Be honest about your concerns and feelings. In one study, the agent was effective in 65% of a selected group of men. A man's ability to have an erection before surgery or radiation affects whether he will have ED after treatment. It is age-related, chronic, progressive, and greatly under-treated. Impotence is a widespread phenomenon; about half of couples entering sex therapy and one quarter of those entering marital therapy will complain of this problem. Sex therapy is distinct from sex surrogates. Not being able to achieve an erection on occasion is rarely cause for concern. 8 ​early signs of erectile dysfunction, on-demand treatment regimens have shown efficacy rates of 60–70% [74]. Medications such as Cialis and Viagra, which prevent an enzyme in the penis from causing erection loss, are sometimes prescribed.

They also cannot be taken with nitrates or Adempas (riociguat), a medication used to treat pulmonary hypertension. Regular physical activity improves blood circulation and decreases the risk of heart disease, diabetes, and obesity, all of which can have an impact on sexual function. It can take the form of about 20 one-hour sessions. Sex therapy for couples experiencing ED is similar to traditional couples therapy. These men may have success using a penis pump, which draws blood into the penis and induces an erection. How is it caused?

Then the appropriate treatment can begin.

This feature is not available right now. If you aren’t quite ready to talk to a therapist about your psychological impotence, there are some alternative therapies you can try at home. What's more, many of the lifestyle factors that contribute to sexual problems are ones that affect overall health and well-being, both physical and mental. Many men have found that their erections have improved and they are able to have intercourse. You may feel pain during ejaculation after treatment, though it usually goes away over time.

Men who have had cancer treatment may find that it simply takes time to regain sexual function. It's often a side effect of the treatments for prostate cancer, such as surgery or radiation therapy. What are the risks of Penile Injection Therapy? Methods for reversing ED fall into three categories: Your health care team might be able to steer you to a support group in your town. Each type of treatment has its own advantages, disadvantages and side effects. Replacement androgens are available in the following four forms:

Most often, one small surgical cut is made. Implants allows a couple to be spontaneously intimate. Sex drive stays in gear with antidepressant bupropion. Going to a therapist with your partner may also help you work out any relationship issues that have been affecting your sex life so the both of you will be more satisfied. CBT is a proactive and actionable therapy targeted at helping you change the way you think and behave.  While the precise mechanism remains unclear, experts suspect that acupuncture may help regulate nerve sensitivity and improve blood flow to the penis.

If a penile prosthesis is removed, other non-surgical treatments may no longer work.


You will have an assessment, which includes measurement of your height, weight and waist. What are the most common mistakes made by men with ED? If fatigue is a major problem, allow your partner to take the more physically active role.

  • Every case can be different.
  • Lymph node removal.
  • As a result, men may have "dry" ejaculations.
  • Isn’t ED sometimes linked to deeper psychological problems?
  • Contrary to common misunderstanding, sexual contact with, or in front of, the therapist is not a part of sex therapy sessions, and this applies to sex therapy for ED as well.
  • This is not a new treatment Penile injection therapy for ED was first introduced in the early 1980s, and has been used by hundreds of thousands of men.
  • A detailed assessment by a suitably qualified physiotherapist will determine if the pelvic floor muscles are playing a role.


Experts recommend starting "penile rehabilitation" (achieving erections with the help of medications) be started soon after surgery to achieve the best outcomes. Defective inguinal hernia mesh and sexual side effects. Almost any man who is truly motivated can achieve better erections with currently available medical and/or psychological techniques, and treatments are improving all the time. For sex and couple therapists and physicians, Erectile Dysfunction presents a systematic method for evaluating erectile dysfunction, determining whether its basis is primarily organic or psychogenic, and treating it by integrating medical interventions with sex and marital therapy. Between 5% and 25% of men with the condition now see a doctor for help. When erectile dysfunction becomes so frequent that it interferes with a man’s sex life, however, a doctor might diagnose him with erectile dysfunction. Nerves in your pelvic area control blood flow to your penis. Talk about ways to work around the ED. Just a short drive away, we offer ED treatment near Anaheim as well as the surrounding metro areas such as Santa Ana, Huntington Beach, Newport Beach, Irvine, Buena Park and other areas in Orange County.

