Erectile Dysfunction for Men

Let’s talk about erectile dysfunction-openly and freely, not as a shameful or avoided topic. The only way to improve ED is to talk about it- with yourself, by being honest about the concern, with your significant other, and with a trained medical provider. Erectile dysfunction affects the sexual health of more than 30 million men in America and worldwide that number is expected to reach 322 million by 2025. Understanding what ED is, some of the causes, and knowing that there are options, is one of the first steps toward seeking treatment.

What Are The Common Symptoms of ED?

Erectile dysfunction is often singularly thought of just as the ability to achieve and maintain an erection for intercourse. However, ED extends to include changes in erection strength and endurance, in the level of sensation, the presence of an abnormal curvature of the penis, a decline in desire or drive for sex, avoidance of intercourse because of symptoms, a decrease in self esteem or confidence, as well as the regularity with which symptoms are experienced.

This broad definition can encompass several symptoms including:

  • Inability to achieve or maintain an erection suitable for intercourse (ED)
  • Lack of desire in or for sex
  • Inability to become aroused
  • Reduced sensitivity
  • Peyronie’s disease – abnormal curvature in the shaft of the penis
  • Decreased erection strength or endurance
  • Decrease in length or girth
  • Avoidance of intimacy or intercourse
  • Inability to control timing of ejaculation
  • Absent or delayed ejaculation

Even if you can achieve an erection, there can be other signs that could indicate sexual dysfunction. Low libido, premature ejaculation, and retrograde ejaculation are all symptoms. Erectile Dysfunction can be from a variety of causes and appear as countless symptoms. Your next step is to talk to contact Re-new today to learn your options.

What Causes ED?


While it is often thought that erectile dysfunction is just “part of aging,” the potential contributing causes are numerous. Erectile dysfunction risk does increase with age, men with mild to moderate ED experience a 10% increase in risk per decade of life. Meaning that 40% of men in their 40’s, 50% of men in their 50’s, 60% of men in their 60’s and so on. With increasing age, your risk of vascular problems such as atherosclerosis or clogged arteries, increases; leading to higher likelihood of experience erectile dysfunction symptoms. While nearly 90% of erectile dysfunction has a vascular cause, making it the most common cause of natural ED; that is 90% of men with ED have blood flow issues or vascular abnormalities contributing to their symptoms, there are other potential causes that can have a compounding effect on erectile dysfunction. Chronic medical conditions such as hypertension, high cholesterol, diabetes, renal failure and COPD can all contribute to the development and worsening of erectile dysfunction. Others include:

  • Chronic medical conditions
  • Nerve disorders
  • Psychological concerns / Relationship issues
  • Obesity
  • Decreased penile blood flow
  • Certain medications
  • Injury or trauma to the penis
  • Hormonal imbalance
Dr. Melissa Loseke and family

Erectile dysfunction can occur because of problems at any stage of the erection process. Sexual function is an important part of life and overall well-being. Sexual satisfaction, or lack thereof, can impact a person’s overall health and quality of life. Many men with erectile dysfunction will experience depression, lack of confidence and the presence of ED can cause strain on their relationships. Many will complain that their sex life is unsatisfactory, ultimately, often being the instigator for seeking advice and treatment. Some other psychological symptoms that can be experienced include:

  • Avoidance of intimacy or sex with your partner
  • Anxiety, related to intercourse
  • Depression
  • Resentment or frustration with/towards your partner
  • Guilt for not being able to give your partner sexual satisfaction
  • Increases in stress related to ED that affects other areas of life
  • Loss of confidence or feeling of manlihood

Lastly, how you live your life can affect your risk of developing erectile dysfunction. Tobacco use, from cigarettes and chewing tobacco and all other forms, can drastically increase your risk of ED because of the damage to the blood vessels. Heavy alcohol use or participation in illegal drug use can contribute as well. Not eating a well-balanced diet or exercising regularly, which can lead to extra pounds or obesity, all increase your potential for developing erectile dysfunction. This conglomerate of numerous causes for erectile dysfunction can make it not only difficult to treat but why seeking expert medical advice from a healthcare professional trained in sexual dysfunction is so important.


