Erectile Dysfunction Treatments in Rockville Maryland

What is ED?
What is an erection?
This is the hardening of the penis allowing a man to perform sexual intercourse. A penis has two chambers inside called the corpora cavernosa. These chambers extend from the head of your penis deep into the pelvis. The insides of these chambers are made of spongy tissue and can gain blood volume and grow in size. Once a male becomes aroused, their brain sends signals to trigger a hormonal response that allows those same arteries to open and allow blood in. The veins get compressed, trapping blood in a man’s penis.

What are the signs a person might have an issue with ED?
Several factors play a key role in contributing and/or causing ED. Ongoing ED can be caused by, risk factors (that the male participates in), age, diagnosis of certain ailments, and psychological reasons (Mayo Clinic).
Risk factors
Disease
High cholesterol
Diabetes
High blood pressure
Low testosterone
Vitamin D Deficiency
Age
Medications
Some medications aimed to help patients with certain diseases can be dangerous for people getting other treatments for ED. Patients that are taking medications for low/high blood pressure, take nitrate drugs, and/or are on dialysis, should talk to a medical professional to keep them safe.
Psychological factors
Deformities of the penis
Common Tests for ED
Combined Intracavernous Injection and Stimulation (CIS) Test
Color Doppler Ultrasound
Pharmacologic Cavernosometry and Cavernosography
These tests evaluate penile veins and help identify any venous leakages (UCSF Health).

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Age and ED
Age plays a huge factor in ED. It is estimated that by the time a man is in his 40’s, he has about a 40% chance of having some form of ED, and this prevalence increases about 10% per decade thereafter. It turns out that the most common cause of ED, regardless of the patient’s age, is due to a problem (and aging) with the vascular system of the penis (NCBI).
ED vs Similar conditions:
Low Testosterone
Peyronie's disease

Specific treatments for ED
Oral medications for Erectile Dysfunction
Seeing a psychologist: Mental Health Solutions for ED
- Have an erect penis when they wake up in the morning.
- Can get a firm erection when masturbating.
- Have gone through a stressful major life event, such as divorce, separation, death of a loved one, change in job, or moving.
- Grew up in an environment where sex and sexuality were considered negative, wrong, or "bad," or who were sexually or physically abused as a child.
- Lost their mother or father during early childhood.
- Have a history of serious relationship problems.
- Have a history of anxiety disorders or physical problems that have a psychological component (such as irritable bowel syndrome, migraines, asthma, or nervous bladder) (University of Michigan Medicine).
Invasive Treatments for ED: Pumps/surgery/implants
Shockwave Therapy for ED
Shockwave Therapy
“Energy”
FDA Approved
Clinical Use
The Phoenix
“Wave” technologies

Common Myths and Misconceptions
Fact: ED is complicated. Most of the time ED is one of many problems a patient might have and they all will need to be addressed to treat ED effectively.
Fact: 15% of the male population under the age of 40 say they experience ED on at least an occasional basis. Although age factors into ED its not going to be the only factor a medical professional considers (Urosurgery Houston).
Fact: Medical professionals expect that anxiety and/or distress can occur when experiencing ED but its not normally the only cause. Typical it’s because the penis’ blood flow is constricted (caused by possible disease)
Fact: Under rare and severe circumstances, it might be required to conduct invasive surgery for a patient’s ED. Sexual health specialists like Dr Miller can diagnose and treat many ED cases without surgery.
What is the Cost for ED Treatment

What are some research treatments/articles?
Effect of Physical Exercise Combined with Shockwave Therapy on Erectile Dysfunction in Diabetic Patients
The benefits of LI-ESWT therapy in organic erectile dysfunction with chronic renal failure: a case report (2020)
Penile low intensity shock wave treatment for PDE5I refractory erectile dysfunction: a randomized double‑blind sham‑controlled clinical trial
Prevalence of Low Testosterone According to Health Behavior in Older Adults Men
Statistics
Summary
Patients with ED can go through many obstacles diagnosing and treating ED. The treatments are diverse but they might not all produce successful results for each patient. Each patient should look for certain treatments with a doctor’s recommendation.

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