procedure is considered permanent and irreversible.Your doctor will also explain the benefits and risks, including potential complications. Ideally, you’ll include your partner in the discussion with your doctor.
Results
Although penile implants are the most invasive and least often chosen treatment for erectile dysfunction, most men and their partners report satisfaction with the devices. The 10-year device survival is between 60 and 80 percent.
Erectile dysfunction, or ED, is the most common sex problem that men report to their doctor. It affects as many as 30 million men.
ED is defined as trouble getting or keeping an erection that’s firm enough for sex.
Though it’s not rare for a man to have some problems with erections from time to time, ED that is progressive or happens routinely with sex is not normal, and it should be treated.
ED can happen:
Most often when blood flow in the penis is limited or nerves are harmed
With stress or emotional reasons
As an early warning of a more serious illness, like: atherosclerosis (hardening or blocked arteries), heart disease, high blood pressure or high blood sugar from Diabetes
Finding the cause(s) of your ED will help treat the problem and help with your overall well-being. As a rule, what’s good for your heart health is good for your sex health.
How Erections Work
During sexual arousal, nerves release chemicals that increase blood flow into the penis. Blood flows into two erection chambers in the penis, made of spongy muscle tissue (the corpus cavernosum). The corpus cavernosum chambers are not hollow.
Diagram of How Erections Work
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During erection, the spongy tissues relax and trap blood. The blood pressure in the chambers makes the penis firm, causing an erection. When a man has an orgasm, a second set of nerve signals reach the penis and cause the muscular tissues in the penis to contract and blood is released back into a man’s circulation and the erection comes down.
When you are not sexually aroused, the penis is soft and limp. Men may notice that the size of the penis varies with warmth, cold or worry; this is normal and reflects the balance of blood coming into and leaving the penis.
Updated June 2018
Symptoms
With Erectile Dysfunction (ED), it is hard to get or keep an erection that is firm enough for sex. When ED becomes a routine and bothersome problem, your primary care provider or a Urologist can help.
ED may be a major warning sign of cardiovascular disease indicating blockages are building in a man’s vascular system. Some studies have shown men with ED are at significant risk of getting a heart attack, stroke or circulatory problems in the legs. ED also causes:
Low self-esteem
Depression
Distress for the man and his partner
If ED is affecting a man’s well-being or his relationships, it should be treated. Treatment aims to fix or enhance erectile function, help circulatory health and help the quality of a man’s life.
Updated June 2018
Causes
ED can result from health problems, emotional issues, or from both. Some known risk factors are:
Being over age 50
Having high blood sugar (Diabetes)
Having high blood pressure
Having cardiovascular disease
Having high cholesterol
Smoking
Using drugs or drinking too much alcohol
Being obese
Lacking exercise
Even though ED becomes more common as men age, growing old is not always going to cause ED. Some men stay sexually functional into their 80s. ED can be an early sign of a more serious health problem. Finding and treating the reason for ED is a vital first step.
Physical Causes of ED
ED happens when:
There is not enough blood flows into the penis
Many health issues can reduce blood flow into the penis, such as hardened arteries, heart disease, high blood sugar (Diabetes) and smoking.
The penis cannot trap blood during an erection
If blood does not stay in the penis, a man cannot keep an erection. This issue can happen at any age.
Nerve signals from the brain or spinal cord do not reach the penis
Certain diseases, injury or surgery in the pelvic area can harm nerves to the penis.
Diabetes can cause small vessel disease or nerve damage to the penis
Cancer treatments near the pelvis can affect the penis’ functionality
Surgery and or radiation for cancers in the lower abdomen or pelvis can cause ED. Treating prostate, colon-rectal or bladder cancer often leaves men with ED. Cancer survivors should see a Urologist for sexual health concerns.
Drugs used to treat other health problems can negatively impact erections
Patients should talk about drug side effects with their primary care doctors.
Emotional Causes of ED
Normal sex needs the mind and body working together. Emotional or relationship problems can cause or worsen ED.
