Erectile Dysfunction Specialists in Las Vegas, Nevada
As men become older, male sexual health becomes an important concern. Male sexual health concerns can be related to erectile dysfunction, premature ejaculation, delayed ejaculation, pain during sex, decreased sexual desire.
In this blog we will discuss in detail issues related to erectile dysfunction.
Erectile dysfunction is defined as inability to achieve erection sufficient enough for penetration, or the erection may not last long enough for a meaningful sexual encounter.
We are seeing a significant increase in the rate of erectile dysfunction, this is no longer considered a disease of the elderly. Environmental toxicity, excessive stress, highly processed diets, all of these can lead to hormonal disturbances which have been associated with decreased sexual desire, decreased morning time erections which in turn can lead to atrophy of the penile muscle and erections become difficult to achieve and maintain.
Major causes of erectile dysfunction:
- Endocrine disorders such as diabetes mellitus type 1 and type 2, pituitary tumors
- Drug abuse with medications such as cocaine, methamphetamine
- Cardiac problems such as coronary artery disease, congestive heart failure
- Uncontrolled high blood pressure
- Alcohol abuse
- Smoking
- Neurological injury
- Porn induced erectile dysfunction
- Depression
- Anxiety
- Lack of a attraction to the partner
- Chronic kidney disease
- Liver problems
- Lung disease such as asthma and emphysema
- Peyronie’s disease
- Penile trauma
- Multiple sclerosis
- Spina bifida
Porn induced erectile dysfunction:
Pornography has been associated with increased rate of a sexual dysfunction, if you are interested in learning more about this topic, please click the link below to watch my detailed video on this topic.
Porn Induced Sexual Dysfunction
Psychogenic versus Organic erectile dysfunction
In psychogenic erectile dysfunction, erectile dysfunction appears rapidly, is only present in certain situations and not all the time. Most common causes are performance anxiety, depression, uncontrolled anxiety, lack of attraction for the partner.
Organic erectile dysfunction generally has an underlying pathology and erectile function declines over months and years
Medication induced erectile dysfunction
Certain medications are associated with problems with erection. All the list is quite extensive these are some of the common ones
- Spironolactone: suppresses testosterone production, blocks testosterone receptors
- Ketoconazole: blocks testosterone production
- Flutamide: commonly used medication in prostate cancer, suppresses testosterone production and blocks androgen receptors
- Estrogen:
- Progesterone in high doses
- Antidepressant such as amitriptyline and nortriptyline block GnRH release
Role of hormones:
Morning time erections are nature’s Way of keeping the penile muscle healthy by exercising it on a regular basis. When min get a erection in the morning, there is a significant amount of blood flow that is pumped into the penis, replenishing the penile vasculature.
As testosterone levels decline, man may notice a decrease in the frequency of morning time erections . Over time this leads to decrease in blood flow to the penis, which causes a weakening of the penile muscle and erections become hard to maintain.
Optimizing testosterone levels is extremely important to treat erectile dysfunction
Typical workup:
In our office at HEALOR™ ED clinic in Las Vegas , you will have a detailed evaluation by Dr. Raj Singh MD, FACP, FASN. Dr. Raj Singh has several years of experience in male sexual health, and he travels nationally to train other healthcare providers in management of erectile dysfunction and other male sexual health problems
Lab testing may include complete blood count, comprehensive metabolic panel, testosterone levels, estrogen levels, progesterone levels, DHEA, prolactin levels, TSH
Penile Doppler to assess the blood flow in the arteries and veins.
Bio ThesioMeter to assess Nerve Function
TM Flow Scan to assess for circulation issues and nerve testing
Treatment options:
Treatment plans are customized based on hormone levels, health of the penile tissue and many other factors.
Supplements for erectile dysfunction
Many supplements can be helpful in the treatment of erectile dysfunction, while the exact mechanism of action off a lot of supplement is unknown, most of them promote increased blood flow in the penis, relaxation of blood vessels, increase sex drive and raise testosterone levels.
- Yohimbine: block Alpha receptors and increases blood flow
- L – arginine: increases blood flow through the penis
- Omega-3 with Co Q10 to reduce inflamma tion in the blood vessels and improve blood flow.
- Ashwagandha
- Ginseng
- Red wine and grape seed extract
- Niacin
- Pycnogenol
- Vitamin-E
- Horny goat weed
- Rhodiola
- Tongkat Ali
- Zinc: boost testosterone levels
- Boron: boost free testosterone levels by increasing conversion from total to free testosterone
Prescription medications for erectile dysfunction
- Trazodone
- Low-dose sildenafil or tadalafil are used to promote blood flow to the penis
- Papaverine injection: typical dose is 30 mg twice a week. Extremely effective medication and induces erection in up to 98% of individuals
- Alprostodil: injected directly into the penis to induce erection. Injections are not painful
- Tri Mix: Triple therapy Trimix (papaverine, phentolamine, alprostadil) . Extremely effective medication in treating erectile dysfunction
Other treatments for erectile dysfunction
- Penile vacuum pump for home use to strengthen the penile muscle.
- Platelet rich plasma injection: This is a non FDA approved indication for platelet rich plasma. Blood is drawn, spun in a centrifuge, and this growth factor rich plasma is injected in the penile tissue after numbing.
- Shock wave therapy: This is a non FDA approved treatment for erectile dysfunction. A small device used which sends sound waves through the penile tissues causing micro trauma, which may promote formation of new blood vessels and nerve endings and may help improve erectile dysfunction. Sessions are often done weekly and take about 10 minutes to complete. Typically 6-8 sessions are required.
Erectile dysfunction is common, is preventable and treatable. Key to success is to start treatment early before that has been a significant decline in penile health.
If you have concerns regarding erectile dysfunction or are interested in preventing erectile dysfunction in the future, please contact our office by calling 702-362-2273 ors visiting us at HEALOR™ to schedule a visit with one of our specialists to discuss your treatment options.
