Before taking Viagra, tell your doctor if you:
Other oral medications that work in a similar fashion are tadalafil (Cialis) and vardenafil (Levitra). These two drugs are in the same class of medications that includes sildenafil (Viagra) and have generally similar success rates and side effects. Cialis (tadalafil), however, has a longer duration of action, up to 36 hours.
For this treatment, known as "transurethral pharmacotherapy or MUSE the man with erectile dysfunction places a suppository into the urinary tube (urethra) using a plastic applicator. The suppository contains the medicine alprostadil, which is absorbed into the nearby erection chambers (corpora cavernosa). Alprostadil belongs to a group of drugs called vasodilators --drugs that increase blood flow by relaxing and expanding blood vessels. It is identical to a naturally occurring substance found in the body that helps keep the blood vessels open, and it helps treat ED by increasing the blood flow to the penis.
Though suppositories appear to be less effective than either injections or vacuum therapy, the drug can be used to treat erectile dysfunction due to a wide variety of causes.
Before inserting the suppository, you should urinate; the small amount of urine left in the urethra will help dissolve the suppository after you insert it. To help dissolve the suppository, roll your penis between your hands for 10 seconds. If you feel any stinging, continue this motion to help stop it. Sitting, standing, or walking for 10 minutes while an erection develops can help increase the blood flow to your penis to gain a proper erection. Alprostadil usually begins to work in about five to 10 minutes. Intercourse should be attempted within 10 to 30 minutes of using this medication. An erection may continue after ejaculation.
Do not insert more than two doses of alprostadil within a 24-hour period and do not use any more than the doctor-recommended dose. This could result in permanent damage to your penis.
When using a suppository form of alprostadil, it is advisable to use a condom if having sexual intercourse with a pregnant woman. While it is unlikely that a fetus will be harmed by the medication, the condom will protect it from exposure. The effects of alprostadil on early pregnancy are still unknown.
Possible side effects include mild bleeding or spotting from the urethra and stinging of the urethra. Contact your doctor if you experience curving of the penis with pain during an erection, an erection that lasts four to six hours with pain, swelling of or pain in the testes, dizziness, faintness, pelvic pain, or flulike symptoms.
Men who do not have erectile dysfunction should not use alprostadil as a sexual aid. If this medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.
Injections
In intracavernosal injection therapy, more commonly called penile self-injection, a man injects a small amount of medicine into the side of his penis using a tiny needle and syringe. The medicine, usually prostaglandin E1, papaverine, phentolamine, or combinations of these drugs, relaxes the blood vessels, allowing blood to flow into the penis. Injection therapy is effective in treating a wide variety of erection problems caused by blood vessel, nerve, and psychological conditions. The most common adverse side effects are pain and penile scarring (fibrosis). Patients with cerebral vascular disease or severe cardiovascular disease might not be able to tolerate the dizziness and high blood pressure occasionally encountered with injection therapy. Painful erections that last longer than two to three hours can usually be controlled by proper dosing and by following treatment guidelines.
The drug alprostadil, which relaxes and expands the blood vessels (allowing more blood to flow into the penis), comes in several mixtures that can be injected into the base or the side of the penis with a fine needle. An erection usually occurs within 20 minutes.
Be sure that you know which product you are using and that you fully understand the proper way to mix the injection. Do not use alprostadil more often than your doctor has ordered or in larger amount; misuse could cause permanent damage to the penis.
After an injection is mixed, alprostadil must be used immediately. Throw away any unused mixture in the syringe; it cannot be stored for later injection. Do not reuse your needles.
Contact your doctor if any of the following symptoms become worse or do not go away: bleeding at the site of injection, pain at the site of injection, painful erection, bruising or clotted blood in the area of the injection (usually caused by an incorrect injection). Also, report curving of the penis with pain during an erection, an erection that lasts four to six hours with pain, swelling of or pain in the testes, dizziness, faintness, pelvic pain, or flulike symptoms.
Men who do not have erectile dysfunction should not use alprostadil as a sexual aid. If this medicine is not used properly, permanent damage to the penis and loss of the ability to have erections could result.
The vacuum constriction device is a cylinder that is placed over the penis. When the air is pumped out of the cylinder, blood is drawn in, causing an erection. The user then maintains an erection by slipping a band off the cylinder and onto the base of the penis. The band can stay in place up to 20 minutes.
The vacuum device can be safely used to treat most causes of erectile failure. A lack of spontaneity and the fact that using the device can be cumbersome and may cause some discomfort seem to be the biggest concerns of patients.
A very simple Aid is a Rubber Band around the base of the Penis and this will help recover the weakness in the penis. Wear the flat band only during Sex and remove it promptly.
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