Dr.
- PDE5 inhibitors prevent the breakdown of cGMP.
- ED medications are often taken on an as-needed basis.
- Tadalafil's longer duration allows daily low-dose use.
- Viagra's active ingredient is sildenafil citrate.
- Medical evaluation is necessary before starting treatment.
- Not all men respond to ED medications; alternatives exist.
- Rare side effects include priapism and sudden vision loss.
- Some ED drugs are available in generic form.
- Patients should follow dosing instructions carefully.
- Medication efficacy can be enhanced by reducing alcohol intake.
Paul Turek has relied on a range of medications to safely and effectively treat patients. If you have erectile dysfunction, you may be encouraged to learn that a variety of treatment options exist, and Dr. Turek offers the very best that science has to offer. The board-certified urologist and men’s sexual health provider will put your worries and concerns to rest and work with you to find a solution that meets your personal needs. The treatment that is right for depends on many factors, including your age, medical history, other medications you take, potential side effects, personal preferences and treatment goals. When you are sexually aroused, your body releases a chemical called nitric oxide, which relaxes the blood vessels and tissues of your penis.
Use caution with unproven ED treatments
In an effort to offer our patients a more convenient prescription filling option, we will now be selling these generic medications at the office. Beyond this convenience, our second goal is to offer these medications at a lower price than what would be found at your local pharmacy. Understandably, erectile dysfunction is a very distressing condition for any man who experiences it, even mildly. When a man comes into our office concerned about difficulty maintaining or achieving an erection, we take a stepwise approach to his treatment. Erectile dysfunction may be caused by lack of blood flow, including issues associated with medication, previous surgery, or the simple fact that the patient is no longer aroused by their sexual partner.
The Best Practice: Treat Erectile Dysfunction with a Urologist
Once lifestyle and medication issues have been ruled out as the cause of erectile dysfunction, employing medical therapy may improve the patient’s condition. Commonly advertised medications like Viagra and Cialis have been proven safe and their generic versions are similarly so. Dr. Engel will begin with a thorough assessment when you arrive at our office, to understand more about the potential causes of your erectile dysfunction. Some men will find that their concerns are more related to lifestyle and psychological factors than physical problems. This allows your penis to engorge with blood, resulting in an erection. But an enzyme called phosphodiesterase 5 (PDE5) reverses the function of nitric oxide. Sildenafil, tadalafil and vardenafil are phosphodiesterase 5 inhibitors, meaning they work by blocking PDE5. The medications will not make you sexually aroused, but they will allow you to get an erection in response to sexual stimulation and help you maintain it long enough for sexual intercourse. Viagra (sildenafil citrate) is perhaps the best known of the PDE5 inhibitors and produces great results. It takes effect within an hour and lasts three to four hours. It must be taken on an empty stomach to be effective. A newer alternative to sildenafil is vardenafil (Levitra) which has a similar duration of activity but can be taken with food. Cialis (tadalafil citrate) is longer-acting than Viagra and stays in the bloodstream for a longer time, up to 36 hours. Some men take a small dose of the medication daily so there is always some in their system. Depending on your personal needs, Dr.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Kamagra Soft Tabs | 100 mg | 180 + 8 Pills | 425.45€ 405.19€ | |
| Cialis Generic | 20mg | 360 + 10 Pills | 427.34€ 406.99€ | |
| Viagra Super Active | 100mg | 120 + 16 Pills | 198.37€ 188.92€ | |
| Cialis Super Active | 20mg | 30 + 6 Pills | 128.09€ 121.99€ | |
| Cialis Generic | 60mg | 270 + 10 Pills | 443.96€ 422.82€ | |
| Viagra Generic | 150mg | 10 Pills | 36.73€ 34.98€ | |
| Levitra Professional | 20mg | 270 + 6 Pills | 738.98€ 703.79€ | |
| Cialis Generic | 5mg | 360 + 10 Pills | 268.08€ 255.31€ | |
| Kamagra Polo | 100mg | 84 + 4 Pills | 244.49€ 232.85€ | |
| Cialis Generic | 5mg | 60 + 4 Pills | 86.02€ 81.92€ | |
| Viagra Generic | 25mg | 30 + 4 Pills | 47.97€ 45.69€ | |
| Kamagra Polo | 100 mg | 180 + 8 Pills | 446.52€ 425.26€ | |
| Viagra Professional | 100mg | 180 + 4 Pills | 337.30€ 321.24€ | |
| Kamagra Oral Jelly | 100 mg | 10 Sachets | 54.55€ 51.95€ | |
| Levitra Generic | 20mg | 60 + 6 Pills | 131.11€ 124.87€ | |
| Cialis Generic | 5mg | 10 Pills | 29.39€ 27.99€ | |
| Levitra Original | 20mg | 4 Pills | 45.87€ 43.69€ |
Turek may prescribe any one of these medications.
