ERECTILE DYSFUNCTION.

Don’t you love these medical labels?

Erectile Dysfunction – Clinic Treatment Options include Caverject.

What tablets are used to treat Erectile Dysfunction?

Erectile dysfunction is simply when the erections are not hard enough for sexual intercourse. Well, it has to be given a name so it might as well be medicalised!

What tablets are used to treat Erectile Dysfunction?

Mild or Moderate Erectile Dysfunction is an important issue at the men’s health clinic, and can usually be treated successfully in primary care.

Working “backwards” from treatment to cause, it’s fair to say that Viagra and other brands often work well for mild or moderate erectile dysfunction (whatever the cause), and they are safe and well tolerated. There are 3 main brands – Viagra, Levitra and Cialis. They differ in terms of cost, how quickly they work and how long they last for. Viagra is now past its patent & generic Sildenafil is very affordable.

These tablets listed work in around 65-70% of cases. There are other treatments available through erectile dysfunction specialists that may be used when these standard tablets havn’t worked. These range from injections into the penis all the way to surgery for specific situations.

What are the Common Causes of Erectile Dysfunction?

Efforts should be made to establish a cause where possible.

Low Testosterone is not a common cause of erectile dysfunction although checking this may be appropriate. The association between low testosterone and erectile dysfunction is not well established. On the other hand, low testosterone can cause a low libido. There is some evidence that low testosterone may make viagra (or similar medications) less effective.

Erectile dysfunction becomes more common with increasing age and this won’t be surprising. Erectile dysfunction in older guys is often linked to narrowing of the the penile arteries caused by atherosclerososis (furring of arteries caused by fatty plaques). Erectile dysfunction is linked to the causes of atherosclerosis:

What’s important is to screen for cardiovascular risk so that the atherosclerosis can be kept at bay and not develop further. Another way of putting it is to say that older guys with erectile dysfunction are (as an average) at greater risk of heart attacks and other cardiovascular events. The good news is that this risk can be reduced significantly with attention to cardiovascular risk factors.

Therefore Other tests in middle age to older men would include blood pressure, and blood tests for lipids (cholesterol), kidneys and blood sugar.

Partial erectile dysfunction is also common in young men. Most men with erectile dysfunction will experience performance anxiety as a results of the problem, and of course anxiety or other psychological issues may also contribute (a chicken and egg situation – which came first).

What’s important is to screen for cardiovascular risk so that the atherosclerosis can be kept at bay and not develop further

What are the routine tests might be needed?

Blood Pressure.

Blood Tests might include:

  • Testosterone (Other hormone tests may be indicated when there are other pointers to a hormonal problem)
  • Fasting lipids & Glucose
  • Routine biochemistry

What is Caverject?

®Caverject is an injection that the man gives himself directly onto the top of the penis with a needle. The good news is that the ultrafine needle will hardly be felt if at all – it’s the same needle diameter that is used for insulin injections.

This injection treatment works for 80% of men and is often successful when Viagra or equivalent medication is not. The erection follows within around 10-15 minutes of the injection.

The most common risk is fibrosis (hardening just under the skin) which occurs in around 1 in 20 men after prolonged therapy. A  Prolonged erection is most likely to occur when the dose is too high and occurs also in around 1 in 20 men. A normal erection will not last more than 1 hour. A prolonged erection, especially lasting more than 4 hours, requires immediate medical attention to avoid any permanent damage. The upside of Caverject, so to speak, usually outweighs these small risks.

Caverject impulse  is an all-in-one syringe which does not require separate mixing. Caverject impulse is now available in Australia. No-one likes to use needles. However, the needle is ultrafine and very easy to use. The Cost of caverject impulse from pharmacies is currently around $20 to $25 per disposable injection.

Instruction in the use of caverject is available at the clinic. You will need two long appointments with The doctor. The first appointment is for an assessment & discussion. At the second appointment you’ll inject a small dose under direct supervision by the doctor. Don’t worry – the dose is small enough to not cause embarrassment when you leave the clinic! You’ll titrate up the dose yourself at home.

The doctor will discuss the best options for you which may include: medication, testosterone, caverject, or a referral to consider vascular studies or penile implant.

WRITTEN BY: Dr Richard Beatty
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