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Erectile Dysfunction Drugs
Natural treatment can support erectile function by improving overall health. Erectile dysfunction due to vascular disease may readily respond to nutritional changes and herbal support.
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The key, she says, is in the intentionality. "You have to go into it with the attitude of 'playing,' not fixing your sex life. It's all in the intentionality," Foley tells WebMD.
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Hormonal Testing and Pharmacologic Treatment of Erectile Dysfunction: A Clinical Practice Guideline From the American College of Physicians
Most physicians suggest that treatments proceed from least to most invasive. For some men, making a few healthy lifestyle changes may solve the problem. Quitting smoking, losing excess weight, and increasing physical activity may help some men regain sexual function.
Treatments for erectile dysfunction in 2004 include:
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The results suggest it is likely that the two disorders share common mechanisms, said lead author Xiang Gao, MD, PhD, instructor at Harvard Medical School, associate epidemiologist at Brigham and Women's Hospital and research scientist at the Harvard School of public health in Boston, Mass.
When the penis is inflated, the prosthesis makes the penis stiff and thick, similar to a natural erection. Most men rate the erection as shorter than their normal erection; however, newer models have cylinders that may increase the length, thickness, and stiffness of the penis.
Viagra undoubtedly represents a very significant advance in the treatment of erectile dysfunction, but like most drugs it is not without its cautions, contraindications and potential side effects, etc.
"I see a lot of HIV patients that have erectile dysfunction, which is due to neuropathy," Sharlip says. "The virus causes neuropathy, and the antiviral agents that are used for treatment also themselves cause neuropathy."
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Beware of commercial claims of what herbal products can do. Look for scientific-based sources of information.
"Before I would put my money in a vaccine, I would want to think about some of the dietary things people can do," Mason added.
As part of a new screening program to find natural alternatives to Viagra, the study authors analyzed a number of herbal extracts long used for male impotence, including Ferula hermonis or Lebanese Viagra; Cinnamomum cassia or Chinese cinnamon; as well as Epimedium brevicornum aka horny goat weed. All three extracts are reputed to improve sexual performance.
Anxiety, depression and other emotional issues can lead to premature ejaculation. For these issues, seeking the help of a psychologist, psychiatrist or sex therapist may be helpful. Couples therapy may also help if relationship problems are the cause of premature ejaculation.
Vascular function within the penis can be evaluated with duplex ultrasonography. Patients are administered an intracavernosal test dose of a standard vasodilator, such as 20 mcg of prostaglandin E1 (PGE1), and the cavernosal arteries within the corpora are measured before and after the injection. A normal response indicates a peak systolic velocity of 0.35 m/s or more and an end diastolic velocity of -0.04 m/s or less. This is interpreted as adequate arterial blood flow (good peak systolic velocity) without evidence of a venous leak (end diastolic velocity below zero).
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Blood tests can indicate conditions that may interfere with normal erectile function. These tests measure hormone levels, cholesterol, blood sugar, liver and kidney function, and thyroid function. Excess prolactin (hyperprolactinemea) can lower testosterone levels, which can diminish libido. Both of these levels are measured, as well as levels of other sex hormones. If they are persistently low, an endocrinologist (hormone specialist) should be consulted.
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The average wholesale price of alprostadil for transurethral administration ranges from $118.50 for six of the 125-g suppositories to $143.25 for six of the 1,000-g suppositories.12 Dosage is initially 125 to 250 g, with adjustment up or down as indicated. However, in the study cited above,15 few patients responded to less than 500 mg. The treating physician should determine the minimal effective dose. The drug is available in 125-, 250-, 500- and 1,000-g suppositories. More flexibility is available with this form of alprostadil because it can be used twice in a 24-hour period.16
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