Low Testosterone – what causes it?

Low Testosterone – what causes it?

August 5, 2011

What causes testosterone deficiency?

Testosterone is a hormone produced by the testicles and is responsible for the proper development of male sexual characteristics, and is important for maintaining muscle bulk, adequate levels of red blood cells, bone density, sense of well-being, and sexual and reproductive function.

Inadequate testosterone production is not a common cause of erectile dysfunction (ED). When ED does occur with decreased testosterone production, testosterone replacement therapy may improve the ED.

As a man ages, the amount of testosterone in his body gradually declines. This natural decline starts after age 30 and continues throughout life. The significance of this decline is controversial and poorly understood.

Symptoms of testosterone deficiency:

  • decreased sex drive
  • decreased sense of well-being
  • depressed mood
  • difficulties with concentration and memory
  • erectile dysfunction

What are the changes that occur in the body with testosterone deficiency?

Changes that occur with testosterone deficiency include:

  • a decrease in muscle mass, with an increase in body fat
  • variable effects on cholesterol metabolism
  • a decrease in hemoglobin and possibly mild anemia
  • fragile bones (osteoporosis)
  • a decrease in body hair

How do I find out if I have a testosterone deficiency?

The only accurate way to detect the condition is to have your doctor measure the amount of testosterone in your blood. It sometimes may take several measurements of testosterone to be sure if a patient has a deficiency, since levels of testosterone tend to fluctuate throughout the day. The highest levels of testosterone are generally in the morning. This is why doctors prefer, if possible, to obtain early morning levels of testosterone.

What options are available for testosterone replacement?

The options available for testosterone replacement are:

  • intramuscular injections, generally every two or three weeks
  • testosterone patches worn either on the body or on the scrotum (the sac that contains the testicles). These patches are used daily. The body patch application is rotated between the buttocks, arms, back or abdomen.
  • testosterone gels that are applied daily to the shoulders, upper arms, or abdomen.

For a free consultation on what would work best for you, contact us at:

info@coreinstitutes.com or call us at 866-641-CORE (2673)




The key to anti-aging

The key to anti-aging

June 2, 2011

There are a significant number of men and postmenopausal women who can benefit from Testosterone Replacement Therapy. Although it is only replaced in men, women can benefit from a renewed partner.

The andropausal symptoms can be helped and even reversed by the right supplementation of testosterone into the body. The idea of testosterone therapy is to restore testosterone to youthful levels to achieve optimal health and well-being. Testosterone is a vital hormone that plays an enormous role in the sex drive of both men and women. It is known to restore healthy sexual excitement and desire, which in turn improves attitude, relationships and well-being.

The key to anti-aging is linked to simply replacing hormone levels to what they once were in our youthful days.

Male menopause is referred to as Andropause, and is very common in the average aging male. Most people are under the impression that there is no menopause for men, just women. Symptoms for the male are kept quiet and are said to just be a part of old age. Male menopause does exist and only rarely do men get “”hot flashes,”” but there is an increase in morning and nightly fatigue and the male’s erections are less often, less firm, and ejaculation takes place less often. Many men who have used Testosterone Replacement Therapy reach a maximum improvement of sexual function within 30 days. Body fat was decreased in many studies, lean muscle strength increased, and better cardiac health overall was reported.




Testosterone therapy: Key to male vitality?

Testosterone therapy: Key to male vitality?

Considering testosterone therapy to help you feel younger and more vigorous as you age? Know the risks before you make your decision.

The possibilities of testosterone therapy are enticing — increase your muscle mass, sharpen your memory and concentration, boost your libido, and improve your energy level. As you get older, testosterone therapy may sound like the ultimate anti-aging formula. Yet the health benefits of testosterone therapy for age-related declines in testosterone aren’t as clear as it may seem. Find out what’s known — and not known — about testosterone therapy for normal aging.

What is testosterone?

