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Erectile Dysfunction

Men’s Clinics of America effectively treat Erectile Dysfunction. Erectile Dysfunction, sometimes called “impotence,” is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word “impotence” may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire (libido) and problems with ejaculation or orgasm. Using the term Erectile Dysfunction makes it clear that those other problems are not involved.

  • Erectile Dysfunction (ED) is the repeated inability to get or keep an erection firm enough for sexual intercourse.
  • ED affects 15 to 30 million American men.
  • In nearly all instances, ED has a physical cause.
  • ED is treatable at all ages.

Erectile Dysfunction Treatment

There are several treatments available, which can include psychotherapy or surgery. These are considered only as a last option. However, the most favored and best solution is drug therapy. It is testosterone replacement therapy that is utilized by Men’s Clinics of America for which our State Licensed Physicians are uniquely qualified.

Erectile Dysfunction, or ED, can be a total inability to achieve an erection, inconsistent ability to do so, or a tendency to keep only brief erections which tend to fail before the sex experience is complete. These variations make defining ED and estimating its incidence difficult. Estimates range from 15 million to 30 million, depending on the definition used.

According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, an average of 7.7 physician office visits was made for ED in 1985. By 1999, that rate had nearly tripled to 22.3 office visits. This increase happened gradually, presumably as treatments became more widely available and discussing erectile function became accepted. Perhaps the most publicized advance was the introduction of the oral drug sildenafil citrate (Viagra®) in March 1998. NAMCS data on new drugs show an estimated 2.6 million mentions of Viagra® at physician office visits in 1999, and one-third of those mentions occurred during visits for a diagnosis other than ED.

In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs for such diseases or disorders as diabetes, high blood pressure, heart disease, or overweight or prostate problems and/or removal. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence tends to increase with age: About 5% of 40-year-old men and between 15% and 25% of men between 50 and 60 years of age experience ED. Now, ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED at an affordable cost.

Urologists, who specialize in treating problems of the urinary tract, have traditionally treated ED. Most of the urologists attempted treatment of Erectile Dysfunction using such things as Viagra®. Urologists accounted for only 25% percent of Viagra® prescriptions during 1999.

How is ED treated?

ED can be treated in a variety of different ways. Our State Licensed Physician will discuss with you the various treatments available for your unique combination of conditions. There are medicines to improve the response to sexual stimulation, there are medications to create or trigger an automatic erection when taken.

Drug Therapy

None of these ED medications should be used more than once a day. There are ED medications that can be taken by men who take nitrate-based drugs such as nitroglycerin for heart problems. These men should not use pills, such as Viagra®, Levitra® or Cialis® because combining them with nitrate-based drugs can cause a sudden drop in blood pressure. Also, during the appointment, tell our doctor if you take any drugs called alpha-blockers, which are used to treat prostate enlargement or high blood pressure. Our Physicians are used to working with such matters, and the doctor may need to adjust your ED prescription. He will make certain to avoid any combination of drugs that can cause a sudden drop in blood pressure, but you must provide a list of all medications that you take.

Men’s Clinics of Americas effectively treat this condition frequently and Men’s Clinics of Americas’ patients are provided the ability of having fully, enjoyable and satisfactory sexual experiences immediately.

How is ED diagnosed during your visit to Men’s Clinics of America?

During your visit in a very private exam room in which you are placed immediately upon arrival, an examination is performed by our State Licensed Physicians. First, your medical and sexual history is taken. Medical and sexual histories help define the existence and degree and nature of your Erectile Dysfunction problem. A medical history can disclose diseases that lead to ED, while a simple recounting of sexual activity might distinguish among problems with sexual desire, erection, ejaculation, or orgasm. Using certain prescription or illegal drugs can suggest that you have a chemical cause for your problem, since drug effects account for 25% of all Erectile Dysfunction symptoms. Cutting back on or substituting certain medications can often alleviate the problem without further treatment being necessary.

