How does an erection occur?
The penis contains two erectile chambers called corpora cavernosa. When these chambers fill with enough blood, an erection occurs. An erection begins with sensory and/or mental stimulation.
During arousal, the corpora cavernosa relax allowing blood to flow into the chambers. Once the chambers fill to a certain pressure, the outflow valve is closed trapping blood in the penis.
What can harm erectile function?
As we discussed above, normal erectile function is a multifaceted process. The most common causes of abnormal erectile function are due to:
1) Alterations in blood flow: obesity, smoking, high blood pressure, high cholesterol, and age can all lead to diminished blood flow to the penis by damaging and narrowing the blood vessels
2) Medications: many medications can affect libido and erectile dysfunction. Especially troublesome are several medications used to treat depression and blood pressure.
3) Psychological stress (in or out of the bedroom) can also affect erections. If a man has difficulty performing in the bedroom, this can cause an increase in anxiety which can exacerbate the issue.
4) Hormonal imbalance: very low testosterone or high estrogen can not only affect sexual drive but can also affect erectile function
5) Prostate surgery: erectile dysfunction can occur due to nerve damage during this surgery.
6) Anatomic/Curvature issues: Peyronie’s disease which is excessive curvature caused by scar tissue formation, can limit blood flow to the penis and cause pain with erections.
What is erectile dysfunction?
Erectile dysfunction (ED) has many different causes and is incredibly common. ED can affect men of various ages. More than 40% of men age 40 and 70% of men age 70 have some form of erectile dysfunction. This can be caused by many different issues including reduced function of the blood vessels and nerves of the penis as well as medications, performance anxiety and prostate surgery. There are also varying degrees of erectile dysfunction.
Some men may be able to achieve erections but maybe they just aren’t as firm or full as they were in years past. Decreased erectile function can affect your confidence in other areas of life, create anxiety about sexual encounters and lead to distance in relationships. Often men will avoid pursuing sexual activity with their partner because they are worried they won’t be able to perform.
Some may even avoid other forms physical intimacy such as cuddling, hugging and kissing for fear that it will lead to an unsatisfying situation. This can negatively affect relationships by reducing physical and emotional intimacy. Let’s discuss some of the treatment options that can help men of all ages.
What if I can get an erection but it just isn’t as full or firm as it once was?
As with many medical conditions, erectile dysfunction has varying degrees of severity. Typically, the earlier treatment begins the better the chances of success. Dr. Gentry does not define erectile dysfunction as the inability to get an erection but as not being satisfied with the quality of your erections.
You don’t have to wait until there is a significant problem to improve erectile function. Many men in their 30s and 40s will undergo our treatments to improve the firmness and size of their erections and to help prevent erectile dysfunction as they age.
Treatment Options:
Medications:
Medications such as Viagra (Sildenafil) or Cialis (Tadalafil) have been prescribed for over 20 years. These medications work by dilating blood vessels to increase blood flow to the penis. They often work but are short lived and frequently have side effects such as headache, dizziness, and nausea. These medications can also interact with other medications or supplements you are taking.
Although these medications are a viable option for some, they may not always work and can really take the spontaneity out of your sex life. There are also medications such as Caverject/Alprostadil that can be injected into the penis prior to intercourse to dilate the blood vessels, allowing an erection to occur. These medications often work, but can be painful, can take spontaneity out of sexual activity, and typically cost about $100 per dose.
Vacuum Pumps:
Vacuum pumps pull blood into the penis using negative pressure. These devices can improve erectile function but only when used within certain parameters. Using too much pressure or the wrong device may actually damage the penis, worsening erectile function rather than improving it.
Lifestyle Changes:
As we discussed above, conditions and diseases that affect blood vessels can negatively affect erectile dysfunction. Making lifestyle changes that improve the overall health and function of blood vessels can improve erectile function.
For instance, regular exercise, weight loss, and smoking cessation can all improve erectile function. These lifestyle modifications also have positive benefits on your overall health.
What about supplements and other over-the counter treatments?
Some supplements such as arginine and citrilline may help improve blood flow to the penis by dilating the blood vessels. However, the majority of supplements are not effective and can be plain dangerous. These medications are often poorly regulated and may contain harmful chemicals or herbs. There are no over the counter treatments with much success for erectile dysfunction.
Shockwave/Gainswave:
GAINSWave®, is a clinically proven, non-invasive therapy, specifically developed for men seeking treatment to improve their sexual performance. Low Intensity sound waves improves blood flow to the penis and stimulates a healing process to produce new blood vessels.
This is a reliable method proven to improve erectile function without the use of medications, surgery or injections. This technology has been used to treat erectile dysfunction in Europe for 10-20 years. Each treatment is painless and takes 20-30 minutes and there are no activity restrictions. We typically recommend a series of 6-12 treatments at weekly intervals to improve erectile function. (internal Gainswave link)
Platelet Rich Plasma (PRP) and the P Shot:
The P Shot or Priapus Shot is a patented procedure using your own growth factors to improve erectile function. Growth factors from your own blood (Platelet Rich Plasma or PRP) are activated to stimulate the growth of new blood vessels and nerves of the penis.
As of today (July 2019), Dr. Gentry is the only physician in Fayetteville, AR trained to provide the P shot. He trained under Dr. Charles Runels, who developed the P Shot, and first performed the procedure in 2013. The growth factors from your platelets activate your stem cells to produce new blood vessels. This improves erectile function over 3-12 weeks. (internal P shot link)
**Our best results are achieved through our comprehensive program. This combines Gainswave, P shot, penis “rehab”, and can also include medications. This program has a combined success of over 90%.