Testosterone is a hormone produced primarily in the testes. For men, testosterone helps maintain:

  • Bone density
  • Fat distribution
  • Muscle strength and mass
  • Red blood cell production
  • Sex drive
  • Sperm production

If you have an unusually low level of testosterone (hypogonadism), your doctor may prescribe a synthetic version of testosterone. You may be able to choose from testosterone injections, patches or gels.

What happens to testosterone level with age?

Testosterone peaks during adolescence and early adulthood. As you get older, your testosterone level gradually declines — typically about 1 percent a year after age 30.

Does a naturally declining testosterone level cause the signs and symptoms of aging?

Some men have a lower than normal testosterone level without signs or symptoms. For others, low testosterone may cause:

  • Changes in sexual function. This may include reduced sexual desire, fewer spontaneous erections — such as during sleep — and infertility.
  • Changes in sleep patterns. Sometimes low testosterone causes insomnia or other sleep disturbances.
  • Physical changes. Various physical changes are possible, including increased body fat, reduced muscle bulk and strength, and decreased bone density. Swollen or tender breasts (gynecomastia) and hair loss are possible. You may experience hot flashes and have less energy than you used to.
  • Emotional changes. Low testosterone may contribute to a decrease in motivation or self-confidence. You may feel sad or depressed, or have trouble concentrating or remembering things.

It’s important to note that some of these signs and symptoms are a normal part of aging. Others can be caused by various underlying factors, including medication side effects, thyroid problems, depression and excessive alcohol use. A blood test is the only way to diagnose a low testosterone level.

Can testosterone therapy promote youth and vitality?

Testosterone therapy can help reverse the effects of hypogonadism, but it’s unclear whether testosterone therapy would have any benefit for older men who are otherwise healthy. Although some men believe that taking testosterone medications may help them feel younger and more vigorous as they age, few rigorous studies have examined testosterone therapy in men who have healthy testosterone levels — and some small studies have revealed mixed results. For example, in one study healthy men who took testosterone medications increased muscle mass but didn’t gain strength.

What are the risks of testosterone therapy for normal aging?

Testosterone therapy has various risks. For example, testosterone therapy may:

  • Contribute to sleep apnea — a potentially serious sleep disorder in which breathing repeatedly stops and starts
  • Cause your body to make too many red blood cells (polycythemia), which can increase the risk of heart disease
  • Cause acne or other skin reactions
  • Stimulate noncancerous growth of the prostate (benign prostatic hyperplasia) and possibly stimulate growth of existing prostate cancer
  • Enlarge breasts
  • Limit sperm production or cause testicle shrinkage

Should you talk to your doctor about testosterone therapy?

If you wonder whether testosterone therapy might be right for you, work with your doctor to weigh the risks and benefits. A medical condition that leads to an unusual decline in testosterone may be a reason to take supplemental testosterone. However, treating normal aging with testosterone therapy remains controversial.




Testosterone Therapy – Cypionate Description

Testosterone Therapy – Cypionate Description

May 10, 2011

Testosterone Cypionate Description

Testosterone Cypionate Injection, for intramuscular injection, contains Testosterone Cypionate which is the oil-soluble 17 (beta)- cyclopentylpropionate ester of the androgenic hormone testosterone.

Testosterone Cypionate is a white or creamy white crystalline powder, odorless or nearly so and stable in air. It is insoluble in water, freely soluble in alcohol, chloroform, dioxane, ether, and soluble in vegetable oils.

The chemical name for Testosterone Cypionate is androst-4-en-3-one,17-(3-cyclopentyl-1- oxopropoxy)-, (17β)-. Its molecular formula is C27H40O3, and the molecular weight 412.61.

The structural formula is represented below:

Testosterone Cypionate Injection is available as 200 mg/mL Testosterone Cypionate.

