Almost all men experience problems in sexual performance periodically, usually from temporary causes such as fatigue, stress, and even alcohol consumption. When the ability to get or keep an erection firm enough for sexual intercourse becomes chronic, that’s erectile dysfunction, also known as ED.
The National Ambulatory Medical Care Survey (NAMCS) shows that the rate of physician visits for ED is nearly triple what it was in 1985. That doesn’t mean that ED is more prevalent, just that new drugs and advertising have made it ever-more comfortable for men to discuss it. Today experts estimate that ED affects between 15 and 30 million American men.
Finding the Cause of ED
It’s important for men not to simply go racing for a drug like Viagra when they’re experiencing erectile problems. The first step is to discover if there’s another medical problem that could be causing the problem.
Diabetes is a good example. ED is found in up to 50 percent of men with diabetes, and statistics show that African-American males are twice as likely to have diabetes than Caucasians of the same age group. ED may be the first symptom of either diabetes or hypertension (another condition more prevalent in blacks than whites).
Other causes of erectile dysfunction include: lowered testosterone levels; surgeries (especially for prostate and bladder cancer) that might harm the area around the penis, and certain medications, including appetite suppressants and blood pressure drugs.
Turning to Medication for ED
Since Viagra was approved in 1998, two other drugs in the same category have become available: Levitra and Cialis. All three drugs need about 30 to 45 minutes to take effect. The main difference is that Viagra and Levitra last four to six hours on average, Cialis up to 36. That doesn’t mean a man has erection all that time; just that the patient can be ready to respond to stimulation within that timeline.
The degree of spontaneity a man and his partner require are thus important factors in determining what drug (if any) is to be used. The shorter-lived drugs could be fine, for an elderly couple who know that they have sex every Friday night, but they may not work for a man seeking more spontaneity. Someone in his 60s may find his date doesn’t appreciate his checking his watch all the time.
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Both doctors remind patients that all these drugs have side effects, most commonly facial flushing, headaches and heartburn. It is critical for patients to tell their doctor all the medications they’re already taking. None of these drugs should be taken with certain heart medicines, like nitroglycerin. Certain drugs for BPH, enlarged prostate ,may also be inadvisable. Since perhaps 25 percent of men with BPH have ED, that’s something to watch for.
Finding Other Solutions for ED
Both doctors agree that drugs aren’t always the solution to ED. There’s an insertable suppository called MUSE and injections directly into the penis, such as Caverject. The latter uses needles reminiscent of those used in diabetes treatment and thus some patients say it’s not as uncomfortable as it sounds.
There’s also a vacuum pump and, ultimately, surgical implants. The bottom line is that no one method works for every man. It’s important to work with a doctor to evaluate not only which treatment best meets an individual’s immediate physical needs, but his expectations for performance as well.