Treatment for Erectile Dysfunction

Don't stop or change any prescription medicines you take unless your provider cenforce tablets tells you to. If you have erectile dysfunction, you're not alone — and you have many treatment choices. Work with your health care team to find out which ED treatment might work best for you. Erectile dysfunction (ED) drugs are more readily available than ever before, and in general, men have gotten past any stigma about needing them. Yet many men still approach ED drugs the wrong way. Men feel their sex life is not good and see an ED drug as an easy, quick-fix solution. But more times than not, there are underlying issues at play that a pill can't help. While men might have other sexual issues, such as low libido, premature ejaculation, and the inability to achieve orgasm, ED pertains explicitly to not being able to get or maintain an erection. ED drugs address only that issue, by improving blood flow into the penis and keeping the blood in place to maintain an erection. There are four ED drugs currently available: sildenafil (Viagra), avanafil (Stendra), tadalafil (Cialis), and vardenafil (Levitra). At least one ED drug works in about 70% of men, but results vary among individuals. Men who have nerves or arteries damaged by prostate surgery, diabetes, or cardiovascular disease often do not respond as strongly to ED drugs. Finding out is often a trial-and-error approach. Many doctors first prescribe Viagra because it has been around the longest and has a high success rate. If one drug doesn't work after a predetermined period, your doctor may increase the dosage or prescribe one of the others. Sometimes, you have to try all of them before knowing whether ED drugs work for you. An ED drug kicks in within 15 minutes to an hour after you take it and can last anywhere from four to five hours up to 24 hours or longer depending on the drug. (See "ED drugs: How soon and how long?") It's best not to take the pill with food or soon after a meal, which can block absorption. The most common side effects are headaches, upset stomach, nasal congestion, muscle pain, and facial flushing. But most of these are relatively mild and go away after a few hours. ED drugs can make blood pressure temporarily drop, so never use them if you also take medications that contain nitrates. (Nitrates found in food don't pose a problem.) You also need to be careful if you take any other drugs that lower blood pressure. For example, alpha blockers - such as tamsulosin (Flomax) and alfuzosin (Uroxatral), which are used to treat symptoms of an enlarged prostate, lower blood pressure in some men. Make sure to take them at least four hours apart from an ED drug. It's important to realize that ED drugs don't increase sexual desire, and you have to be ready and sexually stimulated for them to work. The drugs won't work well if you are mentally or emotionally not ready for sex. You can't just take a pill, pay some bills or wash the dishes, and then go to the bedroom and think you'll be ready to go.

What Medications Can Treat ED?

In general, you need to be younger than 55, a nonsmoker and in otherwise good health. Sometimes, erectile dysfunction is caused by stress, anxiety or depression. ED also can create stress and relationship tension. If any of these issues affects you, seeing a psychologist or counselor might be a good next step. You also could think about asking your partner to join you for sessions with a certified sexual therapy counselor.

How to use ED pills properly

It's key to get treatment for any medical issue that causes erectile dysfunction. This can help prevent related health problems and improve erections. Conditions that can cause ED or make it worse include: Depression, ongoing stress and other mental health conditions. Some prescription drugs also can cause or play a role in ED. These include certain medicines for depression and high blood pressure. When your mind is not there, you are not going to want sex, and no ED drug can fix that problem. Before trying an ED drug, it's best to step back and analyze your sex life and when your ED occurs. Does it happen all the time or just in certain situations? Is it with only one partner or different ones? Does it ever happen when you masturbate? Are the problems associated with stress or alcohol? Asking yourself these types of questions can help identify if your ED may be more psychological than physical.

You might benefit from sex therapy with your partner, or you may need treatment for a specific condition that affects your desire and sexual arousal, like post-traumatic stress disorder, depression, or anxiety. Medicines that you take by mouth are called oral medicines. They're often the first line of treatment for trouble getting or keeping an erection, called erectile dysfunction (ED). Oral medicines for ED usually work well and cause few side effects. The four main medicines taken by mouth for erectile dysfunction are: They enhance the effects of a chemical the body makes that relaxes muscles in the penis, called nitric oxide. This boosts blood flow and helps you get an erection from sexual activity. Each oral medicine cenforce 150mg tablets for ED has a slightly different chemical makeup. These small differences affect the way each medication works, such as how quickly it takes effect and wears off, and the possible side effects.

• Duration Comparison: Sildenafil/Vardenafil/Avanafil (4-6 hrs), Tadalafil (up to 36 hrs), Injections (1-2 hrs).
• Side Effect Management: Headache, flushing, nasal congestion common; usually mild and temporary.
• Food Interactions: High-fat meals delay sildenafil and vardenafil absorption; less impact on tadalafil.
• Alcohol Limitation: Heavy drinking worsens ED; moderate consumption may be okay with some pills.
• Vision Changes (rare): Non-arteritic anterior ischemic optic neuropathy (NAION) reported with PDE5 inhibitors.

