Erectile Dysfunction
If you are cringing at the thought of injecting your penis with medication to gain an erection, we certainly don’t blame you. It’s hard to imagine that giving yourself a shot in such a sensitive area would be anything but traumatic. However, it’s important to set the record straight, as many patients benefit tremendously from penile shots using the compound known as Trimix. But let’s first discuss how we get there.
The Genesis of Erectile Dysfunction
When we discuss erectile dysfunction, we are not necessarily talking about the inability to get an erection of any kind. Instead, the discussion is about the failure to achieve or maintain the erection that you want. That may mean that the erection is not hard enough for enjoyable sex or that you lose the erection sooner than you would wish.
The causes of erectile dysfunction can be both on the supply side and the demand side. What does that mean? On the supply side, we have blood flow and nerves. Most cases of erectile dysfunction involve vascular issues. Excess weight and obesity, for example, may increase plaque deposits in the artery walls, causing them to narrow. This affects the penis just as much as the peripheral vascular system or even the coronary arteries. Another significant cause of erectile dysfunction is nerve-related. Some patients who have had considerable trauma to the genital or groin area can damage or irritate these sensitive nerves, which ultimately leads to erectile dysfunction. Further, patients who have prostate cancer treatment in the form of prostatectomy or radiation may also experience erectile dysfunction.
On the demand side, we think of low testosterone, desire, and stage fright. For some, erectile dysfunction may be psychogenic, meaning it’s all in their heads. This often happens to younger men who have a sexual encounter that doesn’t go as planned. They then psych themselves out of thinking they may have a problem when, in fact, they need the confidence to know it was a one-time problem. Low testosterone, while heavily marketed by drug companies as a ubiquitous problem in middle-aged men, is not as prevalent or as severe as we think. However, low testosterone can also be caused by a less-than-optimized lifestyle of smoking, being sedentary, and eating poorly. For some, clinical low testosterone is real and requires treatment. Lastly, desire is a big part of erectile dysfunction. Many men, especially in long-term relationships, have lost the spark they once had with their partner or spouse and, as such, are not able to enjoy the sex life they once had. It’s important to remember that no erectile dysfunction treatment increases desire. That must be treated separately.
All this, of course, brings us to the treatment of erectile dysfunction.
Medications are almost always the first-line treatment for erectile dysfunction simply because they are so easy to take and are very effective. Medications include Viagra and Cialis, as well as their generic formulations, Sildenafil and Tadalafil. These drugs are typically very effective in creating the erections needed to have a pleasurable sex life. Still, depending on the severity and progression of ED, they may only have a limited practical usable timespan.
Medication Dosage
Typically, a urologist will prescribe a mid-level dose when patients begin to complain of ED. For Cialis, this is 10 mg, and for Viagra, this is 50 mg. This usually gives us a baseline for increasing or decreasing dosage based on effectiveness. Eventually, usually after several years, the erectile dysfunction has progressed such that medication no longer works reliably. At this point, patients have choices.
- They can move on to a vacuum pump device. This is an approved option for erectile dysfunction, but it does have significant drawbacks. Not only is it cumbersome, but it generates a cold erection – it does not feel very natural.
- Trimix is a very effective but cringe-worthy shot. A patient injects this compound into the shaft of the penis, which creates an almost immediate, long-lasting, and firm erection. Many patients believe that the injection will be excruciating – this is not necessarily true with training from your urologist or advanced practice provider; shots are not only very effective but also relatively painless. Still, upwards of about 50% of patients will refuse shots altogether.
- For patients with severe erectile dysfunction – who are unable to enjoy any erectile function – or for those who do not wish to inject themselves, the ultimate cure for ED is a penile implant. The most popular of these implants is a three-piece inflatable penile prosthesis, which has a pump in the scrotum, a reservoir of liquid in the pelvis, and two silicone shafts within the penis that can inflate on demand. This option is discrete and elegant, with many patients not even needing to tell their partner about the implant.
The Bottom Line
As you can tell from the article above, there are many and varied options for treatment, and patients should speak to a urologist and men’s health specialist to understand more about their condition. While there are very cheap and seemingly easy options available online and overseas, the truth is that you also need a provider who can follow the progression of your condition and help you maintain good erectile quality now and in the future. Qualified urologists and men’s health specialists can do that. Call our office to schedule a consultation and get the right treatment option.