Viagra, Cialis and Levitra Pills

Erectile dysfunction (ED) can be defined as the inability of a man to achieve or maintain an erection sufficient to introduce penis into the vagina and perform satisfactory sexual intercourse. The frequency of erectile dysfunction varies depending on age. If in the age group of 20 to 40 years it is met at average in 3%, then at the age of 40 to 60 years it occurs in 15 – 20% of men. At the age of more than 70 years, erectile dysfunction symptoms can disturb up to 30% of men. At any age, erectile dysfunction is not normal, because the ability to lead regular and satisfactory sex life is one of the inalienable functions of men of any age.

Erectile dysfunction can be caused by two groups of causes: psychological (psychogenic) and somatic (organic). Studies of the last 20 years have shown that erectile dysfunction is rarely caused by purely psychological causes (stress, depression, behavioral patterns, etc.). At the same time, it became known that about 80% of all cases of erectile dysfunction are caused by some physical (somatic, organic) conditions. These include: diabetes, high blood pressure, high blood cholesterol and arteriosclerosis of blood vessels, renal and hepatic insufficiency, thyroid disorders, hormonal disorders, consequences of surgery on prostate and rectum, trauma and diseases of spinal cord and brain (blood stroke, Alzheimer’s disease, etc.), consequences of pelvic injuries, Peyronie’s disease. Erectile dysfunction can also be caused by taking certain medications. Persistent erectile dysfunction can develop due to harmful habits such as alcohol use, smoking and taking drugs.pills for erection

What is place among methods of erectile dysfunction treatment occupied by pills for erection?

Currently, there are 5 groups of methods for treating erectile dysfunction:

  • psychotherapy and sex therapy, which is used only for the so-called psychologically-mediated or psychogenic erectile dysfunction, less often as an auxiliary method for somatic or organic erectile dysfunction;
  • taking pills for erection: Viagra, Cialis, Levitra. It is used as means of the first choice (first line therapy) at all forms of organic erectile dysfunction, regardless of its causes;
  • injectable pharmacotherapy or «erection by order». It is used as second-line therapy for all forms of erectile dysfunction in those cases when pills for erection do not give the desired effect or their use is contraindicated. Pills for erection and injections of vasodilator drugs into penis can be used together, as a variant of combined erectile dysfunction treatment;
  • vacuum-erectile therapy or use to obtain or retain erection of vacuum-erectors of various models and modifications. It is a variant of second-line therapy of organic and less often psychogenic forms of erectile dysfunction:
    • 90% efficiency;
    • no need to use medications that have side effects;
    • non-aggressive method of treatment;
    • helps to create an erection, keeping all precautions;
  • surgical methods of treatment: surgery on vessels of penis and falloprosthesis. The first group of interventions is divided into surgery into veins (limitation of venous outflow) and arteries (the increase of arterial inflow) of the penis. Surgery on veins can be effectively used in selected cases of erectile dysfunction, especially in combination with erection pills. Surgeries on arteries are ineffective and are used rarer and rarer. Falloprosthesis is the most effective and radical of all treatments for erectile dysfunction, the only method that gives a complete cure for organic erectile dysfunction. Surgical methods are usually used only in those cases of organic erectile dysfunction when conservative therapy did not work.

So, pills for erection are first-line therapy, at which treatment of any type of erectile dysfunction most often begins. Viagra, Cialis, and Levitra are today the only drugs available in the world that are effective in the treatment of erectile dysfunction. The effectiveness of all other advertised pills, as a rule, is not proved by their manufacturers and does not differ from dummies.

How do pills for erection work? How harmful are they? Are they addictive? What are side effects and contraindications? What are known drug interactions?

Viagra, Cialis, and Levitra have absolutely the same mechanism of action and are selective inhibitors of the activity of the enzyme – phosphodiesterase type 5 (PDE-5). This enzyme, in its turn, inhibits production in smooth muscle tissue of cyclic guanosine monophosphate (cGMP), which is formed from guanosine monophosphate (GMP) under the action of nitric oxide (NO). The main function of cGMP is to relax smooth muscles of cavernous bodies of the penis. When the action of PDE-5 is inhibited, a much larger amount of cGMP accumulates in cavernous bodies, their smooth muscles relax significantly and much larger amount of blood rushes toward penis, which causes an erection.

