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Answered by: Dr Sri Viknarajan
ED drugs and penis pump no longer works for my erectile dysfunction problem. Please advise. I am 62 years old male
Medications such as antidepressants and antihypertensives may be the cause of your erectile dysfunction, consult with your physician regarding this issue and do not change your medication without consultation.
Reduce or avoid smoking, weight control, blood pressure control and cholesterol control can improve erectile dysfunctions symptoms.
If your problem persists, your doctor may perform a blood test to check your serum testosterone levels, or better known as the male sex hormone. If found to be low, it may be treated with testosterone.
As mentioned in the question, Erectile Dysfunction drugs and vacuum devices (penis pump) are no longer working for you, it may be related to an incorrect dosage or incorrect timing of drug consumption as well as incorrect use of the vacuum device. Sildenafil, Taladafil and Vardenafil should be taken 60 minutes before sexual activity while Avanafil which has a faster onset should be taken 30 minutes before sexual activity.
Penile self-injecting drugs or intraurethral Alprosdatil may be consider as second line treatment options. However, the decision always lies with the patient and an open discussion with your doctor is optimal.
The next step would be surgery which usually is not needed, and the options are penile implants and penile revascularization surgery.
A note of caution, if any of the methods above were used and there is a sustained erection lasting for 4 to 6 hours, this is known as priapism and is a medical emergency, kindly proceed to the nearest emergency department. So, in conclusion, your options after drugs and vacuum devices are intrapenile injections, intraurethral drug administration and surgery.