• Male Treatment Options

    Refer for treatment of underlying medical conditions  

    • Diabetes, hypertension and/or hypercholesterolemia are common underlying causes of sexual function problems.

    Change medications  

    • Some medications used for anxiety, depression, pain management, cardiovascular problems, high blood pressure and other conditions can cause sexual function problems.

    Omit problem drugs or substances

    • Some medications may need to be stopped. Alcohol excess may be corrected, as well as tobacco abuse.

    Hormone treatment  

    • Prolactin is a pituitary hormone that, if elevated, may cause sexual dysfunction. There are medications that can correct this problem. The male hormone testosterone may be deficient, but there are various ways of correcting this condition. Testosterone levels decrease with age; a patient's decreased testosterone level may be normal for his age, and therefore, must be interpreted with this factor in mind. 

    Oral tablet therapy  

    • Yohimbine A tablet that has been available for several decades. Although it has been controversial, it is useful in certain circumstances.
    • Sildenafil (Viagra)
      Proven effective in a large percentage of patients but has certain side effects that may hamper effectiveness. Viagra should not be used with nitrates.
    • Levitra
      A drug similar to Viagra, Levitra was successful in 85 percent of men tested. Levitra is not recommended for patients taking alpha-blockers (sometimes prescribed for prostate problems or high blood pressure) or nitrates. Taking Levitra with these drugs may cause blood pressure to drop to an unsafe level.
    • Cialis
      A prescription drug used to treat ED in men. It may be taken once per day, and can work for up to 36 hours with no restrictions regarding meals. Side effects are minimal, though adverse effects may result if Cialis is taken with nitrates or certain alpha-blockers. 

    Vacuum pump  

    • Pumps have been available for several decades and are quite effective for most patients, though they are somewhat mechanical in nature.

    Constriction rings  

    • Rings are useful in men who can obtain good erections initially but cannot maintain them for completion of intercourse. Rings may also be used in conjunction with penile injection therapy or intraurethral treatment. 

    Intraurethral pellet medication (Muse) 

    • This product uses prostaglandin E1, the same vasodilator used in the approved medication for penile injection. Although not as effective as penile injection in some patients, there are fewer complications.
      Injection therapy. Although used for nearly two decades, the FDA officially approved prostaglandin E1 (Alprostadil) only several years ago. This drug is effective in nearly 90 percent of cases, but it is invasive and the patient must feel comfortable injecting the shaft of his penis with a small insulin needle. Other substances, though not yet FDA-approved, have been used in injection therapy as well.

    Implants  

    • Penile implants are generally reserved for cases in which other modes of therapy prove insufficient due to risk of infection, extrusion and/or equipment failure. A consultation with a member of Lahey's Institute of Urology would be required in this case. 

    Psychological treatments  

    • A consultation with a sex therapist is mainly used for the correction of performance anxiety and/or relationship problems related to sex. The therapist may rule out depression and/or marital issues that require more extensive couples counseling. Information on normal sexual functioning is sometimes required. Usually, behavioral methods are used, as opposed to long-term psychotherapy.

    New treatment options are continually being evaluated and implemented. If there is a treatment you have heard of but do not see listed here, please ask your doctor.
     

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