Erectile Dysfunction (ED, Impotence) (cont.)

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What is the treatment for erectile dysfunction?

The following are treatments for erectile dysfunction:

  1. Working with doctors to select medications that do not impair erectile function
  2. Making lifestyle improvements (for example, quitting smoking and exercising more)
  3. Taking drugs to treat ED such as sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis), or avanafil (Stendra).
  4. Inserting medications into the urethra (intraurethral suppositories: MUSE)
  5. Injecting medications into the corpora cavernosae (intracavernosal injections)
  6. Vacuum constrictive devices for the penis
  7. Penile prostheses
  8. Psychotherapy

Adjusting medications

Many common medications for treating hypertension, depression, and high blood lipids can contribute to erectile dysfunction (see above). Treatment of hypertension is an example. There are many different types (classes) of anti-hypertensive medications (medications that lower blood pressure); these include beta-blockers, calcium channel blockers, diuretics (medications that increase urine volume), angiotensin converting enzyme inhibitors (ACE inhibitors), and angiotensin receptor blockers (ARBs). Anti-hypertensives may be used alone or in combination to control blood pressure. Different classes of anti-hypertensives have different effects on erectile function. Inderal (a beta blocker) and hydrochlorothiazide (a diuretic) are known to cause erectile dysfunction, while calcium channel blockers and ACE inhibitors do not seem to affect erectile function. On the other hand, angiotensin receptor blockers (ARBs) such as losartan (Cozaar) and valsartan (Diovan) may actually increase sexual appetite, improve sexual performance, and decrease erectile dysfunction. Therefore, choosing an optimal anti-hypertensive combination is an important part of treating erectile dysfunction.

Lifestyle improvements

Quitting smoking, exercising regularly, losing excess weight, curtailing excessive alcohol consumption, controlling hypertension, and optimizing blood glucose levels in patients with diabetes are not only important for maintaining good health but also may improve or even prevent erectile function. Some studies suggest that men who have made lifestyle improvements experience increased rates of success with oral medications.

What medications are used to treat erectile dysfunction?

Medications for erectile dysfunction include

  • testosterone,
  • oral phosphodiesterase type 5 (PDE5) inhibitors (sildenafil [Viagra], vardenafil [Levitra], tadalafil [Cialis]), avanafil (Stendra).
  • intracavernosal injections (papaverine, phentolomine, and PGE1 [Trimix], alprostadil injection [Caverject, Edex]),
  • intraurethral suppositories (MUSE).

Oral phosphodiesterase type 5 (PDE5) inhibitors

The common PDE5 drugs approved in the United States are sildenafil (Viagra), vardenafil (Levitra), tadalafil (Cialis), or avanafil (Stendra). Actual head-to-head trials between these drugs have not been done to date to see which is the superior drug. Details on each of these medications for erectile dysfunction are outlined below.

Medically Reviewed by a Doctor on 4/3/2014

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