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Erectile dysfunction

The More the Merrier: Combination Therapies for Erectile Dysfunction

Many people believe that men’s sexuality is simple. “Guys have only one thing on their minds”, we say. Stand-up comedians make jokes about it. But the reality of men’s sexual functioning is much more complicated. And the best solutions might actually be multidimensional.

When it comes to ED, combined therapies can work wonders, especially for men who don’t respond to Viagra or similar medications. But which therapies are worth trying?

Below are medical treatments and lifestyle modification options that may be combined with PDE5 inhibitors:

  • Alprostadil (penile injection or suppository)
  • Testosterone therapy
  • Exercise and diet
  • Psychological counseling

Combining Viagra and Alprostadil

PDE5 inhibitors, commonly known as ED pills, have a very high success rate. Further, they are easy to use and are usually low risk for most men. As such, doctors are happy to prescribe them to patients.

Unfortunately, some ED patients don’t respond well to Viagra and similar drugs. For example, this is found among men who have had a radical prostatectomy with no nerves spared.

When the first-line solution doesn’t work, doctors sometimes recommend a combined therapy using alprostadil. This drug takes the form of an injection, urethral suppository, or cream. A 2018 academic review revealed this approach brought best results when treatment with just one drug failed.

Penile injections can be done using a very thin needle

Penile injections can be done using a very thin needle

Testosterone Therapy in ED Treatment

Before the age of Viagra, testosterone replacement was the go-to option for many patients. This “hormone of masculinity” not only helps improve erections,  but it also leads to an enhanced sex drive. So why are doctors opting for ED pills instead of testosterone these days?

PDE5 inhibitors tend to be more reliable and act quicker, while testosterone therapies are more complicated, requiring the right dosage and a longer waiting period for full effect. Studies show that combining Viagra and testosterone gel doesn’t make much of a difference.

But some physicians take a different approach – if a man shows up with signs of erectile dysfunction (ED), they start him on testosterone and see if this helps. If this is ineffective or produces unwanted side effects, they switch to ED drugs.

Lifestyle Changes for Long-Term Improvement

Today, the medical consensus is that ED diagnosis and treatment should take a man’s lifestyle into account. Behavioral modifications, like changes to one’s diet, might be recommended for men who are overweight. That’s because men with a 42-inch waistline are at much higher risk for ED than men with ten inches less around their midsection.

While Viagra will temporarily help you to engage in sexual activity, if you want to reverse your ED, you need to get serious about diet and exercise. Start with something as simple as a walk in the park. One study showed half an hour of walking daily reduced ED risk by 41%.

Don’t know where to get started with healthy eating? Get some inspiration from the Massachusetts Male Aging Study. Make sure these land on your plate on a regular basis and you’ll have a chance to avoid ED in the long run:

  • Fruit and vegetables
  • Whole grains
  • White meat instead of red
Daily walks help reduce ED risk

Daily walks help reduce ED risk

Psychological Counseling as a Treatment Option

If traditional treatment approaches for erectile dysfunction (ED) don’t work, the problem may be psychological. Approximately 10-20% of ED cases are related to stress, anxiety, depression and other emotional issues. For some men, performance anxiety is the culprit.

ED also be caused by relationship struggles. Men should not be afraid to seek psychological counseling. Speaking openly in front of a trusted professional can help you open up and understand what’s happening.

Be Careful with Alternative Therapies

Many men who suffer from ED are tempted to look for quick remedies. Some turn to alternative therapies for help. While some of them may be a great way to support your overall health, they may not be enough to solve the problem.

When looking for an alternative therapy provider, make sure they are members of professional associations (such as Traditional Chinese Medicine doctors). Never buy herbal remedies from unknown sources as it could prove dangerous to your health. Finally, remember to consult your physician before starting an herbal treatment, as some of the herbs may interact with prescription drugs.

ED is a complicated issue and finding the approach that works for you can be overwhelming. Be patient. Start with basic lifestyle changes and take care of your emotions. Click here to learn about currently available ED drugs and ask your doctor to choose the best one for you.

Anka Grzywacz is a sexologist, reproductive health expert and Certified Sex Coach™. In her online practice she helps busy parents solve their intimate problems.