New drugs for the treatment of erectile dysfunction

Medicines for the treatment of erectile dysfunction in men. TOP-5 best

The treatment of impotence implies a complex measure, including etiotropic (when the cause itself is affected) and pathogenetic (restoring the normal functional state of the gonads) therapy. Modern drugs for the treatment of Erectile dysfunction in men purposefully and effectively eliminate the disease. The main thing is to choose the right therapeutic course.

According to medical statistics, in 75-80% of cases, erectile impotence develops against the background of other somatic pathologies: diabetes mellitus, peripheral atherosclerosis, hypercholesterolemia, kidney and liver diseases, hormonal imbalance, thyroid disorders. And it is important to take this into account during therapy, including in the process of selecting medications.

Fentolamine ("Vazomax", "Dibazin", "Regitin")

The agent belongs to the imidazoline group and is a competitive inhibitor of alpha-adrenergic receptors (found in large quantities in small arteries and arterioles). Settling on these receptors, the substance prevents spasm of blood vessels in the penis, and also enhances endogenous relaxation effects.

When the drug is injected into the cavernous bodies of the penis, its maximum concentration in the peripheral blood is reached by the 30th minute, after which it sharply declines. Phentolamine is intended only to improve erection, it does not affect ejaculation and libido.

Contraindications to the drug are:

Since phentolamine slightly lowers blood pressure, its use is acceptable in men suffering from hypertension. Available in tablet form of 25 mg (pack of 30 pieces) and in injection form (1 ml contains 10 mg of the substance)

Take pills after meals in a single dose - 50 mg (that is, 2 pieces) 3 times a day. The course of treatment is 3-4 weeks. Perhaps intracavernous administration of the drug, in this case, the dose is selected individually.

Alprostadil ("Alprostan", "Vazaprostan")

Refers to analogues of prostaglandin (a substance that is formed from fatty acids, in particular from arachidonic). This medicine contributes to the rapid relaxation of smooth muscle cells and vascular walls in the cavernous bodies, which ultimately leads to an increase and improvement in local hemocirculation. In addition, alprostadil protects cells and tissues from the harmful effects of free radicals and enzymes, activates protein synthesis, and reduces the concentration of cholesterol in the blood.

Indicated as a therapy for vascular, psychogenic or mixed erectile dysfunction.

It is not recommended to take with such diseases:

Alprostadil exists as a solution and suppository, which are applied only topically. Suppositories are inserted into the urethra through its outer opening, located on the head, using a special plastic applicator. Before use, it is advisable to empty the bladder so that the remaining small amount of urine in the urethra helps the drug dissolve faster.

Also, in case of impotence, it is possible to inject the drug when the syringe needle is inserted into the spongy tissues of the penis. It is recommended that this procedure is carried out by a medical professional, and the individual dose is selected by a doctor.

Start injections with a dose of 2.5 mcg, especially with neurogenic or psychogenic etiology of erectile dysfunction. Sometimes, to achieve a greater effect, the dose can be doubled. You can use alprostadil no more than 3 times a week, and the interval between the administration of suppositories or solution should be at least one day.

Despite the high cost, most men have tried this tool on themselves and according to their reviews, in 70-75% of the erection was completely restored as a result of the treatment.

PDE-5 inhibitors ("Cialis", "Viagra", "Levitra")

Classic drugs for the medical treatment of erectile dysfunction in men also include phosphodiesterase inhibitors in their arsenal.

As a result, blood flow in the penis increases and a good erection is achieved.

Any of the presented drugs of the group is prohibited for men with:

The drug is prescribed one tablet at a time (from 5 to 100 mg, depending on the active substance), preferably at the same time of the day and on an empty stomach. The action begins in 30-60 minutes and lasts from 3 to 72 hours. The course is selected by the doctor individually.

Many reviews of men say that the best drug for the treatment of erectile dysfunction in this category is Cialis.

"Ali Caps Plus"

A new drug for the treatment of erectile dysfunction based on natural ingredients, related to dietary supplements.

It includes:

• longleaf eurycoma;
• creeping palm tree;
• Damiana leaf extract.

