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Dx Erectile Dysfunction (E.D.) Treatment:

Erectile Dysfunction

The Merck Manual states:
"Decreased libido is a reduction in sex drive.
Possible causes include psychological factors (such as depression, anxiety, or relationship problems), drugs, and low blood levels of testosterone.
Depending on the cause, doctors may suggest psychological counseling, prescribe a different drug, or recommend testosterone supplementation therapy.

Sex drive (libido) varies greatly among men and may be decreased temporarily by conditions such as fatigue or anxiety. Libido also tends to gradually decrease as a man ages. Persistently low libido may cause distress to a couple.

Occasionally, low libido can be a life-long problem that results from traumatic childhood sexual experiences or from learned suppression of sexual thoughts. Most often, however, low libido develops after years of normal sexual desire. Psychological factors, such as depression, anxiety, and relationship problems, are often the cause. Some drugs (such as those used to treat depression, anxiety, or advanced prostate cancer) can decrease blood levels of testosterone and also lower libido.

When libido is decreased, men have fewer sexual thoughts, interest, and fantasies and they engage in sexual activity less frequently. Even sexual stimulation, by sights, words, or touch, may fail to provoke interest. Men with low libido often retain the capacity for sexual function and may sometimes continue to engage in sexual activity to satisfy their partner.

A blood test can measure the level of testosterone in the blood. The diagnosis of low testosterone (called hypogonadism) is based both on the man's description of his symptoms and his low blood levels of testosterone.

If the cause is psychological, various psychological therapies, including behavioral therapies, such as the sensate focus technique can help. Counseling can help the couple address relationship issues. Men should also understand the role of stress and its impact on physical function. If the testosterone level is low, supplemental testosterone can be given, in the form of a patch or gel applied to the skin or as an injection (see see Testosterone Replacement Therapy (TRT). If a drug appears to be the cause of low testosterone levels, a doctor may consider treating the man with a different drug.."

Medications Used in the Treatment:
1. PDE 5 Inhibitor: Viagra®/Revatio®/sildenafil, Cialis®/ tadalafil, Levitra®/Staxyn®/vardenafil
2. Testosterone creams, patches, oral, pellets injection
3. Prostaglandin E1 agonists(PE1)Caverjet®/alprostadil
4. PE1(Muse®: alprostadil urethral suppository)
5. Vitaros®/Alprostadil cream [not available in US as of October 2014]

*[Editor]:PODCASTS Focus on
Erectile Difficulties

[Editor] PODCAST Focus on Why Men Cheat

[Editor] PODCAST Focus on Berman-Berman study, 25mg up to 100mg of sildenafil is safe for women (this tablet has 20mg; women should use just half).

*Generic Sildenafil 20mg sublingual may be as effective as 50 to 100mg oral Viagra® at $1.00 each
*Compounded Sildenafil and oxytocin sublinqual adds the sexual potential effect of oxytocin for about $10.00/tablet.
*Brand 100mg Viagra® costs $30.00 and probably is no different in crushing the 20mg sildenafil and absorbing it under your tongue.
*Compounded alprostadil with more milligrams/ per milliliter than Caverjet® or Staryx® is available at significant cost savings.

*[Editor] A man cannot expect to have a full, potent erection without having adequate bio-available testosterone in his blood FIRST.

*[Editor] A patented process combines PD5 (sildenafil) with oxytocin in a sublingual tablet. The combination offers unique effects: not only is the erection usually adequate with just one-fifth the oral dosage of PD5, but the absorption of oxytocin heightens the pleasurable sexual experience for both partners (he and she). Results of research and clinical experiments can be found in the

Video Lecture on Oxytocin and Sexual Response.

*[Editor] New F.D.A. Laws have approved specific compounding pharmacies to manufacture unique products at such low prices that a buyer can purchase one year (12-months) of these products for the cost of just two or three months of the newly sanctioned approved E.D. products or before they are released in the United States!
*[Editor] Topical alprostadil 2.5% in a non-irritating base may provide an alternative to Muse®/Vitaros®. It is fast-acting (less than 6 minutes) and has none of the side-effects of PD5 inhibitors (flush, vision changes, drop in blood pressure).

*[Editor] WARNING! Do not use a PD5 inhibitor such as Viagra, even the sublingual tablet, with the topical alprostadil as the risk of a prolonged erection that may need surgical drainage is increased dramatically!

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