Each mL of the 200 mg/mL solution contains:
Testosterone Cypionate 200 mg
Benzyl benzoate 0.2 mL
Cottonseed oil 560 mg
Benzyl alcohol (as preservative) 9.45 mg

Testosterone Cypionate – Clinical Pharmacology

Endogenous androgens are responsible for normal growth and development of the male sex organs and for maintenance of secondary sex characteristics. These effects include growth and maturation of the prostate, seminal vesicles, penis, and scrotum; development of male hair distribution, such as beard, pubic, chest, and axillary hair; laryngeal enlargement, vocal cord thickening, and alterations in body musculature and fat distribution. Drugs in this class also cause retention of nitrogen, sodium, potassium, and phosphorous, and decreased urinary excretion of calcium. Androgens have been reported to increase protein anabolism and decrease protein catabolism. Nitrogen balance is improved only when there is sufficient intake of calories and protein.

Androgens are responsible for the growth spurt of adolescence and for eventual termination of linear growth, brought about by fusion of the epiphyseal growth centers. In children, exogenous androgens accelerate linear growth rates, but may cause disproportionate advancement in bone maturation. Use over long periods may result in fusion of the epiphyseal growth centers and termination of the growth process. Androgens have been reported to stimulate production of red blood cells by enhancing production of erythropoietic stimulation factor.

During exogenous administration of androgens, endogenous testosterone release is inhibited through feedback inhibition of pituitary luteinizing hormone (LH). At large doses of exogenous androgens, spermatogenesis may also be suppressed through feedback inhibition of pituitary follicle stimulating hormone (FSH).

There is a lack of substantial evidence that androgens are effective in fractures, surgery, convalescence, and functional uterine bleeding.

Pharmacokinetics

Testosterone esters are less polar than free testosterone. Testosterone esters in oil injected intramuscularly are absorbed slowly from the lipid phase; thus, Testosterone Cypionate can be given at intervals of two to four weeks.

Testosterone in plasma is 98 percent bound to a specific testosterone-estradiol binding globulin, and about 2 percent is free. Generally, the amount of this sex-hormone binding globulin in the plasma will determine the distribution of testosterone between free and bound forms, and the free testosterone concentration will determine its half-life.

About 90 percent of a dose of testosterone is excreted in the urine as glucuronic and sulfuric acid conjugates of testosterone and its metabolites; about 6 percent of a dose is excreted in the feces, mostly in the unconjugated form. Inactivation of testosterone occurs primarily in the liver. Testosterone is metabolized to various 17-keto steroids through two different pathways. The half-life of Testosterone Cypionate when injected intramuscularly is approximately eight days.

In many tissues the activity of testosterone appears to depend on reduction to dihydrotestosterone, which binds to cytosol receptor proteins. The steroid-receptor complex is transported to the nucleus where it initiates transcription events and cellular changes related to androgen action.

Indications and Usage for Testosterone Cypionate

Testosterone Cypionate Injection is indicated for replacement therapy in the male in conditions associated with symptoms of deficiency or absence of endogenous testosterone.

  1. Primary hypogonadism (congenital or acquired)-testicular failure due to cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome; or orchidectomy.
  2. Hypogonadotropic hypogonadism (congenital or acquired)-idiopathic gonadotropin or LHRH deficiency, or pituitary-hypothalamic injury from tumors, trauma, or radiation.

Contraindications

  1. Known hypersensitivity to the drug
  2. Males with carcinoma of the breast
  3. Males with known or suspected carcinoma of the prostate gland
  4. Women who are or who may become pregnant
  5. Patients with serious cardiac, hepatic or renal disease

Warnings

Hypercalcemia may occur in immobilized patients. If this occurs, the drug should be discontinued.

Prolonged use of high doses of androgens (principally the 17-β alkyl-androgens) has been associated with development of hepatic adenomas, hepatocellular carcinoma, and peliosis hepatis –all potentially life-threatening complications.

Geriatric patients treated with androgens may be at an increased risk of developing prostatic hypertrophy and prostatic carcinoma although conclusive evidence to support this concept is lacking.

Edema, with or without congestive heart failure, may be a serious complication in patients with preexisting cardiac, renal or hepatic disease. Gynecomastia may develop and occasionally persist in patients being treated for hypogonadism.

