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Phosphodiesterase 5 Inhibitors for Erectile Dysfunction
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Besides treating the underlying causes and psychological consequences, the first line treatment of erectile dysfunction consists of a trial of PDE5 inhibitor drugs (Viagra for instance or sildenafil). There are many other treatments that will be discussed on this site.
If an underlying medical condition has been diagnosed, treatment of that disease is appropriate; however, therapy for chronic diseases such as diabetes, hypertension and atherosclerosis does not guarantee the return of erectile function. Any evidence of hypogonadism, hypothyroidism or other endocrine causes should be thoroughly investigated and treated. As a risk factor for atherosclerosis and a common underlying cofactor, smoking should be avoided. If the patient smokes, methods of smoking cessation should be explored. Consideration should be given to changing prescription drugs that could be contributing to the problem (Table 2).
Methodology The rats were exposed to a light/dark cycle, with standard temperature and humidity levels. The animals were randomly selected to receive chemical injection of the streptozotocin (STZ) to induce diabetes. Those rats that did not receive STZ (vehicle injected) served as controls. The experiments began on each of the rats four weeks after the injections.
Men are sterilized with a vasectomy. The man's vas deferens (sperm ducts) are closed off so sperm can't get through.
Some authors advocate measuring prolactin and free testosterone levels as part of the initial evaluation.4,5 The value of this routine testing is uncertain, however, because the incidence of endocrinopathy presenting as erectile dysfunction is reportedly only 2 percent.8 A reasonable strategy is to obtain a free testosterone level in all men aged 50 and older and in those younger than 50 who have symptoms or signs of hypogonadism such as decreased libido, bilateral testicular atrophy or a reduced amount of body hair.9 The prolactin level should be measured if the free testosterone level is low, the patient has a substantial loss of libido or a prolactinoma is suspected on the basis of a history of headache with visual field cuts.10 Measurement of luteinizing hormone levels can be reserved for use in distinguishing primary from secondary hypogonadism in men with low testosterone levels.9
Sildenafil has been found to be well tolerated without important side effects. The reported side effects are usually mild, and include headache, flushing, nasal congestion, nausea, dyspepsia, diarrhea, and abnormal vision (seeing a bluish hue or brightness).
JAMA. 1999;281:421-426.
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Asian ginseng— this will help increase libido and maintain an erection. The typical dosage for this herb is 1,800 mg per day.
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An inflatable penile prosthesis consists of two soft silicone or bioflex (plastic) tubes inserted in the penis, a small reservoir implanted in the abdomen, and a small pump implanted in the scrotum. To produce an erection, a man pumps sterile liquid from the reservoir into the tubes by squeezing the pump in the scrotum.
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"There are lots of different ways to be sexual, and if one way becomes difficult or even impossible, you have to explore, together, the things you can do with each other that are sexually exciting," says Downey.
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One of the most common tests used to evaluate penile function is the direct injection of PGE1 into the corpora. If the penile vasculature is normal or at least adequate, an erection should develop within several minutes. The patient and the clinician can judge the quality of the erection. If successful, this test also establishes penile injections as one possible therapy.
Viagra® is rapidly absorbed by mouth with a bio-availability of about 40% and peak concentrations of the chemical are in the blood within 30-120 minutes. (2) This has been one of the advantages for Viagra®, in that it is capable of being taken as a tablet and is relatively quick-acting. A convenient factor when perhaps one’s partner won’t wait forever!
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The new cream consists of nanoparticles that can carry drugs or other substances, such as nitric oxide, and deliver them in a controlled and sustained manner, according to the researchers, who are from Albert Einstein College of Medicine at Yeshiva University in New York City. Nitric oxide is the signaling molecule that dilates blood vessels responsible for creating an erection.
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The review, which covers more than fifty studies published between 1995 and 2009, provides a valuable overview of the scale of counterfeit internet drugs, with a specific focus on erectile dysfunction (ED) drugs.
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