What should I know before taking ED medications?
However, if lifestyle changes don’t seem to improve the issue, medication is the next logical step. For some men with severe erectile dysfunction or impotence (often post-prostatectomy patients), a penile implant may be exactly what’s needed to achieve a satisfying erection. However, understanding whether a penile prosthesis is the best option requires a consultation with Dr. Engel, one of the most experienced penile implant surgeons in the area and around the US. For more information about our generic medication program, launching soon, we encourage you to contact our office. Side effects are a common concern with any medication.
| Medication | Onset (minutes) | Duration (hours) | Food Interaction |
|---|---|---|---|
| Sildenafil | 30-60 | 4-6 | Fatty meals may delay absorption |
| Tadalafil | 30-60 | Up to 36 | Less affected by food |
| Vardenafil | 25-60 | 4-5 | Fatty meals may delay onset |
| Avanafil | 15-30 | Up to 6 | Less affected by food |
Side effects of Viagra (sildenafil) and Levitra (vardenafil) include: Temporary abnormal vision (more common with Viagra) Side effects of Cialis (tadalafil) are similar and include: Because Cialis remains in your system longer, possible side effects can last longer than those of Viagra or Levitra. It is also important to understand that certain drugs, mainly nitrates used for chest pain and some alpha-blocking drugs used for prostatic enlargement, negatively interact with Viagra and Cialis. Dr. Turek will discuss the potential side effects of Viagra and Cialis and explain the possible interactions. Together, you will determine the best medication to help you get and keep an erection and enjoy improved sexual function.
Don’t Forget about the Important Stuff
*Urologic Surgeons of Washington (USW) is an independently owned and operated care center that may promote, sell, or provide services/products. Privia Medical Group is not responsible for these products or services. Privia’s Authorization & Consent to Treat, Financial Policy, and HIPAA Notice of Privacy Practices are not applicable to these services or products. Medical therapy is a mainstay in the treatment of organic or situational erectile dysfunction. It has given hope to many men who once struggled with the effects of impotence on their mood, relationship and overall quality of life. If you are experiencing erectile dysfunction and want to discuss your medical options with Dr. Turek, please request an appointment at The Turek Clinic.
- Urologist: A specialist who often diagnoses and treats ED.
- Endocrinologist: Specializes in hormonal causes like low testosterone.
- Cardiologist: Important for cardiac risk assessment before prescribing.
- Primary Care Physician: Often the first point of contact and management.
- Mental Health Professional: Treats psychological causes like anxiety or depression.
- Certified Sex Therapist: Can provide specialized counseling for sexual issues.
- Team Approach: Often requires collaboration between different specialists.
Contact us today to schedule your visit. Erectile dysfunction (ED) is a common condition. One recent study estimated that roughly a third of men struggle with it.1 Though the condition does affect more older men than younger men, its impact spans age groups.
Levitra (Vardenafil)
“Right now, PRP and stem cell therapy are unproven,” says Dr. Liroff. “Some small studies say they could help with ED, but others show no results. There are also a lot of questions about how much is effective and which patients might benefit. It’s best to skip these therapies until we have more information.” It can be difficult to address ED with your provider, but remember you’re not alone: ED affects 30 million men in the U.S.