This product contains benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Androgen therapy should be used cautiously in healthy males with delayed puberty. The effect on bone maturation should be monitored by assessing bone age of the wrist and hand every 6 months. In children, androgen treatment may accelerate bone maturation without producing compensatory gain in linear growth. This adverse effect may result in compromised adult stature. The younger the child the greater the risk of compromising final mature height. This drug has not been shown to be safe and effective for the enhancement of athletic performance. Because of the potential risk of serious adverse health effects, this drug should not be used for such purpose.

Precautions

General

Patients with benign prostatic hypertrophy may develop acute urethral obstruction. Priapism or excessive sexual stimulation may develop. Oligospermia may occur after prolonged administration or excessive dosage. If any of these effects appear, the androgen should be stopped and if restarted, a lower dosage should be utilized.

Testosterone Cypionate should not be used interchangeably with testosterone propionate because of differences in duration of action.

Testosterone Cypionate is not for intravenous use.

Information for Patients

Patients should be instructed to report any of the following: nausea, vomiting, changes in skin color, ankle swelling, too frequent or persistent erections of the penis.

Laboratory Tests

Hemoglobin and hematocrit levels (to detect polycythemia) should be checked periodically in patients receiving long-term androgen administration.

Serum cholesterol may increase during androgen therapy.

Drug Interactions

Androgens may increase sensitivity to oral anticoagulants. Dosage of the anticoagulant may require reduction in order to maintain satisfactory therapeutic hypoprothrombinemia.

Concurrent administration of oxyphenbutazone and androgens may result in elevated serum levels of oxyphenbutazone.

In diabetic patients, the metabolic effects of androgens may decrease blood glucose and, therefore, insulin requirements.

Drug/Laboratory Test Interferences

Androgens may decrease levels of thyroxine-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however, and there is no clinical evidence of thyroid dysfunction.

Testosterone Cypionate Description

Testosterone Cypionate Injection, for intramuscular injection, contains Testosterone Cypionate which is the oil-soluble 17 (beta)- cyclopentylpropionate ester of the androgenic hormone testosterone.

Testosterone Cypionate is a white or creamy white crystalline powder, odorless or nearly so and stable in air. It is insoluble in water, freely soluble in alcohol, chloroform, dioxane, ether, and soluble in vegetable oils.

The chemical name for Testosterone Cypionate is androst-4-en-3-one,17-(3-cyclopentyl-1- oxopropoxy)-, (17β)-. Its molecular formula is C27H40O3, and the molecular weight 412.61.

The structural formula is represented below:

Testosterone Cypionate Injection is available as 200 mg/mL Testosterone Cypionate.

Each mL of the 200 mg/mL solution contains:
Testosterone Cypionate 200 mg
Benzyl benzoate 0.2 mL
Cottonseed oil 560 mg
Benzyl alcohol (as preservative) 9.45 mg

Testosterone Cypionate – Clinical Pharmacology

Endogenous androgens are responsible for normal growth and development of the male sex organs and for maintenance of secondary sex characteristics. These effects include growth and maturation of the prostate, seminal vesicles, penis, and scrotum; development of male hair distribution, such as beard, pubic, chest, and axillary hair; laryngeal enlargement, vocal cord thickening, and alterations in body musculature and fat distribution. Drugs in this class also cause retention of nitrogen, sodium, potassium, and phosphorous, and decreased urinary excretion of calcium. Androgens have been reported to increase protein anabolism and decrease protein catabolism. Nitrogen balance is improved only when there is sufficient intake of calories and protein.

Androgens are responsible for the growth spurt of adolescence and for eventual termination of linear growth, brought about by fusion of the epiphyseal growth centers. In children, exogenous androgens accelerate linear growth rates, but may cause disproportionate advancement in bone maturation. Use over long periods may result in fusion of the epiphyseal growth centers and termination of the growth process. Androgens have been reported to stimulate production of red blood cells by enhancing production of erythropoietic stimulation factor.

During exogenous administration of androgens, endogenous testosterone release is inhibited through feedback inhibition of pituitary luteinizing hormone (LH). At large doses of exogenous androgens, spermatogenesis may also be suppressed through feedback inhibition of pituitary follicle stimulating hormone (FSH).

