Whirl around Viagra

Viagra – only the name is already effective, When the potency pill came on the market in 1998, there was a big commotion. Millions, if not billions of men worldwide were attacking. But with the introduction of Viagra, a new era in sexual medicine began. Many scientific studies have been conducted. Their results have made us a long way in terms of men’s health.

Great pleasure has brought the famous blue pill and the manufacturer Pfizer. He was able to book billions. After the expiry of patent protection here in UK in 2013, a price war has started for the prescription drug Sildenafil. Originally a tablet of Viagra 50 mg cost about 10.30 Euro. The imitation products are offered at different prices (see table), so it is worth a price comparison. Basically, however, the generic drugs are much cheaper than the original preparation, since the manufacturers do not have to calculate development costs. The generic Sildenafil is available as Viagra in the original dosage 25 mg, 50 mg and 100 mg. Again, there are different pack sizes.

Which tablets are the most effective?

The pharmaceutical industry offers a variety of different tablets. Here we present the most effective group of substances whose effectiveness has been proven in countless studies:

The most common sexual enhancers are the PDE-5 inhibitors (also called PDE-5 inhibitors). The best-known preparations are Viagra®, Cialis® and Levitra®. The good news for the patients is that the patent protection of Viagra® with the active ingredient Sildenafil expired on June 23, 2013, and thus Sildenafil is offered by many other companies. As a result, prices for Potency funds have been sharply reduced. Since April 2014, Spedra® is also available on the European market. In our experience, Spedra® has brought no benefit to the patients compared with the known three PDP-5 inhibitors.

What should be considered when taking oral sexual enhancer?

Whether Viagra (R Sildenafil), Levitra (F Vardenafil) or Cialis (R Tadadafil): Before you start with the drug therapy, you should definitely clarify the causes of sexual dysfunction in the doctor.

Important: Not all medications are suitable for every man, even if they are indicated. For example, men who need to take nitrates because of their cardiovascular medication are not allowed to take PDE-5 inhibitors (phosphodiesterase 5 inhibitors). “Hands off” is also true for men who have recently had a heart attack or stroke.

There is also a contraindication in men with unstable angina pectoris. Symptoms of angina pectoris are chest tightness and sudden pain in the heart area.

Patients with severe heart failure or abnormally low blood pressure should not take the oral power. The same applies to patients with arrhythmias or low potassium levels.

Mode of action of PDH-5 inhibitors

First of all, PDE-5 inhibitors are not aphrodisiacs. That is, they do not stimulate the sexual center of the brain and lead to arousal by itself. This is a widespread prejudice. Rather, the active ingredient contained in the tablet acts primarily as a blood circulation-promoting substance. That is, PDE-5 inhibitors do not stimulate sexual fantasies or male libido. The PDE-5 inhibitors only help in implementing the desire for sexual union. So if a sexual impulse (this is nerve-dependent) is present, the tablet supports the entire further biochemical course of the erection. On the other hand, if the man does not perceive sexual stimuli, erection does not occur.

The stiffening effect of PDE-5 inhibitors on the penis is due to a small molecule – the nitric oxide, which ensures the dilation of small vessels in the penis and thus leads to a better filling of the cavernous with blood. More blood flow with simultaneously closed drain valves means a stronger and more durable erection.

side effects

Side effects that may occur include headache, nasal congestion, sometimes short-term bluish vision, a feeling of warmth in the neck, or a feeling of pressure in the stomach area. In very rare cases, muscular complaints, such as back pain, may occur.

New study results

Recent studies have shown that about 40 to 50% of patients do not succeed in taking so-called PDE-5 inhibitors. These must therefore resort to other therapeutic measures. Read more about further therapeutic measures for erectile dysfunction here>

For more interested readers, a more detailed account of the mechanism of action of PDE-5 inhibitors:

The active ingredient of the tablet interferes with the nitrogen balance of the cavernous cells and blocks the action of an “erection inhibitor”: The PDE-5 inhibitors inhibit the enzyme phosphodiesterase type 5 (PDE 5). PDE 5 is the antagonist to the erection-promoting substance cGMP (Cyclo Guanosine Monophosphate), a product of NO metabolism that “relaxes” the fine muscle fiber cells in the cavernosum, allowing the blood to flow more easily. In men with erectile dysfunction, the balance between erection-promoting and erectile-preventing substances is out of balance. PDE 5 – and related enzymes – degrade the cGMP even before an erection could occur. Because the PDE-5 inhibitors inhibit this PDE5 action, the erection-promoting cGMP may be longer acting, i. the penis straightens up and stays erect longer. It is crucial that this effect of the PDE-5 inhibitors is targeted and easy to control.

Extracorporeal shockwave therapy as an alternative to PDE-5 inhibitors

It happens again and again that men with potency problems do not respond to PDE-5 inhibitors. In addition, it can happen that men do not tolerate the PDE-5 inhibitors or that contraindications are to be feared. But there are alternatives – for example the low-energy extracorporeal shock wave therapy LESWT (Low Energy Shock Wave Therapy). This promises improved erections without medication.

How it works? The penis is stretched and “shocked” at several points on the shaft with shock waves of around 100 bar. This should lead to the formation of new blood vessels and endothelial cells and thus to the end of erectile dysfunction (ED). The prerequisite is, however, that the procedure be done once or twice a week, over a period of two to three months!

The majority of the results of the scientific studies, which were mostly negative, had a small proportion of cardiovascular patients. As a result, they may benefit more from a LESWT. One thing is certain, however: it can be assumed that the method will become more important. On the other hand, it is completely unclear how often, how long, how intense and with which device the therapy should take place. There are currently about seven manufacturers on the market, with their LESWT devices all very different.