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Fix Erectile Dysfunction and Feel Like a Man Again

Erectile dysfunction can be a man's worst enemy. Learn more about this condition and how you can treat it.

Erectile Dysfunction – Man’s Worst Enemy

Erectile dysfunction (ED), also known as impotence, is a type of sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity. ED can have psychological consequences as it can be tied to relationship difficulties and self-image.

A wide variety of treatments exist. Treatment depends on the underlying cause of the dysfunction. Psychological causes of ED are more common in men who are younger. Organic or physical causes are more common in older men.

Causes

Erectile dysfunction may be caused by a combination of physical and psychological factors. Common physical causes include:

  • Vascular disease
  • Diabetes
  • Pelvic surgery
  • Nerve damage
  • Hormonal imbalance
  • Medications

Common psychological causes include:

  • Anxiety
  • Depression
  • Stress
  • Relationship difficulties

Risk factors

There are several risk factors associated with erectile dysfunction, including:

  • Older age
  • Heart disease
  • High cholesterol
  • High blood pressure
  • Obesity
  • Diabetes
  • Smoking
  • Excessive alcohol consumption
  • Certain medications
  • Injury to the pelvic area
  • Psychological conditions

Complications

Erectile dysfunction can lead to a number of complications, including:

  • Anxiety
  • Depression
  • Low self-esteem
  • Relationship difficulties

Treatment

Erectile dysfunction can be treated with a number of different methods, depending on the underlying cause. Some common treatments include:

  • Oral medications
  • Injections
  • Vacuum devices
  • Penile implants
  • Counseling

Making lifestyle changes, such as quitting smoking and losing weight, can also help to improve erectile dysfunction.

Enrique sits down with Dr. Craig Keyes to learn about erectile dysfunction, its causes and the many treatments now available, including on-demand shots. Wait for the end!

#ErectileDysfunction #MensHealth #MensInfertilty #Impotence

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Video transcription:

