Category: Erectile Dysfunction

The first PDE5 inhibitor to hit the market was Viagra, which won FDA approval in 1998. Its active ingredient is sildenafil. Pfizer, the drug’s manufacturer, discovered its ability to facilitate erections by accident while testing a sildenafil compound for the treatment of angina and high blood pressure. While it was only minimally successful at easing the symptoms of angina, the drug readily induced erections in many of the test subjects.

Introduced in 2003, Cialis (tadalafil) was the next PDE5 inhibitor to reach the market. As originally marketed, the pill was longer lasting than Viagra, retaining its effectiveness for up to 36 hours. Five years later, a lower-strength formulation of Cialis came to market. Available in 2.5- and 5-milligram tablets, Cialis for Daily Use is taken daily so that users can achieve an erection whenever the time is right.

Rounding out the family of PDE5 inhibitors are Levitra (vardenafil), which also debuted in 2003; orally soluble Staxyn (vardenafil), approved in 2010; and Stendra (avanafil), approved in 2012.

There is no way that a “complete list” of ED statistics could be presented here or in any other forum with limited space. And “complete list” would seem to imply data from every conceivable health and medical authority across the globe. What we can give you is the data developed from one of the most exhaustive ED studies ever undertaken in the United States.

This study was published in a 2006 issue of “Archives of Internal Medicine” and based its findings on ED-related questions that were posed to 3,566 men who were 20 years or older. It found that ED affects roughly one in every five men over the age of 20 but had a somewhat higher overall rate among Hispanic men. The incidence of ED increased sharply among elderly men, affecting 77.5 percent of those who were 75 or older.

Based on the data collection in this study, the risk of ED increased significantly among men who had one of the following pre-existing conditions: diabetes, obesity, current smoking, and high blood pressure.

Among the medications prescribed for the treatment of erectile dysfunction, the first line of drugs are the so-called PDE5 inhibitors, which include Viagra, Cialis, Levitra, Staxyn, and Stendra. All of these are oral medications designed to be taken 30 minutes to an hour before sexual activity. They work by temporarily blocking the effects of an enzyme known as phosphodiesterase-5, which tends to impede blood flow to the penis and make it difficult to achieve an erection.

The other main category of prescription ED medications covers the drugs that are directly injected into the penis. Like the PDE5 inhibitors, these drugs are designed to maximize blood flow to the penis. They do so by dilating or widening the blood vessels that supply your penis and generally take effect within 5 to 10 minutes after the injection. Medications in this category include the generic injectables alprostadil, papaverine, and phentolamine and brand name drugs that contain one or more of these generics. Brand name medications include Caverject (alprostadil), Pavabid (papaverine), Bimix (alprostadil and papaverine), and Trimix (alprostadil, papaverine, and phentolamine).

If other forms of therapy have been unsuccessful in resolving your erection difficulties, your doctor might refer you to a urological surgeon for a surgical procedure. According to eMedicineHealth.com, such procedures usually are undertaken to accomplish one of three goals:

Implantation of a prosthetic device in the penis. Such a device is usually either malleable or inflatable. With a malleable prosthesis, the man can physically manipulate his penis into an erect or semi-rigid position suitable for intercourse. For an inflatable prosthetic, two cylinders are implanted within the penis along with a reservoir placed beneath the tissue of the lower abdomen and a pump device in the scrotum. When the pump is activated, it draws fluid from the reservoir to fill up the penile cylinders, thus creating an erection.

Reconstruction of the arteries within the penis to increase blood flow, thus making it easier to achieve erection.

Blocking off veins within the penis that carry blood away, thus allowing an erection to be maintained.

It depends on exactly what you mean by “erection pills.” Like most American pharmacies, CVS can sell you prescription impotence medications, such as Viagra, Cialis, or Levitra, providing you have a prescription from your doctor. Perhaps as early as 2017 or 2018, you may be able to buy an over-the-counter version of Cialis from CVS and other U.S. pharmacies if the FDA approves Sanofi’s proposal to market Cialis OTC under a licensing deal with Eli Lilly & Company.

If by erection pills, you’re thinking of natural remedies, most CVS stores as well as other U.S. pharmacies have a section of the store devoted to dietary and health supplements, some of which have been reputed to help overcome erectile dysfunction. These substances, mostly plant-based in origin, can be purchased over the counter. Supplements that fall into this category include Panax ginseng and Rhodiola rosea.

