Houston, TX

Erectile Dysfunction

Introduction To Erectile Dysfunction

Recent studies now show almost 40% of men over the age of 40 will experience ED, and 1 in 5 Americans may experience early onset ED even in their 20s and 30s. ED can affect self-esteem, increase stress, and negatively affect sexual relationships.

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What Is Erectile Dysfunction

Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for sexual intercourse. Unfortunately, as men age ED is almost inevitable, and typically will worsen with time.

Many men do not seek treatment due to embarrassment, but it is our aim to provide expert care in a confidential and supportive environment. Please call our office to schedule a consultation if ED is of specific concern to you.

The inability to achieve an erection is a quite common condition called erectile dysfunction or ED and can affect men from all walks of life. Understandably, and unfortunately, ED is a topic that can be uncomfortable for many men to talk about, let alone seek treatment for. At HTX Urology our specialists collaborate closely with patients to gain nuanced insights into their condition, an essential step in developing an effective treatment protocol. Whether you are facing ED due to medical conditions, psychological factors, or age-related issues, HTX Urology offers a range of effective treatments tailored to meet your unique needs and improve your quality of life.

Causes of ED

  • Diabetes
  • High Blood Pressure
  • High Cholesterol
  • Low Testosterone
  • Heart disease
  • Obesity
  • Peyronie’s Disease – Penile plaque with curvature
  • Neurological Disease – Parkinson’s Disease, Multiple Sclerosis
  • Substance Abuse – Alcohol, smoking
  • Medications – Beta-blockers, narcotics, anxiolytics, anti-depressants, anti-psychotics
  • Prior Pelvic Surgery
  • Sleep Disorders

When to Seek Treatment for Erectile Dysfunction

Erectile dysfunction can affect practically anyone who is suffering from any of the causes listed in the previous section. The condition can also begin as early as in their 20s. As such, patients who have diabetes, sleep disorders, or obesity would be advised to be aware of the symptoms.

These include being unable to stay erect for long periods of time or get an erection at all. Low sex drive could also be a sign that the patient is suffering from ED. If you’re noticing these health conditions paired with these symptoms, it’s time to seek treatment right away.

Treatment Options

Medications

PDE-5 inhibitors, like Viagra or Cialis, are typically first-line treatment for men with ED. Although effective for many, others do not respond to oral medications, or some men cannot tolerate their respective side effects.

Side effects typically include headache, flushing, runny nose, back pain, and rarely prolonged painful erection or vision changes.

Typically, medication is taken 1-2 hours prior to planned intercourse. Certain meds may need to be taken on an empty stomach. Effects usually last anywhere between 8 to 36 hours. Before starting any medication, ask your physician if you heart is healthy enough for sex.

Testosterone Replacement Therapy (TRT)

A wellness panel is typically checked on initial consultation for erectile dysfunction. This panel usually will check your hormonal axis including your free and total testosterone levels.

Low testosterone, in the appropriate patient, can be replaced to help improve erectile quality, sexual performance, and sexual desire or libido. TRT can also carry other benefits, including improved energy level, and increased muscle mass and stamina.

TRT can be achieved using creams, weekly intramuscular injections, or subcutaneous long-lasting pellets. As always, talk with your urologist as there are also known risks to TRT that merit further discussion.

Wave Therapy for ED

Wave Therapy for erectile dysfunction is a new, cutting-edge treatment modality allowing for strong, spontaneous, long-lasting erections without the need for pills, injections, or invasive surgery. This is a relatively painless procedure that can be done in the office in under 10-minutes. Typically, 6 total treatments are needed to achieve the desired outcome. Results can last for months to years, maximizing a man’s (and partner’s) overall sexual satisfaction. It is also cost-effective long term as alternative treatments require continuous use of somewhat costly medication.

Wave Therapy has many other names. It can be called Low-intensity Shockwave Therapy (LIST), Low-intensity Extracorporeal Shockwave Therapy (Li-ESWT), Shockwave Therapy (SWT), or Extracorporeal Pulse Activation Therapy (EPAT). All names deliver the same effective ED treatment – don’t let the jargon confuse you.

Vacuum Erection Device (VED)

VED is a non-invasive, medical-grade device that uses suction pressure to induce blood flow to the penis. Next, a small band is placed at the base of the penis to maintain an erection for up to 30 minutes.

It is quite effective but does require training for proper use. Insurance companies will rarely cover the cost of the device, but long-term it is more cost-effective than oral medications as it is only a one-time expense. VED is a proven therapy that is of higher quality than “penile pumps” found at novelty shops.

Inflatable Penile Prosthesis (IPP)

Typically, patients opt for surgery with an inflatable penile prosthesis after failing several of the above-mentioned options. This involves major surgery with a 6-week recovery time.

