Erectile dysfunction is one of the most common conditions in men’s health and one of the least talked about. In the Massachusetts Male Aging Study, 52% of men between 40 and 70 had some degree of it (1). Most never ask for help, often because they expect an awkward conversation and a prescription handed over without a question.
It does not have to go that way. This guide covers ED treatment in Miami at Rewind Anti-Aging of Miami: what happens at a confidential visit, why the cause matters, the treatment options, and what results to expect.
Why the cause of ED matters
An erection depends on blood flow, nerves and hormones working together, so ED is a symptom with several possible causes. Finding which one is behind yours decides which treatment will work, and it can matter for more than your sex life.
- Blood vessels. The arteries of the penis are narrower than the arteries of the heart, so narrowing tends to show there first. A meta-analysis of cohort studies found men with ED had a 44% higher risk of cardiovascular events (2). ED can be an early prompt to check your heart.
- Hormones. Low testosterone reduces desire and weakens the mechanics of an erection. Thyroid problems and high prolactin can play a part too. Our guide to signs of low testosterone in men lists the other symptoms that tend to come with it.
- Metabolic health. Diabetes, high blood pressure, high cholesterol and excess weight all damage the lining of blood vessels.
- Medications. Antidepressants, some blood pressure drugs and finasteride are common contributors.
- Stress and performance anxiety, which feed on themselves once an erection has failed once or twice.
The American Urological Association’s guideline recommends a full medical evaluation for men with ED, including a morning testosterone level and a look at cardiovascular risk, not only a prescription for the symptom (3).
What happens at a confidential ED visit in Miami
1. A free first conversation. Thirty minutes, by video or in our Wynwood office. Many men prefer to start by video.
2. A private consultation. Your provider asks about your symptoms, when they started and whether they are getting worse, your medical history, medications, sleep, alcohol and stress. It is a clinical conversation, one-to-one, and it stays confidential.
3. A blood panel. Total and free testosterone, estradiol, SHBG, PSA, a thyroid panel, CBC, a metabolic panel, lipids, fasting insulin, hemoglobin A1c and inflammatory markers. This is what separates a hormonal cause from a vascular or metabolic one.
To get the most from the visit, bring a list of every medication and supplement you take, with doses, and fast for 8 to 12 hours before the blood draw so your results are accurate. Water is fine. Results usually come back within 5 to 7 business days, and your provider walks you through every number.
4. A plan matched to the cause. Your provider starts with the least invasive option likely to work and moves up only if needed.
5. Follow-up. ED treatment usually needs fine-tuning: the dose, the timing, or a different medication. Follow-ups check the result and adjust it, and they can be done by telehealth.
ED treatment options at Rewind
| Option | How it works | What to expect |
|---|---|---|
| Sildenafil | Oral PDE5 inhibitor that increases blood flow | Works in 30 to 60 minutes, lasts 4 to 6 hours |
| Tadalafil | Longer-acting PDE5 inhibitor | Lasts up to 36 hours; a low daily dose keeps you ready without planning |
| Custom sublingual troches | A PDE5 medication combined with oxytocin, testosterone or sermorelin, dissolved under the tongue | Treats more than one cause at once; not available at a standard pharmacy |
| TriMix injection | Alprostadil, papaverine and phentolamine injected with an ultra-fine needle | A firm erection within 5 to 15 minutes; works for 85 to 90% of men |
| PT-141 | A peptide that acts on desire in the brain rather than on blood flow | Taken 45 to 60 minutes before sex |
| Testosterone therapy | Restores low testosterone | Improves desire and erection quality over weeks, and makes other treatments work better |
Tablets first. Sildenafil and tadalafil work for most men, and they are where most treatment starts. The choice between them is mostly about timing and lifestyle; we compare them in Cialis vs Viagra.
When tablets are not enough. TriMix is the most effective treatment short of surgery, including for many men tablets do not help. The idea of an injection puts most men off until they try it: the needle is the same ultra-fine gauge used for insulin, most men describe a pinch lasting about a second, and we teach the technique in the office and supervise your first injection. Our guide to TriMix in Miami covers it step by step.
When desire is the problem. If the mechanics work but the interest is not there, PT-141 or correcting low testosterone addresses that directly. See PT-141 for sexual health.