Viagra™ Side Effects
“Don’t be embarrassed to tell your provider about ED,” says Dr. Liroff. “Your sexual health is an important part of your overall health, and we’re here to help you be your best.” Reviewed by Stephen Liroff, M.D., a board-certified urologist and Physician in Charge at Henry Ford West Bloomfield Urology Clinic. If you have visited our office for Erectile Dysfunction or ED, you know that we are able to prescribe medication for those that need it. Most commonly, we prescribe generic versions of Viagra and Cialis, the two most prescribed ED medications in the United States. Indeed, while half of all ED patients in the U.S. are over the age of 60, one study found that over 25% of men under age 40 suffered from ED to some extent.2 If any of this describes you, then you’re not alone at all.
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra)
- Avanafil (Stendra)
- Udenafil (Zydena)
- Alprostadil (Caverject)
- Apomorphine (Uprima)
- Yohimbine
- Papaverine injections
- Testosterone therapy
ED is very treatable, and several treatments work for most men, but "most" may technically mean only more than 50% of ED sufferers. The truth is that ED has various underlying causes, and those who are confronting it face varying challenges in treatment due to other potential health conditions. So, the question is: What is the best treatment for you? Aside from underlying health considerations, everything from price to how you take a medication can affect your decision. But we're here to demystify ED and your treatment options. To help you out, we’ve reviewed the major online providers and treatments and analyzed a large swath of relevant scientific research.
Cialis (Tadalafil)
Liroff. “When a licensed provider gives you shockwave therapy, it’s safe and has a minimal risk of side effects.” It’s important to know the difference between true shockwave therapy and counterfeit versions. A similar-sounding treatment known as radial wave therapy (rWT) is available at healthcare clinics and even non-medical facilities. Though it promises results, it has no science to back up its claims. “Shockwave therapy has data to show that it stimulates blood flow and generates new blood vessels,” explains Dr.
5. Penile implant
Liroff. “Radial wave therapy doesn’t have these results, and studies have shown that it’s equal to no treatment.” Penile prosthesis surgery, sometimes called a penile implant, might be an option if less invasive treatments haven’t worked for you. “There are different types of implants, depending on your needs and preferences,” says Dr. Liroff. “See a urologist who has experience in penile implant surgery to discuss your options.” Steer clear of herbal medications and “natural supplements” for ED. In this guide, we’ll break down all of your best options. First, to orient you to this landscape, here is a roadmap that breaks down the diverse treatment paths you might take and our characterization of their merits. Most likely to help: Prescription PDE5i medication like sildenafil (Viagra), tadalafil (Cialis), etc. Next most likely to help: Mental health care Best in-office treatment alternative to prescription: Shockwave therapy Best OTC budget options to try: ED rings and/or certain supplements And now, for those in a hurry, here’s a quick snapshot of our specific recommendations across that roadmap.
- Initial Hope: The introduction of Viagra was a monumental breakthrough.
- Quality of Life: Focus shifted from just procreation to sexual satisfaction.
- Mainstream Acceptance: ED became a recognized medical condition, not a joke.
- Research Funding: Increased investment in men's sexual health research.
- Holistic Approach: Treatment now considers psychological and physical factors.
- Patient Empowerment: Men are more proactive in seeking solutions.
- Ongoing Evolution: Continual improvement in treatments and access continues.
Best for trying an ED medication: BlueChew Best overall for daily ED meds: Hims Best if you know you need sildenafil (generic Viagra): Rocket Rx Best mental health care resource for ED: Cerebral Best OTC supplement: Testosterone Support by Innerbody Labs Best at-home device to try: ED vardenafil best price rings If you’re new to ED treatments, there’s simply no more affordable, convenient, or discreet place to start.
Treating ED in a More Inclusive Way
No studies have proven that they work, and they could be dangerous. “The FDA doesn’t regulate ED supplements, so you don’t know what you’re getting,” says Dr. Liroff. “At best, you’re paying for something that won’t give you results. And at worst, you could experience dangerous interactions and side effects.” One of the newest therapies for ED is a gel you apply directly to the penis.
Language matters
This treatment is not yet sold in the U.S. “We need more clinical trials to show that an ED topical gel is as effective as other options,” says Dr. Liroff. “Pills, injections, pumps and shockwave therapy all produce good results and have evidence to show that they work.” Platelet-rich plasma (PRP) and stem cell therapy are two of the newest potential therapies for ED. However, there’s no solid evidence of their effectiveness.