Erectile Dysfunction Treatment Options

QUESTION: I am 55 years old and have trouble getting and maintaining erections. Is this a common problem in men of my age? I know that there are various medications available, can you explain the differences between them?

ANSWER: Erectile dysfunction (ED), or impotence, refers to the persistent or recurrent inability to achieve or maintain an erection. It is a common condition with 52 percent of men aged 40-70 reporting some degree of impotence or erectile dysfunction.

Although erectile dysfunction is more common in older men, this common problem can occur at any age.

Having trouble maintaining an erection from time to time isn't necessarily a cause for concern.

Its incidence is expected to rise due to an aging population, increases in diabetes, smoking, alcohol consumption, obesity and larger numbers of patients being operated on for prostate cancer. It has been estimated that only 10 percent of men with ED visit their doctor for advice or treatment.

Management begins with lifestyle modifications and treating underlying medical conditions. Oral medication is usually the first line treatment and consists of Phosphodiesterase (PDE)5 inhibitors.

These drugs work by preventing the breakdown of PDE5, which is an enzyme in penile smooth muscle which leads to better function of penile erectile tissue. The PDE5 inhibitors, although not initiating an erection, enhance erections to any given sexual stimulus.

There are three different drugs which are commonly used: Sildenafil (Viagra), Tadalafil (Cialis) and Vardenafil (Levitra).