If you cringe at the thought of injecting your penis with drugs to get an erection, we certainly don’t blame you. It’s hard to imagine that putting yourself in such a sensitive area would be anything but traumatic. However, it is important to set the record straight as many patients benefit tremendously from penile shots using the compound known as Trimix. But let’s first discuss how we get there.
The Genesis of Erectile Dysfunction
When we talk about erectile dysfunction, we are not necessarily talking about the inability to achieve an erection of any kind. Instead, the discussion is about the failure to achieve or maintain the erection you want. This may mean that the erection is not hard enough for pleasurable sex, or that you will lose the erection earlier than you would like.
The causes of erectile dysfunction can be both supply-side and demand-side. What does this mean? On the supply side, we have blood flow and nerves. Most cases of erectile dysfunction involve vascular problems. Being overweight and obese, for example, can increase plaque deposits on artery walls, causing narrowing. This affects the penis just as much as the peripheral vascular system or even the coronary arteries. Another important cause of erectile dysfunction is related to nerves. Some patients who have had severe trauma to the genitals or groin can damage or irritate these sensitive nerves, which eventually leads to erectile dysfunction. In addition, patients receiving treatment for prostate cancer in the form of prostatectomy or radiation may also experience erectile dysfunction.
On the demand side, we think about low testosterone, desire and stage fright. For some, erectile dysfunction can be psychogenic, meaning it’s all in their head. This often happens to younger men who have intercourse that doesn’t go as planned. Then they are entertained by thinking that they might have a problem, when, in fact, they need the confidence to know that it was a one-time problem. Low testosterone, while heavily marketed by drug companies as a ubiquitous problem in middle-aged men, is not as widespread or as serious as we think. However, low testosterone can also be caused by a less-than-optimal lifestyle such as smoking, being sedentary, and having a poor diet. For some, clinical low testosterone is real and requires treatment. Finally, desire is a big part of erectile dysfunction. Many men, especially in long-term relationships, have lost the spark they once had with their partner or spouse and therefore cannot enjoy the sex life they once had. It is important to remember that no treatment for erectile dysfunction increases desire. This must be dealt with separately.
All this of course brings us to the treatment of erectile dysfunction.
Medications are almost always the first-line treatment for erectile dysfunction simply because they are so easy to take and very effective. The drugs include Viagra and Cialis, as well as their generics, Sildenafil and Tadalafil. These drugs are usually very effective in creating the erections needed to have a pleasurable sex life. However, depending on the severity and progression of ED, they may have a limited practical time.
Pharmaceutical Dosage
Typically, a urologist will prescribe a mid-level dose when patients begin to complain of ED. For Cialis, this is 10 mg and for Viagra, this is 50 mg. This usually gives us a baseline for increasing or decreasing the dose based on effectiveness. Eventually, usually after several years, the erectile dysfunction has progressed to the point where medication no longer works reliably. At this point, patients have options.
- They can proceed to a vacuum pump device. This is an approved option for erectile dysfunction, but it has significant drawbacks. Not only is it cumbersome, but it creates a cold erection – it doesn’t feel very natural.
- Trimix is a very effective but worthwhile plan. A patient injects this compound into the shaft of the penis, which creates an almost immediate, long-lasting and stable erection. Many patients think the injection will be excruciating – this is not necessarily the case with training from the urologist or advanced practice. the shots are not only very effective but also relatively painless. However, more than about 50% of patients will completely refuse the shots.
- For patients with severe erectile dysfunction – unable to enjoy any erectile function – or for those who do not wish to inject themselves, the ultimate treatment for ED is a penile implant. The most popular of these implants is a three-piece inflatable penile prosthesis, which has a pump in the scrotum, a reservoir of fluid in the pelvis, and two silicone shafts inside the penis that can be inflated when needed. This option is discreet and elegant, with many patients not even having to tell their partner about the implant.
The bottom line
As you can tell from the article above, there are many and varied treatment options, and patients should speak with a urologist and a men’s health specialist to understand more about their condition. While there are very cheap and seemingly easy options available online and overseas, the truth is that you also need a provider who can monitor your progress and help you maintain good erection quality now and in the future. Qualified urologists and men’s health specialists can do this. Call our office to schedule a consultation and get the right treatment option.
