Men with diabetes, radical prostatectomy, and other complicating factors may still benefit from treatment with a phosphodiesterase type-5 inhibitor such as Viagra. Patients who fail a trial of PDE5 inhibitor should be informed of the benefits and risks of other therapies. This of a different PDE5 inhibitor is unlikely to have a profound effect on sexual function and someone who fails a first drug trial, but should be considered in selected cases. Second-line therapies include intra-urethral suppositories, intra-cavernous drug injection, vacuum-constriction devices, and penile prosthesis. Medicated Urethral System for Erection (MUSE). MUSE is an intra-urethral suppository of alprostadil, of vaso-active drug that relaxes smooth muscle in the penis and induces penile erection. Although not as effective as intra-cavernosal penile injection, MUSE is a less invasive treatment option. An initial trial dose of intra-urethral alprostadil should be administered under healthcare provider supervision due to the risk of fainting. The cost of intra-urethral suppositories is high with respect to the overall success and therefore should be used judiciously.
Sildenafil is sometimes used “off-label” to treat other medical conditions, including: .
According to Mayo Clinic, men with erectile dysfunction may experience some or all of these persistent symptoms:
Hypertension (high blood pressure) is associated with ED and is seen more commonly among aging men. In addition, medications prescribed for hypertension, such as beta blockers and thiazide diuretics, have been shown to have detrimental effects on erectile function.
Male infertility is caused by abnormal sperm production, blockage of sperm delivery or low sperm production. Treatments are available that work.
L-arginine supplementation is possibly unsafe for men with blood pressure problems or men who have had a heart attack, allergies, or asthma.
It is well-known that smoking cigarettes can lead to physiological impairments that lead to erectile dysfunction. Research also indicates that this damage is not permanent and can even be reversed if smoking is stopped prior to middle age. For these reasons, it’s imperative that men who smoke cigarettes need to stop in order to maintain their health and sexual function. Having trouble quitting smoking? Consider trying some mind-body practices like reiki, acupuncture and spinal manipulation to help. (20)
It’s true that sexual function declines with age, but recent research shows that many aging men and women engage in sexual activity, and 50 percent of older adults indicate that sex is an important part of their lives. (3) In addition to these findings, researchers indicate that there has been a sharp rise in erectile dysfunction, delayed ejaculation, reduced libido and decreased sexual satisfaction in men under the age of 40. This may be caused by porn-induced erectile dysfunction, a growing problem that’s caused by the ease and accessibility of internet pornography.
Tadalafil is a medicine used to treat erection problems (erectile dysfunction) and symptoms of an enlarged prostate (benign prostate enlargement).
While ED is not life threatening, the condition may result in withdrawal from sexual intimacy, reduced quality of life, decreased working productivity, and increased healthcare utilization. Patterns of care may shift away from surgical and device therapies provided by urologists and toward pharmacologic treatments and/or multidisciplinary approaches. With men increasingly seeking to preserve sexual function and quality of life as they age, the treatment of ED will take on even greater importance in the years to come.
Viagra’s active ingredient is sildenafil, but you might not know it from looking around at your ED options. Why would Viagra be so much more expensive than sildenafil (the active ingredient in Viagra)? Why does anyone opt for the more expensive Viagra if both have the same ingredient?
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Defined by an inability to develop and maintain an erection firm enough for sexual relations, erectile dysfunction (ED) affects approximately one in four men during their lifetime. According to research scientists, up to 75 percent of ED cases occur due to medical causes. When functioning normally, neurotransmitters initiate an erection by relaying signals from the brain to the vascular system. The resulting increased blood flow and pressure to the penis allows tube and elastic like tissue within the penis to expand, achieving erection. Blood flow reduction to the penis Scarring of the penile tissues does not allow for a normal erection- Peyronie's disease Nerve damage (may occur directly to the penis or to areas leading to it) Hormonal or metabolic disorders such as diabetes Psychological conditions (mainly seen with ED in males under the age of 40) Vein leakage, also known as a venous leak Trauma, injury, or surgical procedures to the spinal cord or pelvic area Vascular disorders or disease such as high blood pressure Neurologic related conditions such as multiple sclerosis or Parkinson's disease High levels of cholesterol Heart disease Occurrence and/or treatment for enlarged prostate or prostate cancer Obesity Sleep-related disorders Tobacco use Diseases such as alcoholism and other substance abuse disorders Psychological related issues
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Pharmalogic TreatmentPharmacologic options for treatment of ED include oral phosphodiesterase type 5 inhibitors (PDE5Is) or intraurethral or intracavernosal injection alprostadil.6 Intracavernosal nonprostaglandin agents such as papaverine, phentolamine, and atropine have also been used to successfully manage ED, but none are FDA-approved for this indication. Testosterone replacement may also be considered for men with hypogonadism.6
The bark of the African evergreen yohimbe tree contains a compound called yohimbine, which has been traditionally used as an aphrodisiac.