Men’s Health

Men’s Health

Erectile Dysfunction Treatment in Cleveland, OH

How does Dr. Thirumavalavan Diagnose ED?

At our practice, we provide a comprehensive assessment of your sexual health, including erectile dysfunction. We begin with a thorough history and physical exam, focusing on all factors that could make your erections worse. Importantly, we focus on your overall health as well, to keep your erections as strong as possible. We check some blood work, such as cholesterol, testosterone and estrogen levels, and blood sugars, as all these could affect your erections.

The Two Question Approach

Dr. Thirumavalavan will ask you two questions. If you find that you are not happy with the answers, you should consider evaluation and treatment for ED:

  1. “How hard do you get, from a scale of 1-10, with 10 being when you were 18 years old, 5 being hard enough for penetration, and 0 being nothing?”
  2. "Are you as hard as you want to be, for as long as you want to be?"

Treating ED with Lifestyle Changes

The first treatment option for ED includes diet, exercise, and quitting smoking.  If these efforts fail to provide the desired results, its time to consider other options and perform tests including a penile ultrasound to assess the blood flow in your penis.

Treatment Options for Erectile Dysfunction

There are a variety of methods for treating erectile dysfunction (ED). Your doctor can discuss all of these options with you in more detail. All decisions regarding your best option for treating ED should be made between you and your physician, with consideration given to your individual needs and the risks and benefits of each treatment option.

The treatment options include:

  • Drug Therapy
  • Non-drug Treatment Options
  • Penile Implants
  • Other

Drug Therapy

Drugs for treating erectile dysfunction can be taken orally, injected directly into the penis, or inserted into the urethra at the tip of the penis. The most commonly known drugs on the market today are Viagra®, Cialis® and Levitra®.

Oral Medication

There are several prescription medications that claim to help patients. These pills may help achieve erections in response to sexual stimulation:

  • Pills can help you achieve an erection quickly and may have an effect on sexual intimacy.
  • Do not provide automatic erections like injection drugs
  • Not effective in approximately 30% of cases1
  • Must take at least ½ hour to one hour before anticipated sexual activity2

Some patients may experience side effects, including:

  • Headaches
  • Facial blushing
  • Upset stomach
  • Mild and temporary visual effects

Injections

Some men may be able to gain an erection by self-injecting drugs into their penis, causing it to become engorged with blood. Potential side effects of injection therapy include fibrosis (scarring) and long-lasting painful erections

Advantages of injection therapy:

  • It can easily be self-administered
  • On-set of erection within 5-20 minutes3
  • Injections are shown to have a long-term dropout rate of 37% – 76%.4

Reasons for dropping out of drug therapy include:

  • Desire for a permanent treatment alternative
  • Inadequate response
  • Fear of needles
  • Side effects


Non-Drug Treatment Options

Penile Pumps (Vacuum Devices)

Also called vacuum constriction devices, penile pumps are devices that are placed over the penis to draw blood into the shaft. Once the vacuum creates an erection, the retaining band is slid down to the lower end of the penis and the pump is removed. You can leave the band on for up to 30 minutes.

Advantages

  • On-demand use
  • Non-invasive
  • Drug Free

Disadvantages

  • Erection is not warm to the touch
  • Learning curve
  • Delayed ejaculation

Penile Implants

A penile implant is a device that is placed into a man’s body and is designed to help him get an erection. A penile implant is a long-term treatment, that is covered by many insurance plans, which allows an erection as often as you like, for as long as you wish.

Advantages

  • Easy to use
  • Totally concealed in the body
  • Erections when desired

Disadvantages

  • Surgical Procedure
  • No longer able to get natural erections

Other Treatment Options

Your doctor can provide you with specific details about the pros and cons of each of the following treatments:

  • Lifestyle changes like stopping smoking, losing weight and eating healthier
  • Oral testosterone
  • Intraurethral suppositories (ex. MUSE®)

  1. Goldstein I, et al. Oral sildenafil in the treatment of erectile dysfunction. N Engl J Med. 1998 May 14;338(20):1397-404
  2. http://uspl.lilly.com/cialis/cialis.html#ppi downloaded 2/14/17
  3. http://www.caverject.com/faqs, downloaded 2/13/17
  4. Rajpurkar A, et al. Comparison of satisfaction rates and erectile function in patients treated with sildenafil, intracavernous prostaglandin E1 and penile implant surgery for erectile dysfunction in urology practice. J Urol. July 2003; 170(1):159-163.

Cialis®, Levitra®, Viagra®, MUSE® are trademarks of their respective companies.

 

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Dr. Thirumavalavan will personally evaluate your history and your concerns.  He will take the time to perform a thorough physical exam and explain all of your treatment options to help you decide what is best for you.  Call (440) 613-3406 to schedule an appointment in Cleveland, Beachwood, or Lyndhurst today!

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