Treatment
Alternative Treatments
Testosterone Replacement Therapy
Testosterone replacement therapy is not only effective in inducing puberty in adolescent boys with hypogonadism but may also be helpful for some adult patients with the condition. Some experts believe testosterone replacement therapy also may be helpful for older men whose testosterone levels are deficient.
Other procedures and devices
Vacuum Devices: Vacuum devices, or external management systems, are effective, safe, and simple to use for all forms of impotence except when severe scarring has occurred from Peyronie’s disease.
Using the Device
*The plastic cylinder is put over the penis.
*In so doing a vacuum is created making blood to flow into the penis and creating an erection.
*To retain it a band is put onto the base of the penis and the cylinder is removed
*A three to five minutes interval is the average to achieving an erection
Drawback: Lack of spontaneity is this method’s only major drawback. The erection involves only part of the penis shaft, and the process will certainly seem peculiar in the beginning. When these psychological obstacles are overcome, many couples find the result highly satisfactory.
Success rate: Studies have found that success with the vacuum device is equal to other methods. Between 56% and 67% of men using it reported the device to be effective. In one study of men who had used the vacuum device for many years, almost 79% reported improvement in their relationships with their sexual partners, and 83.5% said they had intercourse whenever they chose. Nevertheless, drop out rates are high. In one 1999 study, for example, the overall drop out rate was 65%.
Side effects: include blocked ejaculation and some discomfort during pumping and from use of the band. Minor bruising may occur, although infrequently. It is very important to use a medically approved pump.
Venous Flow Controllers (Cock rings): Vacuum- less devices that trap blood within the penis are also available. They are called venous flow controllers or simple constricting devices. These devices are typically rubber or silicone rings or tubes that are placed at the base of the erect penis to trap the erection. They can be used by men who can achieve erections but lose them easily. Attention should be taken not to use them for more than 30 minutes or lack of oxygen can damage the penis.
Penile Implants
There are three types in use currently:
*A hydraulic implant consists of two cylinders placed within the erection chambers of the penis and a pump. The pump releases a saline solution into the chambers to cause an erection, and removes the solution to deflate the erection.
*A penile prosthesis is composed of two semi-rigid but bendable rods that are placed inside the erection chambers of the penis. The penis can then be manipulated to an erect or non-erect position.
*A third implant uses interlocking soft plastic blocks that can be inflated or deflated using a cable that passes through them.
Other alternative treatments
Many alternative agents are marketed for impotence. Very few have been studied and some can be harmful.
Yohimbine (Yocon, Yohimex) A folk medicine of many years it has been shown to improve blood flow. However studies have been not been done to a conclusion about its efficacy.
Aphrodisiacs: Aphrodisiacs are substances that are supposed to increase sexual drive, performance, or desire. Some examples include the following:
*Viramax is a well-marketed product that contains Yohimbine and three herbal aphrodisiacs: Catuaba, Muira puama, and Maca. However, no tests have been done to prove its efficiency as well as its interaction with other medications.
*Foods that some people claim have aphrodisiacal qualities include chilies, chocolate, licorice, lard, scallops, oysters, olives, and anchovies. No evidence exists for these claims and certainly no one would ever advocate eating large amounts of such foods, which in cases such as licorice and lard can be dangerous.
*Spanish fly, or cantharides, which is made from dried beetles, is the most widely-touted aphrodisiac and is particularly harmful. It irritates the urinary and genital tract and can cause infection, scarring, and burning of the mouth and throat. In some cases, it can be life threatening.
No one should try any aphrodisiac without consulting a physician.
Still other alternative remedies
Ginkgo: In one small study, 78% of men who had impotence due to poor circulation regained erections after taking ginkgo. More research is needed however.
Ginseng root is a traditional Asian remedy for stimulating sexual function, although no studies have been conducted on its effectiveness.
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