Treatment of impotence

Posted by Arlinda Won on November 24th, 2020

Currently, there are 5 groups of methods for treating erectile disorders:

1. Psychotherapy and sex therapy, which is used only for so-called psychologically conditioned or psychogenic ED, less often as an auxiliary method for somatic or organic ED.

2. Reception of tableted drugs or pills for erection: Viagra, Cialis, Levitra. It is used as a first-choice treatment (first-line therapy) for all forms of organic ED, regardless of its causes.

3. Injectable pharmacotherapy or "erection on request". It is used as a second-line therapy for all forms of ED in cases where erection pills do not give the desired effect or their use is contraindicated. Erection pills and injections of vasodilators into the penis can be used simultaneously as a combination treatment for impotence.

4. Vacuum erector therapy or the use of various models and modifications of vacuum erectors to obtain or maintain an erection. It is a type of second-line therapy for organic and less often psychogenic forms of ED.

90% efficiency.

• There is no need to use drugs with side effects.
• Non-aggressive treatment method.
• Helps to create an erection while keeping all the precautions.

5. Surgical methods of treatment: operations on the vessels of the penis and falloprosthetics. The first group of interventions is subdivided into operations on the veins (limiting venous outflow) and arteries (increasing arterial inflow) of the penis. Vein surgery can be used effectively in selected cases of ED, especially when combined with erection pills. Operations on the arteries are ineffective and are used less and less. Falloprosthetics is the most effective and radical of all types of impotence treatment, the only method that provides a complete cure for organic ED. Surgical methods, as a rule, are used only in those cases of organic ED, when conservative therapy has failed.

So, erection pills are the first line therapy with which most often the treatment of any form of impotence begins. Viagra, Cialis and Levitra are today the only tablets available in the world that have real effectiveness in the treatment of impotence. The effectiveness of all other advertised pills, as a rule, is invented (and at the same time absolutely not proven) by their manufacturers and is no different from a dummy.

How do erection pills work? Are they harmful? Is the addiction to erection pills developing? What are the side effects and contraindications? What are the known drug interactions?

Viagra, Cialis and Levitra have exactly the same mechanism of action and are selective (selective) inhibitors of the activity of the enzyme - phosphodiesterase type 5 (PDE). This enzyme, in turn, inhibits the production of cyclic guanosine monophosphate (CGMP) in smooth muscle tissue, which is formed from guanosine monophosphate (GMP) under the action of nitric oxide (NO). The main function of CGMP is to relax the smooth muscles of the cavernous (cavernous) bodies of the penis. When the action of PDE is inhibited, a much larger amount of CGMP accumulates in the corpora cavernosa, their smooth muscles relax much better and a significantly larger amount of blood rushes to the penis, which causes an erection.

The drugs of this group act selectively in the vascular tissue of the penis and are practically harmless. They do not cause persistent negative effects with prolonged and regular use. Any addiction to erection pills does not develop, except for a purely psychological dependence. Once having tried an erection pill and having experienced its much better quality, feeling again lost sensuality, a man sometimes does not want to give up Viagra, Cialis or Levitra.

The main side effects of Viagra. Cialis and Levitra

• Headaches
• Flushing of the face
• Nasal congestion (rhinitis)
• Nausea and stool disorders (dyspepsia)
• Back pain
• Visual disorders (color vision)

The frequency of side effects depends on the dose of the drug and individual sensitivity. It also depends on food intake before using erection pills. On a full stomach, the frequency of side effects, as well as the effectiveness of drugs, is lower.

An absolute contraindication to taking erection pills is their intolerance (allergy) and the simultaneous intake of organic nitrates (Nitroglycerin, Sustak, Nitrong, Nitrosorbid, Erinit, etc.). With the simultaneous administration of erection tablets and organic nitrates, a fatal decrease in blood pressure can occur. It is highly undesirable and potentially dangerous to prescribe erection pills from the PDE inhibitor group to patients with the following diagnoses:

• Ischemic heart disease with frequent attacks of chest pain.
• Congestive heart failure and a significant decrease in blood pressure.
• Significant decrease in cardiac output.
• Complex complex drug therapy of hypertension.
• Drug therapy that can slow down the elimination of PDE inhibitors from the body.

The described cases of deaths associated with taking Viagra were most often due to the joint use of this drug with organic nitrates.

Such drugs as ketoconazole and erythromycin inhibit the elimination of PDE inhibitors from the body. Persons taking these drugs are advised to reduce the dose of erection pills or to abstain from them altogether. Significantly enhances the effectiveness of erection pills, especially in people with hypogonadism or male menopause (andropause), the simultaneous use of male sex hormones (testosterone).

What is the effectiveness of erection pills and can they completely get rid of ED?

The effectiveness of PDE inhibitors for various forms of ED is, according to various clinical studies, from 60 to 85%. The tablets are designed to be taken before each sexual intercourse, that is, after taking the pill, the erection improves, without the pill the erection will be the same as it was recently before the start of treatment. In recent years, there have been reports that regular daily intake of relatively small doses of erection pills for at least 12 weeks has a certain healing effect, that is, it improves the quality of one's own natural erections. To enhance the effect of PDE inhibitors are used in conjunction with male sex hormones, injections of vasodilators into the penis, operations to limit venous outflow from the penis.

What to do if erection pills don't work?

In such cases, under the supervision of a physician, it makes sense to try second-line therapy or injections of vasodilators into the penis. If this does not help, it is recommended to resort to one of the surgical options. It should be remembered that falloprosthetics has the highest efficiency among all methods of treating impotence.