Erectile dysfunction

The first thing your doctor will do is to make sure you're getting the right treatment for any health problems that could be causing or worsening your erectile dysfunction. A variety of options exist for treating erectile dysfunction. The cause and severity of your condition, and underlying health problems, are important factors in your doctor's recommending the best treatment or treatments for you. Your doctor can explain the risks and benefits of each treatment, and will consider your preferences. Your partner's preferences also may play a role in treatment choices. Oral medications Oral medications are a successful erectile dysfunction treatment for many men. They include: Sildenafil (Viagra) Tadalafil (Cialis) Vardenafil (Levitra) All three medications work in much the same way. These drugs enhance the effects of nitric oxide, a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation. These medications vary in dosage, how long they work and their side effects. Your doctor will take into account your particular situation to determine which medication may work best. Don't expect these medications to fix your erectile dysfunction immediately. You may need to work with your doctor to find the right medication and dose for you. Before taking any prescription erectile dysfunction medication (including over-the-counter supplements or herbal remedies), get your doctor's OK. Although these medications can help many people, not all men should take them to treat erectile dysfunction. These medications may not work or may be dangerous for you if you: Take nitrate drugs for angina, such as nitroglycerin (Nitro-Bid, others), isosorbide mononitrate (Imdur) and isosorbide dinitrate (Isordil) Take a blood-thinning (anticoagulant) medication, alpha blockers for enlarged prostate (benign prostatic hyperplasia) or high blood pressure medications Have heart disease or heart failure Have had a stroke Have very low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension) Have uncontrolled diabetes Other medications Other medications for erectile dysfunction include: Alprostadil self-injection. With this method, you use a fine needle to inject alprostadil (Alprostadil, Caverject Impulse, Edex) into the base or side of your penis. In some cases, medications generally used for other conditions are used for penile injections on their own or in combination. Examples include papaverine, alprostadil and phentolamine. Each injection generally produces an erection in five to 20 minutes that lasts about an hour. Because the needle used is very fine, pain from the injection site is usually minor. Side effects can include bleeding from the injection, prolonged erection and formation of fibrous tissue at the injection site. Alprostadil penis suppository. Alprostadil intraurethral (MUSE) therapy involves placing a tiny alprostadil suppository inside your penis. You use a special applicator to insert the suppository about two inches down into your penis. Side effects can include pain, minor bleeding in the urethra, dizziness and formation of fibrous tissue inside your penis. Testosterone replacement. Some men have erectile dysfunction caused by low levels of the hormone testosterone, and may need testosterone replacement therapy. Penis pumps, surgery and implants Medications may not work or may not be a good choice for you. If this is the case, your doctor may recommend a different treatment. Other treatments include: Penis pumps. A penis pump (vacuum constriction device) is a hollow tube with a hand-powered or battery-powered pump. The tube is placed over your penis, and then the pump is used to suck out the air inside the tube. This creates a vacuum that pulls blood into your penis. Once you get an erection, you slip a tension ring around the base of your penis to hold in the blood and keep it firm. You then remove the vacuum device. The erection typically lasts long enough for a couple to have sex. You remove the tension ring after intercourse. Penile implants. This treatment involves surgically placing devices into the two sides of the penis. These implants consist of either inflatable or semirigid rods made from silicone or polyurethane. The inflatable devices allow you to control when and how long you have an erection. The semirigid rods keep the penis firm but bendable. This treatment can be expensive and is usually not recommended until other methods have been tried first. As with any surgery, there is a risk of complications such as infection. Blood vessel surgery. In rare cases, a leaking blood vessel can cause erectile dysfunction and surgery is necessary to repair it. Psychological counseling If your erectile dysfunction is caused by stress, anxiety or depression, your doctor may suggest that you, or you and your partner, visit a psychologist or counselor. Even if it is caused by something physical, erectile dysfunction can create stress and relationship tension. Tests and diagnosis For many men, a physical exam and answering questions (medical history) are all that's needed before a doctor is ready to recommend a treatment. If your doctor suspects that underlying problems may be involved, or you have chronic health problems, you may need further tests or you may need to see a specialist. Tests for underlying problems may include: Physical exam. This may include careful examination of your penis and testicles and checking your nerves for feeling. Blood tests. A sample of your blood may be sent to a lab to check for signs of heart disease, diabetes, low testosterone levels and other health problems. Urine tests (urinalysis). Like blood tests, urine tests are used to look for signs of diabetes and other underlying health conditions. Ultrasound. This test can check blood flow to your penis. It involves using a wand-like device (transducer) held over the blood vessels that supply the penis. It creates a video image to let your doctor see if you have blood flow problems. This test is sometimes done in combination with an injection of medications into the penis to determine if blood flow increases normally. Overnight erection test. Most men have erections during sleep without remembering them. This simple test involves wrapping special tape around your penis before you go to bed. If the tape is separated in the morning, your penis was erect at some time during the night. This indicates the cause is of your erectile dysfunction is most likely psychological and not physical.

Media release from Pfizer The little blue pill called Viagra® (sildenafil citrate) which revolutionised the treatment of erectile dysfunction (ED) and made a positive impact on men's sexual health has now become more affordable. With the New Zealand patent period on Viagra expiring in June, the market will soon be open to generic medicines. Pfizer, the makers of Viagra, will now also sell this medicine in New Zealand under a second brand called Avigra®. Avigra will provide the thousands of Kiwi men currently using Viagra with a more affordable option, plus the confidence they'll be receiving the same quality of medicine from the makers of Viagra, the most prescribed treatment for ED in New Zealand since its launch in 1998 . "Because Viagra still remains patented throughout most of the world, by launching a second brand in a generic market it allows us to provide the same quality of medicine as Viagra at a more competitive price," says Frances Benge, Head of Primary Care, Pfizer New Zealand Limited. Until now the cost of treatment for ED has prevented some men from receiving it. The recommended retail cost of Avigra is around $8 per tablet (available in boxes of four or 12), almost half the price of Viagra, making it more affordable and allowing more men to access treatment for a healthier sex life. Viagra will still be available in New Zealand at a competitive price for those men who prefer to remain on it. The active ingredient in Avigra has helped more than 37 million men in 120 countries reclaim their sex lives by improving the hardness of their erection. Along with optimal erection, many men using this treatment report an increase in sexual confidence, self-esteem and sexual relations satisfaction. Product information: Prices may vary from pharmacy to pharmacy. Doctor fees and a pharmacy charge may apply. Avigra is a private purchase medicine. Avigra is available in boxes of 4 (sildenafil citrate 25mg, 50mg, 100mg) or 12 (100mg only). It is a prescription medicine for the treatment of erection problems. Avigra must not be used by men taking any form of nitrate medicine. Avigra must not be taken by men with heart conditions that may be affected by the strain of sexual activity. Side effects include headache, dizziness, flushing, indigestion, temporary changes in vision, stuffy nose, diarrhoea, urinary tract infection or rash. Use strictly as directed. If symptoms continue or you have side effects see your doctor.