Your doctor or other health care professional can recommend one for you based on these factors, other health conditions you have and any other medicines you take. This medicine works best when you take it on an empty stomach an hour before sex. The body takes longer to absorb it after a high-fat meal or alcohol. Its effects often last for 4 to 5 hours. It might work longer if you have mild to moderate erectile dysfunction. This medicine also works best when you take it an hour before sex on an empty stomach. As with sildenafil, a high-fat meal or alcohol keep the body from absorbing it as quickly.

About Erectile Dysfunction

Some people have erectile dysfunction due to low levels of the hormone testosterone. In this case, you might benefit from testosterone replacement therapy. Most often, this treatment is prescribed along with ED medicine that you take by mouth. Testosterone replacement therapy comes in many forms, including a shot, patch and pill. Talk to your health care team about your preference and the possible side effects.

Compare ED treatments

If medications don't work or aren't right for you, a different type of treatment might help. This also is called a vacuum erection device. It's a hollow tube with a hand-powered or battery-powered pump. Then the pump is used to suck out the air inside the tube. This creates a vacuum that pulls blood into the penis. Vardenafil usually works for 4 to 5 hours. Its effects might last longer if you have mild to moderate ED. A newer form of the medicine that dissolves on the tongue might work faster than the pill that you swallow. This medication is taken with or without food an hour before sex. It works for up to 36 hours. You can take it in a small dose daily or in a larger dose as needed. You can take this medicine with or without food 30 minutes before sex, depending on the dose.

Alternative Treatment Options

One type uses rods that you can inflate. These let you control when and how long you have an erection. Another type of implant uses semirigid rods, which often are made of silicone. They keep the penis firm but bendable. Often, penile implants aren't recommended until other methods have been tried first.

Causes of ED

Implants have a high degree of satisfaction among people who have tried other treatments that haven't worked. As with any surgery, there's a risk of complications, such as infection. And if a part of the device stops working, you'll likely need more surgery to replace it. Rarely, erectile dysfunction is treated by bypassing arteries that have trouble bringing enough blood to the penis. This surgery is recommended for only a small percentage of people with ED. It lasts 4 to 5 hours, or longer if you have mild to moderate ED. These medicines all work well for ED. When choosing one, tell your doctor or other health care professional what your preferences are, such as cost, ease of use, how long the drug's effects last and side effects. Generic versions of sildenafil, vardenafil and tadalafil are available. Check with your health care team before you take any medicine for erectile dysfunction. Oral ED medicines might not work or might be dangerous if you also take any of the following: Often, these are prescribed for chest pain called angina. Some examples of nitrates are nitroglycerin (Nitro-Dur, Nitrostat, others), isosorbide mononitrate (Monoket) and isosorbide dinitrate (Bidil).

• ED medications are not an instant cure; they assist during sexual activity.
• Always follow dosage instructions provided by your doctor.
• Avoid mixing ED pills with recreational drugs or nitrates.
• Monitoring side effects can help determine the right medication.
• Some men may need multiple tries to find optimal treatment.
• Communicate openly with your partner about ED treatment options.
• Remember that age and health status influence medication choice.
• In some cases, underlying health issues need addressing first.
• Explore alternative therapies if medications are ineffective or unsuitable.
• Use medications as part of a broader approach to sexual health.
• Consider psychological factors that may contribute to ED.
• Keep regular medical appointments for ongoing evaluation.

These are commonly prescribed for an enlarged prostate or male pattern baldness. They include dutasteride (Avodart, Jalyn) and finasteride (Propecia, Proscar). Medicines that block an enzyme called CYP3A4. Oral medicine for ED also might not be safe or work well if you have: Very low blood pressure, called hypotension, or uncontrolled high blood pressure, called hypertension. Kidney disease that needs to be treated with dialysis. These include a heart attack, stroke or a serious heart rhythm disorder in the past six months. An inherited eye disease that affects the retina.

Do ED Medications Have Side Effects?

Once you get an erection, you slip an elastic ring or band around the base of your penis. This helps hold in the blood and keeps the penis firm for up to 30 minutes. The erection often lasts long enough for a couple to have sex. You remove the tension ring after you have sex. Bruising of the penis can be a side effect.

Medication May Not Be the Solution

Ejaculation will be restricted by the ring or band. Your penis might feel cold to the touch. If a penis pump sounds like a good option, ask your care team to recommend a specific model that will work well for you. This treatment involves surgery to place devices into both sides of the penis. There are two main types of implants. Side effects of oral ED medicines are often mild. Visual changes, such as blue tinge to vision, sensitivity to light or blurred sight. Rarely, more-serious side effects can happen, including: Some people have suddenly lost some of their hearing or vision after taking one of these medicines.