Erectile Dysfunction Welcome to the Affordable Drugs erectile dysfunction information page. Here you can learn about what erectile dysfunction is, the causes of erectile dysfunction, erectile dysfunction treatments and more. You can also find the best available erectile dysfunction drug prices. The information contained on this page is not intended to replace the professional advice of your physician.
What is Erectile Dysfunction (Impotence)?
Although there is typically a significant amount of confusion associated with a diagnosis of erectile dysfunction, it is most appropriately defined as the inability of a man to obtain an erection or maintain an erection for the purpose of sexual activity. Erectile dysfunction, which is commonly referred to as impotence, is considered to be an embarrassing topic for most men. The taboo nature of the medical problem often leads to affected individuals failing to seek guidance from their physician, but the truth is that the illness is not a normal part of the aging process.
There are many physical causes of impotence, but some are much more common than others. Some of these physical causes include alcohol and drug abuse, head injuries, liver failure, kidney failure, and fatigue. In addition, some medical conditions often cause erectile dysfunction as well. Such medical conditions include diabetes, hypertension (high blood pressure), multiple sclerosis, and Parkinson's disease. There are also many medications that report impotence as one of their commonly occurring side effects.
More common than the physical causes, there are also many emotional feelings and stressors that lead to erectile dysfunction. Individuals that are under a great deal of stress often report a higher degree of difficulty in achieving an erection. In addition, feelings of depression or low self-esteem can often make sexual activity frustrating and impossible. Many people are plagued with fears of rejection or inadequacy when it comes to performing, and these individuals also often must deal with impotence. Previous bad experiences with sex can also commonly cause impotence or erectile dysfunction.
There is no specific test designed to diagnose erectile dysfunction, but many doctors will obtain blood or urine specimens to first rule out any related diseases. A physical exam may not reveal anything relevant, but the physician and patient can normally discuss enough factors to decide if treatment is necessary.
The many treatments available for impotence often depend on what it is that is truly causing the difficulty. For some individuals, a simple change in their current medications may be necessary. Some patients with emotional feelings as the culprit are able to deal with the problem themselves. Certain rare cases may actually require some type of surgical procedure, but these are not very common. There are also many medications that are designed specifically to combat erectile dysfunction, but a physician should be involved in the decision to try any of them.
The most common myth associated with erectile dysfunction is that it is a normal part of getting older. While it may be true that more stimulation may be required with age, the inability to truly achieve an erection is normally indicative of an underlying problem. There are many potential causes and some of them are quite easy to remedy, but an individual must first seek the appropriate guidance from their family doctor or urologist. Although the conversation with a physician may be slightly uncomfortable, it truly is much easier than dealing with the frustrating consequences of leaving impotence untreated.
Erectile Dysfunction Causes When a man becomes sexually aroused, the process involves the brain, hormones, nerves, muscles, blood vessels, and even emotions. If one of these systems is adversely affected, or the way they in which work together is disrupted, the outcome can be erectile dysfunction. To understand the possible physical causes of erectile dysfunction (ED), it's necessary to also understand the physical processes involved in an erection. An erection occurs when the two cylinders called corpus cavernosum that run along the length of the penis have an increased blood flow that is several times more than the normal amount. As long as sexual arousal continues, this higher rate of blood flow into the penis limits the flow of blood out of the penis and it remains firm until the sexual excitement ceases.
Physical Causes of Erectile Dysfunction
Doctors used to believe that erectile dysfunction was purely psychological. However, it is known today that it is more often the result of physical issues like a chronic health problem, medication, or a combination of things. The most common physical causes are a reduction in blood flow to the penis or some type of nerve damage. These causes are usually brought about by some underlying condition.
1. Vascular disease like hardening of the arteries (arteriosclerosis) brings on reduced flow of blood through the entire body and can lead to ED. This condition is usually connected to a man's age and accounts for around 50% of ED in men over 60. Smoking makes the risk of erectile dysfunction greater if you have arteriosclerosis.
2. Diabetes and its high levels of blood sugar can cause damage to the small blood vessels and nerves in the body, resulting in impaired blood flow and nerve impulses required for an erection.
3. There are over 200 common prescription medications that can contribute to impotence. This includes things like blood pressure and heart medications, antidepressants, and sedatives. Even long term use of alcohol and recreational drugs can bring on erectile dysfunction.
4. Although this accounts for less than 5% of cases of ED, hormone imbalances, like a testosterone deficiency, can lessen desire and result in the loss of an erection.
There are several other less common physical reasons that a man may suffer from ED like neurological problems, pelvic trauma, and radiation treatments. Surgery for things like bladder or prostate cancer sometimes requires that tissue and nerves surrounding the cancerous tumor be removed, increasing the chances of ED.