Hey everyone enrique here, your massage therapist and institution based in new york city and los angeles. Today, I’m in new york we’re going to sit down and talk to dr craig kees who’s, an internal medicine doctor who specializes in men’s health, we’re going to talk about a sensitive topic which affects millions of men and that is erectile dysfunction. We’re going to talk about erectile dysfunction as well the treatment options that he has out there for this specific condition. But before we meet with dr craig keys, make sure you subscribe, set the bell to alert you when I post a new video and thanks again for watching watch the entire video, hey everyone enrique here once again, we’re here today with dr craig keys, a very well-known doctor in new york city and we’re going to talk about erectile dysfunction, which I think is kind of like a taboo kind of thing. Don’t you think, like a lot of people have that condition, but they don’t really talk about it. So since I’ve been affected by that, as you already know, I figured I would wanted to put the spotlight on this and just talk about it. You can explain to us why it happens some of the treatments that you offer. I don’t know anything that can help our viewers learn how to approach this, especially with men. I feel like a lot of times. Men don’t want to seek medical care in general, but specifically for this type of problem. Well, you’re, absolutely right, and in fact I I think it’s a matter of being taboo in a couple of respects. First, it’s taboo among the men who suffer those kinds of experiences and symptoms. They don’t want to talk about it. It’s humiliating! It is they’re made to feel less of a man, because it’s thought to be such a large part of manhood, and particularly among men who have sex with men and those men in particular face a tremendous challenge: securing their identity if they’re not having sex. I had one patient say to me: well, why did I fight for gay rights if I’m not really gay anymore other than in my head? Yeah- and it was really it was a very powerful remark- I hadn’t even considered that, but it’s also taboo- and you may have experienced this in terms of the medical community itself and its comfort was talking about this. When I was in training, it was very difficult to get questions answered about from other medical doctors. Oh really, and- and I know many- many of my patients have remarked that they can’t believe I’m answering some of these questions that they were told. They don’t need to know these answers and that struck me as odd. I never thought having information was a bad thing, and so we make that a really. What what what’s your take on that on on doc does not want you to. I think it’s just uncomfortable for some people to talk about sex, it’s uncomfortable for a lot of people to talk about sex. I agree with you: it’s even more challenging for men. I mean men will talk about sex in the locker room right right, but it won’t be too clinical. It’ll all be tilted towards probably something better than reality. So erectile dysfunction is a broad term that we give to challenges or difficulty achieving and maintaining an erection, and there are two big components of it, and I think this will probably ring a bell for most your most your listeners. On the one hand, there is what we call libido or an interest in sex, a drive, an excitement, anticipation of sex and on the other, is the actual mechanics of it. Getting hard getting in getting off would say, that’s another set of physiologic processes either one of those can or both can go awry. So when we talk about libido or excitement about sex, that is substantially managed in the brain and driven off of hormonal production hormones are are made largely in the brain for for libido, for excitement and to a lesser extent, in the sexual organs. I think all of us were trained by advertising by madison avenue. That testosterone does everything, but, as it turns out it, doesn’t it’s certainly an important hormone, but it has a limited impact. In fact, its greatest impact is on helping men be interested okay. So that’s where the interest really comes from from the testosterone right, not the actual physical right boner. Well, it’s funny because there are some. There are some interplays between those two that is when you get hard, even if you’re made to get hard through no fault of your own, because there are medicines. Now that can make someone hard, even if they’re, in a coma and when you get a boner, your brain senses that tremendous pressure and tension in your penis, and so your your brain from through evolutionary bells and whistles, has decreed that it’s time it’s it’s time to have sex okay, and so, when you’re hard, there is a drive. There is an excitement and it almost feeds itself. But testosterone is a very important part of the initiation. Okay, yes, I think that’s what happened with with my case, because I got tested initially of many years ago and my testosterone was actually very low and the doctor at the time put me out under a gel which it didn’t really work for me and then, when I met you and you put me on testosterone, it really helped me with the like. You said, with the with feeling horny or wanting to have sex, it really made a big difference, like I’m, really grateful for having that treatment. The testosterone treatment so, but I had lost all of that. I had lost the interest in in having sex. I I couldn’t even get a heart on, so it was all these things that were going on with me, and so I so is there a way to differentiate between psychological versus medical like how do we know? How do we test? Which one is it, and how do we I’m glad you raised that, because all through training, I heard that same sort of dichotomy and it would either be. This is all in his head or there’s really something wrong, and I wonder why, if something’s going on in your head, is that not regarded as something’s wrong? I think we spend too much time trying to downplay the role of emotions and the power of the brain in making things happen, and it’s a mistake, because the truth is the treatment is substantially the same if it is problematic enough. Of course, we want to treat anxiety, but some cases of anxiety are really profound and if someone is so anxious about the prospect of having sex that they can’t have it without some sort of physiologic or or pharmaceutical support. I’d be, oh, I can’t say a bad word. I would be a bad person if, if I said oh, no, no, I’m not going to give you any medication at all. Something that I know would work, because I think this is in your head and you have to get it out of your head. No, it’s like saying you have to get your blood pressure out of your heart and blood vessels. No, you treat it medication right, it’s and I think that’s one of the reasons why we’re almost trained not to talk about this stuff, because if you think it’s a mental yeah there’s this there’s such a stigma for having anything related to mental health. But it’s an organ just like any other organ, and your brain is, is a very powerful sex organ and if it’s not functioning, normally the sex isn’t as good as it can be. So, okay, so, dr