Regular use of the drug effectively stimulates the hormonal function of the male gonads, enhances the production of seminal fluid and increases sexual desire.

Ali Caps is taken one capsule in the morning with a sufficient amount of water for 30 days. A second course of therapy can be completed after two weeks.

Not recommended for men suffering from insomnia, heart rhythm disorders, hypertension and atherosclerosis

Impaza is a homeopathic remedy

Impaza is considered one of the most famous homeopathic remedies that effectively restore male power. This drug activates a special enzyme - NO-synthase, which in turn triggers the production of endogenous nitric oxide. Then there is an expansion of small vessels in the penis and its strong blood supply.

According to clinical trials, Impaza not only promotes erection, but also increases libido, increases the pleasure of sexual intercourse. For therapeutic purposes, take one tablet at night for at least three months. If necessary, the course can be repeated after a break of 3-4 months.

Among the contraindications are lactase deficiency and hypersensitivity to the components of the drug. According to the reviews, one can note not only high efficiency, but also the absence of any adverse reactions.

Scheme for the treatment of erectile dysfunction in men with drugs

There are three consecutive lines of treatment for erectile dysfunction, which differ from each other by groups of medications and the method of their administration.

The first drug treatment regimen for erectile dysfunction involves the use of selective phosphodiesterase-5 inhibitors (Tadalafil, Udenafil, Sildenafil and Vardenafil).

Their appointment is possible under the following prerequisites:

• Retained libido.
• The presence of sexual stimulation during the period of accumulation of the main substance in the blood plasma.
• Normal testosterone levels in peripheral blood.

If the first line turned out to be ineffective, the doctor switches to drugs from the second line:

• Papaverine. Antispasmodic, which expands the cavernous bodies to a certain level and contributes to their increased blood supply.
• Prostaglandins
• Phentolamine - blocks alpha receptors, which ultimately improves local blood circulation in the penis.

They are injected directly into the urethra or into the cavernous bodies. The complex use of funds is considered relevant, due to which the effect is achieved faster.

The third line includes surgical reconstruction of the arteries of the penis using balloon plastics or dorsal vein ligation.

The latest remedy for impotence: a list of new drugs

New drugs for impotence are medications that are highly effective and efficient in solving the problem, while they are characterized by a minimum of contraindications (in other words, they are suitable for everyone), and the absence of Side effects.

In the modern world, in the vast majority of clinical pictures, doctors recommend original drugs such as Levitra, Cialis, Zidena and Viagra for erectile dysfunction. Along with their effectiveness, many patients complain about the presence of adverse reactions.

Biologically active additives do not have side effects, however, they are less effective in the treatment of erectile dysfunction, while the required therapeutic result must be expected for a relatively long time.

Thus, all medicines have their own advantages and disadvantages, which does not allow us to isolate the ideal therapy option. In this regard, the process of restoring male strength is characterized by complexity, that is, it includes several ways.

New technologies

As noted, any drug or method of treating sexual impotence is characterized by pluses and minuses, which does not allow us to name the only optimal option that is suitable in all clinical pictures.

In the modern world, developments in this direction are actively underway. The newest remedy for impotence is Uprima. Release form - lozenges. Active components contribute to the stimulation of the neurotransmitter system of the cerebral hemispheres, as a result of which libido in men increases, there is an exacerbation of sensations from sexual intercourse.

The drug was developed and manufactured in the United States of America, clinical studies and trials on volunteers have provided successful therapeutic results. However, the release of the drug showed a different picture.

After the use of the remedy, many representatives of the stronger sex experienced loss of consciousness (deep fainting), as a result of which Uprima was withdrawn from sale for an indefinite period.

However, it is still possible to purchase the medicine, it can be done in specialized stores in Europe. Uprima is currently being developed in the form of a spray.

In the 21st century, research is being conducted on the treatment of erectile dysfunction through genetic engineering. The essence of the method is the following:

• The treatment of impotence consists in introducing specially encoded genes into the male body.
• These genes encode proteins that are structurally similar to natural enzymes; they are detected in extremely small quantities against the background of male impotence.
• Under experimental conditions, the method is characterized by high efficiency.