There is a lack of substantial evidence that androgens are effective in fractures, surgery, convalescence, and functional uterine bleeding.

Pharmacokinetics

Testosterone esters are less polar than free testosterone. Testosterone esters in oil injected intramuscularly are absorbed slowly from the lipid phase; thus, Testosterone Cypionate can be given at intervals of two to four weeks.

Testosterone in plasma is 98 percent bound to a specific testosterone-estradiol binding globulin, and about 2 percent is free. Generally, the amount of this sex-hormone binding globulin in the plasma will determine the distribution of testosterone between free and bound forms, and the free testosterone concentration will determine its half-life.

About 90 percent of a dose of testosterone is excreted in the urine as glucuronic and sulfuric acid conjugates of testosterone and its metabolites; about 6 percent of a dose is excreted in the feces, mostly in the unconjugated form. Inactivation of testosterone occurs primarily in the liver. Testosterone is metabolized to various 17-keto steroids through two different pathways. The half-life of Testosterone Cypionate when injected intramuscularly is approximately eight days.

In many tissues the activity of testosterone appears to depend on reduction to dihydrotestosterone, which binds to cytosol receptor proteins. The steroid-receptor complex is transported to the nucleus where it initiates transcription events and cellular changes related to androgen action.

Indications and Usage for Testosterone Cypionate

Testosterone Cypionate Injection is indicated for replacement therapy in the male in conditions associated with symptoms of deficiency or absence of endogenous testosterone.

  1. Primary hypogonadism (congenital or acquired)-testicular failure due to cryptorchidism, bilateral torsion, orchitis, vanishing testis syndrome; or orchidectomy.
  2. Hypogonadotropic hypogonadism (congenital or acquired)-idiopathic gonadotropin or LHRH deficiency, or pituitary-hypothalamic injury from tumors, trauma, or radiation.

Contraindications

  1. Known hypersensitivity to the drug
  2. Males with carcinoma of the breast
  3. Males with known or suspected carcinoma of the prostate gland
  4. Women who are or who may become pregnant

10. Patients with serious cardiac, hepatic or renal disease

Warnings

Hypercalcemia may occur in immobilized patients. If this occurs, the drug should be discontinued.

Prolonged use of high doses of androgens (principally the 17-β alkyl-androgens) has been associated with development of hepatic adenomas, hepatocellular carcinoma, and peliosis hepatis –all potentially life-threatening complications.

Geriatric patients treated with androgens may be at an increased risk of developing prostatic hypertrophy and prostatic carcinoma although conclusive evidence to support this concept is lacking.

Edema, with or without congestive heart failure, may be a serious complication in patients with preexisting cardiac, renal or hepatic disease. Gynecomastia may develop and occasionally persist in patients being treated for hypogonadism.

This product contains benzyl alcohol. Benzyl alcohol has been reported to be associated with a fatal “Gasping Syndrome” in premature infants. Androgen therapy should be used cautiously in healthy males with delayed puberty. The effect on bone maturation should be monitored by assessing bone age of the wrist and hand every 6 months. In children, androgen treatment may accelerate bone maturation without producing compensatory gain in linear growth. This adverse effect may result in compromised adult stature. The younger the child the greater the risk of compromising final mature height. This drug has not been shown to be safe and effective for the enhancement of athletic performance. Because of the potential risk of serious adverse health effects, this drug should not be used for such purpose.

Precautions

General

Patients with benign prostatic hypertrophy may develop acute urethral obstruction. Priapism or excessive sexual stimulation may develop. Oligospermia may occur after prolonged administration or excessive dosage. If any of these effects appear, the androgen should be stopped and if restarted, a lower dosage should be utilized.

Testosterone Cypionate should not be used interchangeably with testosterone propionate because of differences in duration of action.

Testosterone Cypionate is not for intravenous use.

Information for Patients

Patients should be instructed to report any of the following: nausea, vomiting, changes in skin color, ankle swelling, too frequent or persistent erections of the penis.