For more information on injection, urethral and topical treatments for ED, see our factsheet ‘Injection, urethral and topical treatments for erectile dysfunction’. Moreover, patient satisfaction questionnaires show that up to 90% of men who have undergone penile implants say they would choose the surgery again, and overall satisfaction ratings are higher than those reported by men using oral medication or penile injection therapy. To inflate the penile prosthesis, the man compresses the pump a number of times to transfer fluid from the reservoir to the cylinders. By the way, doctor: does pomegranate juice interfere with medications? If you are interested in donating, please click here or contact us for more information (details at the bottom of this page).

Do you get nervous about pleasing your partner?

You should not hesitate to discuss these concerns with your provider. For example, Us Too is a prostate cancer education and support group that has local chapters where men can talk with each other. If a patient wishes to do injections at home he will come back for a second visit, during which the patient is taught how to do the injections. Again, dedication and investing time in the exercises outside of sessions are needed for maximum effectiveness.

  • Like ICI therapy, IU Alprostadil should be tested in the office, before home usage.
  • As people age, they are often viewed as asexual or as incapable of possessing sexual desires.
  •  With this effect in place, it's possible to get an erection in response to sexual stimulation and to sustain it.
  • Results of a phase I trial testing gene transfer in 11 men with erectile dysfunction who had failed other therapy showed that gene transfer was safe and also had restorative effects.
  • Very important.
  • Pain medications, if taken regularly, can lead to sexual dysfunction.
  • ICI Alprostadil may be used as a mixture with two other drugs to treat ED.

Erectile Dysfunction Treatment in Orange County, CA

The investigators know that treatment for prostate cancer and erectile dysfunction can impact sexual health and quality of life. Can smoking affect a man’s erections?, if you have heart disease, talk with your provider before using these medicines. Drugs that may cause erection problems: medlineplus medical encyclopedia, it is important as you talk with your doctor that you be candid in terms of when your troubles started, how bothersome your erectile dysfunction is, how severe it is, and discuss all your medical conditions along with all prescribed and nonprescribed medications that you are taking. Alternative drugs are often available. When a man is sexually stimulated, arteries widen so that his penis can fill with blood.

The good news is that there are a multitude of different therapies available for addressing ED.

Hormone Therapy

Although lack of sexual attraction to your partner might be one of them, it’s far more likely to be something else. The research is limited. Your doctor can help diagnose and treat your ED, as well as any underlying factors that may be at the root of the problem.

All three of these involve specific bodily systems including the hormones, muscles, blood vessels, nervous system, and emotions. Impotence & traditional chinese medicine, some other extracts of Common Cnidium Fruit such as imperatorin and xanthotoxin also exhibited relaxing effect on rabbit corpus cavernosum with intact endothelium. What are the causes for Erectile Dysfunction? Results have been mixed and are not at all guaranteed, although progress is more likely to be achieved if both partners approach sessions with an open-mind and willingness to share. This is not an indication of a security issue such as a virus or attack. Whether you experience erectile dysfunction as a result of radiation therapy depends on the amount of radiation you receive and how much of your pelvic area is being treated — a greater level of radiation over a greater amount of your body is more likely to cause sexual side effects. This keeps blood in the penis so the erection stays.

Testosterone gels are available for daily topical use to treat male hypogonadism and have the advantage of minimizing the peaks and troughs associated with the use of injectable agents.

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Symptoms of ED include an erection that doesn’t last long enough and an erection that isn’t hard enough for sexual activity. Sildenafil in postprostatectomy erectile dysfunction (perspective), clinical outcomes of intracavernosal injection in postprostatectomy patients:. I’m primarily a counseling psychiatrist, though I’m able to prescribe medication when needed. Medicines in themselves do not work, the erection occurs only when adequate sexual desire and stimulation are present. Erectile dysfunction quiz, learn the answer to this and other questions by taking this multiple choice quiz. Alprostadil doses as high as 40 µg can be used.

