I am often asked by patients, “What is the best way to reverse erectile dysfunction?” The short answer: “There isn’t one.”
Erectile dysfunction is often caused by a combination of many factors, including poor blood flow to the penis, nerve damage from prostate cancer surgery, pelvic muscle weakness, side effects from medication, stress, and psychological conditions.
Treating any medical issue starts by first trying the simplest, safest, and least expensive options. If unsuccessful, more aggressive, complicated, and invasive options can be explored.
For example, when a patient shows signs of arthritis in the knee, the physician does not immediately suggest total knee replacement. We often start by recommending rest, physical therapy, and medication. If these treatments are not successful, we proceed to arthroscopy, endoscopic knee surgery, and ultimately, if all else fails, prosthetic joint replacement.
The same sensible approach should be applied when managing erectile dysfunction. Unfortunately, many patients want a “quick fix” and either ignore or are unaware of many first line treatments that may help prevent or reverse erectile dysfunction.
In order to evaluate all of the medical treatments and solutions for erectile dysfunction, it’s important to first understand what’s needed for your body to create and sustain a long-lasting erection.
Your penis is controlled by a series of small muscles, known as the pelvic muscles. Unfortunately for men, they are weak to begin with and get weaker with age, resulting in soft erections, premature ejaculation, and reduced sexual performance. When exercised and strengthened properly, they create stronger, harder, and longer lasting erections.
Stronger and longer lasting erections are not only created by powerful pelvic muscles. The penis requires forceful blood flow and high testosterone and nitric oxide levels to create rigid erections. Just like the pelvic muscles, blood flow to the penis often diminishes with age, causing erectile dysfunction, soft erections, and loss of sexual performance. Testosterone levels in men also fall with each passing decade.
Healthy penile nerve stimulation is critical for creating and maintaining strong and powerful erections. On the one hand, overly sensitive penile nerves help cause premature ejaculation and can stop you before you ever get started. On the other hand, lack of nerve stimulation can prevent an erection from properly forming.
Proper diagnosis and treatment of erectile dysfunction often involves identifying which of the key factors needed to create and maintain a healthy erection have been compromised. With that background in mind, the following is a sensible six step approach to identifying the underlying issues causing erectile dysfunction and determining which treatments are most appropriate.
Are you maintaining a healthy lifestyle? As we know, strong erections require healthy blood flow, and blood flow to the penis is directly impacted by obesity and cardiovascular issues. Simply put, obesity crushes your manhood. It reduces testosterone levels in the body and destroys sexual performance. Fatty plaque deposits, which clog up your blood vessels, including the artery to the penis, make it harder to obtain and maintain a good-quality erection. Adopting a heart-healthy diet, exercising regularly, drinking alcohol moderately, avoiding tobacco, minimizing stress, getting a good night’s sleep and taking sexual health supplements may improve your overall sexual health and blood flow to the penis.
No muscle system in the human body plays a greater role in preventing and reversing erectile dysfunction than the pelvic muscles. This small, but important muscle system is responsible for forcing blood into the penis and keeping it from leaving. Over time, the pelvic muscles begin to weaken, resulting in soft erections, erectile dysfunction, and weak ejaculations. Fortunately, these muscles can be strengthened, resulting in harder, longer-lasting erections. Even better, when dramatically strengthened, the pelvic muscles can give you superior control, incredibly rigid erections, and significantly improve time-to-ejaculation.
Healthy penile nerve stimulation is critical for creating and maintaining strong and powerful erections. Lack of sensitivity can lead to erectile dysfunction, while overly sensitive penile nerves, help cause premature ejaculation. Moreover, many prostate cancer patients suffer from erectile dysfunction caused by damage to the penile nerves. Vibratory stimulation therapy has been shown to be effective in improving nerve sensitivity, blood flow to the penis, and treating erectile dysfunction.
Oral medications, such as Viagra, Levitra, Cialis and Stendra, are frequently used as the first-line treatment for erectile dysfunction. While these medications have been revolutionary and many men experience significant results from using them, they should not be the first solution. Instead, these should be used after natural interventions fail to work or even in conjunction with natural solutions, such as pelvic muscle exercise. Moreover, these medications are not effective for nearly 50% of men due to underlying medical conditions, complications with other nitrate medications, or nerve damage due to prostate cancer treatments.
Men with significant nerve damage from prostate cancer surgery or prostate cancer treatments may need to turn to urethral suppositories and penile injection therapy when all other options fail. Suppositories are pellets that are placed in the urethra and help to increase penile blood flow. Injections have the same overall effect as suppositories, are placed directly into the penile erectile chambers.
When all treatments fail to reverse erectile dysfunction, the last option is the prosthetic penile implant. These semi-rigid non-inflatable or hydraulic inflatable devices are implanted surgically within the erectile chambers and can be deployed on demand to create an erection. For the right man, under the right circumstances, the penile implant can be a life changer.
Sadly, often times our medical culture and patient population often prefer a quick fix, medications or surgery, before exploring the safer and natural solutions. A sensible approach to preventing and reversing erectile dysfunction, should be to:
Andrew Siegel, M.D., Urologist, Co-founder of The Private Gym, and author of the highly acclaimed book, Male Pelvic Fitness, Optimizing Your Sexual and Urinary Health.
The Private Gym Program is the first FDA-registered pelvic muscle training system for men. In a four-month clinical trial, 75% of men improved erectile rigidity and 90% reported great improvement in their sexual self-confidence. Learn more about how you can strengthen and maintain these critical muscles at The Private Gym.