Some emotional issues that can cause ED are:
Depression
Anxiety
Relationship conflicts
Stress at home or work
Stress from social, cultural or religious conflicts
Worry about sex performance
Updated June 2018
Diagnosis
Finding the cause of your ED will help direct your treatment options.
Diagnosing ED starts with your health care provider asking questions about your heart and vascular health and your erection problem. Your provider may also give you a physical exam, order lab tests or refer you to a Urologist.
Health and ED History
Your doctor will ask you questions about your health history and lifestyle. It is of great value to share facts about drugs you take, or if you smoke or how much alcohol you drink. He/she will ask about recent stressors in your life. Speak openly with your doctor, so he/she can help you find the best choices for treatment
What Questions Will the Health Care Provider Ask?
Questions about your health:
What prescription drugs, over-the-counter drugs or supplements do you take?
Do you use recreational drugs?
Do you smoke?
How much alcohol do you drink?
Have you had surgery or radiation therapy in the pelvic area?
Do you have any urinary problems?
Do you have other health problems (treated or untreated)?
Questions About ED
Knowing about your history of ED will help your health provider learn if your problems are because of your desire for sex, erection function, ejaculation, or orgasm (climax). Some of these questions may seem private or even embarrassing. However, be assured that your doctor is a professional and your honest answers will help find the cause and best treatment for you.
Questions about your ED symptoms:
How long have you had these symptoms? Did they start slowly or all at once?
Do you wake up in the morning or during the night with an erection?
If you do have erections, how firm are they? Is penetration difficult?
Do your erections change at different times, like when going in a partner, during stimulation by mouth, or with masturbation?
Do you have problems with sex drive or arousal?
Do you have problems with ejaculation or orgasm (climax)?
How is this problem changing the way you enjoy sex?
Do you have painful with erections, feel a lump or bump in the penis or have penile curvature? These are signs of Peyronie’s Disease which can be treated but calls for an expert in urology to assess and manage.
Questions About Stress and Emotional Health
Your health care provider may ask you questions about depression or anxiety. He or she may ask about problems in your relationship with a partner. Some health care providers may also ask if they may talk to your sex partner.
Are you often under a lot of stress, or has something recently upset you?
Do you have any anxiety, depression or other mental health issues?
Are you taking any drugs for your mental health?
How satisfied are you with your sex life? Has there been any changes lately?
How is your relationship with your partner? Has there been any changes lately?
Physical Exam
A physical exam checks your total health. Examination focusing on your genitals (penis and testicles) is often done to check for ED. Based on your age and risk factors, the exam may also focus on your heart and blood system: heart, peripheral pulses and blood pressure. Based on your age and family history your doctor may do a rectal exam to check the prostate. These tests are not painful. Most patients do not need a lot of testing before starting treatment.
Lab Tests
Your health care provider may order blood tests and collect a urine sample to look for health problems that cause ED.
Other Tests
Questionnaires are often used by health experts to rate your ability to initiate and keep erections, gauge your satisfaction with sex and help identify any problems with orgasm.
Advanced Erectile Function Tests
For some men with ED, specialized testing may be needed to guide treatment or re-assess you after a treatment fails.
Blood work to check Testosterone and other male hormones
Blood work to measure blood sugar (Diabetes)
Ultrasonography (penile Doppler) to check blood flow
A shot into the penis with a vascular stimulant to cause an erection
Pelvic x-rays like arteriography, MRI or CT scanning are rarely needed to check ED unless there is history of trauma or cancer
Nocturnal penile tumescence (NPT), an overnight test to check for sleep erection
Updated June 2018
Treatment
The treatment for ED starts with taking care of your heart and vascular health. Your doctor may point out ‘risk factors’ that can be changed or improved.
You may be asked to change certain food habits, stop smoking, increase workouts or stop using drugs or alcohol. You may be offered alternatives to the drugs you take. (Never stop or change prescription drugs without first talking to your health care provider.)
Your health care provider may also suggest treating emotional problems. These could stem from relationship conflicts, life’s stressors, depression or anxiety from past problems with ED (performance anxiety).
The treatments below are available to treat ED directly.
ED Treatments
Non-invasive treatments are often tried first. Most of the best-known treatments for ED work well and are safe. Still, it helps to ask your health care provider about side effects that could result from each option:
Oral drugs or pills known as phosphodiesterase type-5 inhibitors are most often prescribed in the U.S. for ED (Viagra, Cialis, Levitra, Stendra)
Testosterone Therapy (when low testosterone is detected in blood testing)
Surgery to bypass penile artery damage for some younger men with a history of severe pelvic trauma. Penile vascular surgery is not recommended for older men with hardened arteries.
Oral Drugs (PDE5 inhibitors)
Drugs known as PDE type-5 inhibitors increase penile blood flow. These are the only oral agents approved in the U.S. by the Food and Drug Administration for the treatment of ED.
Viagra ® (sildenafil citrate)
Levitra ® (vardenafil HCl)
Cialis ® (tadalafil)
Stendra ® (avanafil)
For best results, men with ED take these pills about an hour or two before having sex. The drugs require normal nerve function to the penis. PDE5 inhibitors improve on normal erectile responses helping blood flow into the penis. Use these drugs as directed. About 7 out of 10 men do well and have better erections. Response rates are lower for Diabetics and cancer patients.
If you are taking nitrates for your heart, you SHOULD NOT take any PDE5 inhibitors. Always speak with your health care provider before using a PDE5 inhibitor to learn how it might affect your health.
Most often, the side effects of PDE5 inhibitors are mild and often last just a short time. The most common side effects are:
Headache
Stuffy nose
Facial flushing
Muscle aches
Indigestion
In rare cases, the drug Viagra ® can cause blue-green shading to vision that lasts for a short time. In rare cases, the drug Cialis ® can cause or increase back pain or aching muscles in the back. In most cases, the side effects are linked to PDE5 inhibitor effects on other tissues in the body, meaning they are working to increase blood flow to your penis and at the same time impacting other vascular tissues in your body. These are not ‘allergic reactions’.
Testosterone Therapy
In those rare cases where a low sex drive and low blood levels of Testosterone are at fault for ED, Testosterone Therapy may fix normal erections or help when combined with ED drugs (PDE type 5 inhibitors).
Vacuum Erection Device
A vacuum erection device is a plastic tube that slips over the penis, making a seal with the skin of the body. A pump at the other end of the tube makes a low-pressure vacuum around the erectile tissue, which results in an erection. An elastic ring is then slipped onto the base of the penis. This holds the blood in the penis (and keeps it hard) for up to 30 minutes. With proper training, 75 out of 100 men can get a working erection using a vacuum erection device.
Diagram of a Erectile Dysfunction Vacuum
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Intracavernosal (ICI) and Urethra (IU) Therapies
If oral drugs don’t work, the drug Alprostadil is approved for use in men with ED. This drug comes in two forms, based on how it is to be used: intracavernosal injection (called “ICI”) or through the urethra (called “IU therapy”).
Self-Injection Therapy
Alprostadil is injected into the side of penis with a very fine needle. It’s of great value to have the first shot in the doctor’s office before doing this on your own. Self-injection lessons should be given in your doctor’s office by an experienced professional. The success rate for getting an erection firm enough to have sex is as high as 85% with this treatment. Many men who do not respond to oral PDE5 inhibitors can be ‘rescued’ with ICI.
ICI Alprostadil may be used as a mixture with two other drugs to treat ED. This combination therapy called “bimix or trimix” is stronger than alprostadil alone and has become standard treatment for ED. Only the Alprostadil ingredient is FDA approved for ED. The amount of each drug used can be changed based on the severity of your ED, by an experienced health professional. You will be trained by your health professional on how to inject, how much to inject and how to safely raise the drug’s dosage if necessary.