Laboratory Tests

Hemoglobin and hematocrit levels (to detect polycythemia) should be checked periodically in patients receiving long-term androgen administration.

Serum cholesterol may increase during androgen therapy.

Drug Interactions

Androgens may increase sensitivity to oral anticoagulants. Dosage of the anticoagulant may require reduction in order to maintain satisfactory therapeutic hypoprothrombinemia.

Concurrent administration of oxyphenbutazone and androgens may result in elevated serum levels of oxyphenbutazone.

In diabetic patients, the metabolic effects of androgens may decrease blood glucose and, therefore, insulin requirements.

Drug/Laboratory Test Interferences

Androgens may decrease levels of thyroxine-binding globulin, resulting in decreased total T4 serum levels and increased resin uptake of T3 and T4. Free thyroid hormone levels remain unchanged, however, and there is no clinical evidence of thyroid dysfunction.




Older Men With Low Testosterone Face Greater Depression Risk

Older Men With Low Testosterone Face Greater Depression Risk

March 6, 2011

THURSDAY, March 6 – Low testosterone levels in older men are associated with an increased risk of depression, an Australian study says.

Between 2001 and 2004, researchers at the University of Western Australia in Perth studied 3,987 males aged 71 to 89. The men provided demographic and health information and were tested for depression and cognitive difficulties. The researchers also checked the men’s testosterone levels.

The 203 men who met the criteria for depression had significantly lower total and free (not bound to proteins) testosterone levels than those who weren’t depressed. After controlling for other factors, such as cognitive scores, education level and body-mass index, the researchers concluded that men in the lowest quintile (20 percent) of free testosterone were three times more likely to have depression compared to those in the highest quintile.

The findings were published in the March issue of the Archives of General Psychiatry.

While more research is needed to determine how low hormone levels may be linked to depression risk, the study authors believe it may be caused by changes in the levels of neurotransmitters or hormones in the brain.

“A randomized controlled trial is required to determine whether reducing prolonged exposure to low free testosterone is associated with a reduction in prevalence of depression in elderly men,” the researchers wrote. “If so, older men with depression may benefit from systematic screening of free testosterone concentration, and testosterone supplementation may contribute to the successful treatment of hypogonadal (with low hormone levels) older men with depression.”

Between 2 percent and 5 percent of people are affected by depression at any given time, according to background information in the study. Women are more likely than men to be depressed, but that difference disappears at about age 65. A number of previous studies have suggested that sex hormones may be a factor.




