Erectile dysfunction (ED) is commonly referred to as the inability to attain or maintain an erection that is sufficient for satisfactory sexual performance. It is a widespread issue, affecting 10% of men aged 40-49 years and almost one-quarter of men aged 50-59 years. The prevalence of ED increases with age, affecting over 30% of men aged 60 years and older. In the U.S., the estimated annual cost of treatment for ED is nearly $12 billion.
Over the past few years, there has been an abundance of research on the topic of ED and the most effective treatments. One of the most popular medications in the U.S. for the treatment of ED is Viagra. Since its introduction in 1998, Viagra has been proven to be an extremely effective treatment for ED. In fact, several studies have shown that Viagra improves the quality of life for men suffering from ED. In addition to treating ED, many men have also found that Viagra is an effective treatment for various other sexual dysfunctions such as premature ejaculation, low libido, and erectile dysfunction due to diabetes or chemotherapy treatment.
Before we begin talking about whether or not Viagra is the best treatment for ED, it is important to define what we mean by best. When we say that Viagra is the best treatment for ED, we are not referring to the most effective treatment or the treatment that works for every man. Instead, we are talking about the treatment that is most effective for the majority of men with ED. In order to determine the best treatment for ED, we must first look at the various causes of the dysfunction. The main reason for ED is poor blood flow to the penis. This poor blood flow may be due to one or more of the following factors:
- Arterial Insufficiency – This is when the blood flow to the penis is restricted due to narrowed arteries. The most common cause of this ED are coronary artery disease and hypertension (high blood pressure). In fact, up to 40% of men with ED suffer from some form of coronary artery disease. This condition restricts the flow of blood to the heart and other major arteries such as the aorta and the carotid arteries. One thing to note about these disorders is that they are often asymptomatic, meaning that they do not have any noticeable symptoms. Therefore, it may be difficult to detect the presence of arterial insufficiency unless you are actively seeking treatment for ED. The good news is that drugs like Viagra and other PDE5 inhibitors (more on these later) can help restore blood flow to the penis and improve erectile function. Injection therapy and surgery are other common treatments for arterial insufficiency.
- Psychological Factors – This is when ED is caused by factors such as anxiety or depression which affect the way a man feels and acts. While there is no known cure for psychological factors, counselling and anti-depressant medication can help to improve the quality of life for men who are suffering from ED due to these factors.
- Vascular Dysfunction – This is when ED is caused by problems with the blood vessels in the penis. It can be due to excessive alcohol use which was previously referred to as vasculogenic impotence. However, the most common cause of vascular ED is atherosclerosis. This is when plaque builds up inside the arteries, restricting the flow of blood. This type of ED usually does not respond well to medication and requires surgery to treat. The most common type of surgery for vascular ED is vascular bypass surgery, where they implant an artificial vessel to enable more blood flow. To give you some idea of how common this kind of ED is, roughly 15% of men aged 40-49 have some form of vascular ED.
- Diabetes – This is when ED is caused by malfunctioning of the pancreas, which is responsible for producing insulin. Insulin is a hormone which allows the body’s cells to properly use the glucose (sugar) which they absorb from the food they eat. In some cases of diabetes, the glucose is not being absorbed by the cells, which leads to low blood sugar. One of the most common causes of diabetes-related ED is insulin resistance, where the body’s cells become unresponsive to insulin and therefore do not use glucose properly. This lack of sensitivity to insulin is what leads to the impairment of erectile function in men with diabetes. There are also cases where men are born with an anomaly in the structure of their pancreas, which prevents them from producing enough insulin to regulate their blood sugar levels. In these situations, they are at risk of developing ED. However, this is usually discovered during adulthood and does not affect the majority of men with diabetes as they become more aware of the disorder while still young. Another disorder which causes ED is polycystic ovary syndrome (PCOS). This syndrome is relatively common and affects women more so than men. However, women with PCOS are more prone to developing ED than men. This is due to the fact that they have larger glands than men which make it easier for the blood to be trapped in the penis when an erection is sought. There are also cases where men develop ED due to anxiety or depression which are caused by a poor prognosis regarding their health condition. In these cases, counselling and anti-depressant medication can help to improve their mental outlook and therefore the quality of their life.
- Cancer Treatment-This is when ED is caused by chemotherapy or radiotherapy treatment which are commonly used to treat various types of cancer. In some cases, ED is a very serious problem for men undergoing chemotherapy treatment and can lead to major problems in maintaining an erection. Studies have shown that ED is one of the most common side effects of chemotherapy treatment and is often times painful for men. In these cases, ED becomes another fight for survival as the man fights to maintain his erection. The good news is that newer drugs such as Vimizole and Dapoxetine have been developed which help with this issue significantly and enable men to have better sex lives after treatment.
- Medication-This is when ED is caused by a man taking any drug that can potentially cause ED such as nitrates, erythromycin, amphetamines, or phosphodiesterase type 5 inhibitors (PDE5 inhibitors). The most popular PDE5 inhibitor is Viagra, which was also the first drug to be specifically developed for this purpose. Therefore, we can safely assume that most cases of ED are due to some sort of medical issue. In these cases, treatment is usually very simple and involves either stopping the medication which caused the ED or using a different type of medication to treat the underlying cause. In some cases, it can also be due to a combination of factors, which is why multi-factor treatment should be considered.
Given the above, it should be apparent that Viagra is not the answer for every man with ED. In fact, it has been shown that not every man will have the same results from taking Viagra. This is why it is best to try and pinpoint the root cause of the problem. In most cases, it will be a combination of one or more of the above factors. Once the root cause is found and treated, the ED will naturally improve. However, it is also possible for the ED to get worse if the cause is not treated. There is a reason why this topic is so complicated and why there is such a wide variety of possible causes for ED. The simple answer is that, unlike other diseases, there is no cure for ED. However, there are treatments which can help to improve the quality of life for men who are suffering from this disorder. As we have mentioned above, Viagra is often very effective at treating ED but it is not always the best answer. Other drugs which have been proven to be more effective for some men include: