Treating Erectile Dysfunction (ED) should be a comfortable experience. At Men’s Health Clinics (MHC) our goal is to provide you with a personal consultation where we sit and listen to your goals and expectations before making an assessment.
We then tailor a plan to treat your specific issue. The principal component, in your customized blend of medications, is FDA approved for the treatment of erectile dysfunction.
Getting your love life back on track
is our commitment to you!
“I USED TO THINK ED WAS SOMETHING I HAD TO LIVE WITH.”
Dr. Ramirez specializes in Men’s Health with a focus on treating Erectile Dysfunction (ED), initially practicing in Chicago and most recently in South Florida. He is a member of the Sexual Medicine Society of North America (SMSNA) and the International Society for Sexual Medicine (ISSM). He finds it very fulfilling to help couples remain sexually active at any age. Dr. Ramirez believes the intimacy derived from being able to enjoy each other’s company in this special manner is not only important for the individuals but also their relationship. He has been married for over 20 years, has two sons and enjoys traveling with his family whenever possible.
Dr. Ramirez received his Medical Degree from the University of Illinois at Chicago. He then completed a surgical internship in Virginia, followed by further residency training in Michigan and Illinois. He is currently licensed to practice medicine in Illinois, Indiana and Florida. Dr. Ramirez also holds undergraduate and graduate degrees in Engineering from Boston University. Through prior work experience in Latin America he can also converse with patients in Portuguese and Spanish.
Erectile Dysfunction (ED)
Erectile Dysfunction (ED) is the persistent inability to achieve or maintain an erection firm enough for sexual intercourse. In the past, ED was commonly referred to as impotence. ED affects as many as 18 to 30 million American men. ED has been estimated to affect up to 60% of men with Diabetes and 25% of men with High Blood Pressure. It can begin at any age but its frequency generally increases with age. It is important to remember that ED is treatable.
How does a Normal Erection occur?
To better understand Erectile Dysfunction let us first review normal erectile function. The process of producing a normal erection involves both the nervous and vascular systems. An erection begins with the appropriate stimulation which can be sensory (physical), emotional or a combination of the two. Signals travel from the brain or spinal cord causing a sequence of events which result in increased blood flow into the penis. Increased pressure inside the erectile tissue of the penis causes it to expand. This pressure acts to trap blood in the penis and maintains the erection. The erection ends when the blood flow into the penis is decreased and the outflow is increased. Under normal circumstances, the erection subsides either after ejaculation or when sexual stimulation ceases.
What are some Causes or Risk Factors?
Most conditions contributing to ED fall into two physical categories – those affecting either blood vessels or nerves. Other causes can be psychological in nature but typically account for a small percentage of ED and generally affect younger men.
Vascular (Blood Vessel) Disease: can reduce blood flow and hamper the development or maintenance of an erection. The most common cause is Atherosclerosis (hardening of the arteries). Other risk factors include Cardiovascular (heart/blood vessel) disease, Hypertension (high blood pressure) and Hyperlipidemia (high cholesterol).
Neurologic (Nerve Related) Disease: injuries or diseases involving the brain, spinal cord or local nerves can interfere with the proper nerve signaling required for an erection to occur. This can include patients with multiple sclerosis, Parkinson’s or a stroke survivor.
Diabetes: through damage to small blood vessels and nerves, Diabetes can affect both the blood flow and the nervous system signaling to the penis. Diabetic men are 2 to 3 times more likely to have erectile dysfunction.
Trauma, Radiation or Surgery to the Pelvis: treatments for cancer of the prostate, bladder, colon or rectum can damage nearby blood vessels or nerves interfering with erectile function. Prior trauma to the penis can also result in ED.
Alcohol, Recreational Drugs, and Chronic Tobacco: excessive alcohol use, drug abuse and smoking can cause blood vessels damage and have been implicated in ED.
Medications: a broad range of prescription drugs have Erectile Dysfunction side effects. Examples include some medications for high blood pressure, depression and heartburn.
Psychological: Stress, depression, poor self-esteem, relationship problems and performance anxiety can all interfere with the normal process that leads to an erection. These issues can also worsen ED due to other physical causes.
Hormonal Issues: such as low testosterone, is a less common cause of ED. Replacing testosterone alone will generally increase sexual desire but not correct erectile dysfunction.
Premature Ejaculation (PE)
Premature ejaculation is the most common type of sexual dysfunction for men under 40 years of age, and affects up to 30% of sexually active men to some degree.
