Men's Health treatment in Rochester, NY

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What is ED?

Men can be confronted by many different life-altering diseases throughout their life like, heart disease, stroke, diabetes, cancer, depression but unique to men only are diseases like prostate cancer and benign prostate enlargement. These diseases are compounded as male ages.  Age can have an adverse effect on the male body as well because impotence might become a concern. It might take longer to get an erection, and erections might not be as firm as they used to be (Mayo Clinic).  As a male ages ED becomes more common, it is known that 40% of men are affected by ED at age 40 and nearly 70% of men are affected at age 70 (Cleveland Clinic).

Anatomy of an erection:

Briefly, erections occur when the penis becomes firm, engorged, and enlarged. The penis is made up of 2 chambers, called the corpora cavernosa. The tunica albuginea (the membrane surrounding the corpora cavernosa), helps to trap the blood in the corpora cavernosa, sustaining the erection. Erection is reversed when muscles in the penis contract, stopping the inflow of blood and opening outflow channels (Cleveland Clinic).

Below are factors and conditions that can affect men and cause ED:

Age

The body goes through many processes during the aging process. It is normal for damage or mistakes to occur in our cells and tissue over time. These changes aren’t a problem in our younger years: Our bodies can simply repair many of them, or have enough reserves to make up for them. But the ability to deal with this damage decreases as people grow older (NCBI). So it starts adding up, leading to signs of aging and sexual dysfunction. Here are the different conditions that are related to sexual dysfunction.

Sexual Dysfunction

A problem that can happen during any phase of the sexual response cycle. It prevents you from experiencing satisfaction from sexual activity. The sexual response cycle traditionally includes excitement, plateau, orgasm and resolution (Cleveland Clinic).

Disease

Depression

How a person perceives their body and what it looks like can affect their mental health and possibly make a person depressed. Their skin becomes less elastic and more sunspots and wrinkles appear.

Hypogonadism

Occurs when your sex glands produce little or no sex hormones. The sex glands, also called gonads. 

Erectile Dysfunction

Also known as ED and impotence; is the inability to get and keep an erection firm enough for sex (Mayo Clinic).

Enlargement of the Prostate

Also called prostate gland enlargement — is a common condition as men get older (Mayo Clinic).

Psychological Causes of Erectile Dysfunction:

The main psychological cause of ED is stress. And in various ways, all of the more explicit mental/emotional causes include some form of stress—such as relationship challenges, low self-esteem, depression and guilt.(Psychology Today).

Doctors recommend that anyone who is being treated or recovering from the above disease should refrain from the below risk factors that can exacerbate symptoms and the overall severity of the disease. A doctor in Rochester, NY will take into account possible preexisting conditions, age, and risk factors to determine the proper treatment.

Other Risk Factors:

Men who partake in the below risk factors will be at a higher risk of getting ED
Binge Drinking
Chain Smoking
Sedentary Lifestyle (No Exercise)

A combination of oral medications for the above diseases can cause ED. Talk to your medical professionals if you are taking alpha-blockers to treat prostate enlargement. The combination of alpha-blockers and ED medicines also could cause a sudden drop in blood pressure.

Doctors recommend eliminating the risk factors from your life to stay healthy as we age.

Blood Vessel blockage caused by these conditions:

Heart Disease

The most common is atherosclerosis, the artery-clogging process at the root of most angina (chest pain with exercise or stress), heart attacks, strokes, and other cardiovascular conditions. One result of this disease process is the accumulation of cholesterol-filled plaque inside arteries. Plaque can inhibit blood flow through an artery (Harvard Health). Heart disease is the leading cause of death in the United States, causing about 1 in 4 deaths.1 The term “heart disease” refers to several types of heart conditions. In the United States, the most common type of heart disease is coronary artery disease (CAD), which can lead to heart attack (CDC).

High Cholesterol

Your body naturally produces all the LDL (bad) cholesterol it needs. An unhealthy lifestyle makes your body produce more LDL cholesterol than it needs. This is the cause of high LDL cholesterol for most people (Heart.org).

High Blood Pressure

In fact, men with ED are about 38% more likely to have high blood pressure than those without ED, according to a study that examined the medical records of more than 1.9 million men (Harvard Health).

Diabetes

ED is one of the most treatable complications of diabetes. In fact, over 95 percent of cases can be successfully treated (NFB.org)

Metabolic Syndrome

A condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol.

Parkinson's Disease

Tremor, hypomimia, muscle rigidity, bradykinesia, ‘clumsiness’ in fine motor control, dyskinesias, hypersalivation and sweating may interfere with sexual function (NCBI).

Chronic Sleep Disorders

Some of the signs and symptoms of sleep disorders include excessive daytime sleepiness, irregular breathing or increased movement during sleep. Other signs and symptoms include an irregular sleep and wake cycle and difficulty falling asleep (Mayo Clinic). 

Multiple Sclerosis

In a study of people with MS, 63 percent reported that their sexual activity had declined since their diagnosis. Other surveys of persons with MS suggest that as many as 91 percent of men may be affected by sexual problems (National MS Society).

Priapism

Priapism is inflammation of the penis.

Chronic Diseases

Chronic diseases such as renal failure and dialysis can lead to ED.

