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ERECTILE DYSFUNCTION

November 5, 2004

The three drugs covered in this chapter for the treatment of erectile dysfunction (ED) are vardenafil (LEVITRA), tadalafil (CIALIS), and sildenafil (VIAGRA). All work in a similar way and are members of the family of drugs known as phosphodiesterase inhibitors.

A recent review article[1] on the diagnosis and treatment of ED offers good advice about distinguishing it from other types of sexual dysfunction. “The most important component of diagnosing erectile dysfunction is obtaining a...

The three drugs covered in this chapter for the treatment of erectile dysfunction (ED) are vardenafil (LEVITRA), tadalafil (CIALIS), and sildenafil (VIAGRA). All work in a similar way and are members of the family of drugs known as phosphodiesterase inhibitors.

A recent review article[1] on the diagnosis and treatment of ED offers good advice about distinguishing it from other types of sexual dysfunction. “The most important component of diagnosing erectile dysfunction is obtaining a complete medical and sexual history. It is important to distinguish the condition from other sexual dysfunctions, such as premature ejaculation and loss of libido.”

This review continues, saying: “The circumstances surrounding erectile dysfunction may be helpful in determining whether a situational or nonorganic factor is involved. Sudden onset, maintenance of nocturnal erections, presence of psychological problems and concurrent major life events or relationship issues may be associated with nonorganic erectile dysfunction. Concurrent medical illnesses and any medications the patient may be taking should be reviewed. Erectile dysfunction is often a component of generalized medical illness and may represent the initial presentation of cardiovascular disease or diabetes. The history may also reveal certain reversible or modifiable risk factors, such as tobacco use or inadequate diabetes control.”

A number of drugs can cause sexual dysfunction in both women and men.

Determining the potential benefits of vardenafil, tadalafil, or sildenafil is much more complex than for drugs that are used to treat cancer, heart disease, or high blood pressure, for example, where one of the potential benefits may be increased survival or avoidance of a heart attack or stroke. It is unlikely that untreated ED contributes to decreased survival, even though it may contribute to emotional distress and strained relationships. Weighing the potential benefits of these drugs involves the interactions in a private relationship based on human emotions and a couple’s perception of their quality of life.

There will be many men without erectile dysfunction who will want to try these drugs, seeking to increase their sexual performance. This can only be regarded as risky behavior.