Per the International Society for Sexual Medicine (ISSM) a common description might be “Premature ejaculation (PE) occurs when a man ejaculates before he or his partner want climax to happen.” In the past there were 3 common components of PE descriptions: the period of time from penetration to ejaculation was too short, inability to control the timing of ejaculation, and distress and/or interpersonal difficulty as a result. In 2014, the ISSM proposed a new definition with 2 main subcategories of Premature Ejaculation (Lifelong PE or Acquired PE). It includes more specific details for the amount of time before ejaculation occurs relative to penetration. Lifelong PE occurs from the first sexual experience and ejaculation occurs within about 1 minute. Acquired PE develops after a period of normal sexual functioning and ejaculation occurs within about 3 minutes. However, they note “men who ejaculate between 1 to 5 minutes after penetration may experience the negative psychological consequences that are characteristic of PE” and may warrant treatment.
Viagra® and Cialis® have stopped working for me. Am I still a candidate for treatment?
YES, options are available. Oral medications for Erectile Dysfunction (ED) fall into a class of medications called phosphodiesterase type 5 (PDE5) inhibitors. Frequently, patients notice that PDE5 inhibitors work better initially and can have a decreased effect over time, even to the point where they no longer produce an erection. When these pills fail we have an extremely effective group of medications that can be tailored to your particular needs.
The side effects of ED pills are so bad that although they help my erection I cannot think of using it. How is your treatment different?
In some men oral pills do produce an erection sufficient for penetration but the side effects of the pills (for example: headaches, facial flushing, nasal congestion, indigestion, vision changes, muscular pain or backaches) can be so severe that it prevents them from having sexual intercourse. Our medications work locally and therefore do not cause these side effects.
I’m a long-term diabetic with ED that does not respond to pills such as Viagra®. Is there a treatment that will help me?
Some of the most common conditions associated with Erectile Dysfunction (ED) include: Diabetes, High Blood Pressure, and High Cholesterol. When ED pills do not work in these patients we are able to assist them with local medication tailored to their needs. Additionally, Smoking, Alcohol Abuse or Recreational Drug Use and certain medications (for High Blood Pressure, Heart Disease or Depression) can interfere with erections. Of course, it is important to try to maintain a healthy life style (for example a proper diet, regular exercise and quitting smoking) and continue to monitor and treat your other health issues that can impact your erections.
I was treated for prostate cancer and developed erectile dysfunction. The oral ED medications do not work. Will your treatment help?
Various treatments for prostate cancer (for example: surgical removal of the prostate, radiation, freezing of the prostate) can all result in Erectile Dysfunction (ED). Some of these men did not suffer from ED prior to prostate cancer treatment. They are typically excellent candidates for our local medication therapy. In fact, our approach is used in “penile rehabilitation” after prostate cancer treatment. In some instances, this therapy can even help men regain their ability to achieve spontaneous erections.
It has been years since my last normal erection. My wife recently passed away after a prolonged illness and I would like to pursue a new relationship. I’ve tried ED pills but they don’t work. I’m even considering a penile implant. Is there another treatment that will help me?
Penile implant surgery is invasive and irreversible. Prior to making that decision we would be happy to meet with you. Our local medications have successfully treated men in circumstances such as this. If we are unable to help you attain a penetrable erection the consultation is free.
I’ve heard of many medications on the internet that claim they can treat ED but don’t know which ones to use.
The quick answer is NONE of them. Internet ED medications, especially those not requiring a prescription, are likely not FDA approved; therefore, their contents and purity cannot be guaranteed. It has been noted that some contain dangerous contaminants or ingredients that are not listed on their labels. Also, there have been instances where they were produced not to pharmaceutical manufacturing standards or in industrial equipment not intended for pharmaceutical use. The prime ingredient in our medications is FDA approved for the treatment of Erectile Dysfunction. All of our medications are produced in one of the limited number of FDA Registered Outsourcing Facilities as designated in the Compounding Quality Act of late 2013.
Men’s Health Clinics specializes exclusively in the treatment of Erectile Dysfunction (ED) and Premature Ejaculation (PE). Although we treat men with a range of erectile problems, most of our patients have already tried the conventional first-line ED treatment by taking Viagra®, Levitra® or Cialis® and the pills either no longer produce an adequate erection or the side effects are unbearable.
When the pills fail, we offer a second-line treatment with minimal to no side effects. The principal component of the medication is an FDA approved drug for the treatment of Erectile Dysfunction. The medication is custom tailored to your individual response; there is no “one size fits all”. When appropriate, we offer other treatments such as sublingual medications and gels. We look forward to working with you to help you regain and maintain your erectile function. We also encourage patients to bring their “significant other” to the consultation.
Most of our patients have already tried the conventional first-line ED treatment by taking Viagra®, Levitra® or Cialis® and the pills either no longer produce an adequate erection or the side effects are unbearable.
Consultations are by appointment only.
Weekday, evening and Saturday hours are available. To reserve your preferred time
please call (305) 982-8699.
Free valet parking available behind building; enter off Aragon Ave.
For further information please fill out the online form and a member of our all-male trilingual staff will contact you shortly.