Psychological Causes of Erectile Dysfunction
The brain and emotions are two of things that play a part in triggering an erection. There are a lot of things that get in the way of the sexual feelings that cause an erection and this can lead to erectile dysfunction.
Stress and anxiety, guilt, and depression can all be the reason for loss of sexual desire. Often there is a domino effect: if a man undergoes the loss of his erection, then he may worry that it is going to happen next time. Once the worry about sexual performance starts there can be chronic problems during sex. For someone already suffering from erectile dysfunction for physical reasons, this can amplify the emotional anxieties about sexual performance.
Erectile Dysfunction Diagnosis Erectile Dysfunction is a common problem for many men. If a patient has an occasional occurrence of erectile dysfunction, the problem may be stress related. It is also true that takes longer with age. If however, the patient has a severe and persistent problem getting and maintaining an erection, they should consult a doctor. A doctor can perform erectile dysfunction diagnosis through a number of tests.
Diagnosing erectile dysfunction can be done by measuring blood flow to the penile tissue. Before embarking on expensive tests, the doctor will take a complete medical history. A medical exam can determine if a neurological or vascular disease is responsible for the dysfunction. A history of smoking or hypertension can be determined during an exam. Blood testing can determine if liver and kidney function are normal, and if blood sugar is within the normal range. Blood testing can also determine if there is an excess of prolactin (hyperprolactinemea), which can lower testosterone and affect libido. Blood testing can also check the levels of other sex hormones. A complete blood count (CBC) will be taken determine the levels of white and red blood cells. Levels of fats like cholesterol and triglycerides in the blood may indicate arteriosclerosis, which can lead to inadequate blood flow to the penis. A urine sample may be taken to determine if diabetes, kidney dysfunction or insufficient levels of testosterone.
Other tests that can be used in diagnosing erectile dysfunction include a digital rectal exam to determine if the prostate is enlarged. An enlarged prostate can interfere with nerve impulses to the penis and can inhibit blood flow to the penile tissue. The bulbocavernosus reflex exam can be performed to determine if there is sufficient nerve response in the penis. This exam involves the physician squeezing the glans (head) of the penis. If nerve function is normal, the anus will immediately contract. The doctor determines the correlation between the squeeze and contraction by either feeling it with a gloved finger or observing it.
Penile response can also be observed during sleep with a test of nocturnal penile tumescence (NPT). The average person achieves between five and six erections during the night, especially while in REM (rapid eye movement) sleep. The test can observe and either gauge strain or snap. The test which is used to gauge strain involves placing bands on the tip and base of the penis. During the night, the circumference of the penis is measured at both bands at various times. The snap gauge test involves placing several bands of varying strength around the penis. Erectile function is determined by the breaking of the bands.
Other tests, including contrast dye x-rays and ultrasound can be useful in diagnosing erectile dysfunction. Once a positive diagnosis of erectile dysfunction has been made, your doctor can discuss options with you.
Erectile Dysfunction and Hypertension Research has revealed that erectile dysfunction (ED) may occur at one time or another in about 70% of men. It may be even more common than that because many men may be too embarrassed to mention the issue to their doctors. Studies also show that about 67 to 70% of men with high blood pressure have some level of erectile dysfunction. However, someone who has had moderate high blood pressure for several years may be less likely to have erectile dysfunction than a younger man suffering from serious hypertension for a short period. How High Blood Pressure Can Cause ED
Before explaining why high blood pressure can cause ED, you should understand the physiology behind an erection. Inside the penis are two cavities made of small arteries and veins, muscle tissue, and empty space that are responsible for erections. These two chambers are covered by thin tissue. When a man gets an erection, either the brain or nerve endings in the penis send signals that make the muscles in these chambers relax enough and open wider to allow blood to fill the empty space. This blood flow is trapped in the penis and it expands and stiffens to cause an erection.
So how does high blood pressure affect this process? The most prominent theory is that the excess pressure in the blood vessels caused by high blood pressure can cause damage such as tears in the small arteries in the penis. The body does repair these tears, but this causes those arteries to become thicker. Once the arteries thicken, they can't respond as fast or as efficiently to the need for extra blood, restricting the ability of the penis to get an erection. Another theory is that high blood pressure makes those smooth muscles in the penis unable to relax enough to accommodate the blood flow into the penis.
Often times, men with high blood pressure have lower levels of testosterone, the male hormone that affects sexual arousal.
Treatment for ED Caused by High Blood Pressure
Logically, the first thing to do in these cases would be to treat the high blood pressure with medication. Unfortunately, it is well known that a lot of the most widely used drugs to treat high blood pressure can cause erectile dysfunction themselves or even make it worse. Hypertension pills most associated with causing ED contain diuretics and beta-blockers.
