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The first time he experienced ED in his mid-50s he thought it was just a fluke, which was a reasonable assumption to make. More than half of men experience episodic erectile dysfunction at some time in their life from things like stress, too much alcohol, or as a side effect of medication. Read More About Gene's Story

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Many medications can cause or contribute to erectile dysfunction, including certain blood pressure drugs, antidepressants, and tranquilizers. Men with erectile dysfunction should talk with their doctor if they suspect a prescription or over-the-counter drug may be causing erectile problems. Born This Way? Physiology and Erectile Dysfunction
Talk to your provider if your erection problems have to do with a fear of heart problems. Sexual intercourse is usually safe for men with heart problems. .

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Alternative treatments, such as nutritional supplements, herbal remedies, and acupuncture, are options to consider. However, evidence supporting many of these treatments is spare and due to the lack of FDA regulation the quality of any given supplement is unclear. In several high profile cases allegedly “natural” ED treatments were found to contain erection medications; as these medications have certain side effects and drug interactions (specifically PDE5I and nitrates) there is potential for very serious reactions even with “natural”, non-prescription medications.
Penile prosthesis is the primary form of surgical therapy and is reserved for those men who fail, are intolerant of, or have contraindications to other forms of therapy. Currently, there are several different types of penile prostheses. The simplest is the malleable penile prosthesis, and the most complex is the three-piece inflatable penile prosthesis.

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While medications are a common first therapy, they tend to only work in about 50 percent of men with diabetes. Good blood sugar control can help slow the progression of ED and sexual dysfunction in men. Men with diabetes are more likely to move on to other treatment options, such as the: vacuum erection pump, penile injection therapy, and penile implants. ED and Medications
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All four of the PDE5 inhibitors (Viagra, Cialis, Levitra, and Stendra) are approved by the Food and Drug Administration for on-demand use for erectile dysfunction.

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If you are on treatment for a medical or psychiatric problem and you think that this treatment is affecting your sex life tell your doctor. Alternative treatments that may have less likelihood of affecting sexual function are often available.

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    If ignored, erectile dysfunction can lead to complications, such as an unsatisfactory sex life, low self-esteem, high anxiety, and relationship problems. Getting a partner pregnant also becomes difficult if a man suffers with erectile dysfunction.

    The association of CVD and ED was noted in 1997 as one analysed the results of the MMAS. In this landmark study, 1709 men aged 40–70 years were enrolled between 1987 and 1989. A follow-up some 10 years later revealed a striking relationship between ED and CVD. In this study, it became clear that the risk factors for ED were very similar to those of CVD, such as diabetes mellitus, smoking and dyslipidaemia.18
    Erectile dysfunction, also known as impotence or ED, is the inability to achieve or maintain an erection sufficient for sexual intercourse. Almost all cases of erectile dysfunction are treatable, says Dr. Honig.

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    Viagra first hit the market in 1998. The pill changed the way doctors treated ED and men viewed the condition.

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    Prostaglandin E1 (intraurethral alprostadil or MUSE) can be inserted in a pellet (suppository) form into the urethra to attain erections. It is available in four dosage strengths: 125 mcg, 250 mcg, 500 mcg, and 1,000 mcg. Most individuals need 500 mcg to 1,000 mcg for a satisfactory response.
    Though they rely on the same primary mechanism to treat ED, research confirms that these different PDE-5 inhibitors tend to produce side effects to various degrees. For instance, a slightly higher percentage of people who take sildenafil (and Viagra) report unwanted vision changes, while a slightly higher percentage of tadalafil (and Cialis) users report muscle pain. All in all, most men barely notice any side effects.

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    Blood test A blood sample may help your doctor look for signs of diabetes, heart disease, low testosterone, or other issues such as liver or kidney disease.Urine test A urine test can look for markers of diabetes.Ultrasound/Doppler exam This test can let your doctor see if you have problems with penile blood flow.Psychological exam Your doctor might screen you for depression or another mental health disorder that could be linked to ED symptoms.What Should You Tell Your Doctor About Symptoms?

    Spinal cord traumaMultiple sclerosisDiabetic neuropathyPelvic surgery (prostate, bowel)Parkinson’s diseaseAlzheimer’s diseasePoor Blood Flow
    Using a low-dose pill to help the blood flow around the nerves and help the nerves heal.

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Our patients often undergo a full body exam to determine whether they have early cardiovascular disease, vascular disease or a metabolic condition such as diabetes. Treatment is addressed with a multi-disciplinary approach.

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Erosion of the prosthesis, whereby it presses through the corporal tissue into the urethra, may occur. Symptoms and signs may include pain, blood in the urine, discharge, abnormal urine stream, and malfunction. If the prosthesis erodes into the urethra, a physician must remove it. If the other cylinder remains intact, it can be left in place. A physician leaves a catheter in place to allow the urethra to heal.

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