Aging & Health: Take Charge

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PUBLIC PAGE
Dec 17, 2020

Safe solutions for erectile dysfunction

By Joey Keillor, @joeykeillor

shutterstock_1415704052

 

Erectile dysfunction becomes more common with testosterone decline as men age. It may also occur due to treatments or surgery related to the prostate gland or conditions affecting the nervous system. In addition, the same process of artery clogging that can lead to heart problems can also affect arteries supplying the penis with blood, causing or contributing to erectile dysfunction.

Oral drugs are typically the first choice doctors use to treat erectile dysfunction. Called phosphodiesterase type 5 (PDE5) inhibitors, these include sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis) and avanafil (Stendra). Most men have good results with PDE5 inhibitors, although it can take a few tries to find which one works best for you. When PDE5 inhibitors aren’t effective or aren’t an option, your doctor may suggest:

  • Sexual health counseling — Addressing the emotional and psychological aspects of erectile functioning such as performance anxiety or concern about partner’s pain can be an important aspect of treatment. If an erection is simply not possible due to medical factors, that doesn’t have to mean the end of intimacy. Counseling can help you accept and adapt to redefine your sexual relationship with activities that don’t require an erection.
  • Self-injections — A fine needle is used to inject a drug such as alprostadil (Caverject, Edex) into the penis. This quickly triggers an erection that often lasts 20 to 40 minutes.
  • Urethral suppositories — With these, you use a special applicator to place a tiny suppository of the drug alprostadil (Muse) inside your penis. An erection will begin within about 10 minutes and last 30 to 60 minutes.
  • A vacuum erection device (VED) — This is a tube with a hand- or battery-operated pump. The tube is placed over the penis, and the pump is used to create a vacuum that pulls blood into the penis to simulate an erection. An elastic ring is placed at the base of the penis for up to 30 minutes to trap blood and keep the penis erect. It may feel different from a natural erection, but can still be a great option for some couples.
  • Penile implants — This involves surgically placing a device in the penis to assist with obtaining a firm erection. There are several types of implants, including inflatable cylinders that are controlled by a pump that is placed near the testicles. Another type is a semirigid device that is firm but bendable. Implant devices are associated with a very high level of satisfaction from both partners and can be an excellent option for men unsatisfied with other treatment options.

 

It's not an easy topic to talk about, but there's a conversation about ED going on in the Men's Health group.

 

Men's health and much more, can be found in the Mayo Clinic Health Letter.

 

 

Brand name meds like Viagra and Cialis are still extremely expensive and generally not covered by insurance.
There is a free phone app called GoodRx which can save you hundreds of dollars. A nurse told us about it when balking at an expensive prescription. She looked it up on her phone and immediately found several local pharmacies including Walmart, Target, Walgreens etc. The price was actually cheaper than going through insurance. Have your DR write the prescription for generic Viagra (sildenafil), Cialis (tadalafil), etc. Show the GoodRx screen to the cashier.
no questions asked. They are used to seeing it a lot.
Here is an example. My doctor wrote a prescription for 5mg daily tadalafil (Cialis) with 11 refills. I filled it twice 30 tab $10. I asked if I could fill more than one month at time (yes). I ordered 300 5mg tadalafil. The price was 9 cents per tab. We check GoodRx all the time. It doesn't cost anything to try it.

COMMENT

90 tablets of 20 mg sildenafil (the generic) are about $24.00. I only need 2 and use GoodRX. That is not too expensive.

COMMENT
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