Engel will begin with a thorough assessment when you arrive at our office, to understand more about the potential causes of your erectile dysfunction. Some men will find that their concerns are more related to lifestyle and psychological factors than physical problems. However, if lifestyle changes don’t seem to improve the issue, medication is the next logical step. For some men with severe erectile dysfunction or impotence (often post-prostatectomy patients), a penile implant may be exactly what’s needed to achieve a satisfying erection. However, understanding whether a penile prosthesis is the best option requires a consultation with Dr. Engel, one of the most experienced penile implant surgeons in the area and around the US.
- Vacuum Erection Devices: A non-drug option, sometimes used with meds.
- Penile Rings: Used with a pump to maintain an erection.
- Lifestyle Counseling: Doctor advises on weight loss, exercise, and smoking cessation.
- Psychosexual Therapy: To address anxiety, relationship issues, or depression.
- Regular Exercise: Improves cardiovascular health and blood flow.
- Healthy Diet: Supports vascular health, a key factor in erectile function.
- Sleep Hygiene: Addressing sleep apnea can significantly improve ED.
For more information about our generic medication program, launching soon, we encourage you to contact our office. *Urologic Surgeons of Washington (USW) is an independently owned and operated care center that may promote, sell, or provide services/products. Privia Medical Group is not responsible for these products or services. Privia’s Authorization & Consent to Treat, Financial Policy, and HIPAA Notice of Privacy Practices are not applicable to these services or products. Medical therapy is a mainstay in the treatment of organic or situational erectile dysfunction. It has given hope to many men who once struggled with the effects of impotence on their mood, relationship and overall quality of life.
| Brand Name | Generic Name | Dosage Forms | Mode of Action | Typical Dosage |
|---|---|---|---|---|
| Viagra | Sildenafil Citrate | Tablets | Vasodilation via PDE5 inhibition | 50-100 mg as needed |
| Cialis | Tadalafil | Tablets | Long-lasting PDE5 inhibitor | 10-20 mg as needed |
| Levitra | Vardenafil | Tablets | PDE5 inhibition | 10-20 mg as needed |
| Stendra | Avanafil | Tablets | Rapid onset PDE5 inhibitor | 50-200 mg as needed |
Dr.
Using ED Pills Correctly: The Key to Success
If you have visited our office for Erectile Dysfunction or ED, you know that we are able to prescribe medication for those that need it. Most commonly, we prescribe generic versions of Viagra and Cialis, the two most prescribed ED medications in the United States. In an effort to offer our patients a more convenient prescription filling option, we will now be selling these generic medications at the office. Beyond this convenience, our second goal is to offer these medications at a lower price than what would be found at your local pharmacy. Understandably, erectile dysfunction is a very distressing condition for any man who experiences it, even mildly.
The mental side of sex
When a man comes into our office concerned about difficulty maintaining or achieving an erection, we take a stepwise approach to his treatment. Erectile dysfunction may be caused by lack of blood flow, including issues associated with medication, previous surgery, or the simple fact that the patient is no longer aroused by their sexual partner. Once lifestyle and medication issues have been ruled out as the cause of erectile dysfunction, employing medical therapy may improve the patient’s condition. Commonly advertised medications like Viagra and Cialis have been proven safe and their generic versions are similarly so. Dr. Paul Turek has relied on a pills for men range of medications to safely and effectively treat patients. If you have erectile dysfunction, you may be encouraged to learn that a variety of treatment options exist, and Dr. Turek offers the very best that science has to offer. The board-certified urologist and men’s sexual health provider will put your worries and concerns to rest and work with you to find a solution that meets your personal needs. The treatment that is right for depends on many factors, including your age, medical history, other medications you take, potential side effects, personal preferences and treatment goals.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Kamagra Soft Tabs | 100mg | 32 Pills | 120.11€ 114.39€ | |
| Viagra Professional | 100mg | 180 + 4 Pills | 337.30€ 321.24€ | |
| Viagra Generic | 25mg | 10 Pills | 25.19€ 23.99€ | |
| Priligy Generic Dapoxetine | 60mg | 180 + 10 Pills | 494.76€ 471.20€ | |
| Cialis Professional | 20mg | 30 Pills | 104.57€ 99.59€ | |
| Viagra Generic | 150mg | 60 + 4 Pills | 111.25€ 105.95€ | |
| Levitra Original | 20mg | 48 + 4 Pills | 235.14€ 223.94€ | |
| Kamagra Polo | 100mg | 20 Pills | 83.56€ 79.58€ | |
| Viagra Soft Tabs | 100mg | 30 + 4 Pills | 83.06€ 79.10€ | |
| Cialis Generic | 2.5mg | 270 + 10 Pills | 199.64€ 190.13€ | |
| Viagra Generic | 150mg | 90 + 6 Pills | 147.18€ 140.17€ | |
| Kamagra Gold | 50 mg | 360 + 6 Pills | 713.95€ 679.95€ |
When you are sexually aroused, your body releases a chemical called nitric oxide, which relaxes the blood vessels and tissues of your penis. This allows your penis to engorge with blood, resulting in an erection.
