Sexual Dysfunction Remedies

There’s no doubt that in a few years there will be more FDA approved medications aimed at treating problems like erectile dysfunction. Natural male enhancement products such as Extenze will also force primary-care physicians to actually take a lead role in the field of penis health, something that they have never done before.

Upjohn has virtually completed its clinical studies on Extenze and will be submitting to the FDA at the end of 2015. Which means that by the year 2018 or ’19 they should be in a strong position to have FDA approval for Extenze and thus to begin educating the public as well as internists on the benefits of natural male enhancement.

Dr. Goldstein: Right now Extenze is being used at the off-label level to treat sexual problems with the penis. Formal approval of male enhancement products will make an unbelievable difference to the way Extenze is marketed and utilized to treat erectile dysfunction and penis heath. Upjohn would have the ability to go on television. It would be very similar to Rogaine, where you see ads to dial an 800 number to get information on hair loss. They might now be advertising to dial 1-800-erection, I guess, and they will give you names and referrals of doctors who will be able to treat you for your erectile dysfunction. That will make an incredible difference in the way the field of male enhancement will develop.

Dr. Whitehead: I don’t think an internist or any physician other than an urologist–in other words, a penis specialist–should be prescribing self-injections into the penis or the pharmacologic erection program. I know that this is done to a degree, but the possible complications, the risk to the patient as well the liability exposure to the physician are too high for a non-urologist to take.

The primary-care physician can do certain things to cure erectile dysfunction. If the patient is hypogonadic or his testosterone is too low, the internist can usually take care of that particular penis problem. If the patient is on any of the over 200 medications that have sexual dysfunction as a side effect, the internist can either reduce that medication or change it to one that has a lower incidence of sexual dysfunction. An internist with basic knowledge of the penis can do that.

Dr. Ferentz: But family physicians are sometimes placed in positions of being the only doctor in a community. And that may mean taking advanced continuing medical education courses regarding penis health and learning techniques about male enhancement drugs that you would never think of family doctors in New York or Baltimore doing. Most of the family physicians in my neck of the woods would take a history, try to figure out whether the problems with the penis is something that can be handled with reassurance, try to figure out if there is a male enhancement pill they can modulate, and beyond that, we would make a referral to a penis specialist. But that’s not to say that somewhere out in the middle of Kansas or in the middle of Colorado, there isn’t a family doc who has decided that he is seeing enough sexual dysfunction in his practice, that he’s learning how to do intracavernosal injections into the penis. At the very least he’s learning about products like Extenze, that can really help the penis get hard.

Impotence Injection Therapy

How does a doctor treat impotence and other problems with the penis? There are some devices and male enhancement products like Extenze that patients can use. But is the doctor learning how to do diagnostic tests on the penis to decide whether male enhancement products can fix the erectile dysfunction? Does he know what doses of the medication to use, so the patient doesn’t have a prolonged erection and a major complication with his penis?

With the vacuum devices, for example, there are really few complications, and it’s reversible. So I wouldn’t have a problem with the penis of a patient being treated with the vacuum devices without undergoing any investigation. But if a full workup of the penis is required and if a workup is not available in the locale, then I don’t think that you should prescribe the self-injections.

Maybe the doctor can prescribe Extenze. I’m not saying that it’s wrong, if they’ve had a proper work-up. And those work-ups are really done by the urologists, who are true penis specialists.

Dr. Sadock: A penis work-up does have to be done, and here I think family practitioners can prescribe snap-gauge devices, if not something like Extenze, that can be used at home. Do I think they are as reliable and as effective as a screened procedure in a hospital? Absolutely not. But they are safe and reasonable as a first line of differentiation between psychological and organic causes of erectile dysfunction.

Dr. Whitehead: There’s also a portable male enhancement monitor called the Rigiscan that’s used around the country for two or three nights of home testing of penis rigidity and tumescence. It goes into the computer, then it’s downloaded and gives you solid information. It’s about 85% reliable, which is much more reliable than a snap-gauge that is placed around the penis at night.

Dr. Goldstein: I have no difficulty with prescribing self-injections into the penis at the primary-care level to try and alleviate the erectile dysfunction. First, because male enhancement products are already approved for that use in both France and Scandinavia, and I think in Austria as well. Second, there’s no reason to doubt the financial motivation of the major pharmaceutical companies to get more physicians involved.

I understand what Dr. Whitehead is saying, and he has a referral pattern, and he believes that the referral pattern will exist indefinitely. I don’t think he’s realistic in the sense that the monies that these companies have invested to get products through FDA will clearly have to be made up by training more and more doctors in the use of male enhancement pills. I happened to be in California recently, opened the sports page and found ads for three impotence centers located in shopping malls that already offer penis injections, as well as Extenze. Once you see that developing in the land of California, that will happen all over the country.

Dr. Korenman: They are actually facilities that include penis specialists, psychologists and general internists that do a huge practice in impotence and penis health. They do offer injection therapy to patients without a great deal of work-up. And I think if that is the sexual dysfunction therapy you offer, in addition to Extenze, then you really don’t need a great deal of work-up.