If you have erectile dysfunction, you may visit a doctor to treat the issue. Yet, ED is a warning sign of something deeper.Continue reading
What To Know About Telehealth for Erectile Dysfunction
Erectile dysfunction is awkward. And not just in the bedroom—it can feel uncomfortable to talk about in your doctor’s office, too.
I get that. I’m a board-certified urologist, so ED is one of the most common reasons why men come to see me. Even though I talk about it every day, I know it can still be incredibly uncomfortable for my patients.
And while there have been very few silver linings to the COVID pandemic, there has been one: people are much more willing to engage in telehealth or online doctor visits. And, interestingly, that has made men more comfortable speaking to a professional about ED.
In this article, I want to walk you through what telehealth for erectile dysfunction looks like. I want to dispel some of the myths around it, and emphasize that an online visit with your doctor really can be an effective way to address ED.
It’s accessible, it’s more comfortable, and it can be effective.
Can Telehealth Work for ED Therapy?
Right off the bat: are online ED consultations an effective way to get treatment?
Yes! They certainly can be. Virtually all of the things that I would do in an in-person visit at my clinic to evaluate and diagnose ED, I can do over the phone or via Zoom.
Several studies have even found that online telehealth platforms aimed at treating erectile dysfunction can be effective. Of course, you always want to make sure you’re having your telehealth consultation with a board-certified physician.
Benefits of Telemedicine for ED
There are many benefits for telemedicine:
- Access. Telehealth makes getting ED help much more accessible and less embarrassing than in-person visits.
- Comfort. Telehealth consultations done from the comfort of your home helps you feel more at ease and comfortable talking about ED.
- Convenience. You can have your doctor’s visit from anywhere on your phone or laptop!
- Quality of doctor. I’m based in Sarasota, Florida, but telehealth allows men who want VIP-level service to see me from anywhere.
- Less waiting. No more sitting around for 45 minutes in the waiting room—you’ll know exactly when your consultation starts, and they’re always on time!
- Same high-quality service. According to research, telehealth patients get the same length and quality of consultation as in-person patients do.
What Can a Doctor Do for You Online?
During an online visit, doctors can order any additional testing needed to manage erectile dysfunction. They can:
- Conduct a thorough evaluation of erectile dysfunction signs and symptoms
- Order blood tests to evaluate your hormone levels
- Provide prescriptions for common ED treatment options like Viagra and Cialis that can be delivered to your home.
- Provide information on other treatment options for ED and lifestyle changes that support sexual health
- Offer follow-up visits to evaluate the efficacy of ED treatments
What Can’t a Doctor Do Online?
There are some cases when you will need to see your doctor in person. If you are experiencing any pain, swelling, or discomfort, an in-person consultation may be necessary so that your doctor can do a proper physical inspection.
And, if you’re experiencing any of the following symptoms, you should seek emergency treatment:
- Inability to urinate together with swelling and pain in the lower abdomen
- A sudden onset of pain in the scrotum, or swelling in the testicles
- A prolonged, painful erection that lasts more than 4 hours
Those issues require in-person emergency care. But if you’re concerned about difficulty getting or maintaining an erection, telehealth is a perfect option for you.
How To Prepare for Your Telehealth Appointment
Prepare for a telehealth appointment in the same way that you would for an in-person visit. Have a pen and paper handy to take notes if you need to. Make a list of questions that you have beforehand. And make sure you don’t have any appointments right after so that you don’t feel rushed.
Make sure your internet connection is strong and that your camera and microphone work so that we can both hear and see each other. And make sure you have a quiet, private space where you can speak freely.
How it Works: What Will My Telehealth Appointment Be Like?
When I’m assessing erectile dysfunction, I’m going to ask you to tell me what you’re experiencing and about your medical history. Then I’ll ask some follow-up questions like:
- How long have you been struggling with trouble getting an erection?
- What have you tried so far in terms of ED treatments?
- What are your diet, sleep, and exercise habits like?
There are many different possible causes of ED including vascular problems, low testosterone, poor diet, medications, or even high stress. I’ll ask several questions to try to determine the potential causes.
Depending on the situation, I may recommend some blood tests so we can check your hormone levels, cardiovascular function, or other key markers. These test results can help identify certain causes of ED and can lead to more effective treatments than a one size fits all pill.
