Erectile dysfunction treatment

Men have plenty of fears regarding erectile dysfunction. Fight those fears with facts. Stop worrying and begin learning regarding why men typically aren't getting erections.

Erectile dysfunction, commonly referred to as ED, or impotence, is the inability to achieve and sustain an erection sufficient for satisfactory sexual intercourse. This condition is not considered normal at any age and is different from other problems that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.

What causes ED?

In order to achieve an erection three conditions must occur. The nerves to the penis must be functioning properly; the blood circulation to the penis must be adequate; there must be a stimulus from the brain. If there is something interfering with any or all of these, a full erection will be prevented.

A common problem that affects the majority of men at some point in their life is the occasional failure to achieve an erection. This can occur for a variety of reasons, such as from drinking too much alcohol or from being extremely tired.

Common causes of persistent ED include diseases that affect blood flow, such as atherosclerosis (narrowing of the arteries), nerve diseases, psychological factors, such as stress, depression and performance anxiety, and an injury to the penis. Chronic illness, certain prescription drugs and a condition called Peyronie’s disease (scar tissue in the penis) can also cause ED.

For people who are at risk of developing ED due to personal behaviour, such as drinking too much alcohol, steps may be taken to prevent its occurrence. However, other causes of ED may not be preventable.

Alprostadil to treat erectile dysfunction

Alprostadil is a synthetic hormone treatment for erectile dysfunction that works by stimulating blood flow to the penis. Alprostadil can be given by injection into the penis, as a cream applied to the tip of the penis, or by a small pellet placed in the urethra (the tube that carries urine from the bladder to the penis). An erection should occur in around 5 to 15 minutes after using alprostadil. The duration of the erection will depend on the dose prescribed.

Sildenafil (Viagra) for erectile dysfunction

Sildenafil is a drug used for the treatment of erectile dysfunction (ED) or impotence - the inability to obtain and/or maintain an erection. It belongs to a class of drugs called phosphodiesterase (PDE5) inhibitors. It is also known under the brand name of Viagra and was the first PDE5 inhibitor to be launched in the UK. Sildenafil has been shown in clinical trials to be significantly better than a dummy or placebo treatment in improving erections in men with ED.

Sildenafil works by increasing blood flow to the penis. It achieves this by causing the smooth muscle in the penis to relax and blood vessels to dilate. However, sexual stimulation is required in order for sildenafil to enable and improve erections. Cardiovascular status should be assessed before prescribing sildenafil, especially in older men.

Sildenafil for erectile dysfunction is available as tablets of 25mg, 50mg and 100 mg. The recommended dose is 50 mg orally, on an empty stomach, approximately 1 hour before sexual activity. The subsequent doses should be decreased or increased according to the individual response. The maximum dose is 100 mg and the maximum dosing frequency is once per day.

Alprostadil vs Sildenafil

In general, Sildenafil works for more men. Overall, Sildenafil works for about 70% of men. Alprostadil is effective in 30-40% of men with ED. Alprostadil takes effect in 5-20 minutes and the erection lasts for about an hour or until ejaculation. Sildenafil works as soon as 30 minutes but usually men are advised to take it 1 hour before sex.

Sildenafil tends to have more side effects because it goes into your body. Some men have upset stomach, headaches or muscle pains with Sildenafil. Alprostadil goes only inside the penis. As a result the side effects tend to be local — some men have burning or pain in the penis. Other than that side effects from intraurethral alprostadil are rare.