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ED Treatment Options

  • What did you try to treat your ED?

    I tried Viagra, Cialis and Levitra, and got such bad headaches I had to stop using pills. I also tried the external vacuum pump which worked, but my penis became blue, cold and floppy. Also, it did not feel good when I removed the band over the head of my penis. I used the external pump for about 3 months and then decided to get the implant. I’ve had the implant now for 11 years, and it has never failed to give me a rigid, firm erection.

  • I feel hopeless. What can I do?

    If you are disappointed in yourself or feel distance growing between you and your partner due to erectile dysfunction, please know that you are not alone. Many men suffer from this condition. I myself suffered from it and went into a major state of depression before I found out that it can be treated. I encourage you to Find a Urologist in your area who specializes in men’s sexual health and erectile dysfunction. They can put you on the path to treating your ED and return you to a satisfying and fulfilling sexual lifestyle.

  • Why doesn’t Viagra work for me?

    Depending upon the cause of your ED, pills may not work at all. And for those men where they do work, I understand that prescription pills may stop working after several months. You may have to increase the dosage or try another pill. If, by some chance, none of the pill therapies are effective, you should Find an ED Specialist who can offer several other treatment options.

  • What is the vacuum option?

    The external vacuum device is a plastic cylinder that fits over the penis, and is used by many men to help with their ED. When you create a vacuum, blood rushes into the penis creating an erection. You then place a restriction band at the base of the penis to maintain the erection until intercourse is over. Once you release the band, you lose the erection. I tried this option but my erections didn’t feel natural and it was difficult to be spontaneous.

  • Can ED reverse itself? It’s killing my marriage.

    Erectile dysfunction will probably never reverse itself without treatment. I know from experience that ED affected my sense of self, happiness and relationship with my wife. Our partner can begin to feel like we don’t love them any longer or that we aren’t attracted to them, but ED is not about lack of desire or love. I am not a doctor, I just know what I went through. Here’s what I recommend: you and your partner should attend a free educational seminar to learn more about ED and the treatment options available. You can search for events in your area here. When you are ready to meet with a doctor, Find a Urologist who specializes in men’s sexual health and erectile dysfunction. ED is treatable, but you need to make sure that you pursue the route that is best for you and your partner.

  • What is a penile implant?

    A penile implant is a prosthetic device that is surgically implanted into your body that allows you to have erections. My implant is made up of three distinct pieces: a pump that is inserted in my scrotum, a reservoir filled with saline (salt water) that is placed in my abdomen and two cylinders in my penis. When I want to have sexual relations, I squeeze the pump in my scrotum, the saline leaves the reservoir and fills the cylinders in my penis giving me a solid, rigid erection suitable for penetration. When finished, I press the release button located on the pump and the saline reverts into the reservoir and I go flaccid. More information can be found here.

  • Do the shots work? I’m not so much concerned with the pain, but the interruption of the mood.

    The shots are usually administered prior to foreplay, so you should be ready to go without delay. Your doctor or specialist can better explain to you the time lapse between giving yourself the injection and “go” time. But, shots don’t work for everybody. Let me caution you about one thing: there are many so-called “Men’s Clinics” that advertise on TV. These clinics do not take insurance, make you pay cash, make you sign a contract, and you must go back to the clinic for another injection every time you want to indulge in sexual activity. I encourage you to Find a Specialist who can diagnose the cause of your ED, help determine if injections are a good treatment option for you and show you how to administer the shots yourself at home.

  • I have been using the injections and they are working well. But would pellets work as well?

    If by “pellets” you mean urethral suppositories, I don’t know much about them but I have heard that men may feel pain in the urethra as the pellet dissolves. If injections are working for you, I would suggest talking to your urologist to see if the “pellets,” better known as MUSE®, can work for you too. It’s been my experience in talking with other men who suffer from ED that injection therapy is preferred over urethral suppositories, but this of course is up to the individual.

  • Do over-the-counter medications or home remedies work?

    There are no home remedies or over-the-counter medications to effectively treat erectile dysfunction that I know of. There are, however, several prescription medications and other treatments for ED. I recommend you Find a Urologist who specializes in erectile dysfunction. They will be able to determine the cause of your ED and offer treatment options based on the specific cause and your overall health.

  • I’m 62 years old, with type 2 diabetes and ED. Oral medications only worked for a few months, and the injections are painful. My next step is an implant but I’m worried that it will kill the feeling.

