Impotence Treatments, By Cost
Erectile dysfunction drugs have been the answer to the prayers of millions of men with ED caused by insufficient blood flow to the penis, but they don’t work for everyone and are of little help in relieving the symptoms of nonvascular impotence. However, a number of other options are available, and medical researchers are hard at work looking for still other forms of treatment.
By LULU HOELLER
When the question of erectile dysfunction treatment comes to mind, one immediately thinks of the handful of varied-colored tablets such as Viagra and Cialis that have come to the forefront over the past two decades. It’s easy to to lose sight of the availability of many other treatment options for ED.
While medications such as Viagra have helped millions of men to reclaim their sex lives, they don’t work for everyone. And for some men, these drugs’ side effects and interaction with other medications effectively bar their use.
PDE5 Inhibitors Aren’t Cheap
Although considered a godsend by many men, Viagra and the other PDE5 inhibitors are also fairly expensive and thus out of reach of many. However, the recent introduction of generic alternatives are putting downward price pressure on the brand-name ED drugs. Alternative treatments for impotence run the gamut from natural remedies that cost pennies a day to penile revascularization surgery, which can cost upwards of $50,000 when all associated costs are tallied.
If you’re looking for the best way to resolve your problems with erection dysfunction, here — in ascending order of their costs — are some of the most popular treatment options available to you:
Lifestyle Changes: While lifestyle changes are unlikely to significantly relieve symptoms of advanced erectile dysfunction, they can make a big difference for those who are only beginning to experience difficulty in achieving and maintaining a strong erection. WebMD offers more detailed information about such changes and the effects they can have. Best of all, these changes cost nothing and can actually make a big difference. They include regular exercise, quitting smoking, and stress reduction.
Natural Remedies: Certain nutritional supplements and herbal remedies have been shown to be effective in counteracting the effects of impotence. MayoClinic.com profiles a handful of the most widely used herbal remedies, offering its take on their pros and cons. High on the list of such substances are DHEA (dehydroepiandrosterone), L-arginine, and Panax ginseng, all of which are available in over-the-counter supplement form from your local pharmacy. Bottles with multiple capsules of each of these remedies can be purchased for $25 or less.
PDE5 Inhibitors: By far the most popular of the impotence treatments, the PDE5-inhibiting drugs, including Viagra, Cialis, Levitra, as well as generic formulations of both Viagra and Cialis, temporarily increase blood flow to the penis, allowing you to quickly achieve and maintain erections strong enough for intercourse. You’ll need a prescription to get these drugs, some of which are available for roughly $20 a dose.
Closely related, all of these drugs belong to the same family of medications, known as PDE5 inhibitors, and work by relaxing the smooth muscles of the blood vessels that supply the penis, thus temporarily increasing blood flow to the organ. These FDA-approved medications include Viagra (sildenafil citrate), Cialis (tadalafil), Levitra and Staxyn (vardenafil), and Stendra (avanafil), as well as generic Viagra and Cialis, which are marketed as sildenafil citrate and tadalafil, respectively.
Alprostadil: Designed for use only by those who have been definitively diagnosed with erectile dysfunction, alprostadil is a prostaglandin that causes blood vessels to expand, promoting strong circulation. Not suggested for those of faint heart, injectable alprostadil is marketed in generic form and also under the trade names Caverject, Edex, and Prostin VR. It is to be injected directly into the penis 5 to 20 minutes before intercourse. Injectable alprostadil produces an erection strong enough for intercourse in more than 80 percent of the men who use it.
The medication is also available in urethral suppository form, both generically and under the trade name MUSE (Medicated Urethral System for Erection), which is designed to be inserted into the hole at the tip of the penis. It is less effective in suppository form, producing a strong erection in only 30 to 40 percent of the men who have tried it. The cost of an alprostadil injection typically ranges from $8 to $10 for the generic formulation to $33 to $38 for a brand name injection. In suppository form, alprostadil costs $20 to $25 per suppository under the MUSE brand name.
Hormone Replacement Therapy: Men’s natural levels of testosterone, the primary male sex hormone, reach their peak at about age 17. They plateau for several years and then begin to decline somewhere between the ages of 30 and 40. While some men with low T levels think that taking supplementary testosterone will resolve their erection difficulties, this is usually not the case. More testosterone may make it easier for men to get their libidos fired up, but it is less likely to be a successful treatment for ED. Testosterone replacement therapy is costly, running as high as $400 per month.
Erectile dysfunction is fairly common in men with high levels of the hormone known as prolactin, best known for its role in enabling female mammals to produce milk to nourish their infants. High levels of prolactin in men tend to lower their testosterone levels. This condition can be relieved by treating the men with oral doses of bromocriptine or cabergoline. These drugs should only be taken under the supervision of a doctor. The monthly cost of bromocriptine runs around $200, while cabergoline runs closer to $300 a month.
Vacuum Erection Devices: Also known as vacuum constriction devices or penis pumps, these devices have been in use for more than a century, according to the Department of Urology at Weill Cornell Medical School. These FDA-approved devices all operate on the same basic principle and consist of a clear plastic cylinder with an opening at one end that is placed over the penis. At the other end of the cylinder is a pump mechanism, which is used to pump all the air from the cylinder creating a vacuum. This vacuum draws blood into the penis and allows it to become erect. Once erection is achieved, a tight ring or band is put around the base of the penile shaft to maintain the erection for sexual activity, after which the ring or band is removed, allowing blood to flow back out of the penis. In some of the higher-end devices, the pump is battery operated. These devices generally range from $40 to $400.
Penile Implant Surgery: Usually performed at a surgery center or hospital, penile implant surgery involves the implantation of a device — usually malleable or inflatable — that enables the patient to have an erection for sexual activity when desired. During surgery, the spongy tissue inside the penis is replaced by rigid, semi-rigid, or inflatable cylinders, according to SexHealthMatters.org. In the case of the rigid or semi-rigid cylinders, which are declining in use and account for only about 10 percent of all penile implants, the penis need only be lifted up or bent into place to achieve erection. Much more common are inflatable implants, which can quickly be filled up with saline fluid (from a reservoir implanted near the scrotum) to create an erection. After sex, the fluid can be released to return to its reservoir. Penile implants, including the devices themselves, the surgical procedure, and aftercare, range in price from $15,000 to $20,000.
Penile Revascularization Surgery: This form of surgery has a relatively low rate of success but for some men is the only means of treatment for ED caused by traumatic damage to one or more of the blood vessels that supply the penis. If only one blood vessel is involved and the patient is still relatively young, the success rate climbs to somewhere between 50 and 75 percent, according to WebMD. The surgery involves bypassing blocked or damaged blood vessels in the penis. Total costs for this specialized vascular surgery can run in excess of $50,000.
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