For a side-by-side of every option, read our guide to the best ED treatment options.
What results to expect
Most men get a reliable result on the first or second attempt with tablets or TriMix, once the dose is set. Where low testosterone is the cause, erections and desire improve over several weeks as levels come up, and many men then need less medication or none. Because the blood panel covers cholesterol, blood sugar and inflammation, you also come away knowing more about your heart and metabolic health than when you walked in.
Treatment is also something you can shape around your life. Some men prefer an on-demand tablet; others would rather take a low daily dose of tadalafil and stop planning altogether. Your provider will talk through both, and the follow-ups are there to change course if the first choice does not suit you.
Questions to ask any Miami ED clinic
- Do you run blood work before prescribing, including testosterone and a metabolic panel?
- What will you do if tablets do not work?
- Do you offer TriMix, and will you supervise the first injection?
- Who prescribes, and how do I reach them to adjust the dose?
- Where is the medication dispensed, and is the prescription in my name?
Cost and insurance
Rewind does not accept insurance. Costs are discussed during your consultation, before any treatment begins.
ED treatment in Miami at Rewind
Rewind Anti-Aging of Miami is a physician-led practice at 24 NW 29th Street in Wynwood, open Monday to Friday, 10 AM to 6 PM, minutes from Midtown, Edgewater and Brickell. We provide ED treatment in Miami that starts with the cause, from tablets and custom troches to penile injection therapy and testosterone therapy. Patients come to us from across Miami-Dade and Broward, from Miami Beach and Coral Gables to Doral and Fort Lauderdale. Book a free, confidential consultation or call (305) 922-9622.
Sources
- Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. The Journal of Urology. 1994;151(1):54-61. PMID: 8254833. DOI: 10.1016/s0022-5347(17)34871-1
- Vlachopoulos CV, Terentes-Printzios DG, Ioakeimidis NK, et al. Prediction of cardiovascular events and all-cause mortality with erectile dysfunction: a systematic review and meta-analysis of cohort studies. Circulation: Cardiovascular Quality and Outcomes. 2013;6(1):99-109. PMID: 23300267. DOI: 10.1161/CIRCOUTCOMES.112.966903
- Burnett AL, Nehra A, Breau RH, et al. Erectile Dysfunction: AUA Guideline. The Journal of Urology. 2018;200(3):633-641. PMID: 29746858. DOI: 10.1016/j.juro.2018.05.004
Frequently Asked Questions
Is an ED consultation at Rewind confidential?
Yes. Consultations are private and one-to-one, and your records are protected under HIPAA. Your first conversation can be by video if you would rather start from home.
Why do I need blood work for erectile dysfunction?
Because ED is a symptom, and the cause decides the treatment. The panel checks testosterone, estradiol, thyroid, blood sugar, cholesterol and inflammation. Low testosterone is a common, treatable cause, and ED can be an early sign of heart disease that is worth finding early.
What if Viagra or Cialis have not worked for me?
There are still effective options. Custom troches combine a PDE5 medication with other ingredients, and TriMix injections work for 85 to 90% of men, including many who do not respond to tablets. Correcting low testosterone also makes other treatments work better.
How quickly does ED treatment work?
Sildenafil and tadalafil start working within 30 to 60 minutes, and TriMix within 5 to 15 minutes. Most men find the right medication and dose within the first one or two attempts. ED caused by low testosterone improves over several weeks as levels are corrected.
Where is Rewind's ED clinic in Miami?
At 24 NW 29th Street in Wynwood, Miami, FL 33127, open Monday to Friday, 10 AM to 6 PM. Book online or call (305) 922-9622.
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⚕ Medical Disclaimer
The information on this page is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. All treatments at Rewind Anti-Aging of Miami are performed under the supervision of licensed medical professionals. Individual results may vary. Consult your physician before beginning any new treatment protocol.
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Areas We Serve in Miami & South Florida
Our clinic at 24 NW 29th Street is in Wynwood & Midtown, minutes from Edgewater and Brickell. We also care for patients across Coral Gables, Aventura, Key Biscayne, and Doral — plus the entire state of Florida via telehealth.
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Our team at Rewind Anti-Aging in Miami is here to help you determine if erectile dysfunction treatment is right for your goals.