Management of erectile dysfunction (ED)

Here is a brief synopsis of treatments available for erectile dysfunction and what tests should be done. As always start with history, issues like how long you have had the problem, whether your partner is interested in correcting the problem. What medications do you take that could be aggravating the problem. Are you a smoker of cigarettes or marijuana, abuser of alcohol all these cause ED. Have you had Diabetes or Hypertension and so on. The history should be extensive. Next is the Physical exam and lab tests for hormones and diabetes. Six hormones are tested for as well as standard blood tests.If you are physically normal and have no problems with desire then your doctor may prescribe the PDE5 inhibitor drugs like Viagra. If your hormones, such as testosterone are found to be low these can be replaced. Medical issues can be addressed and any offending medications removed. If these don't work there are medications like "Muse" which the man can put directly into his penis, this will give him an erection that could last 4 hours. A variety of medications can be put into the urethra or injected directly into the penis, by the patient or the doctor. If these are not satisfactory or unacceptable there are surgical remedies which include inserting rods into the penis some of these are firm in consistency and some have to be inflated. My urology colleagues tell me that for the people that have to get implants the satisfaction rate is 90%. If you have more questions please call for an appointment, I would love to go into more detail.

Bringing sexy back!

Last weekend I gave a talk on men's sexual function, actually men's sexual dysfunction to be precise. A lot of couples don't realize that men's sexual function does decrease with age even when the desire is still strong. Hence the immense popularity of Viagra and Cialis kinds of drugs. My talk involved the natural decline in sexual function and how to restore it even if these drugs don't work. Before I switch subjects, many are not aware that if a man has had Cialis within 48 hours he cannot take nitrates for a heart attack or chest pressure. I want to give that little piece of information so that people remember to mention the use of these medications should they find themselves in an emergency room. As it happens the conference called 'Bringing Sexy Back' was for married women only and they had a myriad of concerns about their husband's sexual function. The rest of the 2 days was spent 'getting sexy' with workshops and advice that I think would be hard to find elsewhere. Suffice to say it was 'live' and pretty wild (by my standards at least). I would certainly be happy to discuss either female or male sexual dysfunction with any patients who have an interest in the subject. This conference underscored the very important role that sexual intercourse plays in a marriage and how it reinforces bonding, intimacy and even friendship between the spouses. Here's a heads up: On April 30th at 11 AM I will be speaking at the Howard county Womanfest on "sex, sanity and sleep". The subject matter in this case will be strictly about women and it is free.. More on that in future blogs, in the meantime put some thought into spicing up your sex life and if its not working come and see me.