Erectile dysfunction (ED, “male impotence”) is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis sufficient for satisfactory sexual performance. An erection occurs as a hydraulic effect due to blood entering and being retained in sponge-like bodies within the penis. The process is most often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis. Erectile dysfunction is indicated when an erection is difficult to produce. The most important organic causes are cardiovascular disease and diabetes, neurological problems (for example, trauma from prostatectomy surgery), hormonal insufficiencies (hypogonadism) and drug side effects.
Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but often can be helped. Notably in psychological impotence, there is a strong response toplacebo treatment or counseling sessions with a qualified psycho-therapist. Erectile dysfunction, tied closely as it is about ideas of physical well being, can have severe psychological consequences if left untreated. In many cases, anxiety stemming from the uncertainty of an individuals’ ability to develop an erection can further exacerbate psychological impotence.
Treatment for ED
Core Medical Group takes a multi-faceted approach to treating erectile dysfunction. The first step is an evaluation by one of Core Medical Group’s highly-trained physicians to identify what is causing erectile dysfunction. Upon completing the evaluation, an individualized treatment regimen is created by a Core Medical Group physician. Besides eliminating an underlying cause, such as potassium deficiency or arsenic contamination of drinking water, the first line treatment of erectile dysfunction typically consists of a prescription for a PDE5 inhibitor medication (the first of which was sildenafil or Viagra, followed by Cialis and Levitra). In some cases, however, the PDE5 inhibitor is ineffective or prescribed use of a PDE5 inhibitor is contraindicated because of a patients’ health.
Our Core Medical Group physicians will then explore treatment options ranging from Hormone Replacement Therapy (HRT) to prostaglandin tablets in the urethra or intracavernosal injections with a fine needle into the penis that can cause an erection. The most widely used of these injectable treatments is Trimix, an injectable three-drug cocktail used to treat erectile dysfunction. The active ingredients in the mixture are usually alprostadil, papaverine, and phentolamine. In beginning the use of Trimix, it is critical that our physicians find the correct dosage as it does vary from patient to patient. Additionally, we provide education to our patients on the least invasive way to administer the treatment.
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