What Are My Erectile Dysfunction Treatment Options?
Once we understand the cause of your ED, we’ll be able to discuss treatment options. Treatment options for ED can include:
- Lifestyle changes
- Hormone Replacement Therapy (HRT Therapy)
- Oral ED medications like sildenafil (Viagra) and tadalafil (Cialis)
- The Priapus P-Shot
- Peptide therapies
- Stem cell Injections
- And more.
Remember that not all treatment options are appropriate for every person. That’s why it’s so important to understand your situation before we decide on a treatment plan—we want to choose the treatments that are most likely to work, and that don’t have unnecessary side effects.
If we choose prescription medications as the best option to treat your ED, we have the ability to discreetly and conveniently ship medications to your home, avoiding a trip to the pharmacy entirely.
How Is a Telehealth Appointment with an Erectile Dysfunction Expert Different From Mail-Order Services?
You can find many online ED clinics that offer you a quick consultation, which is usually followed by a healthcare provider writing you a prescription for viagra. Unfortunately, with those clinics, the provider is almost never an expert in urology with specialty training in erectile dysfunction.
The other issue with these online clinics is that, because they make large profits selling oral medications, that’s the only solution they tend to provide. While oral medications like Viagra and Cialis certainly can be effective treatment options, they’re not appropriate for everyone.
Sometimes ED can be a signal of more sinister medical conditions—diabetes, heart disease, high blood pressure, high cholesterol, and others. Quick visits with online mail-order services may not be thorough enough to catch warning signs of these more serious health conditions that require further testing.
Many of these companies are only in the business of selling you medications. They’re not necessarily providing high quality personalized healthcare. Work with a men’s health expert to ensure you get the most effective and appropriate treatment options available.
Telehealth Can Help You Combat ED
Erectile dysfunction is a legitimate health concern that affects millions of men in the US. We take women’s sexual and reproductive health incredibly seriously, but often ED is trivialized in the public eye. Erectile dysfunction can take a significant toll on the mental health, drive and self-esteem of guys who struggle with it. It can also signal that something else is going on with your health.
That’s why it’s so important to get evaluated and treated for ED. You don’t have to suffer from ED or feel marginalized as a result.
Telehealth is a great option for busy men. It’s private, it’s comfortable, and it’s a convenient way for men to get assessed and treated quickly. Best of all, it is effective. If you need help with ED, reach out and book a call with me today.
Badkhshan, S., Ernst, M., Maiers, T., Shapiro, M., & Chevli, K. (2020). Erectile Dysfunction in Telemedicine: The Standardized Patient Experience. The Journal of Sexual Medicine, 17(1), S14.
Ellimoottil, C., Skolarus, T., Gettman, M., Boxer, R., Kutikov, A., Lee, B. R., … & Morgan, T. (2016). Telemedicine in urology: state of the art. Urology, 94, 10-16.
Hsiang, W. R., Honig, S., & Leapman, M. S. (2020). Evaluation of Online Telehealth Platforms for Treatment of Erectile Dysfunction. The Journal of Urology, 205(2), 330-332
Manage ED with Cutting-Edge Science: New Therapies for Erectile Dysfunction
Erectile dysfunction (ED) is an old problem. It’s been around for a long time.
But treatment options are fairly new. The first effective oral ED medication—sildenafil (Viagra)—was discovered in 1989 and was only made available by 1998. Then came tadalafil (Cialis) and more recently vardenafil (Levitra, Staxyn) and avanafil (Stendra).
But our understanding of the causes of erectile dysfunction and how to treat it have grown tremendously since the discovery of sildenafil. These days, we’re able to manage ED with cutting-edge science and new technology.
Here are some of the newest therapy options for treating ED and the science behind how they work.
GAINSWave is the process associated with a revolutionary new therapy for ED called low intensity shockwave therapy.
How it works: Low-intensity shockwave therapies like GAINSWave treat ED by sending pulses of energy into the target tissue—in this case, tissue in the penis. The low-intensity shock waves induce angiogenesis, which is the creation of new blood vessels. This increases blood flow to the penis, making it easier to get an erection.
The therapy may also help regenerate penile nerve tissues by activating key regenerative signaling pathways (PERK/ATF4).