- Legitimate Sources: Requires a valid prescription from a licensed physician.
- Online Consultations: Many reputable services offer telehealth prescriptions.
- Rogue Websites: Avoid sites that sell medications without a prescription.
- Counterfeit Risk: Fake pills may contain incorrect doses or harmful substances.
- Verification: Use pharmacy verification tools to ensure legitimacy.
- Brick-and-Mortar Pharmacy: The most traditional and secure source.
- Compounding Pharmacies: Can create custom formulations under doctor's orders.
But an enzyme called phosphodiesterase 5 (PDE5) reverses the function of nitric oxide. Sildenafil, tadalafil and vardenafil are phosphodiesterase 5 inhibitors, meaning they work by blocking PDE5. The medications will not make you sexually aroused, but they will allow you to get an erection in response to sexual stimulation and help you maintain it long enough for sexual intercourse. Viagra (sildenafil citrate) is perhaps the best known of the PDE5 inhibitors and produces great results. It takes effect within an hour and lasts three to four hours.
The bottom line
“At best, you’re paying for something that won’t give you results. And at worst, you could experience dangerous interactions and side effects.” One of the newest therapies for ED is a gel you apply directly to the penis. This treatment is not yet sold in the U.S. “We need more clinical trials to show that an ED topical gel is as effective as other options,” says Dr. Liroff.
ED drugs are not safe for all men.
“Pills, injections, pumps and shockwave therapy all produce good results and have evidence to show that they work.” Platelet-rich plasma (PRP) and stem cell therapy are two of the newest potential therapies for ED. However, there’s no solid evidence of their effectiveness. “Right now, PRP and stem cell therapy are unproven,” says Dr. Liroff. “Some small studies say they could premature ejaculation treatment help with ED, but others show no results.
ED medications
There are also a lot of questions about how much is effective and which patients might benefit. It’s best to skip these therapies until we have more information.” It can be difficult to address ED with your provider, but remember you’re not alone: ED affects 30 million men in the U.S. “Don’t be embarrassed to tell your provider about ED,” says Dr. Liroff. “Your sexual health is an important part of your overall health, and we’re here to help you be your best.” Reviewed by Stephen Liroff, M.D., a board-certified urologist and Physician in Charge at Henry Ford West Bloomfield Urology Clinic. It must be taken on an empty stomach to be effective. A newer alternative to sildenafil is vardenafil (Levitra) which has a similar duration of activity but can be taken with food. Cialis (tadalafil citrate) is longer-acting than Viagra and stays in the bloodstream for a longer time, up to 36 hours. Some men take a small dose of the medication daily so there is always some in their system. Depending on your personal needs, Dr.
When oral medications might not be safe
These pills are safe and effective for many people, which is why they remain a first-line treatment. Not everyone should take these medications, however. “Oral medications for ED can cause dangerous interactions if you take them with nitrates, which are medications that treat angina or chest pain,” says Dr. Liroff. “ED medicines can also interact with certain heart medications and alcohol.
