Erectile dysfunction is an issue that affects many men. It consists of having trouble getting or maintaining an erection. Many patients find it difficult to discuss this topic due to embarrassment. In the pharmacy, we have a special sensitivity for discussing such delicate topics and referring affected patients to medical professionals. Those affected by erectile dysfunction show many signs of dissatisfaction, insecurity, stress, and psychological problems that affect their relationships and daily life.
As we have indicated, the main symptom of erectile dysfunction is a persistent problem in getting or maintaining an erection. It is usually related to diabetes, heart disease, or other health problems. The cause lies in a problem with male sexual arousal, which is a process involving the brain, hormones, emotions, nerves, muscles, and blood vessels. Sometimes physical and psychological causes combine. In the case of psychological causes, the most frequent ones are stress and anxiety. In many cases, it is due to physical factors such as heart disease, high cholesterol, high blood pressure, diabetes, obesity, atherosclerosis, alcohol abuse, low testosterone, surgery, sleep treatments, or metabolic syndrome.
For more than 20 years now, there have been very good treatments, such as the use of selective reversible PDE5 inhibitors. The first one to be marketed was Sildenafil, whose brand name is Viagra. But there are others, such as Tadalafil (Cialis) or Vardenafil (Levitra).
Interestingly, Sildenafil was initially designed to treat high blood pressure and angina pectoris. During clinical trials, they realized that it had a very mild effect on angina pectoris and produced notable erections as a side effect. They then decided to market it for erectile dysfunction.
As we have mentioned, they are selective reversible PDE5 inhibitors that maintain a high level of cGMP, dilate the blood vessels in the penis, and consequently, an erection occurs.
In the case of Sildenafil (Viagra), it must be taken 60 minutes before sexual activity, and it remains in the body for 4 hours. Tadalafil (Cialis) works much faster, as it acts within the first 30 minutes and remains in the body for more than 24 hours. In the case of Vardenafil (Levitra), it should be taken approximately 25 to 60 minutes before sexual activity. In all three cases, it should NOT be consumed daily, nor more than once a day.
All these medications must be prescribed by a doctor. They are only effective if there is visual or physical stimulation. Caution must be exercised if you are allergic to sildenafil, if you are taking nitrates to relieve angina pain, if you are taking riociguat, if you have a serious heart or liver problem, or if you suffer from retinitis pigmentosa or vision loss due to non-arteritic anterior ischemic optic neuropathy (NAION).