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Erectile Dysfunction.

Erectile Dysfunction (ED) is when a man can't achieve an erection firm enough to have intercourse or cannot maintain an erection for the time required to finish intercourse.

by Dr. Brent Agin, MD

Founder and CEO


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Everyone should be able to enjoy sexual intercourse if they want to, but unfortunately a high percentage of men will develop Erectile Dysfunction (ED). This can be frustrating, but there are research proven options available to help – some you may not have heard of.

Erectile Dysfunction (ED) is when a man can't achieve an erection firm enough to have intercourse or cannot maintain an erection for the time required to finish intercourse.

ED that occurs from time to time could be considered normal, but if erectile dysfunction becomes a common occurrence, it can lead to stress and anxiety making ED worse. ED could be considered a concern if satisfactory sexual performance almost never happens.

Also called impotence, ED can occur at any age, but it is more common in men beginning in their 40’s and increases with age. At 40 years of age, more than 40% of men are affected by erectile dysfunction and these numbers are rising due to obesity and sedentary lifestyles. Some men with ED find it difficult to either get or keep an erection every time they try to have sex, while others get ED symptoms only once in a while. Either way, you should know that you’re not alone.

ED that becomes chronic may be an early sign of a more serious disease of blood vessels, deficient hormone levels, neurological issues or could be simply tied to relationship issues or other psychological problems.

Numerous prescription drugs, recreational drugs, alcohol, and cigarette smoking can contribute to ED. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments may be necessary.

Psychological causes

Psychological factors such as performance anxiety and fear of failure, account for 15-20% of erection issues. Many of the medications that are used to treat psychological conditions also have ED and other sexual side effects.

Most of the psychological causes of ED center around anxiety and depression. Anxiety can cause the release of chemicals that can interfere with blood flow to the penis. After multiple failures, you can develop anxiety from the simple thought of having to perform sexually, creating the problem before even getting started.

A good comparison is those with insomnia (difficulty sleeping) that become anxious about not being able to sleep as evening sets in, releasing chemicals that can directly lead to insomnia.

Physical causes

  1. Medications. One of the unfortunate common causes of ED are prescription medications. Speak to your doctor about ED to see if there are medications that could be safely stopped or changed.
  2. Hormonal deficiencies can also be major contributors to ED. Have your doctor check important hormones such as; testosterone, estrogen, sex hormone binding globulin, LH, FSH, DHEA-s, thyroid, cortisol.
  3. Chronic illnesses, especially ones that can directly affect nerves or blood vessels to the penis.
  4. Structural disorders that cause the penis to not properly work such as Peyronie’s disease, where the tissue becomes dysfunctional with thickened tissue and plaques making erections difficult, angled and even painful.

As with any medical condition, erectile dysfunction is often best treated promptly.

  1. Like muscles and joints need to be exercised, if you are not “exercising” the penis, the tissue that causes erections can become damaged due to disuse.
  2. It is more than just the activity, having a healthy sex life improves self-confidence and personal satisfaction that positively affects many other aspects of life.
  3. More than 50% of men over 40 have erectile issues, so don’t wait to get help.

For those of you frustrated by the lack of solid solutions for unsatisfactory erections there is a solution – safe and reliable penile injections. It sounds much worse than it is, so join all of the happy men that have taken their sex lives back!

Erectile dysfunction may cause or worsen depression and anxiety resulting in feelings of inadequacy, frustration, denial and low self-esteem. If left unaddressed and untreated it can quickly and adversely affect personal, family and business relationships.

Yes, TelewellnessMD® offers both injectable and oral options for treating ED and low sex drive, because not everyone responds to treatments the same. Oral ED medications interfere with the breakdown of chemicals required to obtain and maintain an erection. This keeps more of those chemicals available longer, improving the ability to get and maintain an erection. In many instances, oral ED medications still do not provide adequate erections, or the side effects are too bothersome to continue the treatment.

Phosphodiesterase type 5 inhibitors (PDE5 inhibitors) are the most commonly prescribed drugs for increasing blood flow to the penis to get and maintain an erection. This drug class consists of commonly prescribed drugs, sildenafil (Viagra®), tadalafil (Cialis®) and others.

ED penile self-injections work much more consistently than oral medications and help facilitate blood flow to the penis quickly and effectively. This is a perfect solution for those that oral medications are not an option. Do not let the idea of injecting your penis stop you from trying, it is a small needle and a high percentage of men chose injections over oral medications.

Penile injections began being administered in 1983 and have proven to be the most effective non-surgical treatment for erectile dysfunction (ED) according to the American Urologic Association. For some reason, doctors are not educated on the use of penile injections and so many patients do not even know they exist. Doctors are finally becoming more comfortable prescribing these increasingly popular ED injections due to their efficacy and minimal side effects. 

Administered as a penile self-injection (you administer the injection to yourself), they are considered the most powerful class of anti-erectile dysfunction agents. While the components, on their own, are indicated for a vast number of different conditions, the practice of bringing them together to treat erectile dysfunction has become commonplace in sexual medicine. They are now considered to be the go-to treatment if conventional PDE5 inhibitors (phosphodiesterase type 5), such as Cialis or Viagra are contraindicated, non-responsive or non-tolerated. Once injected, the blend of medications will cause the erectile tissue in the penis to relax, expand and fill with blood, causing an erection within several minutes.

Penile injections can provide longer and fuller erections allowing you to maintain and improve your sexual health!  Penile injections, unlike most oral medications, can trigger an automatic erection in less than 5 minutes.

The injection is done using a very small needle, inserted into the proper area along the shaft of the penis, so the drug mixture is delivered into the corpus cavernosum. The mixture of drugs causes the corpus cavernosum to relax, dilate and become filled with blood, producing an erection. 

Over 50% of Men under 40 have experienced a form of treatable Erectile Dysfunction in their lifetime.


~ Brent Agin MD Metabolix Wellness Center CEO

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