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Here are some frequently asked questions and answers about specific aspects of erectile dysfunction, including its causes and possible treatments.
Q: What is the primary cause of erectile dysfunction?
A: It is estimated that up to 80 percent of all ED is caused by insufficient blood flow to the penis. The primary culprit behind this most common form of ED is atherosclerosis, a process during which arteries become clogged to the point where they can no longer support the robust flow of blood needed to support erection. There is no single factor involved in all cases of atherosclerosis. In some cases, it can be traced to congenital conditions in which the liver overproduces bad cholesterol — low-density lipoprotein — that in turn leads to a clogging of the arteries. In others, it is the result of unhealthy lifestyle choices, such as an unhealthy diet or lack of exercise, or a side effect of underlying illnesses such as heart disease, high blood pressure, or type 2 diabetes.
Q: Can ED develop in men who enjoy relatively normal or even above-average vascular health?
A: Yes, the second-biggest form of ED is psychogenic impotence, in which the inability to get and keep an erection suitable for intercourse is caused by psychological factors, such as depression, anxiety, and inability to cope with stress. While ED of vascular origin usually responds to treatment with PDE5 inhibitors, drugs that temporarily improve blood flow to the penis, psychogenic impotence is unlikely to improve significantly when these drugs are taken. In most cases, men suffering from psychogenic ED will need the help of psychological counselors to help them discover and treat the underlying causes of their impotence.
Q: How do PDE5 inhibitors work?
A: PDE5 inhibitors are so called because they temporarily shut down an enzyme known as phosphodiesterase-5, which can interfere with optimal blood flow to the genitals in men whose vascular health is already compromised. One of the primary tasks of the PDE5 enzyme is to break down a substance called cyclic guanosine monophosphate, or cGMP, which facilitates the erection process by relaxing the smooth muscles that line artery walls, thus increasing blood flow. In men with no significant circulatory problems, the body quickly replaces the cGMP that the PDE5 enzyme has broken down. However, in men with blood flow problems, the PDE5 enzyme usually breaks down cGMP faster than it can be replaced, thus sabotaging erectile function.
Q: What medications interfere with normal erectile function?
A: A wide variety of both prescription and over-the-counter drugs can make it more difficult, if not impossible, to get and keep an erection firm and long-lasting enough for intercourse. In one of life’s cruel ironies, this list includes a number of antidepressants and other psychiatric medicines, often making drug treatment of depression incompatible with regular erectile function. Other categories of drugs that interfere with the erection process include antihistamines; antihypertensives, including diuretics; opiate-based painkillers; Parkinson’s disease drugs; chemotherapy drugs; and recreational drugs. MedlinePlus.gov offers a more comprehensive list.
Q: Do I need a prescription to buy a PDE5 inhibitor in the United States?
A: Viagra, the first PDE5 inhibitor to be introduced, way back in 1998, will soon be available without a prescription in the United Kingdom, but no such move is underway in the United States where you’ll need a prescription to buy the little blue pill or any of the other oral ED drugs.
Q: Must I visit my doctor’s office to get a prescription for a PDE5 inhibitor?
A: eDrugstore.com, which belongs to the Secure Medical family of online facilitators, can set up a complimentary online consultation with one of its team of licensed U.S. physicians. Thus, you have an alternative to visiting your own doctor’s office. The eDrugstore doctor can authorize a prescription if you are determined to be an appropriate candidate for the drug. If you already have a prescription from your own doctor, you can take advantage of eDrugstore’s convenient online ordering system by faxing the prescription or scanning and emailing it along with your order. To learn more about erectile dysfunction, its causes, and the medications available to treat it, click below to access eDrugstore’s Male Impotence page.
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