Treatment options if Viagra or Cialis do not work.

by Alex Shteynshlyuger MD


When it comes to treatment of erectile dysfunction – New York Urology Specialists are a step ahead.  The causes of ED are complex.  ED is often a symptom of other medical conditions.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.


Effective Treatment Options when Sildenafil (Viagra) and Tadalafil (Cialis) Stop Working Well.

ED Treatment Viagra & CialisFor over 70% of men with symptoms of erectile dysfunction, who have difficulty obtaining erections that are sufficiently hard for intercourse or difficulty maintaining erections, medications such as Viagra and Cialis work well.  However over time these medications may stop working as well as they did previously.

There are a number of reasons why sildenafil (Viagra), vardenafil (Cialis), and Stendra may stop working.  Most common reason is progression of the underlying problem, atherosclerosis, worsening high blood pressure, weight gain, worsening diabetes or hormonal abnormality.  In some men, low testosterone may be responsible for lack of responsiveness to medications.

In these situations, addressing the underlying problem is important.  This may involve weight loss, diet, better control of underlying medical problems such as high blood pressure or diabetes. It is not infrequent that this can improve ability of medications to produce a better erection.

Dose and Drug Manipulation

When a medication for impotence such as Viagra, Cialis or Levitra is not working as well as it did before, change of medication from one to another may induce adequate improvement in symptoms.  Change in dose of medications may also be considered by the treating urologist.

Testosterone Replacement

For men with low testosterone levels, testosterone replacement often can improve the quality of erections that they obtain with or without medications such as Viagra and Cialis.

Alternative Treatment Options

Other treatment options when oral medications do not work well, may involve combination treatment with  intraurethral alprostadil (MUSE).

Penile injection therapy with alprostadil, Bimix, Trimix or QuadMix are usually effective when oral medications do not work. This involves injection medications that help to get a hard erection directly in the penis.  In general, injection therapy is effective for many men when medications such as Viagra do not work.  A tiny needle is used and the injection is nearly painless.

Shockwave therapy for ED is an effective treatment option for many men that can allow them to stop using medications such as Viagra or Levitra or allow them to get better quality erections and last longer when they take medications such as sildenafil (Viagra), tadalafil (Cialis) and Levitra.

Vacuum erection pump is an effective treatment option for some men.  It is an inexpensive treatment option for ED but a bit cumbersome. It works best for men in established relationship with an understanding partner.

Penile implant is another effective option when non-surgical treatment options do not work or are not acceptable.  It is a one time treatment that offers a permanent treatment for erectile dysfunction.

PRP for ED is a new treatment for ED that is under investigation.

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If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.

We offer affordable, highest-quality urology care with or without insurance.   Find out our office hours or directions to our office. We offer weekday, weekend and evening office hours.


 

 

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