This may help you feel more in control of the situation and help guide you to treatment options. HIV (BASHH) website www. Don’t ignore erectile dysfuntion: it’s treatable!, if an erection lasts for over four hours, it will need medical attention to make it go down. Research has suggested that a small number of men with ED may benefit from exercises to strengthen the pelvic floor muscles. For more from Lisa please visit www.


For example, sildenafil (Viagra) increases blood flow to the penis, which can provide short-term relief from ED. This is why male smokers are at an increased risk of developing ED, regardless of their age or underlying medical conditions. Once activated you can maintain an erection as long as you desire. You may want to seek out a prosthetic urologist.

Second, ask a medical doctor whether injections which can be administered by you yourself. In most studies, men underwent a massage treatment three to four times per week for at least four weeks. It is necessary to change any negative attitudes toward sex. Inflatable implants make a normal looking erection and are natural feeling for your partner. Some insurance plans cover sex therapy. Once you confirm your privacy choices here, you can make changes at any time by visiting your Privacy Dashboard. Different types of penile prostheses are available and we can help you decide which device is right for you. Giving pelvic floor exercises will significantly improve erectile function in someone with an underactive pelvic floor but will make a hyperactive pelvic floor much worse.

Placement Of Penile Implant

If these options fail, you may be referred to a urologist who can assist with other non-surgical options such as vacuum device or injections or surgical treatment options. Men who are on medicines that contain nitrates such as nitroglycerine should not take oral ED medications. After the first week, over- the-counter pain drugs (such as acetaminophen or ibuprofen) may be substituted for narcotic pain drugs.

That's because most older men, including those who haven't had cancer, will experience difficulty with sex at some time. Then, each member of the relationship is seen for an individual session to get an unfiltered explanation of the problem without the individual feeling the pressure to give acceptable answers but an honest assessment of the situation. Erectile dysfunction treatments, pills such as tadalafil (Cialis), vardenafil (Levitra) or sildenafil (Viagra) may help you achieve an erection. Counseling and therapy with a qualified counselor/psychologist can help the man and his partner identify, understand, and cope with their sexual concerns. In fact, approximately 52% of men who are 40 to 70 years old have erectile dysfunction (ED). The pelvic floor muscles can become weaker or hypoactive or they can have a higher resting tone which is known as a hyperactive pelvic floor. Medication changes Some medications can make ED worse. What causes erectile dysfunction and what can you do about it? When the cause of ED is psychological, however, treatment often begins with to get to the root of any stress, anxiety, or depression that is interfering in sexual relations. These are taken in pill form.

A few studies have found that men who get prostate massage for the symptoms of ED experience improvement. Then a small rubber ring is put around the base of the penis. Porn-induced erectile dysfunction: how to overcome it, "My skin and eyes looks alive for the first time in years," one user states. Using a variety of psychological tests. If you find that you’re unable to get or keep an erection for more than a few weeks, there may be an underlying problem. Lack of spontaneity, discomfort, and cumbersomeness of the device seem to be the biggest concerns of patients. The AUA warns that PDE5 inhibitors can cause mild transient systemic vasodilation, which may be aggravated by alpha-blocking agents.

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First, seek an injection by a doctor. This kind of therapy is unlikely to be very effective if a man or a couple stops the treatment after only have a few sessions. This substance dilates blood vessels, thereby increasing blood flow to the male penis. It is often forgotten that achieving and maintaining an erection requires a man to be psychologically engaged, rather than being the mere puppet of a mindless physical response. Aphrodisiacs: what are the best foods to boost your sex life? Each type has its own pros and cons. Penile vascular surgery is not recommended for older men with hardened arteries. Both partners share responsibility for helping solve the problem, even if it is due to physical causes. Many things cause erection problems.

If atherosclerosis is the cause of your ED, this narrowing is likely to affect other blood vessels in the body as well, including the arteries that supply blood to the heart. 404 page not found, j Androl 1994, 15(Suppl):. We’re here to identify the cause and discuss every possible resolution. Many men may have difficulty obtaining or maintaining erections after various forms of cancer treatment. There is more and more evidence coming out that pelvic floor muscle retraining can be very effective in treating erectile dysfunction. It involves multiple components of the body. ED treatment in sex therapy takes a holistic approach, involving habit evaluation, expectation setting, and communication skills.