Treatment of Erectile Dysfunction

Treatment Options for Erectile Dysfunction (ED)

Erectile dysfunction (ED) can be treated with various options depending on its cause and severity. Common treatments include:

• Lifestyle Changes: Improving diet, exercising, quitting smoking, and reducing alcohol intake can enhance erectile function.
• Oral Medications: Phosphodiesterase type 5 inhibitors (e.g., Viagra, Cialis) are widely used to improve blood flow to the penis.
• Hormone Therapy: For men with low testosterone levels, hormone replacement may help.
• Injection Therapy: Medications injected directly into the penis can cause an erection.
• Vacuum Erection Devices: These devices create a vacuum around the penis, drawing blood into it.
• Penile Implants: Surgical insertion of devices for men unresponsive to other treatments.
• Psychological Counseling: For ED caused by stress, anxiety, or depression.

Taking Medications

PDE-5 inhibitors are commonly used to treat erectile dysfunction (ED). These drugs increase the production of cGMP, which helps maintain a stable blood flow to the penis, supporting and prolonging a naturally occurring erection. While each PDE-5 inhibitor has unique properties, they share the benefits of rapid onset and long-lasting effects. ED symptoms typically diminish 30-60 minutes after taking the medication, with the duration of improved sexual function ranging from 4 to 36 hours, depending on the specific drug and dosage.

The erection mechanism remains natural, requiring sexual arousal for effectiveness. PDE-5 inhibitors do not cause spontaneous erections in non-sexual situations.

The first approved PDE-5 inhibitor for ED treatment was Sildenafil (Viagra), released by Pfizer in 1998. Alternatives like Tadalafil (Cialis) and Vardenafil (Levitra) became available in 2003, and Avanafil (Spedra) was introduced in Germany in 2014.

When choosing a treatment, it's essential to consider the severity of ED, any contraindications, and individual patient factors. A medical consultation, often preceded by an online questionnaire, is needed to obtain a prescription in the appropriate dosage.

Comparing ED Medications

PDE-5 inhibitors have revolutionized the treatment of erectile dysfunction (ED), offering a non-invasive alternative to mechanical devices, injections, or surgery. The efficacy and safety of these medications have been validated through clinical studies.

In Germany, four active ingredients from the PDE-5 inhibitor group are approved for use, each working similarly but differing in onset, duration, side effects, and food interactions.

Sildenafil and Tadalafil are the most commonly used due to their proven results across various levels of ED severity. Generic versions of these medications are available in Germany, meeting stringent requirements for composition and effectiveness, making them reliable alternatives.

These treatments can be prescribed by doctors on the platform.

Sildenafil and Tadalafil are the most popular options based on patient use and feedback, showing excellent results across various ED severities.

"Viagra" isn't the only brand name for Sildenafil. Since 2013, generic Sildenafil has been available in Germany, meeting strict requirements to match the original drug's composition and effect. So, if doctors from "SofortArzt" prescribe Sildenafil under a different brand name, it is still a reliable option. Generic versions of Cialis and Levitra are also available, offering similar efficacy to the original brands.

Possible Side Effects of ED Medications

PDE-5 inhibitors, such as Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra), and Avanafil (Spedra), can cause side effects, though they are generally well tolerated. Common side effects include:

• Headache: The most frequently reported, affecting around 10-20% of users.
• Flushing: A warm sensation or redness, particularly on the face and neck.
• Indigestion: Stomach discomfort or acid reflux.
• Nasal Congestion: A stuffy nose is another common complaint.
• Dizziness: Some users experience lightheadedness or vertigo.
• Visual Changes: Temporary changes in color vision or blurred vision may occur.
• Muscle or Back Pain: Particularly with Tadalafil.
• Nausea: Some individuals report feeling nauseous after taking the medication.

Rarely, more serious side effects like priapism (a prolonged erection lasting more than four hours) can occur, requiring immediate medical attention. Individuals with certain conditions, such as severe heart problems, or those taking nitrates for chest pain, should avoid PDE-5 inhibitors due to risks of significant blood pressure drops.

When Should ED Medications Be Avoided?