ICI therapy often produces a reliable erection, which comes down after 20-30 minutes or with climax. Since the ICI erection is not regulated by your penile nerves, you should not be surprised if the erection lasts after orgasm. The most common side effect of ICI therapy is a prolonged erection. Prolonged erections (>1 hour) can be reversed by a second injection (antidote) in the office.
Men who have penile erections lasting longer than two to four hours should seek Emergency Room care. Priapism is a prolonged erection, lasting longer than four hours. It is very painful. Failure to undo priapism will lead to permanent penile damage and untreatable ED.
Intraurethral (IU) Therapy
For IU therapy, a tiny medicated pellet of the drug, Alprostadil, is placed in the urethra (the tube that carries urine out of your body). Using the drug this way means you don’t have to give yourself a shot, unfortunately it may not work as well as ICI. Like ICI therapy, IU Alprostadil should be tested in the office, before home usage.
The most common side effects of IU alprostadil are a burning feeling in the penis. If an erection lasts for over four hours, it will need medical attention to make it go down.
Surgical Treatment
The main surgical treatment of ED involves insertion of a penile implant (also called penile prostheses). Because penile vascular surgery is not recommended for aging males who have failed oral PDE5 inhibitors, ICI or IU therapies, implants are the next step for these patients. Although placement of a penile implant is a surgery which carries risks, they have the highest rates of success and satisfaction among ED treatment options.
Penile implants are devices that are placed fully inside your body. They make a stiff penis that lets you have normal sex. This is an excellent choice to improve uninterupted intimacy and makes relations more spontaneous.
There are two types of penile implants.
Semi rigid Implant (Bendable)
The simplest kind of implant is made from two easy-to-bend rods that are most often made of silicone. These silicone rods give the man’s penis the firmness needed for sexual penetration. The implant can be bent downward for peeing or upward for sex.
Inflatable Implant
With an inflatable implant , fluid-filled cylinders are placed lengthwise in the penis. Tubing joins these cylinders to a pump placed inside the scrotum (between the testicles). When the pump is engaged, pressure in the cylinders inflate the penis and makes it stiff. Inflatable implants make a normal looking erection and are natural feeling for your partner. Your surgeon may suggest a lubricant for your partner. With the implant, men can control firmness and, sometimes, the size of the erection. Implants allows a couple to be spontaneously intimate. There is generally no change to a man’s feeling or orgasm.
Penile Implant
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What is the Surgery Like?
Penile implants are most often placed under anesthesia. If a patient has a systemic, skin, or urinary tract infection, this surgery should be postponed until all infections are treated. If a man is on blood thinners, then he may need to talk with a medical expert about stopping the medications for elective surgery and healing.
Most often, one small surgical cut is made. The cut is either above the penis where it joins the belly, or under the penis where it joins the scrotum. No tissue is removed. Blood loss is typically small. A patient will either go home on the same day or spend one night in the hospital.
Recovery Time after Penile Implants:
Most men will feel pain and will feel better with a narcotic pain-relief drug for one to two weeks. After the first week, over- the-counter pain drugs (such as acetaminophen or ibuprofen) may be substituted for narcotic pain drugs.
Discomfort, bruising and swelling after the surgery will last for a few weeks.
For the first month, men should limit their physical activity. The surgeon will explain when and how much exercise to do during the healing period.
Men most often start having sex with their penile implants by eight weeks after surgery. If there is persisting swelling or pain, the use of the implant may be delayed. The surgeon or health care expert in the surgeon’s office will talk about how to inflate and deflate the implant.
There are risks to prosthetic surgery and patients are counselled before the procedure. If there is a post-operative infection, the implant will likely be removed. The devices are reliable, but in the case of mechanical malfunction, the device or a part of the device will need to be replaced surgically. If a penile prosthesis is removed, other non-surgical treatments may no longer work.
Most men with penile implants and their partners say that they’re satisfied with the results, and they return to more spontaneous intimacy.