    Taking the step to decide to have an implant is certainly a big step. However, let me tell you, from someone who had the implant done 11 years ago, it was one of the best decisions I have ever made. After the healing period, I was able to return to all the activities that I did prior to surgery, and no one can tell that I have anything implanted. The feeling is very natural and my orgasms are the same. If you still have your prostate, you will be able to ejaculate; if not, like me, you can orgasm but there will be no ejaculate. You can read more about the implant here.

  • I really want sex but I have major trouble getting an erection. I’m 53 and don’t want to end up losing my wife due to this very disturbing issue.

    It sounds like you might be suffering from erectile dysfunction (the inability to have an erection suitable for vaginal penetration). This condition is more common than you would expect especially as we get on in age. I suggest you Find a Urologist in your area who specialize in men’s sexual health and erectile dysfunction. Also, I encourage you to take your wife with you, since erectile dysfunction is a couple’s issue, not just a male issue. Many women blame themselves for their partner’s inability to have erections, and it would be a good experience to learn that the issue is not their fault and that the situation is curable.

Causes of ED

  • What causes ED?

    Erectile dysfunction is caused by the inability of the vessels in the penis to fill with blood, expand the penis and remain firm to allow for penetration during intercourse. This can be caused by many factors such as diabetes, heart disease, medications, prostate cancer treatment and even anxiety and depression. On this website, there are a number of articles written by doctors who treat ED. A couple of the articles go into detail about all of the various causes of ED. No matter what the cause, however, it is fully treatable. My suggestion is to Find a Urologist who specializes in men’s sexual health and erectile dysfunction. They will be able to determine the cause of your ED and offer you various treatment options.

  • Can poor blood circulation cause erectile dysfunction?

    Yes, it’s possible. Erectile dysfunction occurs when the vessels of the penis cannot fill with or hold onto the blood to get and maintain an erection. The tiny vessels that deliver blood to the penis are often affected by diseases that include circulation problems, like diabetes and heart disease.

  • I failed to perform due to stress and fatigue a couple weeks ago and I can’t stop thinking and worrying about it. How can I get my sexual confidence back?

    I would suggest that you speak to your family doctor and see if they can recommend ways to minimize your stress level. Stress can certainly play a huge part in the inability to perform successfully and it is very common. If it’s more than stress, you should Find a Urologist who specializes in men’s sexual health.

  • What is causing my ED? Could it be smoking cigarettes?

    Erectile dysfunction can be caused by many things and smoking is definitely one of the contributing factors. But ED can be a precursor to other medical conditions such as vascular disease, diabetes and neurologic disorders that have not yet manifested themselves in your everyday health. A specialist will be able to determine the cause of your ED and offer you treatment options to solve the problem.

  • How old were you when started experiencing ED?

    I was 58 years old when I was diagnosed with prostate cancer. I had a prostatectomy and developed erectile dysfunction soon after. I began pill therapy but it did not work for me, causing me terrible headaches. I then tried an external vacuum pump, which did work, but it was not very spontaneous. After I gave up the external pump, I went into a major depression for over a year, with no erections whatsoever. When I was 60, I visited a urologist who specializes in men’s sexual health and learned about the prosthetic penile implant. I have now had the implant for 11 years and it was one of the best decisions I have ever made.

  • The problem I have is that my penis is bent like a hook. What’s happening?

    You may be suffering from ED caused by Peyronie’s disease (the bending of the penis). I encourage you to Find a Urologist who specialize in men’s sexual health and erectile dysfunction. They will be able to offer you treatment options to help correct the Peyronie’s issue. Peyronie’s disease is treatable, just like ED is. Ask your doctor about details of the recommended treatment, which may or may not include surgical implantation of a prosthetic penile device.

  • I have diabetes and it’s impacting my sex life. What should I do?

    Diabetes is one of the main causes of erectile dysfunction. The best thing for you to do is find a urologist in your area who deals with men’s sexual health and erectile dysfunction. They will be able to determine the exact cause of your erectile dysfunction and offer you treatment options based on the primary cause of the problem and any other medical conditions you might have. Men with diabetes and ED can be successfully treated.

  • What could cause me to have ED at the age of 26?

    I’m sorry to hear that you are suffering from ED at such an early age. However, ED is not a condition that is solely for older men. Many men your age suffer from it, and there are remedies to effectively treat it. I am not a doctor, but I understand that the onset of ED at an early age could be caused by diabetes or something called “venous leakage.” Read more about the causes of erectile dysfunction at the expert articles section here. I also would like to encourage you to see an ED specialist soon so you can learn more about your particular situation.

  • I am a 27-year-old gay man who just became sexually active a few months ago. I can masturbate with no issues but now that I’m sexually active with partners, I have been experiencing the classic signs of ED. Any answers are greatly appreciated and I know most of the responses may not apply since I am of the homosexual population.

