Erectile Dysfunction
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Treatment of Erectile DysfunctionIf you see a doctor for erectile dysfunction, his evaluation should consist of three basic elements: a medical and psychosexual history; the appropriate physical exams and laboratory tests; and an agreed course of treatment. Treatment of erectile dysfunction should develop from the least invasive therapy towards more invasive therapies if the less invasive ones do not work. Least invasive: Oral therapy (e.g., sildenafil, tadalafil, vardenafil), Psychosexual counseling, Vacuum pump and constriction device Most invasive: Penile prosthesis implant, Arterial and venous surgery Phosphodiesterase 5 inhibitors (Viagra, etc) for the Treatment of Erectile DysfunctionPhosphodiesterase 5 (PDE5) inhibitors are effective therapeutic agents for erectile dysfunction with organic, pyschological, and mixed causes. PDE5 inhibits cyclic guanosine monophosphate hydrolysis in the tissues of the corpus cavernosum and so increases penile response to sexual arousal. PDE5 inhibitors are relatively non-invasive, convenient, have high efficiecency, and low levels of side effects. There are three PDE5 inhibitors available: sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). Viagra was the first PDE5 inhibitor approved for use by the FDA, is highly effective in increasing erectile function (i.e., attaining and maintaining an erection) for most men with erectile dysfunction. Side effects including headache, flushing of the face and dyspepsia, occur in fewer than 20% of men. The great thing is that it works even with severe cases of impotence caused by prostate cancer, diabetes mellitus, spinal cord injuries and neurologic disorders. Cialis is also a PDE5 inhibitor, but with a different chemical structure, and is also good at improving erectile function for most men. Unlike the other PDE5 inhibitors which generally affect erectile function for approximately 4 hours, Cialis can improve erectile function for up to 36 hours. Side effects, which include headache, dyspepsia, and back pain, occur in fewer than 15% of men. It is effective in treating erectile dysfunction associated with medical conditions such as hypertension, diabetes, coronary artery disease, and depression. Levitra is a PDE5 inhibitor similar in chemical structure to Viagra, and is effective in treating most men with erectile dysfunction. Side effects, which include headache, rhinitis, flushing and dyspepsia, occur in less than 25% of men. Levitra is effective for treating erectile dysfunction in men with coronary artery disease and diabetes. Comparison of Viagra, Cialis, and Levitra They are all potent PDE 5 inhibitors which act in the same way. Cialis has a longer life in the body than Viagra or Levitra. They share some common characteristics: they produce a dose-dependent improvement in erectile function among most men with erectile dysfunction; they are effective for many different causes of erectile dysfunction, including diabetes; the man' sage of the patient does not influence their efficiency; they are relatively well tolerated and tend to have minimal side effects (headache, nasal congestion, and dyspepsia are the most common); all three are contraindicated in patients taking certain heart medication. Alprostadil for the Treatment of Erectile DysfunctionIntra-urethral administration of alprostadil (known as MUSE) can be an effective treatment for erectile dysfunction for men who cannot take Viagra, or for whom it does not work. MUSE is a small, medicated pellet that is inserted into the urethra; an erection develops about five to ten minutes later and persists for about half an hour to an hour. Alprostadil can also be administered intra-cavernously by injection as well; some men may prefer this approach. Alprostadil should not be used when a man is having intercourse with a partner who is pregnant, unless barrier contraception (i.e. a condom) is used. Treatments and Psychosexual Counseling For Erectile DysfunctionViagra and its ilk have become standard therapy when treating cases of erectile dysfunction. You can compare and review PDE5s Cialis, Levitra and Viagra online here. But this increased emphasis on the physiological causes of sexual dysfunction may have led to a simplistic tendency to look for simple medical solutions to problems which may have their real roots in a man's sexual relationship with his partner. The list below outlines some of the issues for men given a drug to treat erectile dysfunction. Psychosexual Issues for Men Using Viagra1 Satisfying sexual relationships are not just the product of a firm erection. 2 Sex has differing levels of importance to all couples. 3 What will happen to the relationship when the man gets his erection back? How will their sex life be affected? 4 Restored erectile function can reveal other sexual dysfunctions including premature ejaculation and low desire. |
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