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Libido - Erectile Dysfunction

Erectile dysfunction (ED), also known as impotence, is the inability to achieve or sustain an erection for satisfactory sexual activity. Erectile dysfunction is different from other conditions that interfere with sexual intercourse, such as lack of sexual desire and problems with ejaculation and orgasm.

Medications for erectile dysfunction include:


In patients with hypogonadism, Testosterone treatment can improve libido and erectile dysfunction, but the response of erectile dysfunction in men with hypogonadism to testosterone is not complete; many men still may need additional oral medications such as Sildenafil, Vardenafil or Tadalafil.

Oral phosphodiesterase type 5 (PDE5) inhibitors:

Sildenafil (Viagra)

Viagra was developed and is being marketed by the pharmaceutical company Pfizer. Viagra acts by inhibiting cGMP specific phosphodiesterase type 5, an enzyme that regulates blood flow in the penis.

Vardenafil (Levitra)

Vardenafil's indications and contra-indications are the same as with other PDE5 inhibitors; it is closely related in function to Sildenafil (Viagra) and Tadalafil (Cialis). Structurally, the difference between the Vardenafil molecule and Sildenafil is a nitrogen atom's position and the change of Sildenafil's piperazine ring methyl group to an ethyl group.

Tadalafil (Cialis)

Cialis (Tadalafil) is a PDE5 inhibitor. Cialis has recently been approved for the treatment of pulmonary arterial hypertension. Cialis half-life is around 17.50 hours, which is much longer than Viagra (4-5 hours) or Levitra (4-5 hours).

Intracavernosa injections:

Medications can be injected directly into the corpora cavernosa to attain and maintain erections. Medications such as papaverine hydrochloride, phentolamine, and prostaglandin E1 can be used alone or in combinations to attain erections.

Caverject (Alprostadil) is used as an intracavernosal injection or a urethral suppository to facilitate attainment of a sexually functional erection in males with erectile dysfunction (ED, impotence).

Intraurethral suppositories:

Prostaglandin E1 can be inserted in a pellet (suppository) form into the urethra to attain erections. This technique also is not popular because of occasional side effects of pain in the penis and sometimes in the testicles, mild urethral bleeding, dizziness, and vaginal itching in the sex partner.

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