    First, let me say that this information has no bearing on your sexual orientation. ED is a condition that does not differentiate between straight or gay, it happens with no proclivity to gender preference. Erectile dysfunction has many different causes. Many times, ED is the precursor to medical conditions such as vascular disease, diabetes, neurologic disorders and others that have not yet manifested themselves in your everyday health. I encourage you to speak with a specialist about this. You can find a GLMA-approved urologist here. I know it takes courage to seek information about ED, but please do not let your sexual orientation stand in the way of leading a happy, satisfying and fulfilling sexual lifestyle.

  • I can maintain an erection and ejaculate if I watch porn but not with my partner. I am 66. I need some help here.

    The best advice I can offer you is to Find a Urologist who specializes in men’s sexual health and erectile dysfunction. Working together with this specialist, they will be able to determine the cause of your problem and offer you treatment options to help you overcome the issue. Make an appointment as soon as possible, speak frankly and candidly to the urologist, and I am sure you will be on your way to solving your issue. I’m sorry I cannot give you more definitive information about your issue, but I am not a physician, only a patient who suffered from ED and found a successful treatment.

  • I’m taking a lot of medication that interferes with my erections.

    Medications are one of the factors that can cause erectile dysfunction. What you need to do is Find a Specialist in your area who specialize in men’s sexual health and erectile dysfunction. They can determine the cause of the ED and which medicines, if any, are actually causing the condition. They will work with your general practitioner and offer you treatment options to help alleviate your ED.

Getting a Penile Implant

  • How long does the surgery last?

    The surgery usually lasts about one hour, give or take a few minutes. This, of course, is an average; it depends on the prosthetic urologist and the surgical approach they take and the patient’s anatomy. My surgery, 11 years ago, lasted one hour and I went home the next day. I think most surgeons will keep you in the hospital on a 23-hour outpatient surgery basis so they can monitor your healing. You should ask your prosthetic urologist about their specific recommendations.

  • What happened after your surgery?

    Healing generally takes five to six weeks but varies by individual. I had some scrotal swelling for about two weeks and then that subsided. I think most men go back to work after two weeks but it is possible to return to work sooner if you are a fast healer. After about four weeks, I returned to the urologist’s office and was shown how to use the pump. I was instructed to pump it and release it for about a week to get used to the feeling. After the week was up, I saw the doctor again to make sure I was using the pump correctly. At that point, I was cleared and told to return to a normal and happy sexual lifestyle.

  • How long did it take until you were able to drive?

    People heal at different rates depending on their unique physiology. In my case, I was able to drive one week after the surgery. I returned to work after two weeks.

  • How soon after the surgery were you able to have intercourse?

    That is something that each doctor will let their patient know. In my case, I went back to the doctor for a follow-up visit after four weeks. He told me that at the beginning of the fifth week (after surgery), I should begin to pump up the implant and release it to get accustomed to the feeling and find a “sweet spot” since you are squeezing on your scrotum. After three or four tries, the “sweet spot” becomes evident and there is no discomfort in pumping up the implant. I went back to the doctor at the end of the fifth week and he asked me to show him how I was progressing. He said it was fine, and that I could go home and once again have intercourse.

  • Did you have pain after leaving the hospital and how long did it last?

    Individuals heal at different rates and have different thresholds of pain tolerance. In my case, the doctor sent me home with pain pills; however, I never took one. I really did not have any pain. What I felt was discomfort due to the swelling, and I found that two over-the-counter pain medications really were sufficient to relieve the discomfort. I did, however, have to sleep with two pillows between my legs when I slept on my side, because without the pillows your scrotum is squeezed between your thighs and I guarantee you that sleep will not come easily. I was also told to wear jockey briefs instead of boxer shorts, since they would support and cradle the scrotum thereby reducing the pull on the scrotum.

  • How do they determine the size of implant you need?

    When you go in for the surgery, the prosthetic urologist will measure you once you are under anesthesia and find the optimal size to give you the most length possible without causing any injury. Chances are very good that you will probably be very close to the size you were before you began suffering from ED. I have heard that some doctors recommend that patients use a vacuum erection device for some time prior to surgery if they’ve experienced ED for a long while.

  • How long after surgery were you able to go back to work? I work in a warehouse and do a lot of walking and lifting.

    After my implant surgery, I was able to return to work after the second week. I had a desk job with very little lifting of heavy objects, so the surgeon said if I took care, I should have no problem returning after two weeks. But, the amount of time that you need to stay home is really something to be discussed with your doctor, since individuals heal at different rates.

