What is erectile dysfunction?
Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. In fact, it is sometimes referred to as impotence, although this term is now used less often. An erection is the result of increased blood flow into your penis. Blood flow is usually stimulated by either sexual thoughts or direct contact with your penis.
About half of men ages 40 to 70 have erectile dysfunction (ED) to some degree, although only 1 in 10 report a complete inability to have erections. Taking an erectile dysfunction drug produces an erection sufficient to start intercourse in about 70% of otherwise healthy men.
What causes erectile dysfunction
There are many possible causes of impotence, they can be both emotional and physical conditions. Common causes include the following:
- cardiovascular disease
- diabetes
- hypertension
- high cholesterol
- obesity
- low testosterone levels
- other hormone imbalances
- kidney disease
- increased age, stress, anxiety, and depression
You may have erectile dysfunction if you regularly have trouble getting an erection, difficulty maintaining an erection during sexual activities, or reduced interest in sex. Occasional erectile dysfunction is common. Many men experience it during times of stress. However, frequent erectile dysfunction can be a sign of serious health problems that need treatment. Furthermore, it can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.
Treatment for erectile dysfunction
For men who have trouble keeping an erection firm, long enough for sex, erectile dysfunction can be treated using either oral medications (taken by mouth) or injectable medication (injected into the penis). These medications work by increasing blood flow to the penis and allow you to get an erection in response to sexual stimulation.
Oral medications are often the first line of treatment for erectile dysfunction. These prescription drugs work well and with this, can cause few side effects. Examples of oral medications for erectile dysfunction are Sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis), and avanafil (Stendra).
Caveject is the only injectable medication available to treat erectile dysfunction. It is injected into the penis as directed by your healthcare provider. Dosage is based on your medical condition and response to therapy. Caveject usually works within 5 to 20 minutes to produce an erection that lasts for about 1 hour. It should not be used more than 3 times a week with at least 1 day between each dose.
The difference between erectile dysfunction drugs
Although all drugs for erectile dysfunction work in a similar way, each medication has a slightly different chemical makeup. These minor differences affect certain factors such as how quickly the drug takes effect, how long it lasts, and how often it can be taken. Your healthcare provider will consider these factors as well as other conditions you may have when deciding on the best drug for you. Other factors to consider are your personal preferences, cost, and ease of use.
High fat meals affect the absorption and effectiveness of Viagra (Sildenafil) and Levitra (Vardenafil).
Cialis (Tadalafil) is available in four strengths – 2.5mg and 5mg which can be taken once daily every day for “on demand” effect and 10mg and 20mg which is taken when needed.
Staxyn is an orally disintegrating tablet which dissolves on the tongue and should be taken without liquid.
A comparison of erectile dysfunction drugs
| Drug | Onset of Action | Duration of action | Frequency of use |
| Viagra (Sildenafil) | 30 – 60 minutes | 4 hours | When needed but not more that every 24 hours |
| Cialis (Tadalafil) 10mg, 20mg | 30 - 45 minutes | 36 hours | When needed but not more that every 24 hours |
| Cialis (Tadalafil) 2.5mg, 5mg | On demand | continuous | Once daily |
| Stendra (Avanafil) | 15 – 30 minutes | 6 hours | When needed but not more that every 24 hours |
| Levitra (Vardenafil) | 30 – 60 minutes | 4 – 5 hours | When needed but not more that every 24 hours |
| Staxyn (Vardenafil) | 60 minutes | 4 – 6 hours | When needed but not more that every 24 hours |
| Caverject (Alprostadil) | 5 – 20 minutes | 1 hour | No more than 3 times weekly |
Onset of action – How soon the drug starts to work after taking it
Duration of action – The length of time the drug remains effective
Frequency of use – How often the drug can be taken
When erectile dysfunction drugs might not be safe
Before taking any medication for erectile dysfunction, you should see your healthcare provider as these medications require a prescription.
Erectile dysfunction drugs should be used with caution or avoided:
- If you take Nitrate drugs — commonly prescribed for chest pain (angina), such as nitroglycerin (Minitran, Nitro-Dur, Nitrostat), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Dilatrate-SR, Isordil)
- When you have very low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension)
- If you have severe liver disease or kidney disease that requires dialysis
- When you had a heart attack, stroke, or life-threatening irregular heart rate within the past 6 months.
If any of the above applies to you, you should discuss other options with your healthcare provider.
Side effects of erectile dysfunction drugs
Most men who take erectile dysfunction drugs do not experience side effects. Otherwise, the most common side effects for oral erectile dysfunction drugs are:
- Flushing
- Headache
- Indigestion
- Visual changes such as blue tinge to vision, sensitivity to light or blurred vision
- Stuffy or runny nose
- Back pain
The main side effect of Caverject is penile pain which occur in approximately 37% of persons using it and can range in intensity from mild to moderate.
Please discuss with your healthcare provider for more information.
