Erectile Dysfunction

One of my areas of focus is restoring sexual health to men and couples. We know that this is important not only for personal enjoyment, but for its impact on wellness, preventing depression, and enhancing a couples’ relational health.

Men and women value sexual intimacy at any age! Research shows that 73% of couples up to the age of 64 are sexually active and 26% of couples up to the age of 84 remain sexually active.  Unfortunately, physical obstacles to sexual intimacy present themselves more often with age.

ED (erectile dysfunction) is the most common sexual concern for men. In fact, 1 in 5 men ages 40-60 struggle with some form of ED and the majority of men after the age of 70 are impacted by ED. ED is typically caused by limitations in blood supply or nerve injury that may occur after prostate cancer treatments or pelvic surgery.  While blood supply to the pelvis diminishes with age, conditions such as diabetes, high blood pressure, and high cholesterol can accelerate changes in penile blood flow.

In our practice, we acknowledge the influence that ED has on overall emotional and relational health. Research shows that many men living with ED eventually experience feelings of failure, isolation, and hopelessness after years of ineffective treatments.  Erections are not just about “having sex” for many men. Healthy sexual responsiveness contributes to a sense of wholeness, confidence, and masculinity.

The ED quiz on www.edcure.org
will help you to assess the severity of your ED
and understand treatment options.

Multiple treatment options are available for men with ED. The degree of ED and the goals of each patient will help us pursue treatment options that will help achieve sexual restoration.

Treatments:

Behavioral therapy:

Some men with mild ED may responds to lifestyle changes that improve blood supply to the pelvis. Healthy eating, regular exercise, blood pressure and cholesterol control, weight loss, and smoking cessation have shown to improve circulation throughout the body.  Pursuing total body health may help improve erections for some men.

Oral Medications:

Oral medications are PDE-5 inhibitors that work by enhancing smooth muscle relaxation and thus promoting blood flow into the penis to help achieve and maintain an erection. Success rates for these medications vary widely. Side effects may include headache, congestion, facial flushing, blurry vision, visual changes. Men who are taking nitrates for heart disease should not take these medications.  Men with diabetes, heart disease, and prostate cancer treatments often do not achieve successful erections with these medications.

Vacuum Pump:

The vacuum erection device (VED) is a clear plastic cylinder with a pump that may be attached directly to the end of the penis. A constriction ring or band is placed on the cylinder at the other end, which is applied to the body. The cylinder and pump are used to create a vacuum to help the penis become erect; the band or constriction ring is used to maintain an erection.  The erection is cool to touch, and some patients may experience bruising and discomfort at the base of the penis.

Intraurethral pellets:

Urethral suppositories may be inserted into the tip of the urine channel in order to deliver a medication that enhances blood flow.  The medication may cause facial flushing, lower blood pressure and urethral irritation that may be transferred to partner.

Injections:

Penile injections work by creating smooth muscle relaxation of the arteries of the corpora thereby resulting in an erection. The injection is self-administered using a small needle into the shaft of the penis. While this option can create some more reliable erections for men, risks may include pain at injection site, scarring in the penis, and prolonged erection.

Implant Surgery:

Penile implants can provide sexual restoration for many couples and has become a successful treatment for many men in our practice. Implants provide a reliable, spontaneous erection that lasts as long as the patient desires. The implant is placed in a 40-minute outpatient procedure and patients are able to be sexually active 4 weeks after the procedure. If you’d like to be sexually active whenever the desire occurs, and to have the confidence to achieve and maintain a natural looking/feeling erection for as long as you desire, the penile implant is the only option that has this potential.

Your Visit:  Pursuing sexual wholeness is an important step towards overall health and enhanced intimacy. Having worked with many patients with sexual challenges, Dr. Thompson provides a comfortable atmosphere that welcomes openness and hope.

• Should a man bring their partner to the appointment? Absolutely. Some couples find that conversations around sexual loss are very difficult.  With some insight and delicacy, we are often able to help couples navigate their fears and align their goals for sexual recovery. When couples are able to leverage their mutual respect and care for one another, they can approach sexual challenges with hope and find effective solutions. In fact, research shows that couples who work together on their sexual challenges report higher levels of overall intimacy!
• What treatment option would you typically recommend first? As a sexual health specialist, I can help you pursue the best treatment options by taking into account the severity of your disease, your individual and partner goals, as well as the risks and benefits of each option.

To hear more about one patient’s journey towards sexual restoration, listen to our Radio Show: Interview with Jack.