So many ED websites - but which are safe to use?

Erectile dysfunction and the drugs to treat it

around 40% of men suffer from erectile
dysfunction at some time in their lives

Estimates vary, but around 40% of men suffer from erectile dysfunction (ED), also known as impotence, at some time in their lives. The problem is widespread and not a minor one. Impotence impacts on wellbeing, pleasure and self-esteem.

Impotence of some degree is so common it is almost normal.

Why do men get impotence?

The strength of erections reduces with age. This, coupled with anything which reduces the circulation, and possibly a contribution from stress reduces erections. Once a man becomes concerned about his performance, it can lead to a vicious cycle.

Most men with reduced erections are not generally unwell, although as a group these men tend to be generally less fit than they could be. Many have no health problems at all apart from their erectile dysfunction.

Types of erectile dysfunction

The most common form of ED is due to a combination of things. Good erections occur when there is a good blood supply to the penis and the blood vessels are working well.

Middle aged men who are troubled by ED often have no one specific problem which explains their symptoms. Their examination and investigations by a doctor are often normal.

Anything which affects the circulation, such a high cholesterol or high blood pressure can cause impotence. On the other hand the circulation may be fine, but the signals going from the brain to the blood vessels of the penis via the nervous system may be faulty in some way.

Text books divide the causes of ED up in circulatory causes (vascular) or ED caused by problem with the nervous system (neurogenic) or due reduced hormone levels (endocrine) or ED caused by emotional or psychological factors (psychogenic). There is often no one clear cause and there may be no diagnosable cause.

ED and alcohol and smoking: Men who smoke and men who drink get ED more than others. Alcohol in excess reduces hormone levels, the quality of sleep, and overall vigour. Smoking affects the circulation and reduces blood flow.

It is also worth mentioning that men who drink and take ED drug treatments at the same time take risks they should not.

ED and diabetes: Diabetes has an effect on the circulation and on the nervous system. Poorly controlled longstanding diabetes is often associated with ED. Some diabetics qualify for ED treatment on the NHS, but this is rationed to a few tablets a month and then only to selected patients. Good control of diabetes tends to reduce the likelihood of developing impotence.

ED and heart diseases: Heart diseases are nearly always the result of narrowing or blocking of the arteries supplying blood to the heart. The narrowing of the arteries is normally not restricted to heart. The blood vessels to the pelvis and penis are often also narrowed. Heart attack and ED are often found in the same person.

Men who have heart disease are sometimes prescribed nitrate tablets. Nitrates interact with the most commonly prescribed ED drugs and they cannot be taken at the same time. However, men who have recovered from heart attacks and are capable of fairly vigorous exercises and are not taking nitrates can still benefit from ED medication.

Should men with erectile dysfunction see their regular doctors?

Doctors sometimes think of ED as a signal condition; an early warning of possible problems with circulation. This is one reason all men with ED should tell their doctors about it.

Once the GP is told, tests may be arranged. In the end, depending on what is found, GPs are quite likely to advise nothing more than maintaining a healthy lifestyle and avoiding cigarettes. GPs may recommend regular or occasional Viagra or other tablets and nothing more.

Online clinics can provide advice and information, and assessments of ED and can be a reliable source of genuine medication, but care must be taken to use only reputable clinics.

Available treatments

The majority of men with ED are treated with tablets. And the majority of these are prescribed one of the very well known PDE5 inhibitors; Viagra, Cialis or Levitra. These tablets are usually the most effective treatment for impotence from most causes.

The description PDE5 inhibitor is given to drugs which slow down the action of an enzyme, phosphodiesterase. This enzyme plays a part in producing erections.

There are other treatments apart from tablets, which may be more appropriate in some cases, for example, where ED starts after an operation, or results from spinal injury or where PDE5 drugs are ineffective or are contraindicated. These treatments include surgical implants which can be inflated by a pump. Medications can also be injected directly into the base of the penis to produce short-lived erections in difficult to treat cases.

Where ED is situational and associated with emotional and personal stresses and concerns, counselling can be effective. ED drugs are sometimes used as an adjunct to counselling until problems resolve.

Testosterone injections were a popular treatment in some parts or the world a few years ago and are coming back into favour with some doctors in the UK. They should not be used without a definite diagnosis of low testosterone.

How to choose an ED drug for yourself?

Viagra, Cialis and Levitra all work in a similar way. They are generally remarkably effective. Historically, most men take Viagra; it was the first of it's type on the market and is the most familiar. It works within an hour or so, sometimes less, and last for a few hours. Levitra works for longer and Cialis, with duration of action of up to 36 hours, last the longest of all. Cialis might be a better choice for a man planning a romantic weekend. Viagra might be more suitable for a man going on a date. The choice is personal and depends on things such and previous experience, cost and convenience.

When obtaining medication online it is important that checks for contraindications are undertaken and that only genuine tablets and not fakes are supplied.

The best known tablets in the world

Viagra is probably the best know medication in the world. This is not surprising. Along with Cialis and Levitra, Viagra is a very effective drug for one of the most troubling conditions men suffer from, erectile dysfunction (ED).

These tablets are available online from reputable clinics although prices vary greatly and care is needed in selecting an online clinic to ensure only genuine medication and not fakes are obtained.

Viagra, the chemical name of which is Sildenafil, and the other PDE5 inhibitors, are a bit of a magic bullet for impotence. They are rare amongst drugs in as much as they work almost exclusively where they are needed in the body and when they are needed, with very few side effects in most men who take them.

Viagra, Cialis and Levitra all work in the same way. They increase the blood flow to the penis during sexual arousal. If there is no arousal the drug action is not triggered. There is no automatic erection. The erection occurs when it is needed.

These drugs increase the amount of a chemical in the penis which produces erections. They increase the blood flow.

Summary

ED is common and in many cases an isolated health problem. It can be distressing and damaging to relationships. It has many different causes, although often the exact cause is difficult to diagnose. Doctors should be informed. The most widely taken treatments are PDE5 tablets. Other treatments are available although usually reserved for special cases.

As with any medication, tablets should be used with care and on the advice of doctors, and the patient information leaflets which are included in pill packs should be followed.