Erectile Dysfunction Treatments

Sexual medicine has made major advances in recent years. A number of new treatments have become available and a number of older ones have been refined. I briefly discuss the most common and promising options now available for erection problems. As you probably suspect, all have pros and cons.

Before getting to them, however, it’s important to say that they rarely destroy your existing capacity to experience pleasure or to ejaculate. If you now feel sensation when your penis is stroked, you’ll feel sensation when it’s stroked after having a penile implant or taking papaverine injections. If you can ejaculate now, you’ll be able to ejaculate afterward.

Before deciding on a particular option, especially the more invasive ones like penile injections and implants, it’s a good idea to talk to others who have tried it. Your doctor may be willing to give you the names of a patient or two who have had an implant, are using vacuum devices, or are injecting themselves. You’ll be getting a skewed sample, of course — it’s doubtful he’ll give you the name of a dissatisfied patient — but the information you can get by talking to several of these people is still invaluable. Be wary, however, if you get a true believer, someone who talks as if the option he chose is a miracle with no limitations or problems. Try to get both sides. What’s good about the treatment, what limitations does it impose, what problems is he having with it?

Testoterone Injections

If your testosterone level is low, the urologist may prescribe a series of testosterone injections given every few weeks for several months. Testosterone can also be given orally, but this is less effective than shots and can cause liver damage.

ADVANTAGE:

DISADVANTAGE:

Yohimbine

This is a drug in pill form that comes from the bark of an African tree and is commonly given to men complaining of erection problems and low sexual desire. Yohimbine has produced dramatic results in animal studies. In one of them, rats who were injected with large doses of yohimbine engaged in twice as much sex as rats that didn’t get the injections. What, if anything, this has to do with humans is unclear. As of this writing, the experts are not in agreement on the effectiveness of yohimbine for men with erection problems. Some claim good results, others don’t. Since yohimbine doesn’t seem to have any serious side effects for most men, it may be worth a trial if your doctor suggests it. If it helps, fine; if not, look at other options.

Arterial and Venous Surgery

There are several types of operations to repair or bypass clogged arteries and to seal leaky veins. I am not going into them in detail here, because as of this writing, the results are not impressive, at least not by my standards. Although the medical literature contains articles by doctors in Europe who claim very high success, the urologists and vascular surgeons I’ve talked with say they don’t get anywhere near these results. This may change in the future, of course, but you should be cautious if your doctor recommends them. Find out what his results have been, especially on long-term follow-up, and insist on talking to several men who’ve had the operation. You might also want to ask the doctor for references in the medical literature and read the articles about the type of surgery being suggested for you. This reading is rough going, but it may be worth the effort to give you a better idea of what the results might be. Right now the best candidates for arterial surgery are young men whose blood-flow problems stem from trauma such as accidents.

Vacuum devices

Papaverine or Prostaglandin Injections

DRUG THERAPY FOR ERECTILE DYSFUNCTION

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