Madeeha Syed

Five non-medical causes of erectile dysfunction and how to overcome them.

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Learn about the common causes of erectile dysfunction and discover effective strategies to overcome this issue. Explore expert tips, remedies, and lifestyle changes that can help restore your sexual health and confidence. Don't let erectile dysfunction hinder your relationships any longer—find solutions today.

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AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

Erectile Dysfunction Pills - Hit Or Miss?

Introduction

Sexual dysfunction is a common problem among both men and women. Approximately 43% of women and 31% of men report suffering from some form of problem during sex.<a href="#accordion">[1]</a>&nbsp;In men, sexual dysfunction encompasses sexual desire, orgasm, pain, and sexual arousal (maintaining erections).<a href="#accordion">[2]</a>&nbsp;Difficulty achieving or maintaining an erection is not unusual. One can experience such problems from time to time, especially if facing relationship problems or dealing with stress. However, if it progressively worsens and affects one&#39;s sexual life, it becomes a health concern.

<a href="https://www.merisehat.pk/disease/erectile-dysfunction">Erectile dysfunction</a>, or ED, is defined as an inability to maintain a firm enough and lasting erection for satisfactory sexual intercourse or achieve an erection when one wants. Although its prevalence increases with age, aging isn&#39;t a cause of ED.<a href="#accordion">[3]</a>&nbsp;Instead, several physical and psychological conditions can predispose one to ED; these include <a href="https://www.merisehat.pk/disease/depression">depression</a>, diabetes, cardiovascular disorders, and obesity.<a href="#accordion">[4]</a>&nbsp;Moreover, the use of certain medications, smoking, drug use, and alcohol consumption can also affect a person&#39;s sexual function.&nbsp;

ED is highly prevalent in the Pakistani male population, affecting 80.8% of men attending primary care clinics.<a href="#accordion">[5]</a>&nbsp;However, the true burden of the disease in the country cannot be established due to underreporting of cases. The stigma surrounding sexual health makes men hesitant to discuss their issues with a healthcare professional and at times even friends and family. Moreover, many are unaware that ED is a highly treatable condition. Thus, it not only affects one&#39;s sexual and mental health but also the overall quality of life. 
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Understanding Erectile Dysfunction Pills

Over the years, researchers have developed several treatment options for ED, ranging from pills and aids to surgical implants. However, oral pills such as phosphodiesterase (PDE) 5 inhibitors continue to be the first line of treatment for erectile dysfunction.<a href="#accordion">[6]</a>&nbsp;The widely popular pill, Viagra (sildenafil) was one of the first FDA-approved oral pills for ED.&nbsp;

PDE5 inhibitors relax the penile muscles during sexual arousal, thus increasing blood flow to the chambers and causing an erection. They are typically 60-80% effective at treating the symptoms of ED.<a href="#accordion">[7]</a>&nbsp;Although all are similar in safety and effectiveness, there is a difference in how long the drug&#39;s effect lasts and the side effects of the medication.&nbsp; 
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There are four FDA-approved PDE5 inhibitors for use against ED. They include:

<ol>
	<li>Viagra (Sildenafil) - The famous blue pill was the first PDE5 inhibitor approved for ED. It is typically taken at least an hour prior to sexual intercourse and has a quick onset of action (30 minutes). The recommended dosage is 50 milligrams(mg), and its effect typically lasts for 4-5 hours. For maximum absorption, it is advised to take the drug on an empty stomach.&nbsp;</li>
	<li>Cialis (Tadalafil) - Unlike other ED pills, tadalafil has an extremely long duration of action (36 hours). It is often prescribed as a daily 5mg dose in patients suffering from benign prostatic hyperplasia and ED. Although similar to Viagra in terms of onset and safety, people often prefer tadalafil because it improves sexual confidence.<a href="#accordion">[8]</a>&nbsp;Therefore, it is often prescribed for people with psychological factors causing ED.&nbsp;</li>
	<li>Stendra (Avanafil) - Avanafil is a newer class of PDE5 inhibitors and is typically taken 30 minutes before sexual intercourse. Compared to other ED pills, avanafil is preferred in people with cardiovascular disorders as it has fewer effects on blood pressure<a href="#reference" target="_blank">9</a>. Thus, making it safe to use in those taking anti-hypertensives.&nbsp;</li>
	<li>Levitra (Vardenafil) - This particular drug has the shortest onset of action (10 minutes) and is effective for 4-5 hours. However, it can lengthen the QTc interval and is not prescribed in patients with prolonged QTc or those taking antiarrhythmics.</li>
</ol>

