Non-Medicamental Treatment
Why is it Necessary to Treat Erectile Dysfunction?
Normal Sexual Life Restores
During therapy you and your partner will return to enjoying regular and stable sex life. It is proved that people living regular sex life, have better mental and physical health.
Quality of Life and Relationship between Partners Improve
Erectile dysfunction also affects psyche of a man and his interpersonal relationships. As a result of erectile dysfunction quality of life and often also relationships with his partner worsen. Treatment greatly reduces dysfunction effects and slows its progression, increases man’s self-esteem and his self-confidence, also it help to maintain good partnership.
Accompanying Dangerous Diseases are Determined
Studies have shown that erectile dysfunction can be an early symptom of diabetes or cardiovascular disease, which can lead to myocardial infarction or blood stroke. Therefore, physician at patient’s with erectile dysfunction examination checks presence of these diseases and prescribes appropriate treatment if necessary.
For adequate erectile dysfunction and possible comorbidities treatment it is extremely important to contact and consult your doctor.
Medicamental Treatment
Erectile dysfunction manifests symptomatically.
Erectile dysfunction treatment aims at recovering erection sufficient for full sexual intercourse.
ED treatment includes orally drug therapy (pills) or intracavernous injections as well as surgery.
Methods of erectile dysfunction treatment over the last decade have significantly changed:
- 1970s: psychosexual therapy and penile prosthesis.
- 1980s: revascularisation, vacuum-constrictor devices and intracavernous introduction of medications.
- 1990s: transurethral introduction and oral medications.
- 1998: release of the first phosphodiesterase type 5 inhibitor (PDE-5) – sildenafil, has revolutionized ED treatment.
1. First-line therapy includes PDE-5 inhibitors and this group is defined as treatment recommended by European Association of Urology (EAU) and the American Urological Association (AUA).
PDE-5 inhibitors group include: Canadian Pharmacy online Viagra (sildenafil), Cialis (tadalafil) and Levitra (vardenafil) manufactured in pills, in different dosages. The main advantage of all drugs in this group – effectiveness at all forms of ED and good tolerability. PDE-5 inhibitors are used a certain time before sexual intercourse, and for effect onset sexual stimulation is required. Doses are selected individually.
During sexual stimulation at excitation nerve impulses are transmitted from brain to penis. At the same time cavernous bodies’ nerve endings release special substances and start processes that lead to cavernous bodies smooth muscles relaxation, which facilitates blood flow to penis and its swelling (erection).
There is a special phosphodiesterase type 5 enzyme (PDE-5), which breaks down chemicals, that allow muscles to relax. This causes penile muscles to constrict again, resulting in decreased blood flow to penis and returning it to relaxed state.
Sildenafil blocks PDE-5 enzyme, thus contributing to cavernous bodies smooth muscles relaxation, blood flow to penis and erection.
Sildenafil is the most studied drug, most effective in treating patients with ED among the group of PDE-5 inhibitors molecules. It can be applied in dosage of 25 – 100 mg one hour before sexual intercourse. Maximum drug concentration in blood plasma on an empty stomach is achieved 30 – 120 minutes after administration. Sildenafil effect is maintained for 4 hours. Drug effect appears after 14 minutes.
The most widely used group of drugs for erectile dysfunction treatment – PDE-5 inhibitors – are prescribed in 96% of cases, while 4% use A- adrenoblockers, sedatives, androgens, adaptogens and others.
2. Second-line therapy – in absence of oral medications effect intracavernous injections of vasoactive drugs may be used. Advantages of this method include high efficiency, ease of use, low risk of priapism (prolonged, usually painful erection that is not associated with sexual excitement), minimal side effects and systemic manifestations, rare relative contraindications.
Disadvantages: invasive administration, pain in injection site, fear of pain before injection, possibility of ecchymoses.
Also, in some cases, intraurethral drugs introduction is used (alprostadil).
3. Third-line therapy includes penile prosthesis.
In conclusion it should be noted that in most cases sildenafil results in successful erection and sexual intercourse.