The details of your sex life are one of the most intimate and private things you hold in life. Anything that interferes with these moments, such as erectile dysfunction, can lead to a litany of problems. Sharing these difficult topics with a professional may seem even more dubious.
You’re not alone. Erectile dysfunction affects 30 million Americans, and, thanks to medical advancements, many treatment options exist if you can’t consistently get or maintain an erection. We took a more detailed look at the various medications and alternative treatment methods available to get your sex life back on track.
What Causes Erectile Dysfunction?
Erectile dysfunction is one of the most common men’s health concerns. Sometimes the cause is as simple as old age. But, for many men, erectile dysfunction isn’t a primary medical condition, meaning it’s a symptom of another underlying issue. For example, issues with your vascular system may not provide enough blood flow to your penis to enable an erection.
Certain heart problems link back to genetics and family history, but external factors, such as being overweight, can raise the risk for vascular disease and diabetes — two major causes of erectile dysfunction. Hypertension and side effects from certain medications can also lead to erectile dysfunction. You can also experience erectile dysfunction after suffering from a brain or nerve injury that disrupts the signals sent to your penis.
As much as erectile dysfunction is physical, your mental health plays a role, too. Neurotransmitters, such as serotonin, dopamine, and norepinephrine, control your mood and stress levels.
Anxiety and depression occur when your brain has lower levels of these neurotransmitters. Depending on your mood, you may not be able to have or maintain an erection. Rumination over these thoughts can lead to performance anxiety.
Erectile Dysfunction Medications
If you’ve watched television at any point during the last few decades, you’re likely familiar with erectile dysfunction medications from the commercials. Or maybe you know them from that all-too-familiar bottle of blue pills. Avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn) are phosphodiesterase 5 (PDE5) inhibitors that block the release of PDE5 from happening too quickly. In turn, the muscles in your blood vessels relax and help increase blood flow to your penis to start and keep an erection.
In general, you can take these drugs with or without food, although sildenafil and vardenafil are most effective on an empty stomach. Of the four medications, avanafil works the fastest, according to Harvard Health. Drug interactions differ from person to person, but here’s a general summary of how each medication works in your body:
- Avanafil — Works in 15-30 minutes; lasts up to 6-12 hours
- Sildenafil — Works in 30-60 minutes; lasts up to 4-5 hours
- Tadalafil — Works in 30-45 minutes; lasts up to 24-36 hours
- Vardenafil — Works in 30-60 minutes; lasts up to 4-5 hours
Erectile dysfunction medications hit the mainstream drug market in 1998 almost by accident. Drug researchers initially studied sildenafil to treat high blood pressure and angina (chest pain from heart disease). The results were ineffective, but the drug carried one notable outcome: the ability to produce and keep erections.
Once the drugs became more widespread, consumers bought into the hype as a way to solve their performance issues. The one drawback was price, although that issue went away in 2017 when generic versions of Viagra hit pharmacies and drug stores. Now, you can get a 30-day script of 25-mg sildenafil tablets for as low as $20 using your Community Cares Rx Prescription Discount Card.
Erectile dysfunction medications aren’t magic pills. They don’t work for everyone and certain factors, such as food or alcohol, can limit their benefits. You should also know taking a pill alone won’t produce an erection — you must receive stimulation for it to work.
Consult with your doctor before starting any erectile dysfunction treatment plan. Certain medications can adversely react with nitrates such as nitroglycerin (Nitrostat), isosorbide mononitrate (Monoket), and isosorbide dinitrate (Isordil). Problems may also occur if you have hypotension, hypertension, or issues with your liver or kidneys.
Drugs That Cause Erectile Dysfunction
It’s easy to turn to erectile dysfunction medications to help solve your problem. However, certain medications can actually serve as the root of the problem. Side effects from these drugs cause about 25% of erectile dysfunction cases, according to Harvard Health.
Taking these medications are necessary to treat major medical conditions, but they can come with a price. Many of these drugs decrease blood flow, which is why erectile dysfunction is a common side effect.
Certain high blood pressure medications are the main offenders. Beta blockers, thiazide diuretics such as chlorothiazide (Diuril), chlorthalidone (Thalitone), and hydrochlorothiazide (Aquazide H); and loop diuretics such as furosemide (Lasix), torsemide (Demadex), and ethacrynic acid (Edecrin) can cause erectile dysfunction as a side effect because they decrease blood flow and limit zinc levels needed for testosterone production. Not all blood pressure medications cause erectile dysfunction, though. Alpha blockers, ACE inhibitors, and angiotensin-receptor blockers are generally safe to take.
Antidepressants, antihistamines, antipsychotics, anticholinergics, anti-androgens, anti-ulcer drugs, opioids, and some anticancer drugs can also cause erectile dysfunction. If you fall into any of these categories, check with your doctor about changing medications or your current dosage.
Lifestyle Changes to Make
While medications are a common fix, it’s important to remember erectile dysfunction medications often treat the issue associated with the problem, not the problem itself. It would be like your car leaking oil and fixing it with an oil change. It may solve the short-term issue, but it doesn’t address the overarching problem.
You can get out in front of erectile dysfunction with simple lifestyle changes. For starters, a modified diet and increased exercise can help since diabetes and obesity often lead to erectile dysfunction. Excess fat leads to increased estrogen levels that can impact your testosterone. You may also see a noticeable change in your ability to get an erection by quitting smoking.
Make sure you track your vascular health. Damage to your arteries will impact blood flow to your penis. While you may not think that extra slice of cake or second helping of french fries can disrupt your sex life, high blood pressure, high cholesterol, and high blood sugar can all lead down an unwanted path to erectile dysfunction.
Alternative Erectile Dysfunction Remedies
Your doctor is there to assist you when mediation or lifestyle changes don’t solve erectile dysfunction. Here are some additional remedies:
Vacuum Erection Device
Just as it sounds, you place a Vacuum Erection Device (VED) over the penis and use air suction to pull blood into the penis and form an erection. The device comes with a hand pump that delivers air through a hose. You’ll also place an elastic band around the base of the penis to prevent blood from escaping and losing the erection.
Don’t confuse a VED with novelty items sold in stores. You can get one through your doctor with a prescription.
Penile Injections and Suppositories
Instead of taking oral medications, injections provide a concentrated dose that can carry a higher success rate compared to pills. You administer the drug either through an injection at the base of the penis or a urethral suppository the size of a rice grain at the head of the penis.
Alprostadil (Muse) is the drug of choice for suppositories. Certain injection mixes contain alprostadil (Caverject) with phentolamine (OraVerse) or phentolamine and papaverine. Other mixes combine higher concentrations of phentolamine and papaverine with lower amounts of alprostadil.
An implanted prosthesis is often the last line of treatment behind medications, temporary pumps, and injections since there’s always a chance for complications with any surgical procedure.
Once you can move beyond any potential risk factors, an implanted prosthesis is effective in producing and maintaining erections. You can then choose between an inflatable implant or a semirigid rod.
A majority of the implants feature a custom cylinder in the penis that you activate by pumping a bulb in the scrotum. The pumping mechanism sends sterile saline into your penis to create an erection.
In a three-piece inflatable implant, you store the fluid in a reservoir under the abdominal wall. With a two-piece inflatable implant, the reservoir is implanted in the scrotum with the pump. The erection lasts as long as you want until you deflate it, a process that releases the fluid back into the reservoir.
You can also opt for a surgical procedure that implants a semirigid, firm rod that you bend away from your body during intercourse. The downside is you may have difficulty concealing the implant under your clothes since it’s always rigid.
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