In cases of erectile dysfunction caused by high blood pressure that are resistant to this type of treatment, other options like surgery, injections, and alternate drugs may be tried.
Erectile Dysfunction and Diabetes Erectile dysfunction is a very common problem in men who have diabetes. In fact, erectile dysfunction is three times more common in men suffering from diabetes than in other men, and an overwhelming 85% of diabetic men have reported experiencing erectile dysfunction. If left untreated, erectile dysfunction can lead to marital problems, sexual frustration, and even depression. Thankfully there are a variety of treatments intended to reduce the risk of or cure erectile dysfunction in diabetic men. In simple terms, erectile dysfunction is defined as the inability to achieve or maintain an erection that is adequate for sexual activity. Some men may not be able to achieve an erection at all, while others simply cannot maintain one throughout the entire act of sexual intercourse. In diabetic men erectile dysfunction is common for a variety of reasons. Excess glucose (sugar) in the blood stream can eventually damage the blood vessels and nerves that cause erections. Poorly controlled levels of blood sugar can also reduce the amount of the chemical nitric oxide released in the body. Lack of nitric oxide can reduce blood flow to the penis, resulting in erectile dysfunction. In addition, cardiovascular conditions that frequently accompany diabetes can contribute to erectile dysfunction as well. When blood vessels become too narrow or hardened, blood flow is restricted, making it difficult or impossible to get or maintain an erection.
One of the most important steps for limiting episodes of erectile dysfunction is to keep your blood sugar levels under control. If you take charge of controlling your blood sugar levels starting at the onset of diabetes, the chance of nerve and blood vessel damage can be greatly reduced. Managing your medications can also help. There are some medicines that list erectile dysfunction as a potential side effect. If this is the case, talk to you doctor about switching to a different medicine. Various lifestyle changes can also help. Smoking can narrow your blood vessels, which reduces blood flow to the penis resulting in erectile dysfunction. Alcohol consumption can also damage blood vessels. Limiting your alcohol intake and quitting smoking can help reduce your risk of erectile dysfunction.
If erectile dysfunction brought on by diabetes is causing distress in your life, controlling your diabetes and making lifestyle changes may help. If nothing seems to be working, try speaking with your doctor about changing your treatment plan and possibly taking a prescription designed to help with erectile dysfunction.
Erectile Dysfunction and Your Partner No matter how you choose to characterize it - erectile dysfunction, impotence, just not being in the mood - ED can be devastating to the relationship between partners. However, with some basic communication skills and creative thinking, you can not only reduce the adverse effects but also turn it into a positive method for discovering new methods of sexual expression. The first thing to keep in mind is that honesty and communication are essential. Trying to cover up erectile dysfunction as simply being "too tired" or some other excuse can lead to your partner feeling rejected. In fact, that's the biggest danger of covering up impotence with what you might think are harmless lies. Your sexual partner invests some measure of their identity in being attractive to you, and if you simply push them away that identity becomes eroded, and can lead to further problems down the road.
A better strategy is to let them know that they are attractive, sexy, and that you are excited by them - regardless of the erectile dysfunction. It is useful for both partners to remember that impotence is limited to one area of the body, and there are many other ways to express sexual desire and romantic feelings. When faced with erectile dysfunction, you and your partner can both decide to simply ignore it and focus on pleasuring other parts of the body in ways that don't involve an erect penis.
You and your partner may also decide to find other ways to foster intimacy between the two of you, such as sensual massage or some other shared activity. Playing games, snuggling up and watching movies, even getting dressed and going for an aimless walk can all become ways for you to connect to your partner. The key is to make it clear that the impotence doesn't change your desire to focus on your partner, or receive their attention. The only way to really do this is to talk about it openly, honestly, and with a realistic attitude about educating both of you about the subject of erectile dysfunction.
Taking an active step to create a new, positive experience out of a potentially damaging situation can strengthen any couple. Communicate openly and make sure both you and your partner are honest about your needs and feelings. A little reassurance and some creative sensuality can keep impotence from harming your relationship with your partner.
Erectile Dysfunction Treatments Erectile dysfunction is becoming an increasingly frequent problem in men in modern times. It is capable of turning a romantic night out into a man's greatest fear, and can be a large source of stress for relationships and marriages. Erectile dysfunction can make a man feel inadequate and his partner feel unattractive, two issues which can breed a plethora of problems. Luckily, modern pharmacology abounds with a wide variety of erectile dysfunction treatments that can put the string back in any sufferer's step! The big three are of course Viagra, Levitra, and Cialis, but each drug is unique in its own right. They are all erectile dysfunction treatments and each is a phosphodiesterase type 5 (PDE5) inhibitor, but each drug utilizes a different active ingredient that is metabolized slightly differently in each case.