keys, what would you tell someone that has been told by other physicians that it’s a mental thing to for this man or this person to seek treatment instead of just think, keep thinking that it’s a mental thing? What would you recommend to them? Well, what I would tell them is: that’s really encouraging news, because there are so many things that are now available to help us overcome some of the challenges we have that are caused by our brain anxiety, nervousness difficulty. Thinking fears, irrational fears, many many things are: are treatable or amenable, okay to therapies, various therapies, and so what we find is there are many young men for whom their their mechanics their plumbing their physical selves are very robust, but the problem is the expectations of their performance are so high. So many of us are watching porn at a young age and have some crazy notion that, oh that’s how I’m supposed to look when I’m having sex right, there’s, nothing like what s ex is actually like and if you’ve ever been at a porn food, it’s like a minute and a half of something that looks exciting and then about an hour of setting up and getting everything ready. So it’s not really anything like what you see right, that’s a good point, and yet many young men are thinking. Oh my god, I don’t look anything like that. I can’t perform like that. I can’t stay hard for a two-hour movie. I can’t so the I can’t penetrate nine people and they’re not expected to penetrate nine people but they’re so anxious about how far a gap there is between what they see in porn and in the media and where they believe they are right. Now I’ll often have someone come in saying I I’m fine on my own, I’m perfectly fine. I have no trouble at all the instant I have to get into some sort of social situation with with even one other person. That’s it. I just know. I can’t live up to it right right and now, when they hear oh there’s absolutely treatment for this, and it’s it’s the treatment that we’ll do. Okay, everyone knows about the pills and the pills are great, but what the pills do? Viagra Cialis, levitra, they’re, really good at slowing down the metabolism of the hormones we make of the testosterone actually of the prostaglandins that make us hard. Oh okay, so it’s not so much about being interested in sex. I think we can get there, but it is the actual performance, and so what happens is if you take the pills you do. Okay, as long as you’re making a lot of that hormone, but you can imagine what happens if you get very nervous. Adrenaline is the best boner killer of all. So can I take some xanax before I before my next encounter? Actually, but what happens is you’ll you’ll, try something right now and you’ll. I suspect that you will think. Oh, my god. Well now, there’s nothing to be nervous about okay, yes, because I do get nervous because I like, like I mentioned before it’s hard for me to just to stay erect. I get to that point and then sometimes it’s hard to stay. To maintain that I mean it’s your head in my head. Sometimes it’s easy. Some guys take 10 min 10, 15 minutes and they’re done so that’s good for me, but some guys take longer, and then I’m like, oh my god, and that’s when I start panicking right. Yes, because you’ve placed this huge expectation in yourself, I should be able to serve this whole range of needs that other people have and we can’t it’s perfectly normal not to be able to okay. So I have two questions about testosterone. Why is cystoscopy so controversial? I’ve been see before I saw you, I saw other doctors, which was clear that my testosterone was low and, and they did not want to put me on testosterone except for the first doctor, then the other ones that I talked about again. They didn’t want to talk about it. They said that all kinds of of bad things that were going to happen to my body, and so I’m like. Why do you think it’s so controversial and then the other thing is that how do you compare medicine to when you go to dnc or one of those those whole foods stores where they have a row of of these vitamins and minerals that that that promise to give you to to work as testosterone or or maintain your libido and maintain your sexual drive? Do you recommend those or or over something more medically, like testosterone or the or the other medicine that you may recommend? Well, so for the first question, why is testosterone treatment so controversial and I think it’s controversial because it is regarded as a drug of potential abuse and probably back 50 60 70 years ago, when testosterone was first being produced artificially, it became clear that it could create certain kinds of effects, but we didn’t know all of the effects, and so many people in the clinical community got nervous and they’re saying we know. Testosterone affects the muscles and it makes them look bigger and better. That’s true, but we also know it affects the bone marrow. We know it affects the bones. We know it affects the prostate. We know it affects the brain and on and on, and what makes anybody nervous is okay he’s using it now. He may not have a problem tomorrow, but what are the long-term effects? I think at that point in our history we had had a number of examples of things that seemed perfectly innocuous and then 20 years later, people are getting the horrible lung cancer from asbestos. Asbestos seemed like a miracle fiber because it was so fire [ __ ] fire resistant. Well, it also causes lung cancer, and so that’s an example of why we get skittish about like, let’s not all, say it’s perfectly fine. What the controversy comes, though, when there are differences of opinion about how long do you have to wait? How how hard do we have to wring our hands before we say? Well, these are adults and we’re going to be with them as they enter into this treatment and we’re going to monitor carefully we’re not just going to give them six years of treatment to take off on their own wish them a happy day we’re going to spend time with them and just as as we’ve been doing, monitoring the numbers and making sure we don’t have to tweak it, and we did in our case, I I think that is what’s different than or from what its use originally seemed to be a lot of people in great big guys and gyms and based on your experience. Is there any research out there on testosterone? Oh there’s a great deal of research and that’s what’s helped. I think a lot of clinicians begin to assess those risks and share those risks with their patients, so that they together can make some decisions about here’s where we want to place our bets here. We’ll take a small risk here and we’ll keep we’ll watch it carefully, and if we see any indications that that risk is coming to fruition, then we’ll tamp it down. Okay, and what about like? The things that you see over the counter right that allegedly help with well one of the things that’s challenging, and many of them may actually be of some use. But what’s really challenging is that the the the bar isn’t as high as it is for a pharmaceutical agent that has to go through years and years of testing for both safety and efficacy. Some of these things that are supplements are regarded as foods, and so it’s not regulated