Preparations of this group act selectively in the vascular tissue of the penis and are almost harmless. They do not cause permanent negative effects at prolonged and regular use. No addiction to pills for erection does not develop, with exception of purely psychological dependence. Once having tried a pill for an erection and having felt much better its quality, a man does not want to refuse from Viagra pills.

The main side effects of Viagra. Cialis and Levitra and their frequencies are summarized in percent in the table below.

Viagra (100 mg) Levitra (20 mg) Cialis (20 mg)
A headache 19 15 11
Hot flushes 19 11 5
Nasal congestion (rhinitis) 5 7 5
Nausea and diarrhea (dyspepsia) 6 7 17
Pain in the back 9
Vision violation (color perception) 3

The frequency of onset of side effects depends on the dosage of the drug and individual sensitivity. It also depends on an intake of food before using pills for erection. On the full stomach frequency of side effects, as well as the effectiveness of drugs is lower.

Absolute contraindication to reception of pills for erection is their intolerance (allergy) and simultaneous reception of organic nitrates (nitroglycerine, etc.). At the simultaneous reception of pills for an erection and organic nitrates, fatal decrease of arterial pressure can appear. It is extremely undesirable and potentially dangerous to assign pills for erection from PDE-5 inhibitors group to patients with the following diagnoses:

  • ischemic heart disease with frequent attacks of chest pain;
  • congestive cardiac insufficiency and a significant decrease in blood pressure;
  • significant reduction in cardiac output;
  • complex drug therapy of hypertension;
  • drug therapy, which can slow clearance of PDE-5 inhibitors from the body.

Described cases of deaths associated with taking Viagra were caused most often by combined use of this drug with organic nitrates.

Clearance of PDE-5 inhibitors from the body is slowed by such drugs as ketoconazole and erythromycin. People who take these drugs should reduce the dosage of pills for an erection or completely refrain from them. Significantly enhances the effectiveness of pills for erection, especially in persons with hypogonadism or male menopause (andropause), concurrent use of male sex hormones (testosterone).

How and when to apply pills for an erection and what is the difference between Viagra, Cialis, and Levitra?

Pills for erection from PDE-5 inhibitors group (Viagra, Cialis, Levitra) are the first choice for any form of organic erectile dysfunction. They are appointed immediately before sexual intercourse in a period of time from 30 minutes to 1 hour before planned sex. In some cases, drugs are prescribed regularly before each sexual intercourse, sometimes it is recommended that they are taken only when, in the opinion of the patient, there is the greatest chance of failure. These medications have differences that are useful to know.

  • Viagra has the largest clinical experience because has been in use since 1998. This drug has already helped more than 16 million people worldwide and is the most well-studied of all erection pills. Viagra should be taken 1 hour before sexual intercourse, it works up to 4 hours and after its administration side effects occur more often in comparison with newer PDE-5 inhibitors. Before taking Viagra is not recommended to eat fatty foods, as it reduces the effectiveness of the drug.
  • Levitra can be taken 15 minutes before planned sex, duration of its action is somewhat larger than that of Viagra, and frequency of side effects is lower.
  • Cialis is taken 30 minutes before planned sexual intercourse, fatty food does not affect its activity, and it acts up to 36 hours and sometimes more. For this, Cialis is called a «weekend pill». One pill allows you to be «in tone» the whole weekend. To compare the profile of side effects of all 3 drugs, you can again refer to the table above.first-line therapy for ED

What is the effectiveness of pills for an erection and is it possible to completely get rid of erectile dysfunction with their help?

The effectiveness of PDE-5 inhibitors for various forms of erectile dysfunction is according to various clinical studies from 60 to 85%. Pills are intended to be taken before each sexual intercourse, i. e. when you take a pill, erection improves, without a pill – erection will be such as it was recently before the beginning of treatment. In recent years, reports have appeared that regular daily intake of relatively small doses of pills for erection for at least 12 weeks has a definite healing effect, i. e. Improves the quality of natural erections. To enhance the effect, PDE-5 inhibitors are used in conjunction with male sex hormones, injections of vasodilators into the penis, surgery to limit venous outflow from the penis.

What should I do if erection pills do not work?

In such cases, under the supervision of a doctor, it makes sense to try second-line therapy or injections into the penis of vasodilators. If this does not help, you should resort to one of the surgical options. It should be remembered that the highest efficiency among all methods of treatment of erectile dysfunction is falloprosthesis.

Category: Erectile Dysfunction

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