Man’s bedroom troubles

Man’s bedroom troubles

Erectile dysfunction (male impotence) is a condition characterized by the inability to obtain or maintain an erection sufficient to lead satisfactory sexual intercourse. Having erection problems from time to time is not necessarily a cause for concern, but if erectile dysfunction is an ongoing problem it can cause stress, relationship problems, or even affect your self-esteem and self confidence.

Today there are several effective treatments of erectile dysfunction, which vary according to the extent of the problem, its origin, the needs of the patient and the couple: from drug therapy, to psychosexual, to surgery.

Erectile Dysfunction Pills

The real innovation in this area are phosphodiesterase 5 (PDE-5) inhibitors. These are oral drugs, able to improve erectile function by enhancing the effect of nitric oxide (NO), the main mediator of penile erection. These drugs, in fact, by inhibiting the enzyme phosphodiesterase 5, cause the relaxation of the smooth muscle cells of the penis to be amplified, guaranteeing a more rigid and long lasting erection.

The first PDE5 inhibitor was introduced on the market in 1998. It was Sildenafil Citrate, contained in the blue pill Viagra. Two additional medications, Vardenafil and Tadalafil, were added in the years that followed. By inhibiting PDE5, Sildenafil, Vardenafil and Tadalafil obtain the effect of amplifying the action of NO and thus enhancing the physiological mechanism of erection. Therefore, PDE5i doesn’t directly induce an erection, but rather optimises the mechanism in the presence of a physiological stimulus. Therefore, for PDE5i to work, there must be at least a minimum endogenous production of NO. The mechanism of action is similar for all three drugs, which have been shown in important clinical studies to be effective and well tolerated.

In ten years, millions of patients around the world have taken PDE5 inhibitors, demonstrating in the field that they are safe drugs, even if taken repeatedly over the long term, as long as the warnings and contraindications listed on the package insert are respected. Frankly, Viagra pills caused nearly revolution.

PDE5i are taken orally and assimilated into the circulation through the gastrointestinal tract. In a variable time from about 20 minutes to two hours after taking, depending on the molecule, the dosage used and the individual response, the drug reaches adequate blood concentrations and produces its inhibitory effect on PDE5, enhancing the erectile response. The erection, however, is not at all “mechanical” or “automatic”, far from it! Indeed, it assumes that there is not only normal sexual desire, but also adequate erotic stimulation.

Kamagra (Sildenafil Citrate) represents today the first therapeutic choice in almost all forms of erectile dysfunction, effective and well tolerated in over 70% of ED cases. Kamagra is a well -known Viagra generic form with even better results than Viagra. It’s produced by Indian pharmaceutical company Ajanta Pharma Ltd and it’s easy to buy Kamagra from any trusted online pharmacy.

Of course, not all cases of erectile dysfunction are created equal. We know that ED can be of different etiology and severity, and the effectiveness of PDE5s can vary in different patient categories. However, there is no form or type of erectile dysfunction in which Kamagra is not effective, at least in a minority of patients. For this reason, whatever the type of ED, most specialists consider other treatment options only after these oral medications have proved ineffective.

Further Treatment of Erectile Dysfunction

Although the majority of ED patients respond optimally to PDE5 inhibitors, the outcome of this therapy is unsatisfactory in approximately 20-30% of patients. Furthermore, in cardiopathic patients taking nitro derivatives, that is the common antianginal drugs, PDE5i are contraindicated and cannot be used.

For this minority of patients, second-line treatments, of a medical or surgical type, are therefore used, which make it possible to restore sexual activity in almost all patients. 

Here are the specifics:

  • Intracavernous pharmacotherapy: Alprostadil is a PGE1 prostaglandin-based drug, which is injected directly into the penis and causes powerful vasodilation of the cavernous arteries, promoting erection. Although invasive, this therapy is well tolerated, and represents the main second-line option in cases not treatable with PDE5i.
  • Vacuum device. Some patients prefer to use the vacuum device, a mechanical tool that induces an erection by creating a vacuum effect pushed around the penis, and thus drawing blood into the corpora cavernosa. The blood remains “trapped” in the penis thanks to a constriction ring that is applied to the base of the corpora cavernosa. 

Psychosexual therapy

It is still not entirely clear how psychological factors can favour the onset of Erectile Dysfunction. However, conditions such as stress, anxiety and depression cause the hyperactivity of the sympathetic nervous system, favouring the onset of this pathology. A particular condition is represented by the so-called performance anxiety, which inhibits erection.

It is common among young peopleat the first sexual experiences, among those facing a new partner, or among those who have just failed in sexual relations. In the event that the Erectile Dysfunction is to be attributed to psychological factors, psychosexual therapy is essential to eliminate the factors that have determined it. This healing strategy is also useful in case of organic dysfunction to relieve the sense of anxiety that comes from the discomfort of erectile deficit.

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