Don’t suffer in silence. This problem can often be solved
Many men with impotence hesitate to speak with a doctor about their problem. One reason for the reluctance is the widespread belief that impotence – which is also called erectile dysfunction – is due to psychological problems. But in about 80 percent of the cases, the causes are mainly in the body, not the mind.
And sufferers would be wise to speak up. The sooner the problem is treated, the more likely that treatment will succeed. What’s more, sexually active men who suddenly have trouble sustaining an erection need to be evaluated immediately, since impotence may signal an imminent heart attack or stroke.
New Relief for Impotence
In 1995, Caverject became the first prescription drug approved by the Food and Drug Administration (FDA) for diagnosing and treating erectile dysfunction. When Caverject is injected into the penis, it produces an erection in five to twenty minutes without interfering with sensation or ejaculation. The active ingredient, alprostadil, is a synthetic hormone that works by relaxing the muscle tissue in the penis to improve blood flow. A study of 683 men – conducted by the drug’s maker, Pharmacia & Upjohn Inc. – who self-administered Caverject, found that 94 percent were able to have sex after the injection.
Potential side effects: pain at the site of injection, scarring, or an abnormally prolonged erection. The latter is usually corrected by adjusting the dose.
Caution: Caverject use is not recommended more than three times a week or more than once in 24 hours. Men with the gene trait for sickle-cell anemia and those who have had multiple myeloma, leukemia, an anatomical deformation of the penis, or penile implants should not use this medication.
Hormone replacement therapy (HRT) can help the millions of men with impotence problems that are related to a deficiency of testosterone, a naturally occurring hormone that is essential for the maintenance of male sexual activity. Treatment is given either by intra-muscular injections or testosterone patches, a newer therapy which delivers a small but steady dose of the hormone through the skin. Unlike earlier patches that were applied to the scrotum, the most recently approved patch, Androderm, may be placed on the abdomen, back, thighs, or upper arms.
Potential side effects: pain, inflammation, or blistering at the application site; headache; depression; prostate problems; rash; or intestinal bleeding.
Caution: Edema, or swelling of the tissues, may be a serious complication of testosterone treatment in patients with preexisting heart, kidney, or liver disease. Anyone who has been treated for, or is suspected of having, breast or prostate cancer should not use this medication.
Other Options
- For some men whose impotence stems from impaired circulation, pelvic muscle exercises called Kegels can help.
- Hand-powered vacuum pumps are often recommended for persistent impotence. The pump (actually a tube) forms a vacuum around the penis. As air is sucked out of the tube, blood flows into the penis, creating an erection.
- Inflatable or noninflatable implants.
- The injectable drug papaverine, alone or with phentolamine (Regitine), is widely prescribed for impotence, although the drugs haven’t received approval for that use from the FDA.
- Vascular surgery, to boost the blood supply to the penis, is usually effective only in younger men who can obtain an erection but not sustain one.
- Reconstructive surgery may be used for those with Peyronie’s disease, where scar tissue forms on the penis.
For more information on impotence or to locate support groups, such as Impotents Anonymous and I-ANON, call the Impotence Institute of America at 1-800-669-1603.
The Causes of Impotence
Vascular disease: 33 percent
Diabetes: 25 percent
Neurological disorders: 11 percent (multiple sclerosis, spinal-cord injuries)
Prostate, bladder, or colon surgeries: 10 percent
Prescription medications: 8 percent
Substance abuse: 7 percent
Altered levels of testosterone or thyroid hormone: 6 percentSource: The American Urological Association
News Flash!
The FDA has approved MUSE, a pellet form of alprostadil (the active ingredient in Caverject). The drug, which is inserted into the opening at the tip of the penis, will be packaged in small, single-use disposable containers.