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Treatment Options for Men


Developed from the peptide Melanotan 2, PT 141 is the only pharmacological product available to treat both men and women. It is branded as Vylessi for female sexual dysfunction. PT-141 acts directly on the nervous system to increase desire, arousal, and sexual function. For men, this means you gain more than just the ability to achieve an erection, you increase sensation, desire, pleasure, motivation for sex, better erection strength and endurance, and decreased refractory period. Ladies you get improved desire, motivation, clitoral sensation, and increased ability to orgasm. As a couple, you not only reignite your passion for each other but get to intimately reconnect in your relationship.


Commonly known as Cialis, tadalafil belongs to a class of medications known as phosphodiesterase inhibitors or PDE5 inhibitors. It is used primarily to treat erectile dysfunction and symptoms associated with benign prostatic hypertrophy (BPH), such as urinary urgency, hesitancy, and frequency, weak stream or dribbling, incomplete bladder emptying, or painful urinating. Tadalafil can also be used to improve exercise capacity in patients with pulmonary arterial hypertension. In combination with sexual stimulation, tadalafil works by increasing blood flow to the penis, resulting in an erection. It can be prescribed in a variety of manners, including from daily use to as needed prior to sexual activity, alone or in combination with other medications to enhance benefits, and an oral tablet, rapid dissolve tablet, or troche, all designed to improve the delivery of the medication and increase effectiveness. Tadalafil takes about 20-30 minutes to begin working and typically lasts for up to 36 hours, making it ideal for a weekend with your significant other.


Popularly known as Viagra, sildenafil was the first marketed PDE5 inhibitors. It is used primarily to treat erectile dysfunction and does so by increasing penile blood flow with sexual stimulation. Sildenafil can also be used to treat exercise ability in adults with pulmonary arterial hypertension. It is available as a tablet, suspension, troche, and cream, both alone and in combination with other medications to improve results. Sildenafil is best taken 30-60 minutes prior to intercourse and typically lasts 2-4 hours. In the United Kingdom, it is available over the counter but in the United States requires a prescription from a medical provider. Sildenafil can have added benefit for men experiencing ED related to anti-depressant use. It is unclear if it provides any benefit to women. Sildenafil has frequently been discussed in recreational use, with the belief that it increases libido, improves sexual performance, and increases penis size. The studies are limited but they do suggest a little effect on those factors. However, the benefit was exhibited in the refractory period, 25 mg of Viagra recreationally did reduce post-ejaculatory refractory time, although significant placebo effect was also demonstrated. Sildenafil has been researched in other areas such as jet lag and sports performance for its vasodilation qualities.


Oxytocin is a powerful peptide hormone that acts as a neurotransmitter in the brain. It is thought to be involved in social cognition and behavior, ranging from mother-infant bonding and romantic connections to group-related attitudes and prejudices. Oxytocin is released from the anterior pituitary during moments of snuggling or social bonding, giving it the nickname the “cuddle” or “love hormone.” In women, oxytocin plays a role in the birthing process and nursing. It causes uterine contractions during labor and helps shrink the uterus after delivery. Oxytocin is released as a result of suckling during breastfeeding leading the “let down” of milk to the infant. For men, oxytocin facilitates bonding and may help with the formation of social memories, both pleasant and unpleasant.

Oxytocin levels rise during sexual stimulation and orgasm in both men and women and play an important role in sexual arousal. Studies show elevated oxytocin levels immediately after orgasm and in men, increased levels throughout sexual arousal, not just the following orgasm. Oxytocin targets erectile tissue having an indirect effect on the ability to achieve an erection in men. It is also thought to be associated with ejaculation by increasing sperm count and contracting ejaculatory tissues. Oxytocin has been proposed to have a benefit in premature ejaculation through its mediation by vasopressin receptors. In both sexes, oxytocin is suggested with increased concentration to increase the intensity of orgasm. From a relationship standpoint, it can enhance trust, growth, empathy for partners, increase positive relationship memories, improve fidelity, foster more positive communication, and allow better processing of bonding cues.