  • I might be interested in an implant. Can you explain how it works?

    After struggling with erectile dysfunction for some years, and feeling very depressed, I finally decided on the implant after several other treatment options did not work. It was one of the best decisions I ever made! The implant itself is pretty straight forward. It is comprised of three separate pieces: a pump that is situated in your scrotum, behind your testicles; a reservoir that is placed in your lower abdomen, filled with saline (salt water); and a set of cylinders that replace the spongy tissue in the shaft of your penis. When you want to have intercourse, you squeeze the pump, the saline leaves the reservoir and fills the cylinders in the penis giving you a solid, rigid erection, suitable for penetration. When finished, you hit the release button located on the pump and the saline reverts back into the reservoir and you go flaccid. If you click here you can read about the device and see an animation and live demonstration.

Living with a Penile Implant

  • Do you feel the implant all the time?

    Once the swelling resolves, I could feel the implant for about one month. After the month was over, I can tell you that unless I go to use the implant, I really do not know that it is there. It becomes part of you. I have never had any time when there was any indication of the implant that I was aware of.

  • After the recuperation, was there anything you found you could not do prior to the implant?

    Absolutely not. After the surgery, the doctor told me to take it easy for a couple of weeks. I started to drive after one week and went back to work after the second week. When the soreness and swelling was gone, approximately six weeks after surgery, I returned to all my previous activities. I went back to the gym and began my workout routine with my trainer. I returned to the recumbent bike, and I worked my way back to 10 miles per day within one week after returning. There is NOTHING that I did prior to the surgery that I could not do after the surgery.

  • Is your orgasm the same as before?

    Absolutely. However, you must remember that if your ED was caused by prostate cancer and you had your prostate removed, there is no ejaculate when you climax. The feeling I have is exactly the same “pumping” sensation as when I had ejaculate.

  • Have you had any problems with the device since the surgery?

    Absolutely not. It has performed perfectly for over 10 years now. The erection is hard and stiff and will allow for any position of intercourse you choose.

  • Did you lose any length of your erection due to the implant surgery?

    This is a question I am asked all the time. The answer is the following: I noticed a 1/2 inch decrease in penile length following my prostatectomy. I didn’t notice a loss of length after receiving my implant. During penile implant surgery, I was measured for the correct implant size based on my anatomy. I know that is a concern for some men receiving penile implants.

  • Will the implant make me bigger than before?

    My implant did not make me any bigger than I was before as far as length. It did, however, restore girth (width) to my penis since my cylinders expand in width.

  • I’m concerned about the pump in the scrotum area. I cross my legs a lot; does it feel uncomfortable with the implant?

    I had the implant done 11 years ago, and I can truthfully say that after the average six-week healing period, you will not even know that there is a pump in your scrotum. I work out, ride a bicycle and do everything I was able to do prior to the implant. I have never been able to feel the pump in my scrotum, unless I went looking for it, to use it for sexual activity.

  • Is your penis as sensitive now as it was before your operation? Also, do you have any trouble ejaculating?

    I had the implant done 11 years ago and have never regretted one day. My penis is as sensitive after the implant as it was before, and in some cases, I have heard men say that their sensitivity has increased. My sensation of orgasm is exactly the same as before and the implant doesn’t interfere with ejaculation. In my case, since I had my prostate removed, I do not ejaculate, but the sensation of ejaculating is still there.

  • Has the implant had an effect on your self-esteem?

    I was so depressed when I suffered from erectile dysfunction that it affected every part of my life. I felt like I was not a full man and could not please my partner as a “real” man could. However, after the surgery, I regained all my self-esteem and felt once again like a young man. Having the implant changed my life and brought back my vitality and joy of living.

  • Where is the saline reservoir located? Can you feel or see it?

    No, I really can’t see or feel any part of the implant, including the reservoir with saline. It is not very large and is located in the lower part of my belly. I am completely comfortable when I work out with guys and shower afterwards; they have absolutely no idea that I have a device implanted.

  • How would you describe the “hardness” of your erection with a penile implant?

    The hardness of the implant is equal to the hardness you achieved prior to having any erectile dysfunction issues. The implant gives you a solid, rigid erection suitable for any type of intercourse you want to indulge in. I have had the implant for 11 years now, and it has never failed to provide me with an erection that I would say is as good, if not better, than when I was a young man.

Partners

  • Does your partner notice any difference during sex?

    My wife has said that she would be hard pressed to tell that there was any difference at all. One of the benefits of the implant I have (the AMS 700™ implant), is that the cylinders expand in girth. The decision to have the implant was one of the best decisions I have ever made. It brought back my manhood, stopped my depression in not being able to function as a “true” man, and has returned me to having a satisfying and fulfilling sexual lifestyle.

