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What is Erectile Dysfunction?
Erectile dysfunction (ED) is the repeated inability to achieve or maintain an erection sufficient for satisfactory sexual performance1. It occurs in 15 to 30 million men in the United States.  Incidence of ED increases with age but can be successfully treated.
How does an Erection Occur?
The process of an erection is complex and intricate. The sequence of an erection starts with a stimulus, either physical or mental, that is received in the brain. The brain sends a signal through the nerves to the penis causing relaxation of the penile blood vessels. Relaxation of the blood vessels allows blood to flow into the penis. There is high pressure in the penis that traps the blood in the corpora carvenosum causing a sustained erection.  The corporus carvenosum is two parallel columns of erectile tissue that forms the body of the penis.
What Causes ED?
ED can be caused by many different factors. Problems are classified as psychological, physical or both. Psychological problems result in 10-20% of all cases. They include stress, anxiety, guilt, depression, low self-esteem and indifference. These patients often fail to respond to psychogenic stimuli. Physical problems account for the majority of cases. Any condition that results in the breakdown of the sequence of events that causes an erection can lead to ED. The most common diseases that cause ED are listed and include diabetes, kidney disease, neurological disease, vascular disease, and malignancies.
-Peripheral vascular disease, arthrosclerosis (hardening of the arteries), and hypertension (high blood pressure) compromises blood flow to penis
-Spinal cord injury or stroke impairs nerve conduction to the brain
-Diabetes impairs peripheral nerve conduction to the penis
ED can also be caused by medications and is known as medication induced ED. There are over 200 possible medications that can alter the ability to have an erection. Possible medications include those listed in the table below. Please consult your physician prior to discontinuing any medication listed.

Drug Class Generic Brand
Antihypertensives and Diuretics Hydrochlorothiazide Esidrix, Hydrodiuril, Inderide, Moduretic, Oretic, Lotensin
Triamterine Maxide, Dyazide
Furosdmide Lasix
Chlorothalidone Hygrotone
Bumetanide Bumex
Guanfacine Tenex
Methyldopa Aldomet
Clonidine Catapres
Verapamil Calan, Isoptin, Verelan
Nifedipine Adalat, Procardia
Hydralazine Apresoline
Captopril Capoten
Enalapril Vasotec
Metoprolol Lopressor
Propranolol Inderal
Labetalol Normodyne
Atenolol Tenormin
Phenoxybenzamine Dibenzyline
Spironolactone Aldactone
Antidepressants, Anti-Anxiety Drugs and Anti-Epileptic Drugs Fluoxetine Prozac
Tranylcypromine Parnate
Sertraline Zoloft
Isocarboxazid Marplan
Amitriptyline Elavil
Amoxipine Asendin
Clomipramine Anafranil
Desipramine Norpramin
Nortriptyline Pamelor
Phenelzine Nardil
Buspirone Buspar
Chlordiazepoxide Librium
Clorazepate Tranxene
Diazepam Valium
Doxepin Sinequan
Imipramine Tofranil
Lorazepam Ativan
Oxazepam Serax
Phenytoin Dilantin
Antihistamines Dimenhydrinate Dramamine
Diphenhydramine Benadryl
Hydroxyzine Vistaril
Meclizine Antivert
Promethazine Phenergan
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Naproxen Anaprox, Naprelan, Naprosyn
Indomethacin Indocin
Parkinson's Disease Medications Biperiden Akineton
Benztropine Cogentin
Trihexylphenidyl Artane
Procyclidine Kemadrin
Bromocriptine Parlodel
Levodopa Sinemet
Anti-Arrythmics Disopyramide Norpace
Histamine H2-Receptor Antagonists Cimetidine Tagamet
Nizatidine Axid
Ranitidine Zantac
Muscle Relaxants Cyclobenzaprine Flexeril
Orphenadrine Norflex
Prostate Cancer Medications Flutamide Eulexin
Leuprolide Lupron
Chemotherapy Medications Busulfan Myleran
Cyclophosphamide Cytoxan

Diagnosis of ED
A doctor will do a thorough examination that will include the following: medical/ sexual history, medication history, surgical history, physical exam, blood work, and an international index of ED questionnaire that will assess quality of erectile function and sexual intercourse.


The information on this website if purely informational and should not be used to diagnose, cure or treat any patient without the direction and supervision of a physician. If you are intersted in using Tri-Mix or any other treatment for erectile dysfunction make sure to check with your physician first. This and any therapy should be individualized for you by a prescribing physician that knows you, your medical history, and any current and prior medication history. Tri-Mix is not approved by the FDA for the treatment of Erectile Dysfunction and does require a prescription that can only be filled at a compounding pharmacy.

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