Treatment Options for Erectile Dysfunction 10/13/2016 Confidential assessment that will determine the cause for the problem...

September 16, 2016

Treatment Options for Erectile Dysfunction

Sexual problems are more common than most people think. Over half of all couples will experience some form of sexual dysfunction during their lifetime. Some of these problems can be easily resolved, while others may need assistance from a medical professional.


For men, Urology Health Specialists can help patients who experience such difficulties as the inability to achieve or maintain an erection (impotence), problems with orgasm, premature ejaculation, and loss of interest in sex. Failure to achieve or sustain an erection happens to most men at some time or another, but for about half of men over the age of forty, the problem can become chronic because of a variety of factors.


Urology Health physicians offer a confidential assessment that will determine the cause for the problem and a personalized treatment plan to correct it. In fact, research shows that the majority of all sexual problems are physically related. Therefore, before treatment begins, a careful assessment is our recommended course.


For men with erectile dysfunction, a Urology Health Specialist urologist will perform a comprehensive history and physical examination, along with possible blood tests. Depending upon the conclusions of the initial assessment, diagnostic studies may be ordered or a trial of medical therapy may be started. Our urologists offer a full range of treatment strategies after completion of the initial evaluation.


“The form of treatment recommended, such as medication, penile injections, vacuum erection devices, or surgery depends on each patient’s individual needs, explains Dr. Michael Hagg, a urologist with Urology Health in Wynnewood. “When considering a medication treatment for ED, there are several drugs approved by the FDA that offer tangible benefits.”


Sildenafil (Viagra) is among the most familiar medication on the market for treating ED, prescribed to tens of thousands of men over the past two decades. In addition, both Levitra and Cialis have also become more widely used. All of these medications have been extremely helpful for many men with ED. Viagra usually starts to work within 30 minutes, and lasts up to four hours. Levitra is similar to Viagra, while Cialis has a longer time of effective use after it is taken, often lasting up to 36 hours. Our urologists can help you select the right medication for your personal needs. Some patients cannot take these medications because of drug interactions or other side effects, and for one in three patients, these medications are not effective.


“Sildenafil is a drug for treating erectile dysfunction, based on delaying the work of an enzyme called phosphodiesterase that helps maintain the erection by controlling the enzymes working during penis physical stimulation, explains Dr.Hagg.

And while Sildenafil increases blood flow to the penis during sexual stimulation, it’s important to point out that Sildenafil does not cure erectile dysfunction or increase sexual desire.


“Sildenafil is not an aphrodisiac, but many men who take it still expect it give them an instant feeling,” says Dr. Hagg. “The expectation for an immediate ‘kick’ from the drug is so intense that a common reaction from many patients is a slight panic that the drug isn't going to work.”


If you are experiencing problems achieving or sustaining an erection, Urology Health can help. Our urologists combine their extensive experience with a compassionate approach to care. Reach out to one of our Urology Health Specialist physicians to learn more about your treatment options.


Questions & Answers About Sildenafil (Viagra)


Q: How does the Sildenafil work?
A: When an erection occurs, the smooth muscles in the penis and in the arteries of the penis must be relaxed. Sildenafil works by increasing the smooth muscle relaxation in the penis during an erection. It is like stretching a rubber balloon before blowing it up to make it easier to inflate. The enzyme that the medication specifically works on is phosphodiesterase type 5 (PDE-5) that is almost exclusively found in the penis.


Q: Will the medication cause relaxation of all the smooth muscles in the body?
A: NO. The enzyme (PDE-5) is specific to the penis. Sildenafil is highly specific for the enzyme in the penis.


Q: What are the side effects?
A. Mild headache 16%, Flushing 11%, Indigestion 7%, Runny nose 7%, Transient visual disturbance (blue haze) 3%.


Q: Are there any serious side effects.
A: NO. The incidence of serious side effects (such as cardiovascular incident) is minimal.


Q: Does this drug cause an erection that will not go down (priapism)?
A: NO. Sildenafil does not cause erections without sexual stimulation. It is not like penile injections or intraurethral therapy.


Q: Are there any contraindications?
A: YES. The only contraindication is the use of nitrates (sublingual nitroglycerine, long-acting nitrates, nitrate pastes), as Sildenafil combined with nitrates can cause a drop in blood pressure. If you are unsure whether you are on these medications, check with your physician before considering this medication.


Q: What about any interactions with other medications?
A: There have been no interactions with other medications including diabetic medications, blood thinners, antacids, aspirin or alcohol.


Q: Will I get a spontaneous erection in 60 minutes?
A: NO. Again, the beauty of the pill is that it works with natural stimulation. No stimulation means no erection.


Q: What happens if I don't use it in an hour?
A: The beneficial effect can be seen as late as 8 hours. Most of the effectiveness is within the first 4 hours. You will not have an erection if you are not stimulated.


Q: What if it doesn't work?
A: Viagra requires sexual excitation to work. You may be too tired or insufficiently sexually excited. If it does not work repeatedly you should make an appointment to discuss treatment alternatives.




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