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Erectile dysfunction and the drugs to treat it

In many cases, medications are all a man needs to stay sexually active.

Erectile dysfunction (ED) affects almost 70% of men ages 70 and older. Fortunately, treatment is often just a matter of taking a pill. “We usually start with oral medications, and they’re effective in about 50% of the cases,” says Dr. Michael O’Leary, a urologist at Harvard-affiliated Brigham and Women’s Hospital and editor of the Harvard Special Health Report What To Do About Erectile Dysfunction.

Why it happens

ED is diagnosed when a man has difficulty attaining and sustaining an erection sufficient for sexual intercourse. Causes include stress, depression, an enlarged prostate, clogged arteries, obesity, smoking, and nerve damage resulting from diabetes, multiple sclerosis, or Parkinson’s disease.

Medication side effects may also lead to ED. Common culprits include blood pressure drugs, antidepressants, tranquilizers, and even over-the-counter painkillers such as aspirin, naproxen, ibuprofen, and acetaminophen.

SEX at what COST?

ED drugs are effective but costly. Prices range from $12 to $36 per dose. However, many health insurance plans cover them, although most have a limit of four pills per month. Larger prescriptions of ED drugs may be covered by insurance if ED is also accompanied by benign prostatic hyperplasia (an enlarged prostate).

Photo: Thinkstock

Treatment

Prescription medications are the first line of treatment. You’ve probably heard of sildenafil (Viagra), approved in 1988. Since then, the FDA has approved similar drugs, including vardenafil (Levitra, Staxyn), tadalafil (Cialis), and avanafil (Stendra). An erection occurs when changes in the blood vessels to and from the penis temporarily let more blood in and less blood out—so the penis swells. The prescription drugs all enhance these blood vessel changes.

What’s the difference among the medications? Timing. Most last four to 12 hours. Cialis works for up to 36 hours. All of the drugs need to be taken about an hour before activity, but some may work in half an hour or less, such as Levitra and Staxyn. None is an aphrodisiac. “You don’t just take a pill and wait for an erection. You have to have proper stimulation for the drug to be effective,” says Dr. O’Leary.

The drugs may have some side effects such as headache, flushing, upset stomach, and nasal congestion. Very rare side effects are vision and hearing loss. And not everyone is a candidate for ED medications. Men taking nitrates or those with unstable cardiovascular disease should not use them.

For best results

No matter which ED medication your doctor recommends, you should take the pill on an empty stomach. “If you have a belly full of food, it’s hard for the medication to get absorbed,” explains Dr. O’Leary. He also says excessive alcohol use may reduce the effectiveness, although a glass of wine won’t have an impact. And if the medication doesn’t work the first time you try it, he suggests trying it a few more times on other occasions before moving on to other options such as injections, implants, counseling, vacuum devices, or surgery.

Remember, too, that lifestyle change can help relieve ED. Try exercising, losing weight, quitting smoking, limiting alcohol intake, and eating a healthy diet. 

Posted by: Dr.Health

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