Clinical Trials
Several restorative or regenerative treatments are under investigation for the future treatment of ED:
Extracorporeal shock wave therapy (ESWT) – low-intensity shock waves that aim to fix the erectile tissues and help restore natural erections.
Intracavernosal injection of stem cells – to help cavernous tissue regrowth
Intracavernosal injection autologous platelet rich plasma (APRP) – to help cavernous tissue regrowth
These are not currently approved by the FDA for ED management, but they may be offered through research studies (clinical trials). Patients who are interested should discuss the risks and benefits (informed consent) of each, as well as costs before starting any clinical trials. Most therapies not approved by the FDA are not covered by government or private insurance benefits.
Supplements
Supplements are popular and often cheaper than prescription drugs for ED. However, supplements have not been tested to see how well they work or if they are a safe treatment for ED. Patients should know that many over-the-counter drugs have been found on drug testing to have ‘bootlegged’ PDE 5 Inhibitors as their main ingredient. The amounts of Viagra, Cialis, Levitra or Stendra that may be in these supplements is not under quality control and may differ from pill to pill. The FDA has issued consumer warnings and alerts.
More information may be found here.
Updated June 2018
After Treatment
All of the treatments for ED (except for implant surgery) are used as needed for sex and then wear off. The treatments help the symptoms, but do not fix the underlying problem in the penis.
If medical treatments don’t work as well as hoped:
Changing the dosage (for PDE5i, IU or ICI alprostadil) as prescribed by the doctor may help
Reviewing the instructions again may reveal a missing step in a treatment plan
Considering a different path may be necessary: emotional/relationship counselling, a vacuum erection device or penile implant are all good alternatives when others methods fail. Don’t give up!
Updated June 2018
More Information
Frequently Asked Questions
How do I know my ED is physical and not mental?
It’s hard to know. Health providers now realize that most men have an underlying physical cause of ED. For most patients, there are both physical and emotional factors that lead to ED. It is impossible to prove that there is no psychological part to a man’s ED.
If I worry about being able to get an erection, can I make a bad condition worse?
Nothing happens in the body without the brain. Worrying about your ability to get an erection can make it difficult to get one. This is called performance anxiety and can be overcome with education and treatment.
Can I combine treatment options?
This is often done. However, only combine treatments after talking with your health care provider about this. Erections can last too long with drug therapy, which is dangerous. Ask your doctor for proper instructions.
I was fine until I began taking this new drug, what should I do?
Never stop or change a prescription medication without first talking with your health care provider.
Many drugs can cause ED, but some cannot be changed because the drug’s benefits are too important for you. If you feel sure that a specific drug has caused the ED problem, ask your health care provider if you can change drugs. If you must stay on the drug that is causing the problem, there are ED treatments that can help.
We know pills, pumps, and surgeries work for erectile dysfunction, but what about food? Are there things you can eat that can help with ED? There are reasons to think there may be, even if more evidence is needed to confirm the potential of the following foods.
Goji berries have a long history tied to sexual fertility. The long history uses of Goji showed that goji berries significantly:
increased sperm quantity and movement
shortened erection, capture, and ejaculation response
improved sexual ability
improved recovery of testosterone levels
Research suggests that goji berries may be an alternative to prescriptions for erectile dysfunction, like Viagra.
Longan
Longan is the fruit of the longan tree (which is scientifically known as Dimocarpus longan).It looks like a berry or a grape and tastes mildly juicy and sweet.
Longan tonics have been popular since time immemorial with Chinese women to increase their sensuality and appearance. The fruit helps to increase energy and stave off fatigue.
Chives
Chives, aka those little green disks you can find in most Chinese dishes, not only taste great but are full of vitamins, minerals, protein and sugar often used in medicine to cure illness. In Chinese, Chives are nicknamed “grow man health,” which translates to “the grass that raises your man health” Chives actually possess sulfides that, when combined with vitamin B1, help reduce fatigue and recover strength, hence increasing male stamina and virility.
