Erectile dysfunction

Drug therapy for erectile dysfunction

One drug in particular, sildenafil ("Viagra"), has become an international phenomenon since its launch in the late 1990s because it’s one of the first drugs to offer a relatively simple safe drug treatment that helps the majority of men with erectile dysfunction – at least 70 per cent report improved erections. The drug does not directly give a man an erection but it works by boosting the natural mechanism that leads to an erection. When a man is sexually aroused, certain tissues in his penis relax, allowing blood to flow in and fill the penis. Viagra helps by elevating the levels of the chemical that causes the tissues to relax. These effects were discovered accidentally. The drug was originally developed to improve blood supply to the heart in angina sufferers.

In a small number of cases, people who have taken sildenafil have complained of headaches, flushing and stomach-ache. It can also cause some visual problems, including an increased sensitivity to light, blurred vision or an inability to tell the difference between blue and green. Men who are already taking medicines that contain nitrates, such as nitro-glycerine (usually for angina or heart disease), are strongly advised not to use Viagra as this is dangerous and may result in a heart attack.

Other similar drugs are tadalafil ("Cialis") and vardenafil ("Levitra").

Penile injections: The injection of drugs such as alprostadil directly into the tissues of the penis to trigger an erection was more common before the advent of new drugs such as sildenafil. The drugs relax muscles and increase blood flow to create an erection. They are also available as pellets to insert in to the urethra (the opening at the tip of the penis).

Vacuum Devices: These work by creating a partial vacuum around the penis, which draws blood into the organ. The devices have three components: a plastic cylinder, into which the penis is placed; a pump, which draws air out of the cylinder; and an elastic band, which is placed around the base of the penis to maintain the erection after the cylinder is removed and during intercourse.

Surgery: There are different types of surgery. Implanted devices, known as prostheses, can restore erection in many men. These can come in different forms. For instance, paired rods can be inserted into the corpora cavernosa to enable the user to manually adjust the position of the penis. Alternatively, inflatable cylinders can be inserted inside the penis and expanded using pressurized fluid. In some cases doctors may attempt to repair blockages in damaged arteries. However, this usually only works if the blockages are not widespread.