Assisted Loving: Personalized Treatment for ED & PE

By Ginger Manley | Posted: Friday September 2, 2011

Dear Ginger:

What are these male sexual health clinics that I see advertised in the sports pages of the newspaper? Is this where I should go if I’m having trouble with ED? What happens there? Does insurance cover this?

-Charley


Dear Charley:

Great questions! I see these advertisements myself and often have the same questions, so after hearing from you I decided to make a site-visit to both of the ones that I usually see advertised.

My first visit was to the office of Nashville Male Medical Clinic, located in a large medical office building in the heart of downtown Nashville. My initial impression was it was definitely a male- oriented business, since there were no female employees on premises, as far as I could tell. Having noted this, I was welcomed warmly and every accommodation to speak with me and to show me around was given by the men who worked there, including Evan Bass, the General Manager. This clinic is part of a franchise chain of 20 or so located in large metropolitan areas across the U.S. The Nashville office has been here for 13 years. They have a medical staff of three Internal Medicine physicians, two of whom are retired from other practices and one who is still practicing. They are not affiliated with any of the other medical institutions in the Middle Tennessee area. Their aim is to provide highly-personalized care to their patients and they do so by scheduling as much time as is needed to take a history and to do evaluations and lab tests. In general they treat two types of sexual disorders, erectile dysfunction (ED) and premature ejaculation (PE).

My second visit was to New Life Men’s Clinic located in the Cool Springs Professional Building in Franklin. As with the first one, the staff is entirely male, but in this case there are just two men—Dr. Louis Heusmann, a retired orthopedic surgeon, and Dennis, a paramedic. New Life is owned entirely by Dr. Heusmann and is not affiliated with any other groups. The physical office layout was very professional. Dr. Heusmann greeted me on arrival and spent almost an hour with me answering every question and providing me with an armload of information to take home. They also provide highly personalized care, scheduling up to an hour or more to take a thorough medical history and to do evaluations and lab tests. As above, they also treat ED and PE.

Both clinics treat men who come to see them either alone or with their mate. According to Dr. Heusmann, a man’s pride may keep him from seeking treatment on his own, and it is often the wife or girlfriend who persuades a man to finally seek help for ED. As I have discussed in previous columns, ED is caused by 1) the natural process of aging, 2) the side effects of having diabetes or the medications used to treat high blood pressure and high cholesterol, or 3) the changes occurring after treatment for prostate cancer or BPH. Both clinics treat ED from all three causes.

A typical patient might be a 59-year old man (we’ll call him Jim) with ED who has tried conventional treatment with ViagraTM, LevitraTM, or CialisTM but is not satisfied with the results at this time.

Here’s how it goes: Jim makes an appointment— he can call on his own or be referred by his health- care provider—and arrives for the appointment alone or with his mate. After preliminary intake information is done, Jim is seen by the physician who takes a detailed history and performs a physical examination. If Jim is a candidate for a different treatment, the doctor may give him a prescription for a sublingual (under-the-tongue) tablet which contains one of the ingredients like in the ED drugs mentioned earlier. Some men who don’t respond to oral pills do respond to those given sublingually. If Jim is not a candidate for sublingual tabs, the doctor may tell him about treatment with TriMixTM, a compounded prescription drug that is injected directly into the penis. (OK—I heard that groan, all you men. It’s not nearly as bad as you might be thinking—if you’d like to learn more, go to http://www.trimixinjection.com/index.html).

While TriMixTM is not FDA approved for this use, differing versions of the combination of medicines in it have been around for more than 30 years and have been shown to be safe and effective. The doctor gives Jim a test shot of TriMixTM which usually will produce an erection within 5 minutes. If all goes well and Jim is ready to try this at home, he will be instructed in self-injection and given a supply to take home with him. Jim will be seen in follow up on a regular basis. Both clinics say they regularly turn worried men into smiling men when they leave after the first visit.

Now the bad news, most of this is an out-of- pocket expense, which can run about $1000 with the office visits and a year’s supply of medicine. Some private insurance will pay a portion of the office visit and lab tests, but Medicare does not cover any of it.

So, there you have it, Charley. What do I think about all of this? Well, if I look at it from a man’s point of view, then maintaining or regaining an erection when I want one is probably one of my top wishes in life. From a wife’s viewpoint, it is pretty important to me, also, but I might not feel quite the urgency or embarrassment my husband feels. From a healthcare provider’s vantage point, I think these niche clinics are a very important addition to the health care services in this community. If you decide to visit one of them, be a smart consumer—ask lots of questions and don’t agree to any treatment unless you feel fully informed and ready to commit.

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