Even if the temptation is great, help from the sex shop or medications from the internet are not a solution to a medical problem that is often just the tip of a health iceberg. The successful treatment of erectile dysfunction can only succeed if the actual cause of the disorder is known.
Dubious drugs for potency problems
For one, the drug therapy must be accompanied and controlled by the doctor - even if the health insurance may not pay the drug. On the other hand, you should avoid illegal drugs, so actually prescription drugs that are delivered without a prescription, from the Internet. With side effects you have no liability to the manufacturer. In addition, the tablets could have been counterfeited or improperly handled and stored.
The best place for drugs for the treatment of erectile dysfunction is the pharmacy. The spectrum of treatment for erectile dysfunction ranges from medication to mechanical aids and vascular surgery to the implantation of penile prostheses. In all cases, psychological care (as a couple or individual therapy) is worthwhile, even if the causes may be purely organic. And not to forget: underlying diseases must be treated adequately.
Erectile Dysfunction: Oral medications
There are various drugs that can help the man to new stability, all are prescription. The doctor decides together with the person concerned which preparation is suitable.
- Most commonly used are phosphodiesterase-5 inhibitors - sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) - which inhibit the breakdown of the enzyme cGMP and thus prolong its stability. But only if the man is actually aroused and his blood and nerve supply still allow an erection. Men taking medications for heart disease should not take phosphodiesterase 5 inhibitors - there are always deaths! Depending on the active ingredient, the tablets are taken half to twelve hours before sexual intercourse, the effect begins after 30 minutes and can last up to 24 hours.
- Preparations containing the active ingredient apomorphine (eg Uprima®, Ixense®) act as dopamine receptor agonists where the erection starts - in the head. Apomorphine in the brain amplifies the natural signals that trigger an erection, such as a stimulating touch or the sight of an attractive woman; Sexual stimulation is needed. It works quite fast and is also a solution for men with cardiovascular diseases.
- Phentolamine (Vasomax®) is a non-selective alpha-receptor blocker that can support an erection by acting on the penile muscles.
If the potency disorder is associated with a hormone deficiency, usually testosterone, this or its precursor dehydroepiandrosterone (DHEA) can be ingested, injected, stuck to the skin as a patch or applied as a gel to the skin.
Medicines on the spot
Unlike orally administered drugs, the local drugs with the active ingredient alprostadil act directly on the penis. For many men, this type of treatment is associated with great mental resistance.
In the swollen body auto-injection therapy (SKAT), an active ingredient is injected directly into the erectile tissue. Because an extremely thin needle is used, there is hardly any pain. The erection occurs after about 10 minutes.
In another system, the MUSE® (Medicated Ureter System for Erection), the active ingredient is introduced as a mini-tablet via an applicator into the urethra. However, the success rate is lower than with the SKAT application and it takes longer for the effect to occur. Both forms are of particular help to men in whom the disorders are due to damage to the nerves, such as after operations in the pelvis.
Mechanical aids in potency disorders
Even with the help of a vacuum pump, an erection can be achieved. For this purpose, the penis is inserted into a transparent plastic cylinder and then produced there with a small hand or electric pump negative pressure. As a result, blood flows into the erectile tissue and makes the penis stiff.
Once a sufficient erection is present, the backflow of blood from the erectile tissue is prevented with a penile ring. Cock rings can be used whenever a natural enough initial erection is possible. The penis ring is striped over the erect penis to the root of the penis. The erection can then be maintained, but an anatomically customized specimen must be used. In addition, they must not be worn for more than 30 minutes, because otherwise the entire blood supply suffers.
Surgical procedures and implants for impotence
If the cavernosum can not be adequately supplied with blood or the blood drains too quickly, a vascular operation can be performed. However, the success rates are not very high, so this intervention is only carried out in exceptional cases.
The insertion of a cavernous implant is problematic. In this operation, large parts of the natural erectile tissue are destroyed and can not be restored. Therefore, this treatment is only for discussion in case of failure of all other treatment options for discussion.