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What impotence treatments are available?

Smoking to Stop Erectile Dysfunction Peter Dazeley/Getty Images For many men, stopping smoking is an erectile dysfunction remedy, particularly when ED is the result of vascular disease, which occurs when blood supply to the penis becomes restricted because of blockage or narrowing of the arteries. Smoking and even smokeless tobacco can also cause the narrowing of important blood vessels and have the same negative impact. If you smoke, talk to your doctor about quitting and whether prescription aids can help you. Currently the cast has been implanted in two patients post penile prosthesis removal as a result of infection. The cast self-absorbs after approximately 4–6 weeks. Results of the two test patients revealed successful salvage replacement after the cast had resorbed. Although one patient did have evidence of corporal fibrosis, the other patient was found to have intact penile length and no corporal fibrosis. A more timely approach to re-implantation of the penile prosthesis may be necessary after cast reabsorption to prevent fibrosis in future cases. Both patients were able to be re-implanted with a penile prosthesis and are satisfied with results without recurrence of infection. Further patient research is warranted before such salvage intervention can be considered a treatment option. The following technology is not only innovative, but provides another therapy modality for infected penile implants and a tool for surgeons to provide better outcomes to their patients.

Introduction Nearly every primary care physician, internist and geriatrician now understand that many older men retain an interest in sexual activity as they age. Some primary care physicians think that sexual potency in older men is the norm, and that if it is lacking, it is ‘all in the head.’ This viewpoint has not been supported by current literature. The Massachusetts Male Aging Study (MMAS) found that 52% of men between 40 and 70 years old reported having some form of erectile dysfunction (ED).1 The reality is that ED is a natural part of ageing and that the prevalence increases with age. In the MMAS, they found that roughly 50% of men at 50 years old, 60% of men at 60 years old and 70% of men at 70 years old had ED. Thus, nearly all men who live long enough should develop ED. The myths that surround the problems of impotence or ED confound the attempts of patients to receive treatment and the attempts of physicians to help them.1 Many factors can contribute to sexual dysfunction in older men, including physical and psychological conditions, comorbidities and the medications used to treat them. Aspects of an ageing man’s lifestyle and behaviour and androgen deficiency, most often decreasing testosterone levels, may affect sexual function as well.

A study of men between the ages of 30 and 79 years showed that 24% had testosterone levels below 300 ng/dL and 5.6% had symptomatic androgen deficiency.2 The percentage of men who engage in some form of sexual activity decreases from 73% for men aged 57–64 years to 26% for men aged 75–85 years.3 For some men, this constitutes a problem, but for others it does not. The aetiology for this decline in sexual activity is multifactorial and is in part due to the fact that most of the female partners undergo menopause at 52 years of age with a significant decline in their libido and desire to engage in sexual activity. A study by Lindau and colleagues3 that examined sexuality in older Americans showed that 50% of the men in a probability sample of more than 3000 US adults reported at least one bothersome sexual problem and 33% had at least two such problems.3 This article will review the normal changes that occur with ageing, factors that influence these changes, individual variations and perspectives, and the available treatment options for ED and androgen deficiency. In a small number of men, blood tests may show abnormally low levels of testosterone, the male sex hormone. In such cases your doctor might prescribe a course of testosterone injections or a testosterone implant. The supplements can help boost sex drive as well as increasing the ability to have erections. Testosterone gel or patches, applied daily to the skin, are another option.

Sleep Is a Natural Erectile Dysfunction TreatmentJamie Grill/CorbisPoor sleep patterns can be a contributing factor for erectile dysfunction, Mucher says. One review published in the journal Brain Research emphasized the intricate relationship between the level of sex hormones like testosterone, sexual function, and sleep, noting that testosterone levels increase with improved sleep, and lower levels are associated with sexual dysfunction. Hormone secretion is controlled by the body’s internal clock, and sleep patterns likely help the body determine when to release certain hormones. Adhering to a set sleep schedule is a natural erectile dysfunction remedy, and can help ensure that those signals are clear and consistent.4Quit Smoking to Stop Erectile DysfunctionPeter Dazeley/Getty ImagesFor many men, stopping smoking is an erectile dysfunction remedy, particularly when ED is the result of vascular disease, which occurs when blood supply to the penis becomes restricted because of blockage or narrowing of the arteries. Smoking and even smokeless tobacco can also cause the narrowing of important blood vessels and have the same negative impact. If you smoke, talk to your doctor about quitting and whether prescription aids can help you.

It’s important to remember that the U.S. Food and Drug Administration doesn’t regulate quality, strength, purity, or packaging of herbs. If you choose to take herbs, be sure to get them from a reliable source. Panax ginseng Called the herbal Viagra, Panax ginseng (red ginseng) has solid research behind it. Researchers reviewed seven studies of red ginseng and ED in 2008. Dosages ranged from 600 to 1,000 milligrams (mg) three times daily. They concluded there was “suggestive evidence for the effectiveness of red ginseng in the treatment of erectile dysfunction.” More current research is examining how red ginseng influences ED. Ginsenosides are one element present in Panax ginseng extract that have action at the cellular level to improve erection. The action of Panax ginseng appears to be most effective for those with high lipids in their blood and metabolic syndrome. This herb is known to have anti-inflammatory action, improve lung function, and improve blood flow in other diseases AMTOTO — all characteristics that may reduce ED.

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