  • My husband can’t keep an erection and he doesn’t feel like having sex with me. What can I do to help?

    Hi, my name is Marilyn and I am Cliff’s wife. Cliff felt it would be best to have a woman’s response to your situation. Sex is an important expression of love between two people. For most men, the inability to have, and maintain, an erection cuts to the core of their manhood. It is emotionally painful when he cannot express his love as a man. But there are options for treating ED. I recommend you both attend an educational seminar to learn more. You can search for events in your area here. When you are ready to meet with a doctor, Find a Urologist who specializes in ED and be completely candid with the urologist. Your presence will let your husband know that he is not alone. You both need a solution to ED, and in my experience, this is the best way to start.

  • My boyfriend and I have an amazing connection and enjoy each other. The only “problem” is that he has ED. How can I get him to open up and start the conversation about seeking help?

    Many men find it totally embarrassing to talk about erectile dysfunction to anyone, including their physicians. I suggest you attend an educational event that deals with erectile dysfunction and the treatment options available. You can search for events in your area by clicking here. These seminars are free of charge, full of information and both of you are welcome to attend. It will help your partner realize that he is not alone and that ED can be completely treated.

  • My boyfriend and I want to marry but ED has been a major problem. Marriage will not survive with this issue and he blames me for the problem.

    I’m sorry to hear that you are having these problems. What your partner should know is that ED can be treated and you can lead a very satisfying and fulfilling sexual lifestyle. I would highly suggest that you Find a Specialist in your area who specialize in men’s sexual health and erectile dysfunction. They will be able to determine the cause of your partner’s ED and offer various treatment options ranging from the least invasive, which is pill therapy, to the most invasive, which is a prosthetic penile implant. I myself suffered from ED, and 11 years ago decided to have the penile implant done. I have never had a moment’s trouble with the implant, and my partner has said that it feels exactly the same as before. The satisfaction rate for this therapy is about 98% for both the recipient and the partner.

Cost and Insurance

  • What does it cost to get a penile implant?

    The cost of the prosthetic penile implant depends on the type of insurance you have and whether the carrier covers the surgery. If you are on Medicare, they will pay 80% of the cost and usually your supplemental will pick up the remainder. If you do not have Medicare, then it is based on your policy coverage. When you decide on the surgery, the prosthetic urologist’s office will contact your insurance company to determine exactly what will be covered and what your out-of-pocket expense will be. In my case, my insurance company covered the entire cost less a $50 co-pay.

  • Does insurance cover the prosthetic penile implant procedure?

    The prosthetic urologist’s office will call your insurance company to determine exactly what is covered and what is not. That way, you know what your out-of-pocket expenses will be prior to the procedure. If you have Medicare, they cover 80% of the total cost of the procedure and usually your supplemental insurance picks up the remainder; however, you might have a small co-pay based on your coverage. If you are not on Medicare, it may be helpful to read the expert article about insurance coverage here or visit the FAQ section of this website. You can also talk to your ED specialist’s office; they often offer payment plans or programs to help men who need an implant be able to have the procedure done.

  • What if I don’t have insurance?

    If you do not have insurance, you can contact the manufacturer to determine if you are eligible for the Financial Assistance Program. I understand that there are some ED specialists who offer set price cash pay procedures. You can learn more about self-payment options here.

  • My insurance company turned me down. What can I do?

    Many times, if you contact the insurance company directly, they will turn you down. But if the doctor’s office contacts them, they may get a different answer. I would ask your prosthetic urologist’s office to handle it for you and you might be surprised.

  • My husband is very depressed about ED. Our insurance bills us $300 for one month’s supply of pills. He is about to retire and we will only have COBRA, and they won’t pay for anything not medically necessary. What can we do?

    I’m sorry to hear that your husband is suffering from erectile dysfunction, and that the pill therapy is so costly. I’m not quite sure what COBRA covers in the way of ED treatments, but let me give you something that might be effective. Find a Urologist who specializes in men’s sexual health and erectile dysfunction. Many of these doctors work with compounding pharmacies that can produce the pills at a much reduced rate. You should also discuss COBRA’s unwillingness to pay. In many cases, the doctor’s office will get much more assistance with coverage than if you try talking to the insurance company yourself. The specialist can also recommend other treatment options, such as an external vacuum pump. This works for many men and is a rather inexpensive treatment option since it is a one-time expense. Once your husband is eligible for Medicare, they pay for most of the treatment options, including a prosthetic penile, implant which is the treatment that worked for me.

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