To comprehend the science behind ED treatments, it’s crucial first to understand the physiological process of achieving and maintaining an erection. It involves psychological, neurological, hormonal, and vascular factors. The process involves:
- Sexual stimulation (physical or psychological)
- Release of neurotransmitters in the brain
- Relaxation of smooth muscles in the penis
- Increased blood flow to the penis
- Trapping of blood in the corpora cavernosa (erectile tissue)
- Compression of veins to maintain the erection
Disruptions at any stage of the process result in erectile dysfunction, which is why treatments target various aspects of this physiological cascade.
Oral medications – PDE5 inhibitors
The most widely known and used treatments for ED are oral medications known as phosphodiesterase type 5 (PDE5) inhibitors. These drugs include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).
How does PDE5 inhibitors work?
- PDE5 inhibitors block the action of the enzyme phosphodiesterase type 5.
- It breaks down cyclic guanosine monophosphate (cGMP), which relaxes smooth muscles.
- By inhibiting PDE5, these drugs allow cGMP to accumulate, leading to prolonged relaxation of smooth muscles.
- This relaxation increases blood flow to the penis, facilitating and maintaining an erection.
PDE5 inhibitors do not directly cause an erection but enhance the natural physiological response to sexual stimulation. This is why these medications are not considered aphrodisiacs and require sexual arousal to be effective. At the ED Clinic Rowlett, healthcare providers carefully assess each patient’s medical history and current health status before prescribing PDE5 inhibitors, as these medications interact with other medicines in some patients.
Injectable medications – Alprostadil
Injectable treatments offer an alternative for patients who don’t respond to oral medications or cannot take them due to contraindications. The most common injectable medication is alprostadil, a synthetic version of prostaglandin E1.
- Alprostadil is injected directly into the base or side of the penis.
- It works by dilating blood vessels, increasing blood flow to the penis.
- It also helps relax smooth muscle tissue in the penis.
- The result is a rapid onset of erection, typically within 5-20 minutes.
Testosterone replacement therapy
For some men, ED is caused by low testosterone levels. In these cases, testosterone replacement therapy (TRT) may be recommended.
- Testosterone is administered through gels, patches, injections, or pellets.
- It helps restore normal testosterone levels in the body.
- This improves libido, energy levels, and erectile function.
It’s important to note that TRT is only effective for ED caused by low testosterone and carries its risks and benefits. Comprehensive testing at facilities determines if low testosterone is a contributing factor to a patient’s ED.
Shockwave therapy
A newer and promising treatment for ED is low-intensity extracorporeal shockwave therapy (Li-ESWT).
- Low-intensity shock waves are applied to various areas of the penis.
- It is thought that these waves stimulate blood vessel growth.
- They may also recruit stem cells to promote tissue regeneration.
- Improve blood flow to the penis and boost erectile function.
While still considered experimental by some, early studies have shown promising results, particularly for men with vasculogenic ED. As new research is conducted in this area, the centre provides patients with cutting-edge treatment options. The latest scientific advancements in this field are crucial for men experiencing ED. For example, it offers comprehensive evaluations to determine the underlying causes of each patient’s ED and develops personalized treatment plans based on the most up-to-date scientific evidence.