The Re-new Shot™

The Re-new Shot, similar to the Priapus Shot®, is a non-surgical procedure that utilizes the healing capacity of your own biologics, to treat erectile dysfunction and Peyronie’s disease. Your own biologics contain growth factors that instigate the healing cascade leading to repair, rejuvenation, and revitalization of the tissues and the penis. At Re-new Institute, we have developed a cutting-edge procedure that further enhances the benefits of of your own biologics with the addition of powerful peptides. The Re-new Shot™ is a safe procedure with no downtime and is available only by the trained physicians at Re-new Institute.

By combining peptides with your own biologics, patients are able to increase new blood vessel and nerve formation, reduction of scar tissue, and tissue repair at a much higher degree than using biologics only. The procedure requires a simple blood draw to extract blood. Numbing medication is used to minimize discomfort of the procedure, our goal is that your fear of pain is greater than the actual pain experienced from the procedure. This revitalizing blend of your biologics and peptides is then injected directly into the penis. Results can be immediate but are typically noticed starting 2-3 weeks after the procedure and maximizing around 6-8 weeks after injections. Benefits can last anywhere from 12-18 months. The procedure may need to be repeated to continue improvements and can be combined with other ED treatments as well as testosterone replacement therapy. You achieve longer and stronger erections that are more sustainable, enhanced sensation and orgasms, increased libido, increased sexual stamina, better sexual performance, decreased refractory period, improved circulation and blood flow, and the potential for an increase in length and girth or a straighter penis.

TriMix or QuadMix

These are specialty compounded medications for erectile dysfunction that allow for direct delivery into the penis without the medications having to travel throughout the body, potentially weakening their effect, via injection. TriMix is a combination of Alprostadil, Phentolamine and Papaverine, while QuadMix includes the addition of Atropine. All medications are individually FDA approved and have been used in combination for more than 30 years to treat erectile dysfunction. Together these medications have a vasodilating effect that causes the corpus cavernosum to relax and dilate which allows for blood to flow into the penis resulting in an erection. The benefits are usually quick acting, leading to a strong erection in approximately 2-15 minutes, that is not influenced by food or alcohol consumption or other medication use. TriMix and QuadMix are self administered at home and can be used several times per week if desired. They are often reserved for patients with severe ED and are highly prescribed for those who have had a radical prostatectomy for prostate cancer. There is also some research suggesting that TriMix/QuadMix can help prevent penile atrophy and preserves tissue integrity with consistent use, and even a potential return to spontaneous erection. TriMix and QuadMix is a safe and reliable method for achieving and maintaining erection for men suffering from moderate to severe ED.

Preventing Sexual Dysfunction

While there are more treatment options than ever for ED, the best treatment is still prevention. At the top of the list in ED prevention is making changes to your lifestyle. Lifestyle habits that can affect ED:

  • Healthy lifestyle choices
  • Managing of existing and chronic medical conditions
  • Regular exercise
  • Smoking cessation
  • Limit alcohol use and avoid illegal drugs
  • Decrease stress
  • Seek knowledgeable medical professionals and obtain appropriate treatment

Making smarter food choices, exercising, and working to manage stress is a big step in the right direction for preventing ED. Stress, especially professional and personal stress (such as relationship trouble) is considered one of the main reasons for ED in middle-aged men.

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What causes erectile dysfunction?

The causes of ED can be numerous from physiological to psychological. 90% of men who suffer from erectile dysfunction have a vascular component, meaning a decline in blood flow and since an erection hinges on appropriate blood flow, the result is a decrease in erection strength and endurance or the inability to achieve or maintain an erection. Some of the physiological causes of ED can include high blood pressure, high cholesterol, diabetes, tobacco and alcohol use, being overweight, low testosterone, and certain medications. Previous surgeries such as prostate surgery can also contribute to erectile dysfunction.

Can medications cause or worsen ED?

The simple answer is yes. Some medications used to treat hypertension or elevated blood pressure as well as anti-depressants can worsen or contribute to the development of erectile dysfunction. But besides erection issues, they can also drastically reduce your desire or drive for intercourse, often leading to relationship strains and a decline in self-confidence. It is important to discuss all medications and your goals with our Re-new providers during your consultation and visits so that we can optimize your results.

Why is erectile dysfunction so common?