Quail Eggs
Quail eggs are delicious and nutritious. They are chalk full of amino acids that the body needs, whatever those are. Traditional Chinese medicine says quail eggs mend the human body’s “five viscera” (heart, liver, spleen, lungs and kidneys), benefits the essence of blood and increases male virility. It is said that men who eat quail eggs on a regular basis will have increased sexual capabilities, strength and muscles…all night long.
Lamb Kidney
In order to increase your kidney yang, you sometimes have to eat the kidney of another animal. Lamb kidneys have tons of protein and vitamins needed to get the blood flowing. In China, men who are impotent believe eating lamb kidney will restore their virility. Lamb supposedly warms the joints and strengthens the lower back and legs, increasing your sexual ability.
Okra
Ripe okra is used in traditional Chinese medicine for its leaves that contain healing ingredients. Not only does okra increase male virility, it can be used to treat certain urinary problems. No wonder okra has earned its name “the plant Viagra.”
Watermelon
This sweet, refreshing fruit has a compound that can have effects similar to ED meds on your blood vessels. It may even rev up your sex drive, studies say. Most of watermelon is water, but the rest is loaded with lycopene, an antioxidant that’s good for your heart, prostate, and skin.
Oysters
These shellfish may boost your testosterone levels, and that can help with sex drive. They’re also chock-full of zinc, a nutrient your body needs. But you may save yourself problems by making sure they’re cooked. Make sure you know where they come from, and that they’re cooked properly.
Coffee
Coffee
Your morning cup of joe is more than a satisfying pick-me-up. It may give your love life a boost, too. Men who drank two or three cups’ worth of caffeine a day were less likely to have erectile dysfunction, one study found. That’s because caffeine helps boost blood flow. Not a java fan? Many teas, sodas, and sports drinks also have caffeine.
Dark Chocolate
USANA Nutrimeal™ Dutch Chocolate
This treat may have perks below the belt. An ounce a few times a week can help your ticker — and what’s good for your heart could be good for other parts, too. Chocolate is rich in flavanols, plant nutrients that can increase blood flow and lower blood pressure. It also helps your body make more of nitric oxide, which can help with erections and is in many ED medications.
Nuts
Walnuts have lots of arginine, an amino acid your body uses to make nitric oxide. They’re also good sources of vitamin E, folic acid and fiber. Don’t add more than a few small handfuls to your daily diet, though. Nuts are high in calories.
Juice
Grape Juice
Maybe you enjoy an adult beverage made from grapes, but here’s a reason to drink the stuff kids like. Nutrients in Concord grape juice also increase the amount of nitric oxide in your body. If you’re not wild about drinking grape juice, try pomegranate juice. It appears to have the same effect.
Garlic
The strong-smelling bulb may help between the sheets. If plaque forms on the walls of the arteries, blood flow could be cut off or reduced. That could cause a problem when it comes to romance. Garlic in your diet may help keep your arteries healthy and clear as you age.
Fish
salmon Fish
Salmon and other fatty fish are great sources of heart-healthy omega-3 fatty acids, which may boost nitric oxide in your body. They’ll lower your blood pressure and your risks for heart attack and blood clots. Aim for 8 ounces of salmon a week. Sardines, fresh albacore tuna, and mackerel are other good sources of omega-3s.
Greens
Kale Green
Kale is also a nitric-oxide booster. Aside from the possible benefits to your sex life, leafy greens are nutritional powerhouses. They’re packed with vitamins, minerals and omega-3s.
Peppers
capsicum Pepper
You might spice up your love life by adding some chili peppers to your diet. The stuff in cayennes, jalapenos, habaneros, and other peppers that give them their heat relaxes the arteries — and that helps blood flow to the heart and other organs, including the penis. Chilies can also help lower blood pressure and cholesterol and prevent blood clots.
Olive Oil
Olive oil may help your body make more testosterone. It’s also full of the good-for-you monounsaturated fat, which can help get rid of the bad cholesterol in your body. Opt for extra-virgin olive oil — that means the olives were pressed without chemicals or high heat, which preserves the healthy antioxidants.
