The Patient

Russell is a 43 year old man of good health. He has been happily married for 17 years.

In His Own Words

I guess that I was going through a kind of mid-life crisis and although I am happily married, I sometimes had problems getting an erection. I worried that it could be she was not as physically attractive to me as she once was.

Of course, I still love her dearly. I know that I do not have erection problems per se, as I still get good erections most mornings and when I am by myself.

The Treatment Strategy

Russell has a problem called psychogenic erectile dysfunction. He is able to get good erections on his own, but not with his wife. There are many reasons for this problem, including guilt, stress, insecurity and tension in the relationship.

The Boston Medical Group Telemedicine physicians measured Russell’s blood flow through the penis using echo Doppler studies and found it to be in the normal range.  A course of treatment was prescribed to ensure that he had an erection every time he made love, regardless of his state of mind.

Results

He was able to overcome the nervousness and tension when he made love, as he had the certainty that he would not fail.  Not long after, Russell’s confidence had been restored and he had overcome his fear of failure. He began to enjoy lovemaking once again.

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A Case of Physical Erectile Dysfunction

The Patient

George is a 68 year old diabetic. He was once a heavy smoker but he gave this up years ago. He used to work as a real estate agent and he was forced to retire 10 years ago due to the immense stress of his job.

In His Own Words

I retired shortly after my first heart-attack. My physician advised it, or he said that I may not see sixty. I also have high cholesterol and high blood pressure for which I take medication.  The thing is, I really feel young. Since I have retired, I have become active again. I now play tennis at the club three times a week and my wife and I swim most mornings, either at the beach if it is warm enough, or at the local indoor pool. I really enjoy life but for one thing it has been 10 years since I had my last erection.

I did try pills, although my own physician advised against it. I was desperate I guess, and was prepared to try anything. Well, pills did kind of work the first few times that I used it but now, even using the strongest dose, it does not work. I was concerned about the effects that any new treatment might have on my existing health problems. I put off making an appointment for several months. Now I wish I would have come in sooner.

The Treatment Strategy

George was examined by a Boston Medical Group Telemedicine physician who measured the blood flow through his penis using an Echo Doppler.  It was found to be below the normal range. A biothesiometry study was also conducted to see if there was any nerve deterioration due to his diabetes. Fortunately, there was not.

The physician explained the results to George and recommended that we treat him using a combination of locally acting vasodilators. These medications have been safe and effective in many patients who, like George, have other medical problems.  The physician administered a test dose of medication in the medical center and received a positive outcome.

Results

George is now able to achieve erections on a regular basis.