Patient History

During your visit in a very private exam room in which you are placed immediately upon arrival, an examination is performed by our State Licensed Physicians. First, your medical and sexual history is taken. Medical and sexual histories help define the existence and degree and nature of your Erectile Dysfunction problem. A medical history can disclose diseases that lead to ED, while a simple recounting of sexual activity might distinguish among problems with sexual desire, erection, ejaculation, or orgasm.

Using certain prescription or illegal drugs can suggest that you have a chemical cause for your problem, since drug effects account for 25% of all Erectile Dysfunction symptoms. Cutting back on or substituting certain medications can often alleviate the problem without further treatment being necessary.

Physical Examination

A physical examination can give clues to systemic problems. For example, if the penis is not sensitive to touching, a problem in the nervous system may be the cause. Abnormal secondary sex characteristics, such as hair pattern or breast enlargement, can point to hormonal problems, which would mean that the endocrine system is involved. The examiner might discover a circulatory problem by observing decreased pulses in the wrist or ankles. And unusual characteristics of the penis itself could suggest the source of the problem—for example, a penis that bends or curves when erect could be the result of Peronei’s disease.

Doppler Ultrasound

Doppler ultrasound is used to evaluate blood flow, venous leak, signs of arthrosclerosis, and scarring or calcification of erectile tissue. Erection is induced by administering prostaglandin, a hormone-like stimulator produced in the body. Ultrasound is then used to see vascular dilation and measure penile blood pressure (which may also be measured with a special cuff). Measurements are compared to those taken when the penis is flaccid.

How does an erection occur?

The penis contains two chambers called the corpora Cavernosa, which run the length of the organ (see figure 1). Each chamber is like long tubes within the penis. A spongy tissue fills the chambers. The chambers also contain veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora Cavernosa and is surrounded by the chambers. Erection begins with stimulation, either physical or mental or both. Impulses from the brain and local nerves cause the muscles of the corpora Cavernosa to relax, allowing blood to flow in and fill the chambers. The blood creates pressure in the corpora Cavernosa, making the penis expand. Blood becomes trapped in the corpora Cavernosa, thereby sustaining the erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed. Ejaculation causes the penis to contract.

Figure 1.

Arteries (top) and veins (bottom) penetrate the long, filled cavities running the length of the penis-the corpora Cavernosa and the corpus spongiosum. Erection occurs when relaxed muscles allow the corpora Cavernosa to fill with excess blood fed by the arteries, while drainage of blood through the veins is blocked.

What causes Erectile Dysfunction (ED)?

Since an erection requires a precise sequence of events to occur, ED can occur when any of the events is disrupted. Often as a result of disease, or the taking of medications, the most common causes of ED, men begin to experience Erectile Dysfunction. Diseases—such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease—account for about 70% of ED cases. Medications for diseases, such as high blood pressure, heart disease, overweight or prostate problems and/or removal often are causes. Between 35% and 50% of men with diabetes experience ED. In addition, many other common medicines—antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug)—can produce ED as a side effect.

Clearly, life sustaining medications which are beneficial for other conditions cannot be discontinued, however, some lifestyle choices also contribute to heart disease and vascular problems raise the risk of Erectile Dysfunction, such as excessive use of alcohol, recreational drugs, smoking and avoiding exercise are also possible causes of ED.

Also, surgery (especially radical prostate and bladder surgery for cancer) can injure or sever nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora Cavernosa.

Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10% to 20% of ED cases. Men with a physical cause for ED frequently experience the same sort of psychological reactions (stress, anxiety, guilt, and depression). Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone.

Testosterone

Testosterone can reduce ED in some men with low levels of natural testosterone. Care must be taken by our State Licensed Physician in prescribing Testosterone for you, as it may cause liver damage. Testosterone is effective for creating increased desire for sex, and many men lose that desire due to a decreased secretion of Testosterone by their own bodily organs. Our State Licensed Physician will make that determination with you during your visit to Men’s Clinics of Americas. And prescribe it for you.

Visit us in Houston for an erectile dysfunction consultation.