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Shockwaves, stem cell therapy, and innovative drugs are on the horizon for possible treatment of erectile dysfunction (ED). In the meantime, prescription medications like Viagra work exceptionally well for most men.
For nearly two decades now, the oral erectile dysfunction drugs known collectively as PDE5 inhibitors have basked in the spotlight as the leading-edge treatment for male impotence. How might that change in the foreseeable future?
Already waiting in the wings or on the drawing boards are alternative forms of treatment that may one day supplant the oral ED drugs or at least share with them the spotlight. None has yet managed to make the same sort of splash created by the 1998 debut of Pfizer’s Viagra, the little blue pill that was the first of the PDE5 inhibitors.
ED Drugs Don’t Work for Everybody
While PDE5 inhibitors have been the answer to a dream for millions of men unable to get and keep an erection on their own, these drugs are not appropriate for all patients and treat only ED caused by insufficient blood flow to the penis. Compromised blood flow to the genitals is the largest single cause of ED, but male impotence can also be caused by psychological issues and traumatic injury to the male genitals.
Offering a preview of potential future treatments for ED, two Egyptian researchers from the Department of Urology at Egypt’s Suez Canal University published a systematic review of innovative trends and perspectives in June 2016. Their vision of things to come appeared in the “Arab Journal of Urology,” a peer-reviewed journal published on behalf of the Arab Association of Urology. Following are some of the advances in ED treatment that are likely to emerge in the near future.
New and Improved PDE5 Inhibitors
Ezzat A. Ismail and Ahmed I. El-Sakka, authors of the review, reported that laboratory and animal tests have shown that a novel Chinese PDE5 inhibitor dubbed TPN729MA appears to have a longer duration of action than the oral ED drugs now available.
Meanwhile, South Korean researchers have developed another PDE5 inhibitor known as udenafil, already on the market in several countries under the brand name Zydena. Some tests have shown that udenafil is not only effective in the treatment of ED but also has been shown to improve cognitive function in animal testing.
Soluble Guanyalate Cyclase Activators
Not all ED patients with compromised blood flow to the penis respond positively to PDE5 inhibitors. For many of these men, the problem lies in their apparent inability to produce adequate levels of the nitric oxide that then triggers the synthesis of a substance known as cyclic guanosine monophosphate, or cGMP. This substance in turn signals the smooth muscle tissue lining artery walls to relax, thus increasing the volume of blood that they can carry. To circumvent this problem, researchers have developed agents known as soluble guanyalate cyclase (sGC) activators, which can achieve similar results by following different pathways. Two of these sGC activators currently under study are known as BAY 60-2770 and BAY 41-2272.
Stem Cell Therapy
As in many other areas of medicine, urologists are looking at ways in which stem cell therapy might be used to treat ED in patients that fail to respond to other modes of treatment. According to WebMD.com, gene therapy hopefully would generate proteins or other substances that ED patients are no longer able to synthesize within their own bodies and thus allow the patients to regain some degree of erectile function. Among the types of stem cells currently under study, according to Ismail and El-Sakka, are adipose tissue-derived stem cells, human umbilical cord blood mesenchymal stem cells, and bone marrow-derived stem cells.
Low-Intensity Extracorporeal Shockwave Therapy
Another promising avenue of treatment for erectile dysfunction is low-intensity extracorporeal shockwave therapy. Although the precise mechanisms of this therapy are not fully understood, it is believed that low-level shockwaves delivered to the shaft of the penis may help to heal injured tissues or cells through the creation of new blood vessels and by improving the function of smooth muscle and endothelial cells. The latter both play a critical role in erectile function.
Uprima (Apomorphine)
Already sold under the brand name Uprima in some markets outside the United States, apomorphine comes in a tablet that dissolves under the tongue, according to WebMD. It works by increasing brain levels of dopamine, a neurotransmitter associated with increased sexual interest and sensation. In its current form, the drug produces nausea and vomiting in some patients, and it has also caused some users to briefly lose consciousness. Such side effects obviously are problematic, so developers are working to develop an alternative form of delivery — a nasal spray — that will have fewer adverse effects.
Topiglan
A topical application of the vasodilating drug alprostadil, Topiglan may offer an improved system of delivery for the drug that is already widely used in penile injection therapy as well as intraurethral suppositories. Still undergoing trials, it remains to be seen if this delivery system works as well as penile injection therapy, which is extremely effective but a less appealing form of treatment, particularly for those who are needle-phobes. Topiglan comes in cream form, according to WebMD.
Melanocortin Activators
Men whose erection problems are caused by psychological factors, such as depression or extreme anxiety, currently have few options but to seek professional counseling to get to the root of those mental issues. That could change, according to WebMD, if tests of melanocortin activators demonstrate that the drugs can safely be used in humans to produce erections, an effect already produced in animal testing.
If this article has piqued your interest and you would like to read more about sexual health and function, as well as other topics of interest to health care consumers, check out our blog. And if you want to order proven ED medications like Viagra online, with unmatched convenience, we invite you to visit eDrugstore.com.
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