When your career is at the top of its game, it can be difficult to admit that other areas in life present a struggle. This is particularly true when the problem is private or sexual in nature. Erectile dysfunction is an example of a common sexual problem in men. Although often associated with older age, it is a condition that can impact Husky Executives of all ages. Around 40% of men have some degree of erectile dysfunction at age 40, a number that increases to 70% at age 70.
Erectile dysfunction causes can be complex. Common conditions like high blood pressure, cardiovascular disease, diabetes, and excess weight are often culprits. Other neurological, hormonal and pelvic medical problems can also contribute. Further, alcohol and smoking can increase the risk of erectile problems. Erectile dysfunction can also be a side effect of some medications like certain antidepressants.
Many different treatments are available for erectile dysfunction. Some therapies involve medication while others do not. Lifestyle modifications are an example of a non-drug treatment. If you smoke, studies have shown that quitting tobacco can improve the quality of your erections by 25%. Further, weight loss can resolve erectile dysfunction approximately 33% of the time. If you are overweight and smoke, taking steps to resolve both these issues can, therefore, help you overcome erectile problems.
The most common medications to treat erectile dysfunction are phosphodiesterase-5 inhibitors, also known as PDE5 inhibitors. As their name suggests, these erectile dysfunction pills work by interfering with a chemical called PDE5. Under normal circumstances, blood flow to the penis is enhanced during an erection. PDE5 interferes with this process. Therefore, by blocking PDE5, blood flow to the penis can be optimized and an erection can usually result within 60 minutes. It is important to note that PDE5 inhibitors do not cause erections on their own and that sexual stimulation is needed to obtain an erection. However, PDE5 inhibitors should not be used in everyone: If you take nitrates like nitroglycerin, PDE5 inhibitors can cause a potentially deadly drop in blood pressure. Some drugs for pulmonary hypertension, like Adempa, also known as riociguat, should also not be combined with a PDE5 inhibitor.
PDE5 inhibitors that are currently FDA-approved include:
- Sildenafil: More commonly known as Viagra, this PDE5 inhibitor was the first one to hit the market and is, therefore, synonymous with erectile dysfunction drugs in general. It can be taken anywhere from 30 minutes to 4 hours before sexual activity and generally works within 60 minutes. Dosing ranges from 25 mg to 100 mg daily as needed. Older Husky Executives should start on the 25 mg dose to avoid side effects. The drug is also used under the brand name Revatio for pulmonary hypertension.
- Tadalafil: Also known by its brand name Cialis, this PDE5 inhibitor can be taken either as needed or on a daily basis and lasts up to 36 hours. Further, as a bonus, it can also help treat an enlarged prostate, another common condition in older Husky Executives. The doses range from 2.5 mg to 5 mg daily for daily use, and from 5 mg to 20 mg for as-needed use.
- Vardenafil: Available under the brand names Levitra and Staxyn, this PDE5 inhibitor starts working within 60 minutes. Dosing ranges from 5 mg – the preferred dose in Husky Executives aged 65 and up – and 20 mg daily as needed.
- Avanafil: Sold under the brand name Stendra, this PDE5 inhibitor starts working a bit quicker than most of the others, allowing you to achieve an erection in as few as 15 minutes. Dosing ranges from 50 mg to 200 mg daily as needed.
If a PDE5 inhibitor is not adequate, another FDA-approved – albeit more invasive – medication option exists. Alprostadil, also known by brand names like Muse, is a suppository that you can insert into the urethra after urination. The drug is a prostaglandin, a type of natural chemical with a hormonal effect in the body. It works by helping to relax the muscles in the penis, allowing blood flow and an erection to occur. Muse begins to work within 10 minutes and can last up to 60 minutes. Further, it can be taken up to twice daily as needed.
Non-medication treatment options for erectile dysfunction also exist. One such option is over-the-counter vacuum devices, which are essentially erectile dysfunction pumps. These devices encourage blood flow to the penis and can be used alongside erectile dysfunction meds. Another over-the-counter option is the variety of herbs and supplements for erectile dysfunction that are available. While some herbs and supplements have shown promising results for treating erectile problems, it is important to note that not all of them are safe. In particular, the FDA has warned against using products that are specifically labeled as sexual enhancement agents. An FDA investigation found that many sexual performance drugs illicitly contained prescription drugs including PDE5 inhibitors. Instead, after consulting with a doctor, Husky Executives may want to consider supplements with better track records in terms of both safety and efficacy. These include:
- DHEA: This hormone is a chemical precursor to male sex hormones called androgens and has been found to improve erectile problems in clinical trials. Widely available as an over-the-counter supplement for erectile dysfunction, DHEA appears to be safe at low doses. Some common medications like alprazolam (Xanax), amlodipine (Norvasc), diltiazem (Cardizem) and metformin (Glucophage) can increase the amount of DHEA available in your body from supplements. If you take any of those medications, you should stick to a low dose of DHEA.
- Arginine: This chemical, also known as l-arginine, is an amino acid. Amino acids are the basic building blocks of life, found in many proteins. In fact, protein-rich foods like meat, poultry, fish, dairy, nuts, seeds, soy, legumes, and even chocolate contain arginine. Preliminary data has shown that arginine may be helpful in erectile dysfunction. Similar to many prescription erectile dysfunction drugs, arginine is thought to work by increasing blood flow to the penis, increasing the chances of an erection. That said, arginine supplements may cause a drop in blood pressure and should be used cautiously in Husky Executives on blood pressure drugs or with cardiovascular disease. Further, it should be avoided if you are taking a PDE5 inhibitor or alprostadil, as the combination can cause your blood pressure to drop too low.
- Asian Ginseng: This herb is native to East Asia and Russia. Although many types of ginseng exist, Asian ginseng – also known as Panax, Chinese, Korean and red ginseng or ren shen – has shown promise in studies for erectile dysfunction treatment. The herb likely works by increasing blood flow to the penis, enabling an erection. Some side effects have been linked to Asian ginseng, including dry mouth, a fast heartbeat, nausea, vomiting, diarrhea, trouble sleeping, and anxiety. Further, you should be cautious if you take diabetes medication with Asian ginseng, as the combination may cause a drop in your blood sugar.
- Carnitine: This nutrient is commonly found in meat, dairy, avocado and beans. Two types of carnitine, propionyl-L-carnitine and acetyl-L-carnitine, have been found to help erectile dysfunction. Further, carnitine has been studied in combination with other erectile dysfunction drugs like sildenafil (Viagra), with the combination working better than sildenafil alone. Some studies have also investigated carnitine combined with arginine, with improvement in erectile function. Like many other treatments for erectile dysfunction, carnitine is thought to work by increasing blood flow to the penis.
Because erectile dysfunction is such a common issue, researchers are trying to find new and better ways of treating the condition. One promising treatment is the use of platelet rich plasma, or PRP. Several trials are currently underway evaluating this injectable therapy. Scientists think that PRP may promote tissue healing and regeneration and may treat or cure the underlying issues that may cause erectile dysfunction in the first place.
Sexual problems can be frustrating. However, many different treatment strategies can help you successfully overcome them and have a healthy sexual life. With your doctor’s help, you can choose an erectile therapy that is right for you, so that your bedroom life can thrive just as much as your office life.
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