Go Local, not Loco

Posted on by Paul Turek, MD

You’ve tried the triumvirate of pills for erectile dysfunction. Herbal remedies and over the counter concoctions haven’t helped. They either never worked or have stopped working. Frustration and sex are now good buddies. Time to get more creative about improving your morning wood.

The Nature of Your Nature

Much like a rocket, an erection is a complex thing. Much has to happen inside before launching. Nerves must fire, arteries must open, veins must close and blood is moved into large spaces. A symphony of physiology for a few moments of fun.
The first point here is that if things don’t work normally, you really should look at the machinery. The same processes that produce an erection also function in the heart. Maybe that’s why erectile dysfunction is a predictor of heart disease. So, please get that general medical evaluation if you haven’t already done so, as erectile dysfunction can be due to the same things that lead to heart disease.

What’s After the Pills?

Ok, so Viagra, Levitra and Cialis have failed. A sputtering launch or no launch at all. At this point, oral medications can be replaced by “local” therapies directed to the organ itself. Enjoy the spoils of modern chemistry that include:

  • Creams and pills. Available in many forms and strengths, medication can be placed directly into the urethra (the urine tube within the penis) and absorbs into the penis to renew erections. Sounds worse than it is, honestly.
  • Injections.  Although difficult to fathom, injecting medications directly into the shaft of the penis with a short, tiny needle is very effective for the vast majority of men, regardless of the cause of erectile difficulty. You can hang a towel on this one.
  • Vacuum pumps.  Remember what was in the box of belongings given to Austin Powers after he awoke from cold storage? This mechanical approach creates 6 atmospheres (a lot!) of negative pressure (suction) around the penis, filling it with blood. A ring is placed on the penis base to keep it erect. Bulky, but works in virtually everyone.
  • Implants.  Available for 30 years, surgical implants are a last resort, but are also the single most effective treatment available. Implants can be bendable, inflatable, antibiotic-coated and come with various widgets and gadgets. They require 1-2 hours of surgery, however, which makes them a whole lot different from other therapies. They are also irreversible, in that they permanently alter internal penis anatomy making other treatments ineffective. The end-all and be-all for erection issues.

Bottom line is, we can get the erection back when pills fail…you just have to be open to the possibilities. Remember the words of the Roman poet Ovid: “Fortune and love favor the brave.”