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Erectile Dysfunction Discussion

Causes of Erectile Dysfunction

ED has two classifications.

The most common is organic. This usually results in a lack of adequate blood supply to the penis during the need for an erection or the penis' inability to maintain an erection sufficient for penetration during sexual intercourse.

Current Treatments

Pill Forms

Viagra®, Cialis® & Levitra® are three approved tablets currently available. They need to be taken 20 minutes to 1 hour before sexual intercourse. The period of time of half-life, during which they can potentially work can vary between 3 hours up to 17.5 hours.


Can be injected into the penis before sexual intercourse.

Vacuum Erection Device

Also known as "the pump", it is a plastic cylindrical tube placed over the penis with a pump mechanism that removes the air from the tube. This creates a vacuum which works to draw blood into the penis helping it attain an erection. Then a constriction device is placed at the base of the penis to retain enough blood in the penis for sexual intercourse.

Hormone Replacement Therapy

Low testosterone has been treated with transdermal patches, topical ointments or intramuscular injections.


The last resort, end of the line treatment for ED is the implantation of rods into each of the penis' two erection chambers called the corpora cavernosa.

Combination Therapy

Prostaglandin/PGE1, the principle active ingredient in trimix uses an energy pathway known as cyclic adenosine monophosphate (cAMP). PDE5 inhibitors such as Viagra®, Cialis® and Levitra® use the energy pathway known as cyclic guanosine monophosphate (cGMP). For patients who have failed either of these therapies individually, it has been observed the combination of using both at the same time may be a viable option.

Relaxation of the smoth muscles in the penis' erection chambers, the corpora cavernosa, is a critical step in attaining an erection. This relaxation is in part regulated by cyclic adenosine monophosphate or cAMP and cyclic guanosine monophosphate or cGMP.

Prostaglandin E/alprostadil, a principle active ingredient in TriMix-gel®, uses the energy pathway known as cyclic adenosine monophosphate (cAMP). PDE5 inhibitors such as Viagra®, Cialis® and Levitra® use the energy pathway known as cyclic guanosine monophosphate (cGMP).

For patients who failed on Viagra®, Levitra® or Cialis® tablets and who have failed on prostaglandin/alprostadil based medications, combining these two may be more effective for patients where these treatments have failed on monotherapy. Since both cAMP and cGMP mediated vasodilation can lead to penile erection, combining therapies that incorporate both pathways may succeed when single therapies fail. (Nehra A et al International Journal of Impotence Research. 2002 Feb:14 Suppl 1;S38-42)

Viagra®, Levitra® or Cialis® used with TriMix-gel® in combination therapy may be a viable alternative when both modalities have failed in monotherapy.

The information contained on this website is general in nature and is intended for use as an informational aid. It does not cover all possible uses, actions, precautions, side effects, or interactions of the products shown, nor is the information intended as medical advice or diagnosis for individual health problems or for making an evaluation as to the risks and benefits of using a particular product. Although much of the information on this site is derived from the medical literature, you should consult your Doctor about diagnosis and treatment of any health problems. Information and statements on this website have not been evaluated by the Food and Drug Administration (FDA). The products herein are not made under GMP requirements. They are compounded in a licensed compounding pharmacy for the use of an individual patient who has been prescribed these products by a licensed physician. This website makes no claim as to efficacy or safety of these products. This website is not intended for making an evaluation as to the suitability, risks or benefits of use. Before taking any action, consult your Doctor.

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