Is GAINSWave effective? The published literature provides good evidence to suggest that it really works.
In one meta-analysis that included data for 607 patients, researchers found a statistically significant improvement in erectile function in men who received the treatment with no reported adverse side effects.
Platelet-Rich Plasma (PRP)
Platelet-Rich Plasma, or PRP ( sometimes referred to as The Priapus shot or P-shot), involves injecting a concentration of platelets from your own blood into your penis.
How it works: PRP therapy works by injecting platelet-rich plasma from your own blood directly into the penis. Blood has four components: red blood cells, white blood cells, plasma, and platelets. By removing the red blood cells and white blood cells, doctors can concentrate the platelets and plasma and administer it directly in the penis.
Platelet-rich plasma contains proteins and growth factors that stimulate stem cells in the penis to promote repair, regeneration, and remodeling of the blood vessels and normal healthy tissue of the penis. After all, remember that an erection is simply increased blood flow to the penis! The idea is that, by injecting PRP into the penis, it helps restore normal, healthy tissue function and improve blood flow.
Is the P-shot effective? The research is ongoing but looks promising. In one recent review of several studies on PRP therapy, researchers found mostly good effectiveness with no major side effects or adverse reactions.
Most of the research on this treatment has been through small studies with low sample sizes, so it’s certainly still in the research phase. More studies are needed so we can better understand how effective this treatment is and for which men it’s best suited.
Peptides are simply short proteins – nothing more than short chains of amino acids. But they’re amazing!
Peptides are signaling molecules that your body recognizes for very precise functions. Peptides can be quite effective in turning back the clock on aging in a number of ways. And some peptides also appear to be helpful for treating ED.
How it works: Two peptides that have been found to be useful for ED are Melanotan 2 and PT-141. These can be given by subcutaneous injection or by nasal spray and can immediately enhance erectile function. These peptides improve sexual performance by stimulating melanocortin receptors, which are involved in sexual desire and erectile function.
Are peptides effective? Yes! The research on Melanotan and PT-141 suggests that both can dramatically improve erectile function. In one study, Melanotan 2 caused erections in 85% of the individuals, even in the absence of sexual stimuli.
Side effects can include yawning and nausea.
Stem Cell Injections
Stem cells are ‘progenitor’ cells that are not yet specialized and can develop into any other cell in your body.
For ED treatment, stem cells can be used to regenerate normal healthy erectile tissue. Stem cells are harvested from your bone marrow – typically from the iliac crest (the back of your bony pelvis) – and then injected into the penis.
How does it work? Stem cells are used in a variety of therapies because they have been found to regenerate, remodel, and repair damaged tissues. It’s believed that they contribute to regeneration by secreting bioactive chemicals that boost healing.
Are stem cell injections effective? They appear to be. One recent review that summarized 8 clinical trials in humans found that stem cell therapy could be effective for long-term improvement in erectile function. Stem cell therapy is one of the few regenerative treatments that is specifically FDA-approved for the treatment of ED.
Vacuum therapy is used both to create erections suitable for sexual intercourse as well as to stimulate growth and recovery of penile tissue to support healthy erectile function.
How it works: With vacuum therapy, a tube-like device is placed around the penis and connected to a manual or battery-operated pump that creates a pressure vacuum. The negative pressure brings blood into the penis and creates an erection. When used for sex, often a constriction ring is placed at the base of the penis to keep the blood in and to maintain the erection.
Is vacuum therapy effective? Yes, the research finds that the method leads to more satisfying erections. It also seems to have a positive effect on the rehabilitation of penile tissue after prostate surgery.
Intracavernosal “Trimix” Injections
Intracavernosal injections (ICIs), sometimes just called penile injections, involve injecting medication directly into the side of the penis to stimulate an erection. While several different kinds of medication can be used, the most commonly injected medications are papaverine, phentolamine, and prostaglandin E1. When these three drugs are combined, it’s called a “trimix”.
How it works: These medications stimulate vasodilation of blood vessels and relaxation of smooth muscles in the penis to allow increased blood flow and thus make it easier to achieve an erection.
Like oral medications like Viagra and Cialis, penile injection therapy is a short-term treatment that helps men get an erection immediately and lasts for a few hours after injection.