much more than making a twist ice cream cone and so they’re, not even fda approved, oh no, okay, they’re. So I can just create a product and say this will give you the best boner in town. You can say that, and you actually would be able to get away with something like that, because it is you believe it is the best it will give you the best bone or town. It’s your belief right. You have your first amendment right, so the bottom line, I think, is that if you’re dealing with erectile dysfunction or have problems on there, I think the the best bet is just to see medical care instead of going and buying these things or even in the in the black market at the gym or anything, I think the biggest mistake is to assume there’s nothing that can be done right. Okay, the very first guy I treated with the injections was certain. There was nothing that could be done and he he was really reluctant, and I said well, let’s convince us both that there’s nothing we can do and that way we can forget about this and never do it again and- and he said all right, and so I treated him, and he called me from the cab that he took on his way home and he was crying and he said I. I never thought this would happen to me. I I am a different person at this moment. You’ve opened up a whole new trajectory in my life and then he said I thought I was going to have to spend the rest of my life not dating, but having dinners oh like, I would never have seen that yeah really, yes, and it was so powerful to hear that it was very moving to think that something so important was was being so minimized right, largely to protect other people from their feelings of embarrassment. Talking about sex, and so that’s why I would say: I’d encourage everybody. Get it checked out. Okay, it’s it’s like asking for anything, the worst that can happen. Is they say no well now, dr craig keys, he will definitely meet with you and talk to you about it, but I also want to quickly mention also after we started my testosterone treatment. It also like your other piece and it just changed my life completely. Sorry, man, I I was, I was tired. I was moody. I have no sex drive, but when I started the testosterone treatment, it just changed. My whole life in general, like I’m happier, I feel energetic, I’m 52, I feel more vibrant than I did when I was 20.. So for me it’s worked a lot and- and I’m really happy about the true life exactly you are because you just changed entirely so so now, I’m curious about the next shot that you keep talking about. The next injection sure I think what you had mentioned, that you’ve tried the pills and they just really don’t. Do the pills, don’t work for me. I get headaches, I get flushed I get my blood pressure goes. I already have blood pressure problems, so I don’t want to do anything. That’s going to get into my system and stimulating and trigger my blood pressure problems. So what would be my next option? There is another treatment that was developed because we began to create erectile dysfunction by the surgery and radiation and treatment we were doing for prostate cancer 50 years ago. We invented a test to rapidly screen and diagnose people for prostate cancer, and we discovered all these men who had it and then we treated them all and that treatment ended up, causing them to lose their ability to stay hard or really impair it, and so we studied what is it that makes somebody hard and what is it about that surgery that ruins it, and we found out that fooling around with the nerves and and tiny blood vessels down in that area is really a bad idea, largely because that’s the spot, where special hormones are made that only belong in one part of the penis. Here’s a little cross section- okay, it all happens by some hormones hormones- are essentially proteins that tell other things what to do. Okay, that’s a great job. It’s just blocking people around, so these hormones are ones that we can actually deliver directly to that spot, but we have to get them into these chambers that get hard okay, and so we use a needle and the needle is a needle. Yes, a needle- oh my god, and what a lot of men are really surprised to hear that, because the needle goes into the shaft of your penis on the side. Okay, and there are fewer nerve fibers there than there are on the skin, of your elbow or the skin of your earlobes. This is like having a hair plucked. Okay, you promise well we’ll see, I’m very good with paint we’ll turn up the sound okay and then we’ll just let your studio audience rate you on your screen. Okay, now I’m very good with pain, so this injection, what’s in the medicine what’s in the the medicine, are, is made up of it’s primarily this hormone, oh okay and some other compounds that support the blood vessels and their expansion. I get it now. This injection you do it right before you get intimate with someone or how long should I do before? Maybe maybe 10 minutes. So it’s pretty much okay, and how long would it will I stay erect? Well, one of the reasons it’s such a popular treatment is that you can dial it up or dial it back. Oh, so you can kind of time it for okay for the five minute guy versus an hour guy. That’s right! Okay, so this is not going to hurt just a little bit. I’m really going! Not gonna hurt okay anywhere near as much as say the easiest facial okay. So this is only as you as you gonna need it. I can’t just do it on a everyday thing. No, this is something that we call on demand. So when you want to be hard, okay, you do this shot. Okay, and what does this call and how much does it cost? I want it now. It’s all right now, sort of the generic term for the whole family of of treatments is called tri-mix trimming. So this is about trying mix, because there are three ingredients I see, but some others are just two ingredients. Okay, some of the stronger ones are four ingredients. Okay, are there any side effects with this like ignite? One of the wonderful things about this is that it’s the very same hormone, the prostaglandin that you and I make okay to get hard and stay hard. That’s why this was what was created because it was really tough to get a man to make that hormone when we cut up the nerves and blood vessels from the surgery for prostate okay. Here we go. Oh that wasn’t bad, that’s it! That’s it are you still alive, I’m still alive. I think I’m still breathing, I’m actually feeling hard. Now yeah, I was gonna say yes, I’m not nervous anymore. I’m not now that I, the needles, you’ll, make friends anyway on your way back to the office. So guys now you guys know dr craig keys. Now you have different offices right. You work in california right we have an office in palm springs, fort lauderdale here in new york. Okay, that’s perfect! So if you’re, not in new york city, you can go to if you’re near california palm springs or florida, you can still have access to dr keys and his knowledge and his needles. It didn’t hurt, it didn’t hurt at all. So that’s it thanks again for watching and again don’t forget to subscribe. I just showed you my manhood. Now I deserve a subscription thanks again for watching, see you guys next time you.

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