Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are medicines prescribed for erection difficulties caused by either physical or psychological problems. The drugs work only when the man is sexually aroused. The effect is usually seen within 15 - 45 minutes.
These drugs are called phosphodiesterase-5 (PDE5) inhibitors.
Although these drugs have become extremely popular, they do not enhance erections if you are not impotent. And they DO have side effects, which can be as serious as a heart attack or as minor as muscle pain or facial flushing.
These drugs should not be used with certain other medications, including nitroglycerin. When taken with nitroglycerin, a man's blood pressure can become dangerously low. Some men have died after taking these drugs with nitroglycerin.
PDE5 inhibitors should be used with caution if you have any of the following conditions:
- Recent stroke
- Severe heart disease, such as unstable angina, a recent heart attack, or arrhythmia
- Severe heart failure
- Uncontrolled hypertension (high blood pressure)
- Uncontrolled diabetes
- Very low blood pressure (hypotension)
If pills do not work, options such as the following are available.
- Testosterone replacement using skin patches, topical gel, or injections into the muscle may be prescribed if your blood testosterone level is low.
- A medicine called alprostadil, injected into the penis or inserted into the urethra, improves blood flow to the penis. This usually works better than medications taken by mouth.
- An external vacuum device can be used to pull blood into the penis. A special rubber band is then used to maintain the erection during intercourse.
- For some patients, a surgically-placed penile implant (
prosthesis ) may also be recommended or needed.
Many herbs and dietary supplements are marketed to help sexual performance or desire. There are several special concerns for people taking alternative remedies for erectile dysfunction. Also, none of these remedies have been proven effective for treating erectile dysfunction.
Consult your health care provider to see if one of these treatments is right for you.
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