For a number of men, penile injection therapy helps them to successfully overcome their problems of erectile dysfunction. Although a urologist or other specialist may perform the first few of these injections, primarily so the optimal level of dosage can be determined, you will eventually be doing these injections yourself if you find this therapy works for you.

Some of the most widely used medications used for these injections are Caverject (alprostadil), Pavabid (papaverine), Bimix (alprostadil and papaverine), and Trimix (alprostadil, papaverine, and phentolamine). The cost of these injections varies based on the medication used, the dosage required to achieve erection, and the part of the country in which you’re located. Five 20-microgram syringes of Caverject cost roughly $190, or $38.50 per injection.

According to eMedicineHealth.com, most insurance plans cover injections of alprostadil, which in one study of 683 men with ED produced erections suitable for intercourse in more than 90 percent of the subjects. However, Trimix — a combination of three medications — is not covered by most insurance plans.

According to Drugs.com, Adderall is a central nervous stimulant that’s most often prescribed to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy, a sleep disorder that causes extreme sleepiness and occasional daytime sleep attacks. The drug contains a combination of amphetamine and dextroamphetamine, both strong stimulants.

Although WebMD lists the inability to have an erection as an infrequent side effect of Adderall, it seems that a surprisingly large number of men are reporting that they’ve experienced difficulties achieving an erection after taking Adderall for an extended period of time. In one of life’s cruelest ironies, amphetamines tend to increase sexual desire but typically cause erectile dysfunction, according to the Merck Manual.

A quick check of forum posts on this issue shows that many individuals who have been prescribed Adderall for ADHD find that the problem tends to ease after they’ve been on the drug for a while. And some say that their erections while taking Adderall are not as strong as they were previously.

It’s almost certain that you will experience some degree of erectile dysfunction in the first few months after prostate surgery — even nerve-sparing procedures — or radiation treatment for prostate cancer, according to the Prostate Cancer Foundation. The foundation says the explanation for this is fairly simple: “The nerves and blood vessels that control the physical aspect of an erection are incredibly delicate, and any trauma to the area will result in changes to the natural order.”

But don’t give up hope. PCF says that within one year after treatment many men with intact nerves will see significant improvement in their ability to achieve an erection. Roughly 40 to 50 percent of men who’ve undergone nerve-sparing radical prostatectomy will have returned to their pre-treatment function. That number grows to nearly 60 percent with two years of treatment.

Using Viagra, Cialis, or another prescription impotence medication can help the vast majority of men who’ve undergone nerve-sparing radical prostatecomy to successfully achieve erections, according to PCF.

If it’s good for your heart, it’s good for your penis. We’re not sure who to credit for this bit of wisdom, but it’s true. Because strong blood flow to the penis is necessary to achieve and maintain an erection, anything that improves blood flow throughout the body benefits both your heart and your penis. And exercise is no exception.

The Cleveland Clinic cites a number of epidemiological studies that show a link between diabetes, high blood pressure, high cholesterol, obesity, and heart disease. Lifestyle changes, such as beginning a routine of regular physical activity and eating a healthy diet, can reduce some of these risk factors and thus make it far less likely that you’ll fall victim to either heart disease or ED.

Just what form of exercise or physical activity is best for you should be decided in consultation with your doctor. Brisk walking for 20 to 30 minutes daily or using the treadmill at your gym can be a good start.

Antidepressants may lift your spirits, but in doing so they can make it more difficult for you to achieve an erection. It’s a cruel irony. Depression itself causes sexual dysfunction, but a common side effect of almost all classes of antidepressants is erectile dysfunction, according to JohnsHopkinsHealthAlerts.com.

Fortunately, the incidence of ED varies depending on the antidepressant you’re taking. In a study published in the “Journal of Clinical Psychology,” researchers found that 37 percent of those taking antidepressants experienced sexual dysfunction. The lowest rates of sexual side effects occurred among those taking Wellbutrin (22 percent) and Wellbutrin SR (25 percent).

Moderate rates — 30 to 40 percent — of sexual dysfunction were observed among those taking Celexa, Prozac, Effexor, Effexor SR, and Zoloft. Sexual side effects were highest — above 40 percent — among those taking Remeron and Paxil.

On the brighter side, a study published in JAMA showed that Viagra improved symptoms in more than half the men with antidepressant-induced ED.