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“Erectile dysfunction (ED) is the persistent inability to achieve (1) and maintain (2) an erection sufficient for satisfactory sexual performance (penetration). It can affect men of all ages but is more common in older men. It will affect 300 million men worldwide by 2025.”
~ Dr. Rena Malik
Terms you should be aware of for this discussion:
RCT – Randomized Controlled Trials
RDA – Recommended Daily Allowances
ED – Erectile Dysfunction
IIEF – International Index of erectile dysfunction
IU – International Units
HPA – The Health Products Association of Southern Africa
Symptoms of Erectile Dysfunction
Let us first look at how erections work i.e. the cascade of effects. It begins with arousal. When arousal occurs, the body releases nitric oxide – cgmp or cyclic guanosine monophosphate is activated – allows for (smooth) muscles in the penis to relax which in turn allows for blood to enter / flow into the penis.
Simultaneously, the veins in the penis gets blocked off: ta-da an erect penis. Treating the underlying issue(s), is the most important part of this process. If you can have an erection during masturbation or on awakening, the problem is probably stress-related or may be caused by an emotional problem.
If you or someone you know is experiencing symptoms of ED, it’s important to consult a healthcare professional for proper diagnosis and treatment.
Common Causes
Physical Causes:
Cardiovascular diseases
Diabetes
High blood pressure
Obesity
Hormonal imbalances
Psychological Causes:
Stress and anxiety
Depression
Relationship problems
Lifestyle Factors:
Smoking
Excessive alcohol consumption
Lack of physical activity
Symptoms:
Difficulty getting an erection
Difficulty maintaining an erection
Reduced sexual desire
Treatment Options:
Lifestyle changes (diet, exercise)
Counseling or therapy for psychological factors
Medications (like Viagra or Cialis)
Vacuum erection devices
In some cases, surgical options
Taking Sildenafil
Causes of Erectile Dysfunction
Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors (if you prefer herbal PDE5 inhibitors like Horny Goat Weed, Forskolin or Black Ginger). For better and faster reaction time, take on an empty stomach. Peak concentration in the blood is reached after two hours for Tadalafil and about one hour for Sildenafil.
Of note, Sildenafil, a generic Viagra, can be somewhat inhibited after eating a large meal containing fatty foods, and this is not a concern with Tadalafil (generic Cialis). We often suggest sildenafil for married couples or long-term partners with a more predictable sex life. Cialis may be more appropriate for patients who are dating, as the big meals often associated with early dating can cause sildenafil to be less effective.
Possible Side Effects
Generic name: sildenafil (oral) [ sil-DEN-a-fil ]
Brand names: Revatio, Viagra
Drug classes: Agents for pulmonary hypertension, Impotence agents
Sildenafil relaxes muscles of the blood vessels and increases blood flow to particular areas of the body. Sildenafil under the name Viagra is used to treat erectile dysfunction (impotence) in men.
Do not take this medicine if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite (“poppers”). Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.
Dizziness, headache, flushing, nasal congestion, nose bleeds, heartburn or stomach upset may occur. Vision changes such as increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. In extreme cases priapism might occur.
Sildenafil vs Tadalifil
Sildenafil is a ON-DEMAND drug, whilst Tadalafil can be used as a chronic medication and taken daily. Additionally, Tadalafil also helps with the treatment of bph – benign prostatic hyperplasia. Regarding which medication allows an erection to last longer, the clear winner is tadalafil. Sildenafil remains effective for four to six hours, while tadalafil will enable patients to achieve erections up to 36 hours after ingestion, an effect usually seen in younger patients or lesser degrees of ED. In both cases, the drug does not increase desire, instead allowing for a better erection when the desire is present.
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