Drugs that Cause Erectile Dysfunction / Male Impotence

Drugs that Cause Erectile Dysfunction / Male Impotence

December 3, 2010

Here is a list of drugs that cause Erectile Dysfunction / Male Impotence

Drug Class

Generic

Brand

Antihypertensives
and Diuretics

Hydrochlorothiazide

Esidrix, Hydrodiuril, Inderide, Moduretic, Oretic, Lotensin

Triamterine

Maxide, Dyazide

Furosdmide

Lasix

Chlorothalidone

Hygrotone

Bumetanide

Bumex

Guanfacine

Tenex

Methyldopa

Aldomet

Clonidine

Catapres

Verapamil

Calan, Isoptin, Verelan

Nifedipine

Adalat, Procardia

Hydralazine

Apresoline

Captopril

Capoten

Enalapril

Vasotec

Metoprolol

Lopressor

Propranolol

Inderal

Labetalol

Normodyne

Atenolol

Tenormin

Phenoxybenzamine

Dibenzyline

Spironolactone

Aldactone

Antidepressants,
Anti-Anxiety Drugs
and Anti-Epileptic Drugs

Fluoxetine

Prozac

Tranylcypromine

Parnate

Sertraline

Zoloft

Isocarboxazid

Marplan

Amitriptyline

Elavil

Amoxipine

Asendin

Clomipramine

Anafranil

Desipramine

Norpramin

Nortriptyline

Pamelor

Phenelzine

Nardil

Buspirone

Buspar

Chlordiazepoxide

Librium

Clorazepate

Tranxene

Diazepam

Valium

Doxepin

Sinequan

Imipramine

Tofranil

Lorazepam

Ativan

Oxazepam

Serax

Phenytoin

Dilantin

Antihistamines

Dimenhydrinate

Dramamine

Diphenhydramine

Benadryl

Hydroxyzine

Vistaril

Meclizine

Antivert

Promethazine

Phenergan

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Naproxen

Anaprox, Naprelan, Naprosyn

Indomethacin

Indocin

Parkinson’s Disease Medications

Biperiden

Akineton

Benztropine

Cogentin

Trihexylphenidyl

Artane

Procyclidine

Kemadrin

Bromocriptine

Parlodel

Levodopa

Sinemet

Anti-Arrythmics

Disopyramide

Norpace

Histamine H2-Receptor Antagonists

Cimetidine

Tagamet

Nizatidine

Axid

Ranitidine

Zantac

Muscle Relaxants

Cyclobenzaprine

Flexeril

Orphenadrine

Norflex

Prostate Cancer
Medications

Flutamide

Eulexin

Leuprolide

Lupron

Chemotherapy
Medications

Busulfan

Myleran

Cyclophosphamide

Cytoxan




Erectile Dysfunction (ED) Treatment & Diagnosis.

Erectile Dysfunction (ED) Treatment & Diagnosis.

Core Clinic takes a multi-faceted approach to treating erectile dysfunction (ED) / Male Impotence.  The first step is an evaluation by one of Core’s highly-trained physicians to identify what is causing erectile dysfunction.  Upon completing our evaluation, an individualized treatment regimen is then created by a Core physician. Besides eliminating an underlying cause such as potassium deficiency or arsenic contamination of drinking water, the first line treatment of erectile dysfunction typically consists of a prescription for a PDE5 inhibitor medication (the first of which was sildenafil or Viagra, followed by Cialis and Levitra). In some cases, however, the PDE5 inhibitor is ineffective or prescribed use of a PDE5 inhibitor is contraindicated because of a patients’ health.

Our physicians will then explore treatment options ranging from Hormone Replacement Therapy (HRT) to prostaglandin tablets in the urethra or intracavernosal injections with a fine needle into the penis that can cause an erection.  The most widely used of these injectable treatments is Trimix which is an injectable three-drug cocktail used to treat erectile dysfunction. The active ingredients in the mixture are usually alprostadil, papaverine, and phentolamine.  In beginning the use of Trimix, it is critical that our physicians find the correct dosage as it does vary from patient to patient.  Additionally, we provide education to our patients on the least invasive way to administer the treatment.

Diagnosis of ED

A doctor will do a thorough examination that will include the following: medical/ sexual history, medication history, surgical history, physical exam, blood work, and an international index of ED questionnaire that will assess quality of erectile function and sexual intercourse.

Click here for a list of Drugs that cause Erectile Dysfunction (ED)




Erectile dysfunction (ED, “male impotence”) – What is it?

Erectile dysfunction (ED, “male impotence”) – What is it?

Erectile dysfunction (ED, “male impotence“) is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis sufficient for satisfactory sexual performance.

An erection occurs as a hydraulic effect due to blood entering and being retained in sponge-like bodies within the penis. The process is most often initiated as a result of sexual arousal, when signals are transmitted from the brain to nerves in the penis. Erectile dysfunction is indicated when an erection is difficult to produce. The most important organic causes are cardiovascular disease and diabetes, neurological problems (for example, trauma from prostatectomy surgery), hormonal insufficiencies (hypogonadism) and drug side effects

Please click here to view a list of drugs That Cause Erectile Dysfunction.

Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this is somewhat less frequent but often can be helped. Notably in psychological impotence, there is a strong response to placebo treatment or counseling sessions with a qualified psycho-therapist. Erectile dysfunction, tied closely as it is about ideas of physical well being, can have severe psychological consequences if left untreated.  In many cases, anxiety stemming from the uncertainty of an individuals’ ability to develop an erection can further exacerbate psychological impotence.

Click here for Erectile Dysfunction Treatment information