Understanding your treatment options is the first step to managing your condition. There are many options available and it’s important to understand what is right for you.
If you have been recently diagnosed with ED, your doctor may have prescribed oral phosphodiesterase type 5 (PDE5) inhibitors as a first line treatment. The PDE5s include well known oral medications such as Viagra, Cialis, Levitra, and Staxyn and have an average success rate of 66%, according to the NIH.(ref) It’s important to provide your doctor any history of other conditions, such as hypertension or heart disease, to determine if these medications are right for you.
Alprostradil, a prostaglandin, can be given through transurethral delivery as a suppository. According to the AUA, suppositories are not used as often by physicians because of the reduction in efficacy in postmarketing studies.
When oral medications are not effective or your doctor recommends against them due to underlying conditions, intracavernous injections are an available second-line option, recommended by AUA guidelines, and as determined by you, your physician and your compounding pharmacist. Intracavernous injections, also known as penile injections, contains a process where a compounded formulation such as Tri-Mix is injected directly into the corpora cavernosa (side of the penis). The solution is directly delivered to the site rather than absorbed through the body.
Did you know the AUA guidelines indicate that intracavernous injections including Bimix and Trimix are the most effective non-surgical treatment for erectile dysfunction? 5
If treatments are unsuccessful, your physician may consider penile implantation. Penile implants are devices that are surgically put inside the penis to help men with ED achieve an erection.
The thought of injecting a needle into the side of the penis is not comforting. Most men are typically anxious when they are initially presented with the thought. However, according to urologists, it’s all about proper technique. Proper injections are placed at the point of the penis where there are very little nerve endings and many patients find that the procedure itself isn’t that uncomfortable. It’s overcoming that first self-injection that is key. Talk to your doctor about proper technique.
1.Thompson IM; Tangen CM; Goodman PJ, et al. Erectile dysfunction and subsequent cardiovascular disease. JAMA 2005;294(23) pgs 2996-3002.
2. Johannes CB, Araujo AB, Feldman HA, et al. Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. The Journal of Urology. 2000 vol 163(2), pgs 460-463.
3. National Institutes of Health (NIH) Consensus Conference. NIH Consensus Development Panel on Impotence. Impotence. Journal of the American Medical Association. 1993;270:83-90.
4. Mayo Clinic. Available at http://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/basics/causes/con-20034244. Accessed June 17, 2015.
5. What to do about Erectile Dysfunction. A Harvard medical school special health report. 2009. Pg 10.
6. American Urological Association. Available at http://www.auanet.org/education/guidelines/erectile-dysfunction. Accessed April 1, 2015.
7. Walczak MK, Lokhandwala N, Hodge MB, et al. Prevalence of cardiovascular risk factors in erectile dysfunction. JGSM. 2002. 5(6). Pgs 19-24.
8. Lue TF. Erectile dysfunction. The New England Journal of Medicine. 2000. 342(24) pgs 1802-1813.
9. What is penile injection therapy. http://edguidance.com/what-is-penile-injection-therapy/. Accessed June 22, 2015.