Erectile Dysfunction

Erectile dysfunction (ED) or impotence is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance. The providers at Phoenix Family Medical Clinic diagnose and treat patients with Erectile Dysfunction through a variety of programs.

A penile erection is the hydraulic effect of blood entering and being retained in sponge-like bodies within the penis. The process is often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis. The most important organic causes are cardiovascular disease and diabetes, neurological problems, hormonal insufficiencies and drug side effects.

As it may be awkward sometimes to talk with your doctor about erectile dysfunction, our providers will allay your fears and give you the space to be comfortable discussing it with our providers. Problems getting or keeping an erection can be a sign of a health condition that needs treatment, such as heart disease or poorly controlled diabetes. Treating an underlying problem may be enough to reverse your erectile dysfunction.

After initial consultation and lab tests, the provider may decide to prescribe oral treatments like Viagra, Cialis or Levitra, if they are safe for use by the patient.

Medications for erectile dysfunction might not work or might be dangerous if you:

• Take nitrate drugs — commonly prescribed for chest pain (angina) — such as nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) or isosorbide dinitrate (Dilatrate-SR, Isordil)
• Take blood-thinning (anticoagulant) medications, alpha blockers, antibiotics, anti-seizure medications or anti-arrhythmic heart medications
• Have heart disease or heart failure
• Have had a stroke
• Have uncontrolled low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension)
• Have eye problems, such as retinitis pigmentosa, or a family history of certain eye problems
• Have severe liver disease
• Have kidney disease that requires dialysis

Some men might also choose another treatment option to avoid the side effects caused by certain oral medications.

Other types of medications

Nonoral medications for erectile dysfunction include:

• Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Caverject, Edex) or a combination of medications that includes alprostadil into the side of your penis. Each injection generally produces an erection that lasts about an hour. Because the needle used is very fine, pain from the injection site is usually minor. Side effects can include bleeding from the injection, prolonged erection and formation of scar-like (fibrous) tissue at the injection site.
• Alprostadil penis suppository. Alprostadil intraurethral (Muse) therapy involves placing a tiny alprostadil suppository in your penis. You use a special applicator to insert the suppository into the tube that carries urine from your bladder (the urethra). An erection usually starts within 10 minutes and lasts between 30 and 60 minutes. Side effects can include pain and minor bleeding in the urethra.
• Testosterone replacement preparations. Some men have erectile dysfunction caused by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended. Testosterone replacement therapy can be delivered via injection, patch, gel, gum and cheek (buccal cavity), or oral medication. Talk to your doctor about your personal preference and the possible side effects.

Please be sure to discuss in details the duration of your problem and what remedies you have tried so far with our providers. Your providers at Phoenix Family Medical Clinic are here to help treat this disease with utmost concern for your self esteem, safety and privacy. The providers will also discuss any side effects that may be associated with the meds prescribed to you for erectile dysfunction.