Erectile Dysfunction (Impotence) Treatment

IMPOTENCE IS TREATABLE!

There are a variety of treatments available to treat Sexual impotency.

Impotency due to psychological causes:
For Impotency due to psychological cause supportive psychotherapy and sexual therapy is recommended. It is also supplemented with a drug therapy to boost the confidence level of the patient in his ability to achieve and maintain erection, as well as to reduce performance anxiety.

Impotency due to physical causes
Impotency due to physical cause is treated with physical or drug therapy. It is supplemented by a supportive psycho-counseling therapy to re-educate the patient and reduce the damaging effects of short- or long-term impotence to him and his partner.

Non-Surgical Treatments These include Vaccum Devices and Retention Rings; Oral Medications and Hormonal Therapy.

Vacuum Devices and Retention Rings
This device was created by Geddings Osbon , in the early 1960s, to solve his own impotence problem. It works on negative pressure and tension rings, to produce and maintain a naturally engorged erection every time one was needed.

This device works well with majority of men suffering from impotency due to Vascular disease. The vacuum device is a hand- or battery-operated air pump which attaches to a plastic cylinder. The penis is inserted into this cylinder and its mouth is tightened. The pump creates a vacuum inside the cylinder, leading to a pressure difference with the pelvis. Blood rushes into the penis and makes an erection. Then, a silicone or rubber ring is fastened around the base of the penis, in order to block the outflow of venous blood. The erection occurs quickly and may last for long periods (20 minutes or more). This method has been found to be effective in more than 90 % of the cases. But its biggest drawback is that it is too intrusive into the intimacy of the sexual moment. Side effects are minimal like hematomes or pain.

Oral or Local Medication
Oral medications used to treat erectile dysfunction include selective enzyme inhibitors (e.g. Sildenafil - "Viagra," Vardenafil HCL - "Levitra" and Tadafil - "Cialis.").

Viagra ( Sildenafil):
Viagra is the first oral pill to treat impotence. Viagra is manufactured by Pfizer Pharmaceuticals, New York , NY . The FDA approved Viagra on March 27, 1998 . Since it first became available in 1988, i t has helped about 16 million men around the world improve their sex lives. It works for most men whether their ED is mild or severe.

Viagra is a prescription drug that works by increasing blood flow to the penis. It is not a hormone or an aphrodisiac. Once you take it, VIAGRA can work in as quickly as 30 minutes and works for 4 hours so you can set your own pace. And, it is so safe that it can be taken as often as once a day. It is available in three different dosages: 25, 50 and 100 mg.

The most common side effects of VIAGRA are headache, facial flushing, and upset stomach. Less commonly bluish vision, blurred vision, or sensitivity to light may briefly occur. In the rare occurrence of painful, prolonged erections, seek prompt medical attention if erection last longer than four hours.

Levitra ( Vardenafil HCl):
LEVITRA (Vardenafil HCl as the active ingredient) has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of erectile dysfunction (ED ). It has already been highly successful in 50 European countries. It is marketed by Bayer and GlaxoSmithKline .

Levitra is an oral medication that treats erectile dysfunction (ED) in men by increasing the blood flow to the penis to achieve and maintain an erection. According to a recent news release by Bayer/GSK, 90 % of men reported improved erections and may work for up to 24 hours.

Levitra acts in the same way as Viagra, but it is clinically effective up to 89% of the time! Lasts hours longer than Viagra & starts working in as little as 30 minutes compared to 60 minutes-window for Viagra. Moreover, Levitra has no major adverse side effects on the heart or vision whereas Viagra is known to require more monitoring for these side effects.

Cialis ( Tadafil)
Cialis is in a class of medications like Viagra & Levitra known as PDE-5 inhibitors, which are used to treat cases of male impotence. They all work to reduce the effects of an enzyme called PDE-5. Reducing the activity of the PDE5 enzyme means more blood can flow to the penis and less leaves. The net result is an improved and longer erection.

