erectile dysfunction (ED) is a common sexual difficulty among men. It refers to the consistent inability to achieve or maintain an erection sufficient for sexual intercourse. While the prevalence of ED can vary across different age groups, it is estimated that around 20 to 30% of men experience some degree of difficulty with their erections.

The oral agents used for the treatment of erectile dysfunction (ED) are known as phosphodiesterase type 5 (PDE5) inhibitors. Examples of PDE5 inhibitors include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).

These medications work by inhibiting the enzyme phosphodiesterase type 5, which is responsible for the degradation of cyclic guanosine monophosphate (cGMP). cGMP is a molecule that promotes smooth muscle relaxation and vasodilation (widening of blood vessels) in the penis. By inhibiting the breakdown of cGMP, PDE5 inhibitors enhance the effects of nitric oxide, a chemical that is released during sexual stimulation and promotes the dilation of blood vessels.

Improved blood flow is crucial for achieving and maintaining an erection. When a man is sexually aroused, the increased blood flow to the erectile tissues of the penis causes them to become engorged, leading to an erection. By enhancing the blood flow into the small blood vessels (arteries) within the penis, PDE5 inhibitors help facilitate this process and improve erectile function.

It's important to note that PDE5 inhibitors do not directly cause an erection but rather enhance the body's natural response to sexual stimulation. They are effective for many individuals with ED and have become a popular treatment option. However, it's always advisable to consult with a healthcare professional for personalized advice and guidance regarding the use of any medications.

And the PD5 inhibitors increase the level of a natural mediator inside the penis which allows an erection to occur easily or more easily, and it’s critical to understand that. They don’t make an erection occur; they allow erection to occur.
So, if you take one of the pills and you decide not to be sexually active at that time it won’t cause an erection, it’s only while you take the drug, while it’s in your body, before it’s been metabolized away. During that time, it will be easier for you to get an erection.

While the oral medications for erectile dysfunction are very effective, they don’t work for everyone. And so if they don’t work for you, we would then generally suggest going to one of a number of other medications that can used, or therapies that can be used, and that include an external vacuum device, which through vacuum pressure allows an erection to occur, that can include potentially injecting medication into the penis with a very fine syringe, like an insulin syringe.

Although it seems invasive it actually works very well. Medication can be given in through the urethra on the end of the penis which could be absorbed which can be effective.
If the vacuum device, injection therapy, or intraurethral therapy either don’t work for you or aren’t particularly appropriate in your particular situation, there is always the option of having surgery for erectile dysfunction. And that involves the placement of either permanently rigid or adjustably rigid prosthesis inside the penis to produce rigidity sufficient enough for intercourse.   Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health. 

So, if you have questions about erectile dysfunction or low testosterone, whether you think you have these conditions or you wish to explore the therapies, do discuss it with your primary care practitioner. 

good understanding of how PDE5 inhibitors work for erectile dysfunction (ED). PDE5 inhibitors, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), are oral medications commonly used to treat ED.

The mechanism of action of PDE5 inhibitors involves targeting the enzyme phosphodiesterase type 5 (PDE5), which is found primarily in the smooth muscle cells of the penis. PDE5 normally breaks down cyclic guanosine monophosphate (cGMP), a chemical messenger that promotes relaxation of smooth muscle and dilation of blood vessels in the penis. By inhibiting PDE5, these medications prevent the breakdown of cGMP, leading to increased levels of cGMP in the penis.

With higher levels of cGMP, the smooth muscles in the penile arteries relax, allowing blood vessels to dilate and increase blood flow to the erectile tissues of the penis. This improved blood flow results in easier and more sustained erections, assuming sexual stimulation and arousal are present.

It's important to note that PDE5 inhibitors do not directly cause an erection. They enhance the body's natural response to sexual stimulation by facilitating the erectile process. Therefore, if a person takes a PDE5 inhibitor but does not engage in sexual activity or sexual stimulation is not present, an erection will not occur.

Additionally, PDE5 inhibitors have a limited duration of action in the body as they are metabolized and eliminated. The exact duration varies depending on the specific medication. While the drug is active in the body, typically for a few hours, it can be easier for an individual to achieve an erection during that time frame if sexually stimulated.

While oral medications such as Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil) are commonly prescribed and effective for many individuals with erectile dysfunction (ED), they may not work for everyone. In such cases, there are alternative treatment options available. I'll outline a few of them for you:

1. External Vacuum Device: An external vacuum device, also known as a vacuum erection device (VED), is a non-invasive method to achieve an erection. It consists of a plastic cylinder that is placed over the penis, and a pump that creates a vacuum within the cylinder. The vacuum pressure draws blood into the penis, causing an erection. Once the erection is achieved, a constriction ring is placed at the base of the penis to maintain it.

2. Penile Injections: Another option is injecting medication directly into the penis to promote an erection. Alprostadil, a vasodilator, is commonly used for this purpose. It relaxes the blood vessels in the penis, allowing increased blood flow and resulting in an erection. These injections are typically performed using a very fine syringe, such as an insulin syringe.

3. Intraurethral Suppositories: Intraurethral suppositories, such as MUSE (alprostadil), are small pellets that are inserted into the urethra using a special applicator. Once inserted, the medication is absorbed through the urethra into the surrounding tissues, leading to an erection.

It's important to note that these alternative treatments may have different efficacy rates and potential side effects. Therefore, it is crucial to consult with a healthcare professional who can assess your specific situation and recommend the most appropriate treatment for you.

Please keep in mind that I'm an AI language model, and while I strive to provide accurate and up-to-date information, it's always best to consult a healthcare professional for personalized medical advice.

Although it seems invasive it actually works very well. Medication can be given in through the urethra on the end of the penis which could be absorbed which can be effective.
If the vacuum device, injection therapy, or intraurethral therapy either don’t work for you or aren’t particularly appropriate in your particular situation, there is always the option of having surgery for erectile dysfunction. And that involves the placement of either permanently rigid or adjustably rigid prosthesis inside the penis to produce rigidity sufficient enough for intercourse.

So, if you have questions about erectile dysfunction or low testosterone, whether you think you have these conditions or you wish to explore the therapies, do discuss it with your primary care practitioner.Now Health Network