In this short video, doctors explain how recent advances have revolutionized our understanding of ED and the expanded treatment options that are available to you.
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Jeff Brady: Probably ten year ago there were no good, real good therapies for erectile dysfunction certainly no good oral therapies. We did have intracavernosal injection which is where you would inject a medication into the penis with a needle to get erections. That worked well, but obviously people are not excited about placing a needle into the penis. Steven Brooks: We are in a remarkable time. In the last ten years, we have seen dramatic steps forward. Really up until the introduction of Viagra, there were no truly effective medical therapies. With the introduction of Viagra and now it's associated medications, we have seen shift in how erectile dysfunction is treated. Jeff Brady: Pfizer have initially developed Viagra, so BENEFIL as a coronary artery drug. It was used to try and dilate the blood vessels to the heart so that that would improve blood flow to the heart and decrease angina. Unfortunately it do not work very well for men, but they had an interesting side effect that Pfizer has obviously marketed very differently. When pathergy patients had better erections, it didn't work very well for the heart, but it helped their erections. One problem that they did have is that patients would not turn in their medications and some patients actually broke into the Infirmary to get their medications, it still is a medication. Steven Brooks: An erection involves a very intricate cascade of events. You need a visual stimulation, you need the mechanical stimulation, so that there are definite cerebral triggers that are involved in sustaining an erection when a patient is awake during the course of the day. There is a cascade of chemicals that are released, something called Nitric Oxide which then stimulates another chemical called Cyclic GMP and the presence of the Cyclic GMP causes the muscle fibers within the erectile tissue of the penis to relax. Jeff Brady: What these medicines do to foster the phosphodiesterase inhibitors. They black that breakdown of that signal to have an erection so we have an erection that last longer and usually is a bit better. Steven Brooks: All these medications work, give or take within 30 minutes to an hour of taking the medication, it's very important that you-- if you simple take the medication and wait for an erection or if you just have visual cues, you are going to be disappointed. You need manual and physical stimulation to get these, this cascade of events to occur. But we typically suggest to take it 30 minutes to an hour before you engage in relations and that would apply the all three of those medications. Jeff Brady: Levitra and Cialis are in the same classification as Viagra, but they are some what different in their Pharmacogenetics. So what that means that, the amount that is absorbed, the strength that it binds to the receptor and the length that is in the body and hactive is different. For Levitra it may act a little bit more quickly may be in a half hour and last for that 4 to 5 hours. Steven Brooks: I believe efficacy is so much similar with some caveats. Levitra there are some studies that suggest that may be a little bit more effective in diabetics, but overall efficacy is similar. Jeff Brady: There are lot of different ways we can measure erections, we can measure the pressure in the erectile body itself and not everybody going to do that so there are fairly subjective and they are based on patient questionnaires so whenever 100% certain who is better than the other, but using at least patient information how we get a good idea. Steven Brooks: The most typical side effects are indigestion or dyspepsia, flushing, stuff nose, headache, blurry vision or bluish vision. And it's a Cialis has a slightly greater incidence of back pain and muscular aching, but here to it's -- they are all typically less than 10% and I don't mean to infer that you are going to have all the side effects and it's tremendously variable. Some patients have absolutely no side effects or just will
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