Cialis (Tadalafil) helps in improving overall erectile function, ability to achieve erections sufficient for vaginal penetration, ability to maintain erections for successful sexual intercourse, satisfaction with the hardness of erections and confidence in ability to achieve and maintain an erection. It is marketed by Elli Lilly and ICOS.

How Cialis scores over Viagra?

• It takes effect in as little as 15 minutes .
• It works along with sexual stimulation to help achieve an erection, quickly.
• It brings with it the promise of "36 hours of freedom" to achieve an erection whereas Viagra is effective up to four to six hours only.
• It can be taken without any food and alcohol restraints.

Out of these three Cialis has shown in clinical trials to stay in the body longer than the other selective enzyme inhibitors. It promotes erection within 15-30 minutes and enhances the ability to achieve erection for up to 36 hours.

Hormonal Therapy
Hormonal therapy is strictly recommended only for some cases of hypogonadism, i.e., a pathological decrease in the levels of testosterone, Testosterone is artificially replaced by intramuscular injections or by skin patches (applied to the shaved scrotum). Normal levels are reached very quickly, and an effect of the sexual libido and erectile function may be felt after a few days. Male hormone replacement therapy seems to have other beneficial effects also, particularly in elderly man, Muscular mass is increased, fat is decreased, the patient feels better and more vigorous, with less fatigue and higher mental concentration. It also offsets the effects of osteoporosis (a lack of calcium in the bones, which can lead to easy fractures and other ailments).

However, testosterone replacement therapy is more dangerous than its female counterpart (using estrogen). Its clinical use is warranted only after a certain age, and only when the absence of prostate disorders is ascertained by a thorough prostate examination (including ultrasound, rectal touch and clinical history) and the measurement of levels of PSA, an antigenic factor present in the blood in abnormal concentrations when prostate cancer is beginning.

Surgical Treatments

1) Vascular Surgery
For erectile dysfunctions due to vascular causes, there are several kinds of vascular or arterial surgeries. These surgeries close or decrease the number of malfunctioning "escape" vessels (which lead to more firm and longer erections), or by bypassing or cleaning obstructed arteries. The success rate is high, but it is an irreversible and expensive procedure.

2)Penile Implants
These are the most irreversible and drastic ways of achieving artificial erection. Only when all other measures have been exhausted with no longer-lasting effects are achieved is that penile implants are warranted. These are prosthetic devices made of inert silicone, which are surgically inserted into the penis. Normal erection cannot be achieved after that. There are two kinds of penile implants:

Passive implants: Two rods of silicone are inserted into the penis, which remains erect all the time. The silicone rods can be put in different angles, but this may be an embarassment in public occasions such as swimming. Orgasm may be achieved unless there are hormonal or neural factors which impede it.

Active implants:These are inflatable silicone pouches which are also implanted into the penis. The penis remains in flaccid state until a proper manipulation of the prosthesis causes its inflation and consequent erection. One type of implant is activated by pressing the glans (the head of the penis) with one hand. Liquid is transferred from a reservoir to the main inflatable pouches. In another type, the liquid reservoir is implanted into the scrotal sac, and can be pumped by hand.

3) Other Treatments
Other surgical and non-surgical treatments for impotence are being tried in an experimental basis, and there may be a promising future for some of them. For instance, groups of physicians in Russia and Germany have been experimenting with electrical stimulation of the pelvic area using an external pad applied to the abdomen and back. There are already commercial devices using this principle, which seems to increase the blood flow in the genital area. Direct stimulation of pelvic nerves (leading to a nerve-induced erection) by using implanted electrodes and an electrical pacemaker-like device are also being considered.

"Natural" or alternative methods do abound. They range from "natural" foods which have high testosterone or DHEA levels, such as green oats (marketed under the brandname of SEXATIVA) or saw palmetto; to yoga exercises to increase muscle tone and blood flow in the genital area. It is hard to say whether there are real effects or they are just the effect of suggestion or placebo phenomena.

One thing has been scientifically determined, however. The blood levels of testosterone increase just after exercise, or by loosing excessive weight. Thus, a natural way of combating mild hypogonadism might be frequent exercising and keeping a normal weight.

Source: http://www.epub.org.br