Dr. Castellano Health Institure or Orange County, CA.

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OFFICE:  (714) 530-2183 

FAX:  (714) 530-2182


12460 Euclid St Suite 101

Garden Grove CA 92840

Young unhappy couple in bed having problems and crisis

Erectile Dysfunction, or ED, is the inability to achieve a full or consistent erection for satisfactory sexual activity. The problem lies in either not getting enough blood in the penis or the inability to retain it there. Estimates show that up to 40% of men over 40, 50% of men over 50, and 60% of men over 60 will experience ED. We want you to know that you are not alone, ED is more common than you think.

About 80% of ED cases are a result of chronic diseases such as Diabetes, Vascular Disease, and Hormone Disorders. Of the previous diseases mentioned, Diabetes has become the major culprit of ED due to its rising occurrence in our society. As of 2014, 1 out of every 3 Americans was either Prediabetic or Diabetic. Diabetes results in ED through its vascular and neural damage, causing up to 50% of Diabetics to experience ED.

Medications that physicians prescribe to control blood pressure, depression, anxiety, and an enlarged prostate can result in ED. Lifestyle choices such as smoking, obesity, lack of exercise also contribute to ED. Finally, psychologic factors such as stress, anxiety, and depression can worsen or lead to ED as well.

It is useful to know the cause of the ED to treat it correctly. If ED is due to a hormonal imbalance caused by a Testosterone deficiency, the simple and most correct action is to restore the hormone balance. If the issue is poor blood supply to the penis due to chronic diseases, then the answer lies in restoring blood flow to the penis. This can be done by using various methods. Vacuum pumps are simple and non-invasive but have a high dropout rate. There are various medications that can be used to treat ED. Oral medications are derived from the Phosphodiesterase 5 inhibitor (PDE5 inhibitors) class and include such medications as Viagra, Levitra, and Cialis. For those patients who have failed or are unable to take the PDE5 inhibitors, intracorporal injections work best. These medications include Prostaglandin (PGE1) monotherapy, Bimix (2 med combo), Trimix (3 med combo), and Quadmix (4 med combo).


PREMATURE EJACULATION (PE) is when ejaculation occurs before or soon (minutes) after the initiation of intercourse and is associated with feelings of distress or frustration of either partner. PE is more common than we think, occurring in up to 1 out of every 3 men, and unlike ED, is not age-related and can be life-long.

Treatment option for PE include oral medication, topical gels or intracorporal injections. Some men with premature ejaculation benefit from drugs called PDE5 inhibitors, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). A PDE5 inhibitor can be used alone or in combination with a selective serotonin reuptake inhibitor (SSRI). For those patients not responsive to oral medications, we find that the intracorporal injections work best.