Common treatments for ED
Often Erectile Dysfunction is treated by:
Oral/ Drugs treatment
There are 3 different phosphodiesterase PDE5 inhibitors in tablet form available:
- Sildenafil (marketed as Viagra) made by Pfizer
- Vardenafil (marketed as Levitra) made by Bayer/Glaxo-Smith Kline
- Tadalafil (marketed as Cialis) made by Icos/ Lilly
These tablets are currently available from the doctor (and now often online via an online consultation, probably soon over the counter, as well as sold on the "black market"). Many people think they cause an immediate erection or will help them feel sexy, however, they only work when the penis is sexual stimulated. It works by blocking a chemical that usually causes the erection to subside. Depending on the treatment, it will need to be taken 20 minutes to 1 hour before sex. Viagra and Levitra should also be taken on an empty stomach to help with absorption. The period of time over which it works varies between 3 and up to reportedly 36 hours for Cialis. Approximately 70% of patients have a positive outcome with Viagra (with similar results for Cialis and Levitra).
Commonly reported side effects:
- Facial flushing
- Nasal congestion
- Visual disturbance
- Reliance on the drug for future erections
DO NOT USE with nitrates of any kind especially nitroglycerin (used for heart problems) and amyl-nitrate (commonly known as "poppers") as this can cause a dangerous drop in blood pressure and is potentially fatal. For the same reason it is also important that if you are on alpha-blockers for heart and prostate problems that you inform your doctor before taking any of the above.
Alprostadil (marketed as Caverject) is most often used but papaverine hydrochloride and phentolamine can also be used. Injected, usually just before sexual intercourse, directly into the penis or inserted using a special applicator it is almost always effective. However, patients need careful training on how to inject properly and can leave scarring, painful erections and priapism.
These work by placing a plastic tube over the penis, air is pumped out causing a vacuum and draws blood into the penis before a constricting band or ring is placed around the base of the penis. It works in 60-90% of patients and lasts until the ring is taken off. This is suggested for up to 30 minutes - after which it should be taken off or there can be complications. Many men stop using the vacuum as it interferes with spontaneity and is embarrassing to transport.
Possible adverse effects:
- Ecchymosis/ bruising
- Lower penile temperature
- Absent or painful ejaculation
- Pulling of scrotal tissue into the cylinder, becoming trapped under the ring
Some men receive hormones for their erection problem, however, this is a fairly rare treatment.
This is used as a last resort if other treatments have failed, often with a prosthetic implants of artificial rods inserted into the penis.
Counselling can be very helpful when psychological cause are suspected and with help the distress caused by impotence and erectile dysfunction.
Its important to treat the matter sensitively, because in many cases erectile dysfunction is caused by a psychological problem, which may get worse if you get angry or argue about it. Erection problems may improve or even disappear if you dont make a big issue out of having sex and find other ways to be intimate, which can take the pressure off him to perform.