Note: ED pills can have mild side effects, such as flushing, dizziness, headaches, diarrhea, and vision problems. Moreover, the medications are contraindicated in those taking nitrate drugs, or suffering from blood pressure-related problems, liver disease, or severe kidney disease. A more severe side effect of the drug is a painful, prolonged erection. In case of an erection lasting more than 4 hours, professional help should be sought. 
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As per a 2013 meta-analysis, all PDE5 inhibitors are more effective than a placebo for treating ED.<a href="#accordion">[7]</a>&nbsp;They have a similar safety profile; however, the study found tadalafil to be the most effective among other PDE5 inhibitors, followed by vardenafil.&nbsp;

If all are safe and effective, what is the best option? The truth is that the best option will vary from person to person. It will depend on your medical history, the underlying cause of ED, whether you want it for regular use or occasional use, and your lifestyle. Therefore, it is best to discuss all your options with a healthcare professional and then make a decision. 
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Conclusion

Sexual health has a huge impact on a person&#39;s quality of life. Letting societal pressures and social stigmas influence your decisions will only negatively affect your health. And while living with any form of sexual dysfunction can be frustrating, it is important to note that treatment is very much possible. And the presence of a sexual problem is in no way reflective of one&#39;s masculinity.&nbsp;

Therefore, if one suffers from ED or any other sexual dysfunction, seeking a healthcare professional can significantly improve the overall quality of life. Moreover, combining various treatment options such as oral pills. counselling and lifestyle changes can further improve one&#39;s sexual problems.&nbsp; 
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Key Points

<ul>
</ul>

<ul>
	<li>Erectile dysfunction is defined as an inability to maintain an erection firm enough for satisfactory sexual intercourse. It can result from a variety of physical (obesity, diabetes, cardiovascular disease) and psychological (anxiety, depression) conditions.</li>
	<li>Phosphodiesterase (PDE) 5 inhibitors are the first line of treatment for ED. There are currently four FDA-approved pills: sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra).&nbsp;</li>
	<li>All ED pills are similar in safety and efficacy; however, doctors prescribe the drugs based on your medical history, lifestyle, and underlying cause of ED. It is best to consult your doctor before starting any medication.</li>
	<li>Seeking professional help is an important step in treating ED and improving one&#39;s sexual health&nbsp;and overall quality of life.</li>
</ul>

[1] Rosen, R. C., 2000. Prevalence and risk factors of sexual dysfunction in men and women. Current Psychiatry Reports, Volume 2, pp. 189-195.

[2] Wincze, J. P. & Weisberg, R. B., 2015. Sexual Dysfunction: A Guide for Assessment And Treatment. 3rd Edition ed. s.l.:Guilford Press.

[3] Johannes, C. B. et al., 2000. Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts male aging study. The Journal of Urology, 163(2), pp. 460-3.

[4] McMahon, C. G., 2019. Current diagnosis and management of erectile dysfunction. Medical Journal of Australia, 210(10), pp. 469-476.

[5] Shaeer, K. Z. M. et al., 2003. Prevalence of erectile dysfunction and its correlates among men attending primary care clinics in three countries: Pakistan, Egypt, and Nigeria. International journal of impotence research, Volume 15.

[6] Kalsi, J. S. & Kell, P. D., 2004. Update on oral treatments for male erectile dysfunction. Journal of the European Academy of Dermatology and Venereology, 18(3), pp. 267-274.

[7] Yuan, J. et al., 2013. Comparative effectiveness and safety of oral phosphodiesterase type 5 inhibitors for erectile dysfunction: a systematic review and network meta-analysis. European Urology, 63(5), pp. 902-12.

