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Impotence Drugs

When a man has erectile dysfunction (ED), he cannot achieve or maintain a firm erection. ED is also called "impotence." About one in every ten men has ED or some degree of impotence.

Most erectile dysfunction has a physical cause. The side effects of diabetes and prostate cancer treatment can reduce or prevent blood flow and nerve impulses to the penis. So can pelvic injury and the side effects of drugs. Only about 10% of impotence has a psychological cause.

Almost all impotence can be treated. Among all forms of treatment, drug therapy has become the most popular.

How Viagra, Cialis & Levitra Drugs Cause An Erection

Sildenafil, widely known as Viagra, is the main drug used to treat ED. It is one of the most popular drugs in recent history. Viagra treats erectile dysfunction by increasing the capability for blood flow to the penis. Recently, new “impotence drugs” called Cialis and Levitra have been announced.

All three of these drugs are known as "PDE5 inhibitors." How does a PDE5 inhibitor work?

Your brain responds to sexual stimulation by sending out nerve signals. These signals cause the release of a chemical called nitric oxide, which relaxes muscles in the penis to let more blood flow in and compresses the veins that normally carry blood away from your penis. More blood flows in and less flows out. This makes the penis hard and erect. Your body also contains an enzyme called PDE5, which reduces the effect of nitric oxide in producing an erection. A PDE5 inhibitor limits the release of nitric oxide, which temporarily restores the body's natural sexual response.

These drugs are unique because they only work when a man is sexually stimulated. Sexual stimulation is necessary for these drugs to help cause an erection.

Using Viagra To Treat Impotence

According to the manufacturer’s published literature, Viagra works best when taken on an empty stomach about an hour before attempting an erection. Unfortunately, this means that sexual intercourse often must be planned at least an hour in advance. This planning process can disrupt romantic spontaneity.

It is recommended that Viagra be taken only once every 24 hours. A man must be sexually stimulated for the drug to help him get an erection. If a man takes Viagra but does not have sex, his body naturally eliminates the drug over a 6-10 hour period.

The most common side effects are headache, facial flushing, and altered or blueish vision. For more information about side effects call your doctor.

Using Cialis To Treat Impotence

According to the Cialis European label, Cialis can be taken without regard to food. It should be taken prior to sexual activity. The efficacy of Cialis may persist up to 24 hours after the pill is taken. The Australian label states that efficacy may continue for up to 36 hours. The manufacturer claims that current trials indicate the drug may show a response in patients in less than 30 minutes.

The most common side effects are headache, dyspepsia/upset stomach, and back pain. If these symptoms occur, call your doctor.

Using Levitra To Treat Impotence

The manufacturer claims that Levitra stays effective for 5 - 6 hours and that the drug can take effect in as few as 15 minutes, but takes about 25 minutes for most men. The manufacturer says that you can take Levitra with or without food, but preferably not after a heavy or high-fat meal, as this may delay the effect.

The most common side effects are headache and facial flushing. For more information about side effects call your doctor.

Results From Using PDE-5 Inhibitors

Viagra works for about 60-70% of the men who take it. Early clinical data shows that the success rates from Cialis and Levitra will be similar. Combined with sexual stimulation, the drug may produce an erection.

PDE-5 inhibitors do not work as well for men with ED caused by prostate surgery, where the nerves and vascular system may be compromised. In one study, as reported by Novus Information Services, PDE-5 inhibitors helped restore potency in only 30% of men who had undergone a radical prostatectomy. With the drug, some prostate surgery patients only get a partial erection without acceptable rigidity. Sometimes the drug does not work at all.

A man who has been prescribed blood pressure or heart medications, also known as “nitrates,” should not use PDE-5-inhibitors. The following medical or physical conditions also make the use of these drugs inadvisable:

• Severe heart or liver problems.
  

• Recent stroke, heart attack or low blood pressure.
  

• Certain rare inherited eye diseases such as retinitis pigmentosa.
  

• Bleeding disorders or stomach ulcers.

A doctor must prescribe Viagra and other PDE-inhibitors. Certain prescription and over-the-counter drugs can interact with PDE-5-inhibitors. It is always important to tell your doctor about all the medications you are taking.

Viagra Results

Viagra works for about 60-70% of the men who take it. Combined with sexual stimulation, the drug gives the user a rigid and long-lasting erection.

Viagra does not work as well for men with ED caused by prostate surgery and diabetes, where the nerves and vascular system may be compromised. Some men only get a partial erection without acceptable rigidity. Sometimes the drug does not work at all.

A man who has been prescribed blood pressure medications should not use Viagra. The following medical or physical conditions also make the use of Viagra inadvisable:

• Severe heart or liver problems.
• Recent stroke, heart attack or low blood pressure.
• Certain rare inherited eye diseases such as retinitis pigmentosa.
• Bleeding disorders or stomach ulcers.

A doctor must prescribe Viagra. Certain prescription and over-the-counter drugs can interact with Viagra. It is always important to tell your doctor about all the medications you are taking.

PDE-5 Inhibitor Advantages

• Non-invasive.
• Easy to use.
• Safe with only some side effects (see above.)
• Must incorporate sexual stimulation for predictable and long-lasting erections.
• Allows more spontaneity than penile injections, urethral suppositories, or vacuum erection devices.
  

PDE-5 Disadvantages

• Erections may not be as rigid, predictable, or long lasting as desired.
• Takes time to work; a delay that can dampen spontaneity.
• High cost per dose.
• See side effects listed for each of the PDE-5-inhibitors above

Other Impotence Drugs

Alprostadil - This is the active medication in the urethral suppository known as MUSE. It also can be used for penile injection therapy.

Papaverine - May be used for penile injection therapy.

Testosterone supplements - These supplements can reduce impotence in some men who have low levels of natural testosterone. But only about 4% of men have this problem. Side effects may include fluid retention, prostate enlargement, and liver damage. Supplements can be administered orally, by patch, or by injection.

Yohimbine tablets - Yohimbine is an organic alternative that provides minimal positive results. Doctors occasionally prescribe this drug for intermittent erectile dysfunction. The drug can sometimes stimulate desire and improve the quality of the erection. Common in the early 1990's, yohimbine use has dropped greatly since Viagra was released.

A man takes Yohimbine three times per day for 4-6 weeks to test its effect. About 15-20% of users report some success. However, stopping the tablets may bring back impotence. There can also be side effects. These include headaches, sweaty palms, dizziness, and nausea.

Phentolamine - This drug is also used for penile injection therapy. A tablet form using phentolamine as an active ingredient was recently reviewed in clinical trials. Concerns about use of the tablet form have delayed introduction.

Oral Apomorphine - This is a sublingual (under the tongue) form of medication that affects the brain signals to the penis, versus the blood flow as in PDE5 drugs. Uprima™ is available outside the United States. Apomorphine offers a positive opportunity for patients who may have cardiovascular disorders such as hypertension and coronary artery disease, and therapy may include antihypertensives or nitrate medications. Early clinical data shows side effects are more prevalent than with Viagra; the most common side effects are headaches, nausea, and dizziness.