At the moment, research is carried out exclusively in laboratory conditions, however, trials on groups of volunteers are planned.

Gene therapy can take a significant amount of time to gain official approval for human trials and public acceptance.

New items for male power

Medical statistics provide depressing information, if literally ten years ago problems with potency concerned men of elderly and mature age, then at the moment young boys aged 20-25 years old become impotent.

In connection with such statistics, many pharmaceutical companies are trying to develop a drug that would meet all the requirements such as safety, harmlessness, lack of contraindications, side effects, good interaction with other drugs.

The drug Topiglan is under development. Release form - cream of local action. The main active ingredient that fights erectile dysfunction is alprostadil.

Even if clinical studies confirm the high productivity of the gel, it is still not completely clear which category of patients will benefit from this novelty. Since the substance alprostadil can already be introduced into the body by injection or in the form of suppositories.

New products to restore erectile ability:

As for the last point, the medicine is also under development. It is in the form of a solution injected directly into the nasal passages. It is noted that studies show high results in relation to psychogenic impotence.

The use of melanocortin activators is a controversial issue, as long-term safety is not fully known. In addition, they are not suitable for the treatment of male impotence of organic etiology.

Injections into the penis

There are many forms of drugs that help restore sexual abilities in men. In the vast majority of situations, the use of tablets and capsules is recommended, as they are most convenient to use.

However, in a number of pictures, the expediency of prescribing a tablet form is absent, so the doctor recommends injections into the penis. The peculiarity is that the injection is carried out directly into the cavernous (cavernous) body of the reproductive organ.

As practice shows, the lack of certain medical skills can lead to the fact that this form of medication will have to be abandoned. If long-acting injections can be given in a medical institution, and they will work for several months, then single injections (for example, Papaverine Hydrochloride) must be done before each sexual intercourse.

The side effects of injections are as follows:

• Pain syndrome.
• Burning.
• Pain during sex and ejaculation.

It is noted that injections can lead to such a pathological condition as priapism (a strong erection lasting from 3 hours, while accompanied by painful sensations). Therefore, if there is a tendency to such a pathology, they are not recommended.

Injections into the reproductive organ increase blood circulation in it, provide a high-quality riser, which is enough for normal intimacy.

Other therapies

The treatment of erectile dysfunction is based on the causes that led to the pathological failure in the male body. Accordingly, having established the exact cause, it is more likely to speak of a favorable outcome.

If psychological impotence is observed, then therapy is recommended by a sex therapist or psychologist. Usually, sedative pills are prescribed, as well as erection stimulants to give a man confidence in himself and his abilities.

When a disease is the cause of a male problem, the main treatment regimen is aimed at eradicating it, additionally symptomatic therapy is prescribed to help restore sexual function.

Generally speaking, the methods for restoring potency are as follows:

Surgical intervention is an extreme measure, it is recommended in those clinical pictures, when all other methods and methods have not given the required therapeutic effect.

Peruvian Maca is not a novelty, but a remedy that is popular due to its effectiveness in restoring male strength.

Levitra is a new drug for the treatment of erectile dysfunction

Published in: Provisorum 1 / 2004 S.I. Gamidov, E.B. Ovchinnikov, V.V

What is "erectile dysfunction"?

The relationship between a man and a woman has been an important component of human life since its inception. At the same time, the sexual component of these relationships is of great importance for both sexes. One of the main characteristics of masculinity in the cultures of various peoples at all times has been the ability of a man to carry out a full-fledged sexual intercourse.

The violation of this ability, namely the inability of a man to achieve and maintain an erection sufficient to satisfy sexual activity, is called erectile dysfunction (ED).

ED is a very common pathological condition. Hundreds of millions of men worldwide suffer from it, and there is a persistent trend towards an increase in the number of patients. This is due to many reasons, including the deterioration of the ecological situation on the planet, the growth of urbanization, as well as the increase in the average age of the inhabitants of the Earth. It is important to note that ED is not a mandatory and inevitable consequence of aging and at any age is considered as a pathology that can and should be treated.