The first of the erectile dysfunction treatments to hit the market was Viagra. This drug was developed by the pharmaceutical company Pfizer, and is composed of the active ingredient sildenafil citrate. Sildenafil Citrate and other PDE5 inhibitors work by preventing the PDE5 enzymes from binding and reacting with chemicals that tighten the muscles in the penis. Rather than destroying the PDE5 enzymes, Sildenafil Citrate merely competes with them for binding sites, resulting reactions of a much lesser extent and still leaving the enzymes intact so they can continue their work after the drug has been expelled from the body. This prevents the drug from causing a priapism, or other maladies that would be associated with a lack of PDE5 enzymes in the penis.
The two name brand treatments that followed Viagra, Levitra and Cialis, are composed of vardenafil and tadalafil respectively. Vardenafil is a simple structural variation on Sildenafil, which allows it to achieve its desired effect for slightly longer than its counterpart as it is more cumbersome for the body to metabolize. Tadalafil shares some structural similarity with its cousins, but it acts over a particularly long period of time comparatively- clinical trials involving the drug were able to suggest a 36 hour duration in healthy adult males, compared to a 6 hour duration in Vardenafil and Sildenafil, earning it the nickname "the weekend pill". Its altered structure also makes it less selective than its counterparts. Vardenafil and Sildenafil selectively inhibit PDE5, and only effect portions of the lungs (which is believed to have a positive effect) and penile tissue. Tadalafil also inhibits PDE11 and PDE6. PDE11 inhibition effects are unknown, but PDE6 inhibition is known to effect vision, causing a bluish tint to users' vision in some cases. Tadalafil is also known to have a much wider variety of drug interactions due to its more accessible chemical structure, making it a poor choice for anyone who is already taking medication, particularly a majority of blood pressure medicines.
All three of these drugs carry risks associated with them, though the side effects are largely mild discomforts and nausea. Regardless, even if you are the peak of physical fitness, you should discuss your desire at length with your physician before you begin taking any PDE5 inhibitors to take steps towards fixing erectile dysfunction. In most cases though, fixing erectile dysfunction will be as simple as obtaining the recommendation of your doctor and making a quick jaunt to the pharmacy to pick up the prescription that your physician has determined will best suit your needs and will pose the least risk to your health given your medical history.
Impotence Drugs Medications used to treat impotence essentially work in the same way - by increasing blood flow to the penis, thus facilitating an erection. Because each medication acts differently to increase blood flow, there are various side effects, administration requirements, and contraindications for each drug. Phosphodiesterase Type 5 (PDE5) Inhibitors
Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil)
During sexual stimulation, the smooth muscles in the blood vessels supplying the corpus cavernosum relax, causing increased blood flow and an erection. The chemical which relaxes the smooth muscles, cyclic guanosine monophosphate (cGMP), is broken down by the enzyme PDE5. These impotence drugs, the first effective oral impotence treatment, help maintain an erection by blocking PDE5.
Patients taking medications with nitrates, including nitroglycerin or recreational drugs called "poppers", cannot take PDE5 inhibitors. Viagra also inhibits PDE6 in the retina and can decrease the blood flow to the optic nerve, causing sudden vision loss. This is rare and not as likely with Cialis or Levitra.
All PDE5 inhibitors need to be taken before sexual activity; Viagra takes the longest to work, up to one hour, but Levitra can work in just 16 minutes with physical stimulation.
Prostaglandins
MUSE, Edex, Caverject (alprostadil)
These impotency drugs work much faster than the PDE5 inhibitors - in just 5 to 10 minutes. Prostaglandins relax certain muscles in the penis and widen the blood vessels to increase the blood flow and help start and maintain an erection.
MUSE is a suppository inserted into the urinary opening 10 minutes before sexual activity. Edex and Caverject are injected into the corpus cavernosum of the penis. Because is it a local reaction, there are fewer side effects, however, patients with blood problems like sickle cell anemia or leukemia should not use these prostaglandins.
Alpha Blockers, Psychedelics
Yohimar, Testomar, Aphrodyne, Erex, Yohimex, Tohimbe, Yocon (yohimbine)
Alpha blockers, by blocking the action of adrenergic receptors, increase blood flow by dilating blood vessels and relaxing smooth muscle tissue. Yohimbine is also a tryptamine and has stimulant and psychedelic properties. Impotence drugs with these actions treat erectile dysfunction due to diabetes, psychological reasons, and blood vessel problems.
Because yohimbine does not work directly in the penis, it may take several weeks to work. Patients who have a history of mental disorders or are taking medication for mood problems, like antidepressants, cannot take yohimbine. The most common side effect is headaches, but these impotence drugs are dangerous in high doses.
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