Are Intracavernosal injections effective? Yes. Research has consistently suggested that injection therapy can be as effective as PDE5 inhibitors like Viagra, Cialis, Stendra, Staxyn, or Levitra. Injection therapy is a great option for men who can’t take oral medications due to specific contraindications. Always make sure to take medication under the guidance of a doctor, since overdosing with injection therapy can cause major problems!
New ED Therapies Aren’t Always Better
While the newest, cutting-edge technologies are promising for those with hard-to-treat ED, the fact is that new treatments aren’t always better. Indeed, some of the classic advice on managing ED is as pertinent as ever.
That’s because treating ED requires a comprehensive, systems-based approach. In most cases, lifestyle changes can meaningfully contribute to better sex life.
Here is the less exciting—but still effective—advice I give my VIP clients for better sexual health:
- Exercise. We know that regular exercise is related to erectile function. It also boosts testosterone, which is an important component in healthy sexual function.
- Quit smoking. Men who smoke are about twice as likely to experience sexual dysfunction as those who don’t.
- Drink less. Alcohol is one of the most common causes of ED. Consume less alcohol for better erections.
- Eat a balanced diet. Switching to a healthy diet and caloric intake are associated with improvements in erectile function.
- Maintain a healthy weight. Obesity is a known risk factor for ED and losing excess weight can help treat it.
- Manage your stress. Stress can lower your testosterone and make it harder for you to get hard. Finding ways to cope with your stress can improve your sexual health.
Find the Appropriate ED Treatment for You
These days, ED is almost always treatable thanks to new technology and cutting-edge treatments. But don’t assume ED drugs like Viagra (sildenafil) and Cialis (tadalafil) are the only option for you.
Instead, get a full evaluation to find the cause of your ED. You want to make sure that it isn’t a warning sign of more significant underlying cardiovascular disease.
As a men’s health expert with over 20 years of experience treating erectile dysfunction,I can recommend the most appropriate ED treatment option for your particular case.
Schedule an appointment with me and get your ED treated today!
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In Male 2.0™, Dr. Tracy Gapin has turned everything we once thought we knew about men’s health and performance upside down. The old model of how to be “a man” is broken. A man who works himself to death. Unfortunately, a man who tries to NOT get sick but isn’t really healthy either. And a man who takes a pill for every ill but is never really cured. That was Male 1.0. Now, imagine being THE MAN ─ owning your performance in the bedroom, the weight room, and the boardroom. Living a fully optimized life. Becoming limitless. This is Male 2.0!
Tracy Gapin, MD, FACS is a board-certified Urologist, world-renowned Men’s Health & Performance Expert, Author, and Professional Speaker. Using state-of-the-art biometric monitoring, nutrition, and lifestyle intervention, Dr. Gapin coaches Fortune 500 executives and evolutionary leaders of business, sports medicine, and high performance. He specializes in cutting-edge precision medicine with an emphasis on epigenetics, providing men with a personalized path to optimizing health & performance. www.GapinInstitute.com
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Campbell, J. D., Trock, B. J., Oppenheim, A. R., Anusionwu, I., Gor, R. A., & Burnett, A. L. (2019). Meta-analysis of randomized controlled trials that assess the efficacy of low-intensity shockwave therapy for the treatment of erectile dysfunction. Therapeutic Advances in Urology, 11, 1756287219838364. https://doi.org/10.1177%2F1756287219838364
Epifanova, M. V., Gvasalia, B. R., Durashov, M. A., & Artemenko, S. A. (2020). Platelet-rich plasma therapy for male sexual dysfunction: Myth or Reality?. Sexual Medicine Reviews, 8(1), 106-113. https://doi.org/10.1016/j.sxmr.2019.02.002
Giuliano, F. (2004). Control of penile erection by the melanocortinergic system: Experimental evidence and therapeutic perspectives. Journal of Andrology, 25(5), 683-691. https://doi.org/10.1002/j.1939-4640.2004.tb02842.x
He, M., & von Schwarz, E. R. (2020). Stem-cell therapy for erectile dysfunction: a review of clinical outcomes. International Journal of Impotence Research, 33, 1-7. https://doi.org/10.1038/s41443-020-0279-8