The importance of erectile dysfunction for men of different ages can hardly be overestimated. Erectile dysfunction leads to the development of anxiety, self-doubt and even depression, significantly reducing the quality of life of both the patients themselves and their partners.

Anatomy of the problem

Anatomy and physiology of erection

Picture). In the process of developing an erection, blood flow to the cavernous bodies increases significantly and the outflow of blood from them is limited, which ensures an increase in the size of the penis and its rigidity (hardness). This process is provided by a complex interaction of hormonal, nervous and vascular factors, however, the primary impulse that triggers a complex mechanism of physiological reactions, ultimately leading to the development of an erection, occurs in the brain and is the result of mental activity. Thus, in an erection, a reflexogenic component is distinguished, which is the result of impulses coming from the genital area, and a psychogenic component resulting from the receipt of signals from the brain, which in turn are the result of the interaction of visual, tactile, auditory and taste sensations, as well as various sexual thoughts and fantasies.

Causes of erectile dysfunction

Erectile dysfunction is divided into groups depending on the reasons for its development, i.e. violations of certain mechanisms of erection. At the same time, psychogenic and organic erectile dysfunction are distinguished, and within the latter, hormonal, neurogenic and vascular.

Psychogenic ED is more common in young men and is a consequence of increased anxiety, conflicts between partners, depression and other disorders of the psychological state of patients.

At the heart of hormonal ED are violations of the synthesis and the relationship between various sex hormones. This form occurs relatively rarely, while being potentially curable. Hormonal disorders are usually manifested not only by erectile dysfunction itself, but also by other signs, including a decrease in libido, changes in hair growth, etc.

Neurogenic ED is observed in various neurological diseases, such as spinal cord injury, multiple sclerosis, peripheral neuropathies, as well as damage to the pelvic nerve plexuses after radical operations on the rectum, bladder and prostate gland.

Vascular ED. The most common form of organic ED is its vascular form, in which blood flow to the cavernous bodies of the penis and / or outflow of blood from them is disturbed. Damage to the vessels of the penis may be a consequence of generalized vascular pathology against the background of age-related changes, as well as arterial hypertension, atherosclerosis, and diabetes mellitus.

Medication-induced ED is a special form of erectile dysfunction. erectile dysfunction that develops while taking various medications. Among the drugs that can lead to the development of erectile dysfunction, drugs for the treatment of arterial hypertension and psychotropic drugs are of the greatest importance.

ED treatment methods:

Physical activity, proper nutrition, quitting smoking and excessive alcohol intake, fighting overweight are important therapeutic factors in patients with erectile dysfunction. However, in many cases this is not enough and then you have to resort to the use of various therapeutic techniques.

Psychotherapy and/or behavioral therapy as a stand-alone treatment can be effective in the absence of organic causes of ED, since psychological factors are very important in all forms of ED. A correct study of the psychological state and an attempt to alleviate the patient's psychosexual anxiety should be an obligatory part of the therapeutic effect in this pathology.

Vacuum devices help many patients, but only a small number of patients are satisfied from an aesthetic point of view.

Surgical treatment in the form of operations on the vessels of the penis, very popular in the past, is currently used extremely rarely due to its low long-term effectiveness. However, in young patients with pelvic and perineal trauma, surgical restoration of the patency of the vessels of the penis in some cases gives good results.

The installation of prostheses in the penis in almost all cases leads to a complete cure of patients, but at present this method is resorted to only when all other treatment methods are ineffective.

The method of introducing drugs into the penis, despite its rather high efficiency, has certain disadvantages, the most important of which is the need for painful injections into the penis and the presence of complications such as priapism (painful prolonged erection).

