Treating Potency Disorders: Erectile dysfunction medications are cheaper than ever. But they also have side effects and not everyone should take them
Modern drugs should also allow for potential problems spontaneous sex
If a man wanted sex, but could not, for a long time there were only two reasonably effective aids: a cumbersome vacuum pump or unpleasant injections into the penis. Accordingly, the joy was great over a small blue, diamond-shaped tablet, which came on the market in 1998. Finally, men with potency problems had a discreet and effective treatment option.
The use of PDE-5 inhibitors, as the drug class is called, has quickly established itself as the standard therapy for erectile dysfunction. However, the drugs brought with them a big disadvantage: they were expensive. Around 15 euros cost a single tablet – hardly affordable for many affected men.
Sex spontaneously possible
That has changed in the last few years almost abruptly. Already in 2015, the Viagra drug Sildenafil lost its patent protection, in November 2017 followed by the “weekend pill” became known Tadalafil. Because now other manufacturers offer preparations containing these ingredients, the prices of the drugs dropped by up to 60 percent.
This also opens up a new treatment option for affected men. “Tadalafil is effective for longer and in low dosage for daily long-term therapy,” explains Dr. med. Christian Leiber, Head of Andrology at the University of Freiburg. This allows sexual activity at any time, without planning in advance. The remaining PDE-5 inhibitors, however, must be used up to half an hour before sexual intercourse.
Training for the erectile tissue
Leiber suspects that a regular intake also supports the usual and mostly unnoticed nocturnal erections. “That’s a kind of training for the cavernosystem,” explains the expert.
In addition, patients with a benign prostate enlargement who could not respond to or tolerate the usual drugs from the group of alpha blockers could benefit. Leiber: “Tadalafil also has a positive influence on urination in these patients.”
No miracle pills
Wonder Pills are PDE-5 inhibitors but by no means. In diabetics with disorders of nerves and vessels, the drug therapy is often ineffective. Even in prostate cancer patients after a radical surgery or after radiation, the tablets usually do not hit. And if the testosterone level is too low, the PDE-5 inhibitors often also do not show sufficient effects. The doctor can measure the level of the hormone in advance in the blood.
“A medical diagnosis is generally indispensable to check whether the patient is suitable to take such medication, whether he knows how the therapy works and what he has to pay attention to,” says Leiber.
Potency points to the heart
This is especially true for heart patients. For example, you have to be very careful when taking nitrates at the same time. Because in connection with PDE-5 inhibitors, the blood pressure can drop sharply. Androloge Leiber advises those who have to do without the medication: “A lifestyle change with weight reduction, exercise and quitting smoking often works just as well as the PDE-5 inhibitors.”
Professor Sabine Kliesch from the German Society for Urology emphasizes that erectile dysfunction must always be treated by a doctor: “Ultimately, it is about patients with a predominantly organic disorder, behind which other serious diseases can hide.” Potency problems are early warning symptoms for cardiovascular diseases:
Warning signal erectile dysfunction
The risk factors for erectile dysfunction are identical to those of cardiovascular disease.
The penile arteries have an inner diameter of about one to two millimeters, the larger coronary vessels of about four to five millimeters. Symptoms occur when a vessel is at least 50 percent closed.
This means that if erectile dysfunction occurs, the coronary vessels may already be closed by one-third. “There are very good studies showing that erectile dysfunction precedes cardiac events such as heart attack and stroke about three to five years,” says Dr. Christian Leiber.