Low Levels of HDL (High-density lipoprotein)

A person’s cholesterol levels are an important measure of heart health. For HDL cholesterol, or “good” cholesterol, higher levels are better.

Prostate Cancer

For men who undergo a radical prostatectomy (removal of the prostate gland), the estimates of how many men will regain their ability to have erections vary widely, from 25% to 80%. Even so-called nerve-sparing surgical techniques lead to erectile dysfunction in up to half or more of all cases (Harvard Health).

Peyronie's Disease

Development of scar tissue inside the penis, the scar tissue will obstruct the blood vessels in the penis.

Surgeries or injuries that affect the pelvic area or spinal cord

Spinal pathology arising from trauma, deformity, and degenerative disease processes may be detrimental to sexual and reproductive function (NCBI).

Low Testosterone

Low testosterone (male hypogonadism) is a condition in which the testes (testicles, the male reproductive glands) do not produce enough testosterone (a male sex hormone) (Cleveland Clinic).

Good Health and ED

Good health is the backbone for a long and quality-filled life. A person’s daily habits can make all of the difference when maintaining good health. Eating whole foods, drinking water, exercising and getting enough sleep can assist your body in producing healthy cells and intern a healthy body. In fact, lifestyle medicine specialist Mladen Golubic, MD, PhD says that, “healthy lifestyle habits can slow or even reverse the damage from high cholesterol or high blood sugar.” (Cleveland Clinic)

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Treatments that are available for ED in Rochester, NY

Oral medications for Erectile Dysfunction

Though these medications might help with ED, a lot of the below medications might have side effects and/or won’t be able to be taken with certain prescriptions (that help deal with the above conditions) (Mayo Clinic).

  • Sildenafil (Viagra)
  • Tadalafil (Adcirca, Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Avanafil (Stendra)

Shockwave Therapy

Low-intensity shockwave therapy (LISWT) this treatment is now being offered for men with erectile dysfunction (ED) caused by inadequate blood flow to the penis, called vasculogenic ED.
Shockwave Treatments: With LISWT, a physician uses a wand-like device to deliver mild shockwaves to the penis. Studies have found that the treatment is associated with the growth of new blood vessels and the recruitment of stem cells to the penis. Each treatment session lasts about 15 minutes. No anesthesia is necessary, and for upwards of 95% of patients, the procedure is virtually painless (Cleveland Clinic)
Shockwave therapy cost: Since shockwave therapy is a fairly new ED treatment that is not covered by insurance plans, your urologist may recommend other ED treatment options first. A shockwave therapy regimen typically includes six separate treatments, but treatment protocols could change as more research becomes available. The out-of-pocket cost for each treatment is between $400 and $500 (Healthcare Utah)

Penis pumps, surgery, and implants

These treatments might not be effective for everyone. Most pumps are custom-fitted to your body to allow you to have a satisfactory erection for sexual intercourse. Your sensitivity and ability to ejaculate should not be affected.

When you should talk to a doctor:

What are some research treatments/articles?

Clinical studies on low intensity extracorporeal shockwave therapy for erectile dysfunction: a systematic review and meta-analysis of randomised controlled trials (2019)

In a meta-analysis of 10 randomized controlled trials involving a total of nearly 900 men with vasculogenic ED, researchers reported that, compared with sham treatment, LISWT resulted in significant improvements in measures of erectile function and penile blood flow (Nature, 2019).

Low Intensity Shock Wave Therapy in the Management of Erectile Dysfunction (2019)

LISWT for ED is under evaluation in the USA. The European Association of Urology Guidelines on ED were recently updated to include LISWT for men with mild to moderate ED. The energy/pulse used in this application is approximately 10% of the energy used for disintegrating kidney stones; no serious side effects have been reported. Shock wave therapy for diabetic ulcers has recently been approved by the FDA (Clincal Trials, 2019).

Plant-based diets and risk of erectile dysfunction in young men (2021)

Erectile dysfunction (ED) is the most common medical issue associated with aging. Beyond the obvious impact on sexual quality of life, data suggests that ED may be an early indicator of cardiometabolic disease (Harvard EDU, 2021).

Vitamin D Deficiency Is Associated with Erectile Dysfunction in Men with Type 2 Diabetes (2020)

The patients with diabetes have a high rate of VDD. There is an inverse relationship between serum vitamin D status and ED among men with T2DM. Obesity, tobacco consumption, physical inactivity and duration of diabetes contribute to ED.(Internal Journal of Diabetes and Endocrinology, 2020)

Prevalence of Sexual Dysfunction and Related Risk Factors in Men with Multiple Sclerosis in Iran: A Multicenter Study (2021)

The prevalence of SD (sexual dysfunction) in men with MS in Iran is relatively high. These patients should be screened, diagnosed, and treated for SD and influencing factors (Springer Link, 2021).

Erectile Dysfunction Treatment With Combination of Mesenchymal Stem Cell Derived Exosomes and Focused Low-intensive Shock Wave Therapy (2020)

To develop and analyze clinical effects of mesenchymal stem cell-derived exosomes intracavernous injections and low-intensity extracorporeal shock-wave therapy combination in patients with severe erectile dysfunction on background of metabolic syndrome and atherosclerosis (UJMH, 2020).

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