American Medical Association Family Medical Guide - American Medical Association [258]
Medication
Sildenafil (also known by the brand name Viagra) is oral prescription medication used for treating erection problems. The drug does not produce erections, but improves erections already induced by sexual stimulation. For this reason, foreplay is essential for this drug to be effective. Sildenafil works by inhibiting the enzyme responsible for diminishing an erection by breaking down a chemical called cyclic guanosine monophosphate (cGMP). The action of sildenafil in the body increases the levels of cGMP, relaxing the smooth muscles in the penis and increasing blood flow into the penis.
Sildenafil is absorbed and processed rapidly by the body. It must be taken at least 30 minutes to 1 hour before sexual intercourse and should not be used more than once a day. Effectiveness depends on the cause of the erection problem, but the drug is effective in 50 to 75 percent of men who use it. Possible side effects include headaches, flushing, indigestion, and seeing some colors differently.
Vardenafil (brand name Levitra) and tadalafil (brand name Cialis) are other oral medications used to treat erection problems. Both drugs work in the same way as sildenafil to help men with erection problems achieve and maintain an erection in response to sexual stimulation.
Self-injection drug therapy
In self-injection drug therapy for erection problems, a man or his partner uses a tiny needle to inject a small amount of medication directly into the side of the penis. The drug relaxes the smooth muscle and widens the main artery that supplies blood to the penis, increasing blood flow to the penis. The injections are relatively painless and produce an erection that begins about 5 to 15 minutes after the injection and lasts from 30 minutes to 2 hours. No foreplay is needed to produce an erection.
Q & A
Medications for Erection Problems
Q. Can sildenafil or another medication improve my sex life?
A. Yes and no. These drugs are prescription medications used for treating the inability to achieve and maintain an erection adequate for sexual intercourse. If you can achieve an erection through sexual stimulation but cannot maintain it, these drugs can help you. Keep in mind, however, that they are not aphrodisiacs, do not arouse or increase sexual desire, and are not substitutes for working on a relationship. Nor do they improve or prolong erections in men who have normal erections.
Q. How do I obtain one of these drugs?
A. These medications are available only by prescription. See your doctor if you have an erection problem. The doctor will give you a thorough examination to diagnose your sexual problem to determine if medication would be helpful. Some Web sites offer prescriptions for these drugs without obtaining sufficient medical information from the person.
Q. I have heart disease and, several months ago, my doctor prescribed nitroglycerin for my chest pain. I use it every day to prevent chest pain. Lately I’ve been having some problems getting erections. I’ve heard that medication could help with this problem. Should I ask my doctor for a prescription?
A. No. You cannot safely use sildenafil, vardenafil, or tadalafil for your erection problem if you are taking heart medications such as nitroglycerin or alpha blockers. The combination can cause dangerously low blood pressure. Make sure your doctor knows about all medications you are taking.
Urethral suppositories
Urethral suppositories are sometimes recommended for treating erection problems. A urethral suppository is a single-use applicator filled with the drug alprostadil, a vasodilator that causes an erection by relaxing the smooth muscle of the penis and widening the main artery that supplies blood to the penis. To use a urethral suppository, insert the applicator about an inch into the urethral opening of the penis. The drug is released, absorbed by the urethra, and transported to the surrounding