Recently there has been an increase in the age of baby boomers. This has brought additional problems such as erectile dysfunction or ED in the scenario. Patients are now seeking new therapy and medications to overcome the problem. While oral medications for ED, known as PDE-5 inhibitors, have revolutionized treatment for the condition, not all men respond equally. Through a series of studies, Jack Mydlo, MD, professor and chair of urology at Temple University School of Medicine and Hospital, has found that when ED medications fail, combination therapy might be the answer.
'Medication used with other non-surgical treatments, such as pumps, injections or urethral suppositories, offers a safe and effective alternative for the small but significant portion of the population for whom oral medication alone doesn't work,' he said. Mydlo has also discovered the importance of motivation, persistence, a supportive partner and realistic expectations in the success of combination therapy, as some treatments can be costly or cumbersome. 'The good news is that in 2006, no one should have to suffer from ED. It just depends on how far you want to go,' Mydlo said. Several organ systems are involved in normal functioning: vascular, endocrine and neuronal. When one or more of these systems is damaged, ED can ensue. Smoking, obesity, cardiovascular disease and psychological stress are among the perpetrators.
Obesity, for example, has physical and emotional consequences, both of which can lead to ED: enzymes in fat tissue convert testosterone to estrogen, and overweight men usually have poor body images. Smoking is also a major cause of ED in men, and studies have shown that quitting smoking can lead to improvements, whether or not one is on medication. A history of injury or pelvic surgery, cancer treatments, and other medications, such as those for mental illness or high blood pressure, can also contribute to ED. In his most recent study, Mydlo determined that a combination of PDE-5 inhibitor and injection safely and effectively relieved ED in patients who had undergone radical prostatectomy.
Other studies have found urethral suppositories and oral medication, or vacuum pumps and oral medication to be effective. The power of combination therapy lies in its ability to overcome several problems simultaneously. Each therapy addresses a different aspect of ED. Over time, Mydlo has observed, many patients use combination therapy less frequently, relying on it more as a 'booster' when needed. Mydlo is currently writing a book on the topic, as well as planning a study that will look at how both men and women respond to combination therapies for ED.