Erectile Dysfunction
Erectile dysfunction can encompass several different conditions of reproductive health and sexual dysfunction. It is a very common condition, but is also a very emotional and sensitive topic to discuss. Erectile dysfunction is defined as the inability to maintain an erection sufficient for sexual intercourse.
Achieving an erection is a complex process involving the brain, hormones, nerves, muscles and blood circulation. If something interferes with this process, the result may be erectile dysfunction. In some cases, erectile dysfunction is the first sign of other serious underlying health conditions, such as cardiovascular problems, that need treatment because erectile dysfunction can share the same risk factors for heart attacks and strokes.
How common is Erectile Dysfunction?
About 5 percent of men that are 40 years old have complete erectile dysfunction, and that number increases to about 15 percent of men at age 70. Mild and moderate erectile dysfunction affects approximately 10 percent of men per decade of life (i.e., 50 percent of men in their 50s, 60 percent of men in their 60s). Erectile dysfunction can occur at any age, but it is more common in men that are older. Older men are more likely to have health conditions that require medication, which can interfere with erectile function. Additionally, as men age, they may need more stimulation to get an erection and more time between erections.
Three Components of Male Sexual Function
There are three essential components of male sexual function:
Interest and desire for sexual activity (libido)
The ability to obtain and maintain an erection
Ejaculation and climax (orgasm)
During your consultation, your provider will help to differentiate which components of the male sexual function are affected. This is an important step because treatment options for differ depending on the affected components. There are many possible causes of erectile dysfunction including physical, psychological, and medication-induced. We work with you to figure out the underlying cause and then determine the best option(s) for treatment.
How do ED medications work?
Most men are familiar with ED medications like Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) because they have been available since the 1990s and have been heavily marketed by the pharmaceutical companies that make them. The oral medications are a great first option for guys who want to improve their erectile function and they work well for many men. These ED medications all work to help you achieve an erection when they are taken before engaging in sexual activity.
All of these ED medications work by the same mechanism but they do vary in how long their effects last and their effectiveness for individual men. The pills increase the amount of nitric oxide present in erectile tissue when it is released by penile nerve endings during sexual stimulation. Nitric oxide causes blood vessels to dilate which increases blood flow into the erectile tissue, producing an erection. The drug’s effect wanes as it is metabolized in the body. The effects of sildenafil and vardenafil last about the same amount of time (approximately 1-3 hours) while those of tadalafil persist much longer (about 36 hours). Not all men experience the same results from each of the medications with many men finding that one works better for them while another may have little effect.
What are the side effects of ED medications?
As with most medications, there can be side effects from using these pills. The vast majority of men experience mild side effects or none at all but in men with high blood pressure, and especially those who take nitrate medication to treat coronary artery disease, the oral medications can lead to a dangerous drop in blood pressure and potentially even a heart attack. In rare cases, the use of these medications can result in an erection that lasts too long and needs to be treated as a medical emergency. We will determine the best medication and dosage for you with the least risk of side effects.
What is the cost of ED medications?
Health insurance plans do not always cover the cost of these medications, or they are covered only in limited quantities. Fortunately, most of them have become available as generics in the last few years which has greatly reduced the cost of using them. At Men’s Health, I am always happy to work with my patients to find the best prices for the ED medications I prescribe.
What are other treatment options for ED?
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