I have worked with thousands of men requiring specialized treatment for conditions affecting sexual performance as well as androgen (testosterone) deficiency. I employ an individualized treatment approach that is tailored to fit the needs of each individual. Every man is different and and requires customized treatment that is not based on a generic one-size-fits-all approach to care. Contact us today to request an appointment.
Certified Nurse Practitioner
Sexual dysfunction is a common condition experienced by men. Sexual dysfunction includes erectile dysfunction, decreased libido or sex drive and abnormal or premature ejaculation. Erectile dysfunction is the most common form of sexual dysfunction and is described as difficulty achieving and/or maintaining an erection. Over 50 % of men between the ages of 40 – 70 will experience symptoms of erectile dysfunction.
- Neurological Disorder: Erections rely on strong nerve impulses sent to the penis. The nerves can become damaged from trauma resulting in nerve injury or due to certain medical conditions such stroke or diabetes.
- Vascular Disease: Abnormal blood flow is the most common cause of erectile dysfunction. Narrowing of the arteries (atherosclerosis) causes a decrease in blood flow to the penis. The veins also play an important role in erections. Men who experience trouble maintaining a firm erection may have a condition called venous leak.
- Psychological disorders: Often overlooked, men under a lot of stress or suffering from depression may experience erectile dysfunction. Some antidepressants can contribute to erectile failure. Men may also develop performance anxiety or become frustrated when they notice changes in sexual function which only makes the problem worse.
- Hormone-induced: Men with low testosterone may experience several a combination of symptoms such as: changes in sexual desire, low energy levels, trouble concentrating, difficulty sleeping, fatigue and erectile dysfunction. Men with too much or too little thyroid hormone, increased prolactin levels, or on hormones prescribed for prostate cancer may also contribute to erectile dysfunction.
Men with low testosterone levels may be prescribed testosterone replacement therapy to improve energy, mood, lean muscle mass and increase sexual interest and libido. Testosterone replacement therapy may not be enough on its own and the combination of testosterone with medication such as Sildenafil, Tadalafil or Vardenafil may be required.
Additional treatment options may be used for men who have are on nitrates, have had treatment failure with the Sildenafil, Tadalafil or Vardenafil in the past or have had a history of prostate cancer.
- Be sure to get plenty of rest
- Eat a healthy diet and exercises regularly to keep good blood circulation.
- Maintain a healthy weight for your height.
- Avoid alcohol before intimacy (and no more than 2 drinks per day).
- Cut back, preferably quit, smoking.
- For diabetics, keep blood sugar well-controlled.
- Talk openly with your partner about your relationship and sex life
Testosterone optimization therapy
Testosterone is the primary sex hormone for men. It is responsible for the growth and development of many key male features and characteristics.
Testosterone is the key hormone that makes a man feel like a “a man”. In men, testosterone helps:
- Keep bones and muscles strong
- Maintain sex drive and erections
- Make sperm
- Determine hair growth and where fat is store on the body
- Make red blood cells
- Boost energy and mood
- High blood pressure
- High cholesterol
- Alcohol abuse
- Obesity and being overweight
- HIV / AIDS
- Long-term use of some medications, like opioids
- Lower sex drive or desire
- Lower quality and frequency of erections
- Difficulty in concentration and memory
- Reduced muscle mass and strength
- Increased body fat
- Low energy/fatigue
- Moodiness and irritability
- Depressed feelings
But overall, you should experience a gradual increase in lean muscle mass, increase libido, increased energy, improved mental clarity and reduced body fat.
American Urological Association website. What is erectile dysfunction? www.urologyhealth.org/ urologic-conditions/erectile-dysfunction(ed). Updated June 2018.
Burnett AL, Ramasamy R. Evaluation and management of erectile dysfunction. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 69.
Burnett AL, Nehra A, Breau RH, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633-641. PMID: 29746858 pubmed.ncbi.nlm.nih.gov/29746858/.
Testosterone optimization therapy
Allan CA, McLachlin RI. Androgen deficiency disorders. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 139.
Morgentaler A, Zitzmann M, Traish AM, et al. Fundamental concepts regarding testosterone deficiency and treatment: international expert consensus resolutions. Mayo Clin Proc. 2016;91(7):881-896. PMID: 27313122 pubmed.ncbi.nlm.nih.gov/27313122/.
U.S. Food and Drug Administration website. FDA drug safety communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. www.fda.gov/drugs/drugsafety/ucm436259.htm. Updated February 26, 2018. Accessed July 6, 2021.