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ask the DoCtor
with Doctor Lawrence Paletz
Beyond Viagra: Help for ED
Q: What is the medical definition of erectile
There are injections of the drug alprostadil (brand
names Edex and Impulse) that produce an erection
Erectile dysfunction, commonly called ED or
impotence, is the inability to achieve and sustain an The drug is also available in a suppository that’s
erection suitable for sexual intercourse.
placed into the penile urethra. Penile implants also
For most men, having trouble from time to time are effective for many men.
isn’t necessarily a cause for concern. But if erectile
If the patient has low serum testosterone,
dysfunction is an ongoing problem, it can cause
hormone replacement may help. An all-natural
devastating stress, affect relationships, and lower
supplement called Protandim is helpful in treating
ED because it reduces oxidative stress on the body
eventually suffer some form of ED. According to
statistics, about 25 percent of men 65 years and
Q: are many women affected by sexual
Surveys show that 43 percent of women over
Q: What are the causes of eD?
40 are unhappy with their sex life. They may
These include decreased blood flow into the
experience a decrease in desire, pain during sex, lack
penis, problems with the nervous system, or low
of orgasm, and a decrease in sexual sensation as they
Other physical causes can be atherosclerosis or
hardening of the arteries, diabetes, smoking, and
dysfunction, but diabetes, heart disease,
side effects from certain medications. People with
neurological conditions and hormone imbalances
injuries of the nervous system or who have spinal
are other factors. Like men, some medications,
alcohol and drug abuse can contribute to the
ED as well as men who have had prostate or
problem. For women, we focus on changes that
rectal surgery. Alcohol and drug abuse can also
normally occur with aging. Hormone therapy often
contribute to the problem. Psychological factors
like depression and stress can lead to ED. Men with
ED can find themselves in the middle of a vicious
Q: What new treatments are on the horizon?
Our team at the Western Institute for Sexual
The more they experience impotency, the more
Health is investigating the use of cardiovascular
they become anxious about their performance.
stents to be placed in the penile arteries to enhance
This leads to more episodes of ED. That’s why I
encourage them to seek help as soon as possible.
We have also developed a program to deal with
Less than one third of men who suffer sexual
the psychological issues such as reducing anxiety.
dysfunction discuss the problem with their health
This psychosexual evaluation helps partners
care professionals, and that’s a shame. There’s no
understand each other’s needs clearly and openly.
The bottom line is that most cases of sexual
Q: how is eD treated?
We have oral medications like Viagra, Cialis, and
Levitra that all work the same way. While they don’t
Lawrence Paletz M.D.
is a board certified
cure ED, they increase blood flow to the penis.
Western Institute for Sexual Health with
We also have vacuum devices, sometimes called
penis pumps, which draw blood into the penis.
Page 8 / July 2013
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PREFERRED THERAPIES: (additional pediatric-specific formulations appear in blue) Most Common Approx Cost Non-Formulary Approx Cost Drug Class Formulary Agent Per Month‡ Per Month‡ Penicillins Augmentin XR 2gm BID BPA, F3, $165/10days Allergy Drugs Analgesics Antidepressants Hyperlipidemics Hypertensives Infectives Allergy Drugs Analgesics A