With over 35 million men suffering from ED in America, it is easy to blame the increasing incidence of ED on aging, especially since we see a continued increase with each decade of life. But it can also be attributed to our lifestyle-being overweight, the food we choose to eat, less exercise, alcohol or tobacco use, lack of hormonal balancing, chronic medical conditions, injuries, and traumas sustain over the course of life. Ultimately, the combined effect of those damages the vascular system over time with compounding effects that lead to not only the presence of erectile dysfunction but it’s worsening over time. It’s important to know that you aren’t alone and you have options, even more than ever before. Call Re-new Institute today, to discuss your goals and learn the cutting edge treatment options available for you.

Is there anything I can do to prevent ED?

There are several things you can do to help prevent erectile dysfunction and most center around a healthy lifestyle. This includes managing chronic medical conditions, limiting alcohol use, not partaking in tobacco use, eating a well-balanced diet, and getting regular exercise to help maintain a healthy weight. It is also important to know that your hormone levels are appropriate. There are also some over the counter supplements that can be taken to help improve blood flow. One of the most important things you can do to help prevent ED or the worsening of it is to seek help and know your options! Understanding that treatment exists beyond Cialis and Viagra is crucial, and there is a treatment option for everyone regardless of severity or underlying conditions.

Can low testosterone cause erectile dysfunction?

Yes, if your testosterone levels are not adequate they can contribute to ED. But beyond, low testosterone can also decrease your desire for sex and lead to decreased erection strength and endurance. It is also important to note that if you are on testosterone replacement therapy that there are components of therapy that if not managed correctly, can actually worsen erectile dysfunction. For those on testosterone, be patient! Improvements in ED related to low testosterone can take up to 18 months for maximum benefit.

Does insurance cover ED treatments?

Well, yes and no. Cialis and Viagra are commonly covered under insurance but can be very expensive. It is often better to utilize a program such as Good Rx to make medications such as Cialis and Viagra more affordable. Unfortunately, most of the other medications or treatments are not covered by insurance. Call Re-new Institute to learn about the available treatment options for ED and pricing.

Can I utilize erectile dysfunction treatments with other treatments?

Often yes, ED treatments can be combined together to optimize results and achieve your goals. Most treatments are generally safe with over the counter medications and prescription medications but it is important to discuss with our providers at Re-new, so that you can get the best and safest treatment for you. Erectile treatments are also frequently combined with testosterone replacement treatments.

What are PDE5 Inhibitors?

These are commonly Viagra, Cialis and Levitra and used frequently in the treatment of erectile dysfunction. They work by blocking PDE5, an enzyme found in the walls of blood vessels which results in relaxation of blood vessels allowing for increased blood flow. They are available in a variation of different forms such as troches, oral tablets, rapid dissolve tablets. To know if you are a candidate for PDE5 Inhibitors, contact Re-new Institute to schedule your consultation.

What is PRP?

Platelet-rich plasma or PRP is a process in which platelets are extracted from the blood and utilized for their healing, growth, and repair benefits. PRP treatments have been present for more than 40 years and got their start in wound care and sports-related injuries. As benefits were documented, the expansion of use for PRP began. Platelet-rich plasma is utilized in urology, gynecology, aesthetics, orthopedic and sports-related fields, and beyond.

What is the process for PRP?

PRP involves a simple blood draw to extract the blood, the amount of blood depends on the specific procedure being done. That blood is then processed in a specific centrifuge to concentrate the platelets. Those platelets are then extracted and utilized to repair the injured area. It is a non-surgical, non-pharmaceutical method to improve erectile dysfunction, erection strength, and endurance, enhance sensation, and more. 

Is Platelet-rich Plasma FDA approved?

The procedure itself can not be FDA approved because it is utilizing your own body for repair and results. However, the kits used to obtain the blood and platelets are FDA approved.

How long does it take to see results from ED treatment?

That is dependent on the patient and their contributing medical conditions. Our goal is to give you the results you want as quickly as possible so that you can get back to living life the way you desire. It is important to know that there are more than 12 options that exist to treat erectile dysfunction and if one doesn’t give you results, talk to our providers so that we can find the appropriate treatment for you.

How do I know what erectile dysfunction treatment is right for me?

By calling Re-new Institute today! Let us tell you about all your options, obtain your medical history and medications, learn about your goals, and develop a treatment plan specific to you.

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