Phosphodiesterase 5 (PDE5) inhibitors

This process is predominantly regulated by nitric oxide, which activates the enzyme guanylate cyclase (GC). The GC enzyme, in turn, increases the synthesis of the second messenger cyclic guanosine monophosphate (cGMP), and it promotes the leakage of calcium ions from cavernous smooth muscle cells. All this leads to relaxation of smooth muscles, increases blood flow to the cavernous bodies and, thus, helps to achieve and maintain an erection of the penis. The enzyme phosphodiesterase type 5 (PDE5) destroys cGMP, leading to contraction of the smooth muscles of the penis. Therefore, the inhibition of this enzyme ( Levitra ) increases the content of cGMP and, as a result, facilitates the onset of an erection.

A revolutionary event in the treatment of erectile dysfunction was the appearance in 1996 of the drug sildenafil citrate, known under the trade name Viagra. This drug, taken by mouth in tablet form, has increased the effectiveness of treatment and enabled general practitioners to help patients with ED. However, many men, especially those with severe ED, diabetes, hypertension, and radical prostatectomy patients, are not fully satisfied with current treatment. In addition, the effect of sildenafil depends on the intake of food and alcohol, which are often sexual components, which creates certain problems with the planning of sexual intercourse. These circumstances lead to the fact that, on average, only 50% of patients taking sildenafil intend to continue treatment.

The next approved PDE5 inhibitor after sildenafil was tadalafil (Cialis). Unlike sildenafil, this drug has a long half-life (17.5 hours) and its pharmacokinetics are independent of food and alcohol intake. Thus, the duration of action of Cialis (36 hours) allows you to be more calm about the so-called planning of sexual intercourse and maintain the spontaneity and romance of sexual relations. However, recent studies show that only 13% of the interviewed patients with ED are interested in the duration of action of drugs and are mainly interested in the reliability (40%) and safety (40%) of the therapy received. In addition, some patients taking tadalafil experience side effects such as back pain, and in some of them these manifestations continue as long as the drug works. Cialis is available in one dosage (20 mg), which creates certain problems with the correction of the therapy, depending on the effectiveness and tolerability of the drug.

Thus, a certain number of patients who are dissatisfied with previous treatment for ED, as well as a large number of patients with undiagnosed and untreated erectile dysfunction, need a new, more effective drug. The ideal therapy for ED seems to be non-invasive, i. oral medication, well-tolerated treatment that is equally effective in the entire population. Levitra (vardenafil hydrochloride), a new, highly effective and most powerful PDE5 inhibitor, meets all of the above requirements among existing drugs to the greatest extent. Vardenafil in relation to the effect on PDE5 is more than 10 times stronger than sildenafil. Vardenafil has less effect on light perception compared to sildenafil and less effect on spermatogenesis compared to sildenafil and tadalafil.

Vardenafil is rapidly absorbed, the maximum level of drug concentration in blood plasma is reached on average 30 minutes after oral administration. The duration of action of Levitra is 4-5 hours, which is enough for a full-fledged sexual intercourse, and there is no accumulation of the drug in the human body. This is a fundamental difference from tadalafil, whose significant half-life is the cause of undesirable effects when taken daily. The effectiveness of the drug is not affected by the intake of food and alcohol.

Clinical studies have shown that vardenafil is a highly effective (85-89%) and safe drug for treating ED. A more powerful effect of this drug on PDE5 allows its use not only in the general population, but also when other PDE5 inhibitors (sildenafil, tadalafil) are not effective. The effectiveness of Levitra in patients with diabetes mellitus and after radical prostatectomy reaches 72%, and in patients who previously unsuccessfully took sildenafil 62%.

Side effects when taking Levitra in most cases are short-term and insignificant.

Due to such properties of this drug as a quick and pronounced effect, independent of food intake and alcohol, patients will be able to plan sexual intercourse at any convenient time. The drug is available in three dosages (5.10 and 20 mg), which allows the doctor to adjust therapy depending on its effectiveness and tolerability. These and other differences from Viagra, such as the lack of tachyphylaxis effect (decreased effectiveness with long-term therapy), offer great promise in long-term ED therapy.

Thus, the currently existing drugs for the treatment of ED allow you to get positive results in most patients. Unfortunately, there remains a part of patients with ED in whom any pharmacotherapy is ineffective. In such patients, other types of treatment are used (combined oral and intracavernous therapy, vacuum therapy, surgical treatments).