[8] Gong, B. et al., 2017. Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis. International Urology and Nephrology, 49(10).

[9] Katz, E. G., Tan, R. B., Rittenberg, D. & Hellstrom, W. J., 2014. Avanafil for erectile dysfunction in elderly and younger adults: differential pharmacology and clinical utility. Therapeutics and Clinical Risk Management, Volume 10, pp. 701-11.

Nimrah H. Sattar

Overview

Erectile Dysfunction (ED) is no longer just a problem for <a href="https://merisehat.pk/doctors/karachi" target="_blank">your doctor to fix</a>. According to the American Heart Association, it&rsquo;s the most common form of male sexual dysfunction in the United States and affects over 18 million men over age 20. It can be caused by multiple factors including medications and lifestyle choices &mdash; but you don&#39;t have to let ED hold you back from enjoying sex! In this guide, we&rsquo;ll explore five non-medical causes of erectile dysfunction and how you can overcome them by making changes in your lifestyle and diet. 
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non-medical causes of erectile dysfunction

If you suffer from ED and you have a healthy heart, then the problem might be reduced blood flow to the penis.

The main cause of this is diabetes, which can affect the arteries in your body and lead to high blood pressure. This condition can also result from smoking and obesity. If you have these conditions, then it&rsquo;s important that you take steps to improve your health as soon as possible.

If you don&rsquo;t want to take medications for ED due to side effects or other reasons, there are some easy things that you can do at home to help treat this condition:

Eat a balanced diet rich in vitamins B6, B12, C and E (these antioxidants will help increase testosterone levels).

Exercising regularly (this will improve circulation) 
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Diabetes and high blood pressure are just two of many vascular conditions that can cause erectile dysfunction. The good news is that these two conditions are treatable with medication. If you have diabetes, your doctor may prescribe metformin, which is typically taken once a day with breakfast and helps control blood sugar levels by increasing insulin sensitivity. If you have high blood pressure, your doctor may recommend taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB), such as lisinopril or benazepril hydrochloride &mdash; two drugs used to treat hypertension (high blood pressure).

Natural remedies: In addition to treating these underlying health issues with medication, you can also take measures in your daily life to prevent them from occurring in the first place by improving your diet and lifestyle habits. Eating foods rich in omega-3 fatty acids like salmon and tuna, exercising regularly, getting plenty of sleep every night are just some ways you can reduce your risk for developing vascular conditions like diabetes or high blood pressure in the future. 
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Prescription drugs are a common cause of erectile dysfunction. Antidepressants, blood pressure medications and cholesterol medications can all contribute to ED. Some prescription drugs may be able to be changed or eliminated entirely in order to reduce the chance of ED.

In some cases, taking additional steps such as eating right and exercising regularly can help lower the risk of erectile dysfunction due to prescription medication use. 
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Obesity: Obesity can contribute to erectile dysfunction, but it&rsquo;s not the only cause. Obesity can also lead to other health conditions that contribute to ED. In addition, obesity itself may cause ED as well as other health problems. If you want to be in optimal shape, consider getting your weight down and maintaining a healthy lifestyle.

There are many ways you can achieve this goal:

<ul>
	<li>Eat a healthy diet rich in nutrients while limiting junk food intake.</li>
	<li>Exercise regularly (at least three times per week).</li>
	<li>Avoid smoking or drinking too much alcohol. 
	&nbsp;</li>
</ul>

If you&rsquo;re dealing with fatigue, stress, anxiety and low self-esteem, it may be time to take a step back and look at the bigger picture.

Worrying about your job or finances can cause your body to shut down in an attempt to protect itself from stress. This can lead to erectile dysfunction by lowering testosterone levels &mdash; which are responsible for your sex drive as well as erections. 
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bottom line

Erectile dysfunction is a very common condition, but it&rsquo;s also one that many men feel too embarrassed to talk about. If you are experiencing problems with your erection, don&rsquo;t be afraid to seek medical help and talk about it with your doctor or even a therapist. There are lots of treatments available now that can help you get back on track without relying entirely on pharmaceutical drugs which may have side effects such as headaches or dizziness.