Erectile dysfunction – explanation, treatment

Quite a common ailment

The problem affects about 10% of men, and between 40-70 years of age, as much as 40%. One study found that approximately 90% of men hide this problem and do not seek medical help.

Explanation

Erectile dysfunction is the persistent inability to develop and maintain an erect penis sufficient for sexual satisfaction. The physiological mechanism responsible for penile erection is the release of nitric oxide in the corpus cavernosum during sexual arousal, which results in an increase in arterial blood flow to the cavernous sinuses of the penis and activation of the veno-occlusive mechanism, and as a consequence, erection. Erectile dysfunction can occur for neurogenic, vascular, psychogenic, anatomical reasons, or it may be caused by the use of certain medications. Coexisting diseases such as: atherosclerosis, hypertension, diabetes, hyperlipidemia, hypogonadism, metabolic syndrome, depression, COPD, as well as a lifestyle to a large extent can significantly increase the likelihood of erectile dysfunction.

Treatment

The efficacy of oral medications is very high. Phosphodiesterase 5 (PDE 5) inhibitors are used to treat erectile dysfunction: sildenafil, vardenafil, tadalafil. These substances differ in properties, the longest duration of action is tadalafil 24-36h, while the other two preparations 4h.

Sildenafil (preparations in doses of 25–100 mg) – well absorbed from the gastrointestinal tract (food reduces and delays absorption). The maximum plasma concentration occurs after 1 hour. Contraindications to use are heart and liver diseases, recent stroke or infarction, low blood pressure, as well as simultaneous use of nitrates or NO-releasing drugs.

Vardenafil (preparations in doses of 5–20 mg) – Stronger than sildenafil, the maximum concentration can be observed from 0.5 to 2 hours.

Tadalafil (preparations in doses of 10–20 mg) – the maximum concentration starts after about 2 hours. Known as the “weekend pill” as it works from 24 to 36 hours.

Avanafil (preparations in doses of 50, 100, 200 mg) is a new drug in the treatment of erectile dysfunction. It is characterized by the fastest onset of action (15-30 minutes) and greater effectiveness. Therefore, it is considered a drug to be used in “spontaneous situations”. It can be recommended for people who take nitrates, as it has no significant effect on blood pressure.

It is worth consulting erectile dysfunction with a doctor who can prescribe a drug containing an active substance such as testosterone, bromocriptine, trazodone, apomorphine, yohimbine or the above-mentioned preparations.

Side effects

The most common side effects of these medicines are headache, back pain, palpitations, nausea, vomiting and muscle aches.

Herbs supporting potency and libido disorders

increasing the synthesis of NO: ginseng root (Ginseng radix), yohimba bark (Yohimbe cortex), maki root (Lepidium radix),
increasing blood flow in the genitals: ginkgo leaf (Ginkgo bilobae folium)

Recommended preparations:
(the same active substance exists under several trade names)

Sildenafil:
Naxigra
Falsigra
Inventum
Lekap
Maxon
Sildenafil Avtavis
Sildenafil Bluefish
Sildenafil Ranbaxy
Viagra

Vardenafil:
Levitra
Vardenafil Accord
Viavardis

Tadalafil:
Tadalafil Aurovitas

Avanafil:
Spedra

Literature:

1.Pharmacodynamics, Volume 1, a textbook for Students of Pharmacy
2.Characteristics of medicinal products
3.J. Dobruch, A. Borówka, Physiology of penile erection, Przegląd Urologiczny

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