In these times of Corona Virus, or COVID-19, there have been jokes made about spouses cooped up together spending a lot more time than usual and perhaps getting on each others’ nerves even more than usual. There have been other jokes about a new little baby boom that may occur in the next year or so. We shall see but in the meantime, it seems like an appropriate time for an update on Erectile dysfunction.
Most men (and women) are familiar with the most well-known ED oral meds such as Viagra and Cialis, although now they are also sometimes referred to with their generic names Sildenafil and Tadalafil. The most recent developments with these medications are that generic versions are now readily available. However, pricing still varies and shopping around is advisable.
If the pills are not adequate, the next two easiest choices are the vacuum pump or an intra-urethral medication that has been known as Muse. The vacuum pump is a low risk as it involves placing a rubber band type device at the base of the penis and then placing a plastic cylinder over the outside of the penis that creates a vacuum that pulls blood into the penis. When the penis is erect, take away the cylinder. After intercourse, take away the rubber band. Although low risk and very cost-effective, it is cumbersome and not for everyone. Muse has been effective in some patients who did not respond to pills but it is easier to use than injections into the penis although similar agents are utilized. The original intraurethral suppository has ranged from difficult to impossible to get for the past few years. But now some compound pharmacies have moved in to fill that void in the market, and such a formulation is available through our office.
If none of the above is satisfactory, injections of medicine into the penis are also possible for motivated patients, but this has a higher risk of prolonged erection or priapism than other options.
The newest treatment is lithotripsy of the penis to stimulate more blood flow and this can be a good option but is not at this time covered by insurance. This is also available by referral through our office.