Erectile Dysfunction Medications
The doctor would like to provide a simple, step-by-step explanation for better understanding.
Erectile dysfunction (ED), also known as male sexual dysfunction, is a common condition among men. It is especially prevalent with increasing age or in individuals with certain underlying medical conditions such as diabetes mellitus, hypertension, and hyperlipidemia. Psychological factors, including stress, as well as declining hormone levels, may also contribute to this condition.
At present, several treatment options are available. One of the primary and widely used approaches with proven effectiveness is pharmacological therapy.
🩺 What are the main medications used to treat erectile dysfunction?
The first-line medications commonly prescribed by physicians are PDE-5 inhibitors (Phosphodiesterase type 5 inhibitors).
This class of medication works by increasing blood flow to the penis, thereby improving erectile function in response to sexual stimulation. These medications do not cause an automatic erection without sexual arousal.
Commonly used examples include:
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Sildenafil – brand name such as Viagra
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Tadalafil – brand name such as Cialis
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Vardenafil – Levitra
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Avanafil – Stendra
What is the mechanism of action of this class of medication?
During sexual stimulation, the body releases substances that cause blood vessels to dilate.
PDE-5 inhibitors work by inhibiting the enzyme phosphodiesterase type 5 (PDE-5), which normally breaks down cyclic guanosine monophosphate (cGMP), a substance responsible for promoting blood vessel relaxation.
As a result:
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The blood vessels in the penile tissue relax
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Blood flow to the penis increases
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Erections improve in firmness and are maintained for a longer duration
🩺 How do the medications differ from one another?
🔹 Tadalafil
Tadalafil is a well-recognized medication with a strong safety profile. Its key advantage is its prolonged duration of action, lasting approximately 24–36 hours.
Indications:
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Treatment of erectile dysfunction
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Management of symptoms associated with benign prostatic hyperplasia (BPH), such as urinary frequency, weak urinary stream, and nocturia
Tadalafil can be prescribed in two dosing regimens:
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Taken as needed prior to sexual activity
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Taken as a low-dose daily medication
⚠️ Sexual stimulation is required for the medication to be effective.
🔹 Sildenafil
Sildenafil is a well-known medication, commonly recognized under the brand name Viagra.
Indications:
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Helps achieve and maintain an erection in response to sexual stimulation
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Also used for the treatment of pulmonary arterial hypertension (under a different indication and dosage regimen)
Sildenafil is typically taken approximately 30–60 minutes before sexual activity.
Do medications in this group have side effects?
Some side effects may occur, including:
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Headache
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Facial flushing or a sensation of warmth
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Nasal congestion
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Mild palpitations
These symptoms are typically temporary and tend to resolve on their own.
Are there any contraindications or precautions?
❗ Important warning
These medications must not be used in combination with nitrate medications (nitrates), such as nitroglycerin, which is commonly prescribed for chest pain related to heart disease. Concomitant use may lead to a severe and potentially dangerous drop in blood pressure.
Individuals who should consult a physician before use include:
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Patients with cardiovascular disease
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Individuals with either high or low blood pressure
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Those with multiple underlying medical conditions
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Anyone uncertain whether their physical health is adequate for sexual activity
🩺 What should be done if testosterone levels are low?
In some patients, physicians may find abnormally low testosterone levels upon evaluation.
In such cases, androgen replacement therapy may be considered. This treatment is appropriate only for individuals with clearly diagnosed testosterone deficiency.
Forms of hormone replacement therapy include:
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Oral medications
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Injectable formulations
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Topical gels or creams
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Transdermal patches
Hormone therapy must always be administered under close medical supervision.
🩺 Summary from the Doctor
Erectile dysfunction is a treatable medical condition and should not be considered a source of embarrassment.
PDE-5 inhibitors are the first-line treatment option, known for their effectiveness and safety. However, the choice of medication, appropriate dosage, and method of use should always be individually assessed by a physician.
If you have any questions or concerns, it is recommended that you seek a direct medical consultation to ensure the most appropriate and safe treatment.