There are several treatment options for ED. The following information is intended to educate lntracavernous Pharmacotherapy (ICP), PDE5 Inhibitors (oral), Vacuum Erection device, and Peptides (PT-141).

lntracavernous Pharmacotherapy (ICP)

ICP is by far the most effective treatment available for moderate to severe ED, with a 90+% efficacy rate. It is safe and suitable for most men with ED, regardless of age or medical condition. It's a highly specialized form of ED treatment and yet simple to administer. ICP treatment has been widely used since the mid 80's. Medical professionals who specialize in this form of treatment use various different combinations of medications.

ICP involves semi-painless injections (with autoinjector) of a small amount of a pre-determined combination of vasodilators into the spongy tissue of the penis. The combination causes dilatation of the penile arteries and penile tissues, resulting in an increase in blood flow to the penis, which is then stored in the erectile chambers. This induced erection feels perfectly natural and normal with the exception that it will not go down after ejaculation. The prescribed formula is individually tailored to allow the erection to last approximately 45-60 minutes, regardless of the occurrence of ejaculation or the state of mind. Once ICP protocol is established, this treatment works predictably and reliably every time.

The medicine used in ICP is a combination of vasodilators, each of which is FDA-approved, known as papaverine, phentolamine, atropine and prostaglandins E1. Since ICP is a localized form of treatment, the side effects are minimal and local. Its overwhelming success rate, minimal side-effects, and ease of use have made E1 a preferred choice for most patients who have access to this type of treatment. For patients who do not respond to or suffer from the side effects of oral medications, ICP is a welcome relief since it works well in most cases.

It is available in 4 different combinations:
- Single med Prostaglandins E1 (alprostadil)
- Bi-Mix: Papaverine and Phentolamine
- Tri-Mix: Papaverine, Phentolamine, Prostaglandins E1
- Quad-Mix: Papaverine, Phentolamine, Prostaglandin E1, Atropine
Depending on the level of ED will depend on which formula to use. There are countless combinations of these medications.

The benefits of ICP Include:

Immediate results. It generally works within a few minutes of application, regardless of age or underlying medical conditions. It may take a little longer with severe ED.
ICP has an overwhelming success rate, it works in the majority of patients, even in those who have tried this treatment before elsewhere.
The medication is applied locally; hence there are no known systemic side-effects.
ICP can be used without restriction to food, wine or other medications.
ICP is easy to apply using an autoinjector which operates simply with the press of a button.
ICP is reported to be curative in many patients with ED. Results may vary depending on the underlying health problems and the severity of ED.

Side effects of ICP:

ICP has a favorable side-effect profile. Given the benefits, the side-effects are minimal. They include:

Lack of erectile response, caused by incorrect application of ICP or insufficient dose of vasodilators.
Bruising, caused by accidental piercing of a superficial vein. A bruise is a superficial bleeding. It may last a few days to 1.5 weeks and is harmless. Will resolve on its own.
Localized pain or tenderness, especially when ED has been a protracted problem. This problem tends to resolve with repeated use when the penile tissue gets used to the sensation of a full erection again.
A prolonged erection (called a priapism) caused by over-reaction to the combination used. This problem is not common but it can occur on the first exposure to ICP when the sensitivity is yet to be established. A priapism must be reduced and subsequent dose-adjustment is necessary to avoid its recurrence.

How should ICP be used?

Medical professionals often recommend ICP as part of a Treatment Program that aims not only to provide a reliable erectile response short-term, but also to improve the long-term prognosis. Each patient is different, hence the treatment program has to be personalized to suit the individual needs and expectations. A course of treatment typically requires 2, at most 3, ICP applications a week for a period of twelve (12) months. In more advanced cases, patients may use ICP 3 to 4 times a week. Generally speaking, the more erections you experience, the easier it is for the next one to occur on its own, stronger and more reliable. You may experience return of natural erections and spontaneous erections during the course of treatment, but it is important to complete the full course of treatment. A follow-up evaluation is very important and necessary.

What is the basis for long-term improvement with a course of ICP treatment?

As a rule, medical professionals cannot make claims or promises to cure, but would focus on optimizing the treatment outcome as a balanced decision between benefits and side-effects. Such a notion is well maintained and respected in order to avoid abuse and false representation. ICP on its own is not intended to cure ED, nor does it promise a cure. With proper dosing, it provides a predictable and dependable erectile response. The observation that many ED patients no longer need ICP after a period has provoked many debates. Such an improvement could be a direct suit of renewed confidence, a psychological gain, or a representation of actual physical improvement, or a combination of several. A few references regarding the claims of a "cure" are included at the end of this information package. Failure to treat ED leads to progressive loss of the remaining healthy tissue and eventually irreversible loss of erectile function if the window of opportunity has been passed. So, it is important to treat ED with urgency, regardless of the final outcome. Long term improvement might be complete or partial; either is worth the effort.

Additional Treatment Options more commonly know

PDE5 Inhibitors:

Oral medications such as Viagra (sildenafil), Levitra (Vardenafil) and Cialis (tadalafil)
Viagra must be taken 30 mins to 1 hour before sex on an empty stomach. In all cases or oral medication, alcohol must be avoided.
Viagra is contraindicated in patients taking nitrates and in those with certain heart conditions.
Oral ED medications are known to potentiate the effects of nitrates, causing blood pressure to drop to dangerous levels.
As their title suggests, these medications are taken orally, and consequently, they are systemically absorbed. Hence, they can cause systemic side effects such as headache, dizziness, fainting, flushing, stuffy nose, dyspepsia (indigestion), diarrhea, blurred vision, altered color perception, pain in the eyes, or even temporary vision loss, palpitations, and anxiety.
The most commonly reported side effects include Headache, flushing, stuffy nose, and dizziness.
There are multiple dosing changes along with lifestyle changes to avoid these side effects

Vacuum Erection Device:

A vacuum erection device may take 12-15 minutes to operate.
The erection achieved can be a complete one.
When using VED to maintain erection achieved, you will need to use a silicone ring to trap blood in the penis. This will enable you to be able to have intercourse. Do not leave ring on for extended periods of time (longer then 45mins). NEVER use any material that is not easily cut in the event it needs rapid removal.
VED can also be used as part of a penile rehabilitation program offered at Eros Health.

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Eros Health ED Treatment Options