Sildenafil Citrate
Finally, depending on the drug, you have to take them 15 minutes to two hours before sexual activity, which requires advanced planning.” If oral medications aren’t right for you, injectable ED treatments are a good next step. “With ED injection medicines, you use a thin needle to place medicine directly in your penis,” says Dr. Liroff. “Up to 85% of men get good results with this treatment, but the main drawback is having to give yourself an injection before sex.” A vacuum erection device, sometimes called a penis pump, creates a gentle vacuum around the penis to create an erection. “Pumps for ED help draw blood into the penis, and then you use a stretchy band to keep the blood in place,” says Dr.
How much do ED medications cost? Are they covered by insurance?
Liroff. “The FDA-approved devices work well for about 75% of patients.” One of the newest therapies for ED is known as low-intensity shockwave treatment (LISWT) or shockwave therapy. “Shockwave therapy emits pulses of energy into the tissues of the penis, which generates a natural healing process,” explains Dr. Liroff. “The tissues respond by increasing blood flow, which helps you get an erection.” You’ll likely need about six shockwave treatments, spaced over a few weeks. Turek may prescribe any one of these medications. Side effects are a common concern with any medication. Side effects of Viagra (sildenafil) and Levitra (vardenafil) include: Temporary abnormal vision (more common with Viagra) Side effects of Cialis (tadalafil) are similar and include: Because Cialis remains in your system longer, possible side effects can last longer than those of Viagra or Levitra. It is also important to understand that certain drugs, mainly nitrates used for chest pain and some alpha-blocking drugs used for prostatic enlargement, negatively interact with Viagra and Cialis. Dr.
How do ED drugs work?
It may take up to three months to see maximum results. “LISWT causes mild tingling, but most patients don’t find it painful,” says Dr. Liroff. “When a licensed provider gives you shockwave therapy, it’s safe and has a minimal risk of side effects.” It’s important to know the difference between true shockwave therapy and counterfeit versions. A similar-sounding treatment known as radial wave therapy (rWT) is available at healthcare clinics and even non-medical facilities.
Who can prescribe ED medications?
Though it promises results, it has no science to back up its claims. “Shockwave therapy has data to show that it stimulates blood flow and generates new blood vessels,” explains Dr. Liroff. “Radial wave therapy doesn’t have these results, and studies have shown that it’s equal to no treatment.” Penile prosthesis surgery, sometimes called a penile implant, might be an option if less invasive treatments haven’t worked for you. “There are different types of implants, depending on your needs and preferences,” says Dr.
What medications are available for erectile dysfunction?
Liroff. “See a urologist who has experience in penile implant surgery to discuss your options.” Steer clear of herbal medications and “natural supplements” for ED. No studies have proven that they work, and they could be dangerous. “The FDA doesn’t regulate ED supplements, so you don’t know what you’re getting,” says Dr. Liroff. Turek will discuss the potential side effects of Viagra and Cialis and explain the possible interactions. Together, you will determine the best medication to help you get and keep an erection and enjoy improved sexual function. If you are experiencing erectile dysfunction and want to discuss your medical options with Dr.
- Telemedicine: A popular and discreet way to obtain consultations and prescriptions.
- Discreet Packaging: Most online and mail-order pharmacies offer this service.
- Privacy Laws: Health information is protected under laws like HIPAA.
- Personal Comfort: Many men prefer the anonymity of online services.
- Direct Delivery: Medications are shipped directly to the patient's home.
- Consultation Records: Kept confidential within the telehealth platform.
- Stigma Reduction: Easier access helps reduce the embarrassment associated with ED.
Turek, please request an appointment at The Turek Clinic.
- Alprostadil can be injected or inserted as a suppository.
- Udenafil is less common but used in some countries.
- Yohimbine is a natural supplement, less effective than meds.
- PDE5 inhibitors may cause vision changes in rare cases.
- Green tea or herbal supplements are not proven ED treatments.
- Alcohol can interfere with the efficacy of ED medications.
- Combining certain ED drugs can cause dangerous drops in blood pressure.
- Men with heart disease should consult a doctor before use.
- Regular exercise and healthy diet can improve ED symptoms.
- Psychological counseling benefits some patients.
Contact us today to schedule your visit. Erectile dysfunction (ED) is a common condition. One recent study estimated that roughly a third of men struggle with it.1 Though the condition does affect more older men than younger men, its impact spans age groups.