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.

Growth Hormone the mystery reparative hormone

The majority of my Anti-Aging patients are male but the reverse is true when it comes to Hormone Replacement. Its an observation that I find interesting, why the difference? I'm not sure.
This month I am going to focus on issues affecting Anti-Aging specifically and many of them are more male directed intentionally because I think that sometimes women's issues are overrepresented.

What is Growth Hormone exactly and why is it so popular? Growth Hormone is naturally secreted by the pituitary it affects almost every organ in the body, it is a master controller of metabolism and muscle tone.

In my opinion, Growth Hormone is a misnomer,oftened referred to as HGH (Human Growth Hormone) it was originally named because children without it didnt grow. In adults once the growth plates are closed there is no opportunity for getting taller no matter how much growth hormone a person takes.
The name gives the impresion of a substance that can cause strange things to grow like horns and cancer, it actually does not. It is in fact HGH a reparative hormone which helps the body repair damage and heal faster.

I recently had a patient whose company sent him to a leading hospital annually for an 'executive' physical. This, and the fact that he had formerly been a triathlete led him to believe that he was very healthy. After he had some arthroscopic surgery last year he became very frustrated because he could not get back to his prior level of fitness. A friend told him he needed to find an Anti-aging physician and he found me. I ran a series of tests on the patient and started him on therapy. We optimized his vitamin, and supplement levels in addition to short course of HGH.
At his 3 month follow up visit, the patient told me he was 'back to 100%'. It took less than 90 days to get him back in condition, something physical therapy and working out had not been able to achieve.
I had another patient who was 35, also an athlete and when he was offered his 5th knee surgery decided there had to be another way.
The first patient asked me an interesting question, one in fact that I couldnt answer: "Why doesnt every patient who is getting surgery get treated like this from the get go?"
I have no idea, but it seems to make sense. Why should this be 'the medicine of the future' when we have the information to help people now? Why dont more orthopedic doctors refer their patients to get 'tuned up' before undergoing the knife?
I put all the patients who come to me for a 'pre-operative' physical on a healing regimen, afterall, surgery is just self-inflicted trauma. We can anticipate the damage that will be caused and limit it.
(For more information on Growth Hormone please see my website).

Another interesting point that this case brings up is: Do you really want your preventive medical care managed in a place that is totally focused on disease? It is fine to go to the country's best hospital for 'Treatment' but the goal of Preventive Maintenance is different. Be clear about exactly what you want from your 'routine' physical exams and what your doctor's focus is. Primary prevention is the art of preventing something before it occurs, secondary prevention (for example a mammogram) is detecting a disease early enough to do something about it and then there is the third option: fixing a problem that is already entrenched.
You choose what works best for you.

More stuff on men

There are a host of complaints that men have that can be indicative of hormone deficiencies or Andropause. These complaints often include weight gain, and a lack of stamina.

For many men aged 35 to 50 the major concern is loss of lean body mass (muscle) around the middle and decreased libido. On occasion there may also be depression, sleep disturbances and loss of vitality.

I think the biggest surprise is how early men begin to manifest signs of hormone imbalance and deficiency. One often associates women with menopause starting in the late 40's not realizing that men can start a decade earlier.

The difference with men is that the changes are not as dramatic as Menopause and so men tolerate them better and gradually get acclimatized to feeling less than optimal.

What to do?
Well, first figure out your baseline in your early 30's.
Did you know that the average testosterone level in men is much lower than it was 50 years ago? Scientist's dont know why this is the case. It may have something to do with the food supply, fertilizers, hormones in meat etc.

Secondly , get a saliva test to check both your hormone levels in the tissues and the balance between them, this would include your sex hormones as well as the adrenal and thyroid hormones.

With this information your Growth Hormone level and the blood chemistry profiles you will be able to evaluate your risk factors for morbidity and mortality.

Many studies have shown a direct link between a man's testosterone level and his risk of early death from all causes including cancers.
We always knew testosterone was important for a man's well being and now we have proof!

Keep your hormone levels optimal, one of the best ways to:

Add years to your life and life to your years!

(Come in and get your levels checked, it could save your life)