Many Options Available to Help with Erectile Dysfunction

By Alvaro Lucioni, MD **

Erectile dysfunction (ED) or impotence is a common condition. More than 30 million men in America experience ED. Unfortunately, many think the cause is “all in their head.”

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Men’s Health Talk: Impotence: Causes and Treatments
When: 6 p.m., Wednesday, Sept. 11
Where: Virginia Mason Federal Way, 33501 1st Way S.
Admission: Free
Registration: Call (253) 874-1604, press 0

There is a medical or physiological cause for the condition in up to 90 percent of cases.  Psychological causes are not common. After an appropriate evaluation, most men can undergo successful treatment. However, many do not want to talk about the issue and some are even embarrassed to bring it up with their physician. Physicians can also be uncomfortable managing ED, and thus many men do not undergo evaluation and treatment.

The most common reason for impotence is an alteration in the normal physiology of erection. There are four main steps in the process of achieving an erection:

  1. Desire for an erection
  2. Signals from the brain to the pelvis urging an erection
  3. Increased blood flow to the penis
  4.  Blood stasis in the penis to maintain an erection.

ED can result due to a problem at any one of these steps. When I evaluate a patient experiencing impotence, I check each of these steps to ensure the treatment is targeted appropriately. The evaluation also includes obtaining a detailed medical history, conducting a thorough examination, performing blood tests (such as checking testosterone levels), and recommending radiological tests as needed (for instance, penile color Doppler ultrasound).

Treatment depends on the cause of the condition. Some men can have a reversible cause, such as low testosterone. Replenishing testosterone can help.  For those who experience ED due to a vascular or neurological issue, the initial treatment involves the use of a medication, such as Viagra®, Cialis®, or Levitra®. Men who do not respond to these medications, or who do not wish or cannot take these medications, have other options that include:

  • Vacuum Erection Device: a manually or battery operated pump that helps increase blood flow to the penis.
  • Muse® (alprostadil): a small suppository placed into the urethra that is rapidly absorbed and increases blood flow to the penis.
  • Penile injections (alprostadil, Bimix, Trimix, Quadmix): a small quantity of medication is injected into the penis to increase blood flow.
  • Penile prosthesis (IPP): surgical procedure involving placement of a penile implant with a pump. While this treatment does involve surgery, it is highly successful and more than 90 percent of patients are satisfied with the outcome. IPP restores spontaneity to sexual encounters.

Erectile dysfunction affects quality of life. Importantly, the condition is treatable.

**

Urologist Alvaro Lucioni, MD,  will speak about impotence at a free men’s health event at 6 p.m. Wednesday, Sept. 11, at Virginia Mason Federal Way. To register, call (253) 874-1604, then press 0, between 8 a.m. and 5 p.m. Monday-Friday.

Comments

  1. I quote “Unfortunately, many think the cause is “all in their head.””. Herein lies one of the main stigmas concerning ED and ED treatments. From my understanding, ED treatments such as Viagra®, Cialis®, or Levitra® do not treat psychological factors (nor do they make your partner seem more sexually attractive). If you cannot become sexually aroused, or at least interested, one’s penis will remain flaccid regardless of treatment. However, the fact that Viagra®, Cialis® and Levitra® are well known to be successful in many cases shows that the most often the cause of erectile dysfunction is usually more physical than psychological.

    BTW, this is a very good informative article that discusses ED without all the hype usually associated with the subject. I’s funny how our brain goes fuzzy whenever topics about sex comes up. Good to read a refreshing exception.

  2. Smoking constricts the blood vessels thereby reducing the flow of blood to the organs.
    When the penis receives a lesser flow of blood, it leads to weaker erections and shortened sexual encounters. For those who do not know, proper or increased flow of blood to the penis results in exactly the opposite. The lesson here is that giving up smoking can directly and indirectly increase your libido and sexual stamina.

  3. Nice post. Beside surgical treatments (like Vacuum Erection Device, Penile injections and Penile prosthesis), non-surgical treatment is the best option to cure erectile dysfunction. One can have generic drugs like Generic Viagra, Cialis and Levitra that works by increasing the flow of blood into the penis resulting hard erections.

  4. Goo blog post. Really liked it.
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  5. Newton Murray says:

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  8. lance justin says:

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  9. enzo lucas says:

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  10. wesley blake says:

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  17. HOW I WAS CURED FROM PREMATURE EJACULATION AND WEAK ERECTION

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    But because of the love my wife has for me, she joined me in search for a cure to save our marriage.
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  18. MY NAME IS KATE NEWBOLD I GIVE ALL THANK TO DR GEORGE

    , his product is by far the best plan for treating fibroids naturally…the practical step by step instructions and the detailed information regarding the real cause and how to treat uterine fibroids were a real eye opener. I started dr george medication after intense bleeding and pain which occurred during one of my rehearsals (I am a professional violinist).

    I was later that week diagnosed with 2 medium sized fibroids which placed an enormous pressure on my bladder. I was advised by 3 different doctors to undergo surgery to remove these fibroids as I was told that there was nothing I could do to shrink or stop their growth. Luckily, I ran into dr george by accident as I was searching for information on the net regarding my condition. I was so relieved to have found that surgery was not always the answer, that it can be dangerous and that uterine fibroid can return even after surgical intervention. In less than 4 weeks of taking dr george herbal portion and following his instruction, both of my fibroid had shrunk by 100% and the second ultrasound taken 7 weeks after I began taking dr george medication, had shown that both of these were completely gone. I also my periods became regular. and now am three months old pregnant, you can contact his email address on drgeorge2580@gmail.com for advice and for his product

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