It is important to note that once a patient opts for placement of an IPP, natural erections are no longer a possibility. Please discuss with our urologists if this option seems right for you, as many men note vastly improved sexual satisfaction after failing multiple other treatment options.

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How Do Erectile Dysfunction Medications Work?

ED medications, including popular options like Viagra (Sildenafil), Cialis (Tadalafil), and Levitra (Vardenafil), work by increasing blood flow to the penis, facilitating and sustaining erections. These medications typically belong to a class known as PDE5 inhibitors, promoting relaxation of the blood vessels in the penis.

We provide you with the full spectrum of oral and injectable ED meds at a discounted price. Meds are shipped directly to your door, avoiding awkward trips to the pharmacist and time wasted on hold with insurance companies. Our oral medications are available in both on-demand tablets and troche forms, which are dissolvable in the mouth for quicker effect.

Oral Medications

Oral medications are often the first step in treating erectile dysfunction (ED). The two most popular medications are Sildenafil (Viagra) and Tadalafil (Cialis). These meds are typically effective in mild to moderate cases of ED. Unfortunately, conventional pharmacies often charge $40-70 per dose, making treatment unaffordable for most men.

Options For Oral Medications

Though different oral medications work in different ways, every medication has its own chemical makeup. It is these differences that can affect the working mechanism of these medicines, such as how quickly they affect and how fast they wear off. Before prescribing these medications, Dr. Dhir will take your interactions with other medicines as well as your health into consideration.

Let us take a look at some of the most common medications prescribed by Urologists and the differences between them:

  • Viagra or Sildenafil: This is a popular and effective medicine most prescribed for men suffering from mild to moderate erectile dysfunction. It is most effective when it is taken on an empty stomach around one hour before sex.
  • Cialis or Tadalafil: This medication can be taken any way- with or without food. Taken about one to two hours before sex, Cialis is effective for around 36 hours. It can be taken as a larger dose or in small doses daily, as per your individual prescription.
  • Vardenafil or Levitra or Staxyn: Most effective when taken around an hour before sex, this medication too can be taken both with and without food. It is effective for around four to five hours and even more if you suffer from mild to moderate erectile dysfunction. There is a newer form of this drug that has been released and dissolves right on the tongue and works faster than swallowing the pill.
  • Avanafil or Stendra: This ED medicine can also be taken with or without food, around 30 minutes before having sex. Depending upon its dosage, the effect of this medication can last for up to six hours.

Due to the similarities between these medications, Dr. Dhir often recommends a particular medication as per your individual preferences. This includes their ease of usage, cost, and the duration of their effects.

Injection Therapy

Injection therapy involves placing a small needle into the penile tissue 5 minutes prior to intercourse. The injection involves a compounded mixture of 3 to 4 medications, appropriately called Tri-Mix of Quad-Mix, that dilate the blood vessels to achieve a strong erection.

Results are immediate with intact sensation. Injection therapy is an alternative for men with moderate to severe ED who either do respond well to oral medication or have undesired side effects such as headaches or flushing. Injectable medications are compounded in a vial and are cheaper per dose than oral medications.

Which ED Medication Is Right For Me?

Choosing the right ED medication involves a personalized assessment of your health, lifestyle, and preferences. HTX Urology’s experienced specialists guide you through the selection process, ensuring that the prescribed medication aligns with your unique needs. All injection prescriptions will be scheduled for an in-office training session for proper use and dosage.

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Preventing Erectile Dysfunction with Lifestyle Modifications

Lifestyle modifications play a crucial role in preventing erectile dysfunction (ED) and promoting overall sexual health. Adopting a healthy diet rich in fruits, vegetables, whole grains, and lean proteins can improve cardiovascular health, reducing the risk of ED. Regular physical activity, aiming for at least 30 minutes of moderate exercise most days of the week, helps maintain a healthy weight and improves circulation, both essential for erectile function. Minimizing consumption of alcohol, quitting smoking, and avoiding recreational drug use can significantly reduce the risk of developing ED.

Managing stress through meditation, yoga, or other relaxation techniques can also help, as stress and anxiety are common psychological causes of ED. Finally, ensuring adequate sleep each night is vital, as poor sleep patterns can affect hormone levels and sexual function. Together, these lifestyle changes not only reduce the risk of erectile dysfunction but also contribute to a healthier, more vibrant life.

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Erectile Dysfunction FAQ’S

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To learn more about symptom management and treatment options for erectile dysfunction we invite you to arrange a consultation. Contact HTX urology today, we have offices conveniently located to serve Greater Houston Heights, Memorial City, Galleria, Webster, and Clear Lake, TX.

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