Before starting ED treatment, it's important to ensure no contraindications exist. Always disclose all health issues and medications when filling out a medical questionnaire. PDE-5 inhibitors should be avoided in the following cases:

1. Cardiovascular Conditions: Not recommended for patients with severe heart disease or those who recently had a heart attack or stroke.
2. Severe Liver Impairment: May be unsafe for those with significant liver dysfunction.
3. Severe Penile Deformities: Conditions like Peyronie's disease may worsen with these medications.
4. Certain Eye Disorders: Such as retinitis pigmentosa or other inherited eye conditions, as PDE-5 inhibitors can potentially affect vision.
5. Nitrate Use: Absolutely contraindicated with nitrates (used for chest pain), as the combination can cause a dangerous drop in blood pressure.
6. Caution with Other Medications: When combined with calcium channel blockers, oral antidiabetics, or other drugs, interactions can occur.

Older men may also need lower doses to avoid adverse effects. Always consult with a healthcare provider to determine the safest treatment approach.

How "SofortArzt" Can Help

"SofortArzt" prioritizes your health and ensures a safe approach to treatment. Before prescribing any medication, a qualified doctor reviews the patient's health status to confirm that there are no contraindications. Only if the treatment is deemed safe will a prescription be issued.

Once a specialist approves the treatment, "SofortArzt" arranges for the quick delivery of the prescribed medication, ensuring patients receive efficient and reliable healthcare assistance. The service provides a convenient way to access qualified medical help quickly and without hassle.

Alternative Treatment Options

Natural Remedies for Potency

Modern medicine offers various natural supplements aimed at enhancing erectile function. These remedies include plant extracts that positively influence blood circulation in the pelvic area and hormonal balance. Here are some well-known options:

• Yohimbine. Derived from the bark of the African Yohimbe tree, it increases blood flow to the penis and enhances nerve signal transmission in the spinal cord, which can facilitate erections.
• Korean Ginseng. Known for boosting testosterone levels and libido, its effectiveness is typically seen with regular use.
• Ginkgo Biloba. Rich in flavonoids and other compounds, Ginkgo improves blood circulation and may help with organic erectile dysfunction.

The efficacy of these natural remedies has not been confirmed by clinical studies, so doctors recommend considering them as supplementary treatments rather than primary options.

Psychological Therapy and a Healthy Lifestyle

Maintaining a healthy lifestyle is a crucial complement to medical therapy, significantly improving the quality of intimate relationships.

For psychogenic erectile dysfunction, addressing and eliminating the underlying causes is essential. Consulting a psychotherapist can help identify and resolve issues that may be reducing sexual function.

Lifestyle improvements such as regular exercise, a balanced diet, and stress management can enhance sexual health and overall well-being.

Targeted Exercise

Poor blood circulation in the pelvic area is a common cause of erectile dysfunction and prostate issues. Home remedies like targeted exercises can positively impact these conditions. Activities such as physical exercise, walking, cycling, and morning gymnastics help improve blood flow and support better sexual health.

Lifestyle Changes

To restore a healthy erection, it’s crucial to maintain a balanced diet:

• Avoid fast food and foods high in bad cholesterol;
• Limit consumption of preservatives, flour, and sweets;
• Eat more fruits and vegetables;
• Drink at least 1 liter of pure water daily;
• Divide daily calorie intake into three balanced meals.

Reducing alcohol consumption and quitting smoking may also be necessary for treating erectile dysfunction. Giving up bad habits improves cardiovascular health and enhances sexual performance. A healthy lifestyle benefits all patients, regardless of the cause of ED.

Psychotherapy and Coaching

Psychological causes of erectile dysfunction may include:

• Low self-esteem;
• Trauma;
• Depression;
• Anxiety disorders;
• Negative first sexual experiences.

When mental health factors are involved or when the condition is highly stressful, psychotherapy or targeted coaching can be effective. PDE-5 inhibitors can aid in recovery by facilitating quicker improvement and preventing extended interruptions in sexual activity.

Other Treatment Options

1. Intracavernous Injection Therapy. This option is suitable for patients who did not respond to oral medications. The injection works within approximately 20 minutes, and the resulting erection lasts for about an hour. However, the procedure requires caution, as improper injections can cause blood vessel damage or penile deformities.

2. Vacuum Pumps. A vacuum pump is placed over the penis, and suction is used to draw blood into the penile tissue, creating an erection. This method offers a temporary solution, with the erection lasting 15-30 minutes. For longer sessions, the pump may need to be used multiple times.

3. Penis Rings. Penis rings are ideal for men who have difficulty maintaining an erection during intercourse. The ring is placed at the base of the erect penis to help sustain the erection throughout sexual activity.

4. Surgical Therapy. Surgical intervention is considered a last resort when other treatments have failed. The procedure involves implanting devices into the penile tissue to support erectile function.