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Ask Dr. David Your Own Question
Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46740
Experience:  Board Certified Physician
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what to do when viagra fails

Customer Question

what to do when viagra fails
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. David replied 3 years ago.

Dr. David :

This is Dr. David

Dr. David :

there are other options if viagra fails.

Dr. David :

there are injection medications into the penis such as alprostadil or TriMix or QuadMix which can help with causing an erection of the penis

Dr. David :

also there are urethral alprostadil suppositories such as Muse which can work as well.

Dr. David :

if those don't work, then the last resort is a surgery for placement of a penile erection prosethsis which can result in an erection. these usually have a fluid reservoir which resides in the testicle and can pump up fluid into the penis to cause it to be hard

Dr. David :

so there are options after viagra.

Dr. David :

let me know if you have questions.

Dr. David :

hello?

Customer:

hello Dr David

Dr. David :

hello

Dr. David :

did you see my response above?

Customer:

I should mention that I had radiation treatment for prostate cancer two years ago, three months afterwards erections were ok and continued to be so for about a year then became weak ,Viagra seemed to help for a while then became inefective.

Dr. David :

I see.

Dr. David :

I am a radiation oncology doctor.

Dr. David :

did they give you anti-testosterone shots with the radiation and afterwards like lupron or zoladex (goserelin)?

Customer:

I understand this is likely to be due to damage caused by radiotherapy,I am using vacuum pump and band which works to a degree,but does have drawbacks

Dr. David :

radiation will not cut the nerves around the prostate which control erections.

Dr. David :

but the radiation does not help these nerves fire any better.

Dr. David :

if you are taking or have taken anti-testosterone shots like lupron or zoladex during and after the radiation therapy, these shots can negatively affect erections.

Dr. David :

and your erections won't get better until these anti-testosterone shots wear off and your testosterone levels recover.

Dr. David :

these anti-testosterone shots are often given during and after radiation therapy for more advanced prostate cancers to make the radiation therapy more effective and the cure rates for prostate cancer better.

Customer:

Yes three months before and during

Dr. David :

then you need to get your testosterone levels checked.

Dr. David :

your testosterone levels could still be low. and if they are very low, then this can also cause problems with the viagra not working.

Customer:

my anti testosterone shots ceased at the end of therapy

Dr. David :

yes, but for some men, their testosterone levels never fully recover.

Customer:

will be two years in june since radietion ceased

Dr. David :

yes.

Customer:

ok thank you I will get my testosteron echecked

Dr. David :

good idea.

Dr. David :

there is controversy about supplementing testosterone in patients who have a history of prostate cancer.

Dr. David :

many doctors worry about it thinking that testosterone will possibly cause the prostate cancer to grow back.

Dr. David :

but doctors at harvard have looked into this and there is really no data supporting this.

Customer:

I assume myGP will do this test for me

Dr. David :

if your testosterone is still low 2 years after radiation and hormone therapy for your prostate cancer and there is no evidence that your protate cancer is active, then you can ask your doctor to try you on some testosterone supplemental therapy to bring up your testosterone levels.

Dr. David :

your GP can order a serum testosterone level

Dr. David :

but they might be scared to give you testosterone given your history of prostate cancer.

Dr. David :

you might have to see a urologist or endocrinologist specialist or expert about testosterone supplemental shots or gels or creams to get your testosterone levels back up.

Dr. David :

http://www.harvardprostateknowledge.org/testosterone-supplementation-after-prostate-cancer

Dr. David :

you can give them this webpage for information.

Customer:

your advice please

Dr. David :

I would advise you to get your testosterone levels checked

Dr. David :

and if they are still low, then that is what is probably causing the viagra not to work.

Dr. David :

if you get your testosterone up to more normal ranges, then most likely 50-100mg of viagra will work for you.

Customer:

I will take your advice thanks vry much

Dr. David :

you are welcome

Dr. David :

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Dr. David :

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Dr. David :

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Dr. David :

you can always reach me as Dr. David if you have other questions.

Dr. David :

http://www.justanswer.com/medical/expert-dr-david/

Dr. David :

is my website if you need to reach me again.

Dr. David :

thanks for using JustAnswer.com

Dr. David :

do you see the ratings area below?

Customer:

Yes am most pleased thank you

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