Impotence Consultation
Impotence, also known as erectile dysfunction (ED), is the inability of a man to achieve or sustain an erection. Although the condition rarely poses further medical problems, it can be disastrous in the life of a man and the life of his spouse or regular sexual partner. While many believe impotence to be a condition that only affects older men, it can be experienced by men of any age.
Men with impotence cannot perform regular sexual activity because they cannot achieve an erection, or if an erection is achieved, it cannot be maintained for any considerable duration. Impotence is rarely total and permanent. It is much more common for impotence to be intermittent and temporary.
According to statistics, by the age of 40, 5 percent of men experience long-term impotence, and the rate increases with age. It is estimated that 15 to 25 percent of men experience long-term impotence at the age of 65.
For categorical and medical purposes, impotence includes men who cannot achieve an erection in 20 percent to 100 percent of the times desired. Failure to achieve an erection 20 percent of the time or less is not considered to be a medical problem.
Impotence occurs due to an interruption of one of the many complex psychological and physiological events that lead to a sustained erection. When a healthy man becomes sexually aroused, two sponge-like chambers running the length of the penis fill with blood, causing it to become erect. The erection is maintained because the chambers, called the corpora cavernosa, engorge, also restrict the blood flowing out of the penis.
The body of a man experiencing impotence is not sending, receiving and/or interpreting the sensory signals required for the blood to flow into the penis and prevent it from escaping. Alternatively, a physiological condition may be preventing the circulatory system or the penis from functioning properly.
Impotence Causes
The specific causes of impotence are numerous. A doctor must be consulted, and tests may be required to determine the exact cause. For some men, the cause is purely psychological, making them unable to become sexually stimulated. Other men have physiological conditions preventing erections, and for some, it is a combination of several factors.
Some of the psychological causes of impotence are as follows:
- Depression
- Stress
- Anxiety
- Guilt
- Negative self-image
- Fatigue
Following are some of the common medical or physiological problems that can lead to impotence:
- Cardiovascular disease – arteriosclerosis, weak veins or poor circulation
- Diabetes
- Blood pressure disorders – hypertension or hypotension
- Nerve disorders or nerve damage
- Cancer
- Hormone imbalance or low testosterone
- Obesity
- Traumatic injury
In addition to the psychological and physiological conditions, impotence may also be caused by medications or lifestyle choices. Certain medications and recreational drugs may affect a man’s ability to achieve an erection. Tobacco products, alcohol and a lack of exercise may also contribute to impotence.
Impotence Medications: Viagra, Cialis & Levitra
The most common treatment for impotence is medication. Several medications, known as PDE5 inhibitors are frequently prescribed for the treatment of impotence. PDE5 inhibitors are available as tablets that are taken orally, and they are very effective for many men suffering from impotence. Oral medications for impotence come in three primary formulations, which are most commonly referred to by their brand names. Each drug works slightly differently, and one may work better than another for a particular individual.
Sildenafil (Viagra)
Viagra was the first PDE5 inhibitor to be approved for use. It is also available in a generic form called sildenafil. Viagra begins to work from 40 to 60 minutes after ingestion and lasts for 3 to 5 hours. It can be taken multiple times per day.
Tadalafil (Cialis)
Cialis is also known by the generic name tadalafil. Cialis works much faster than Viagra and Levitra, with absorption occurring only 15 to 20 minutes after ingestion. Cialis helps men achieve erections for 24 to 36 hours afterward. This medication can only be taken once in a 48-hour period.
Vardenafil (Levitra)
The generic name of Levitra is vardenafil. It is absorbed by the body about 40 minutes after it is taken, and it lasts from 5 to 6 hours. It can also be taken more than once per day.
Differences between Viagra, Cialis & Levitra
While all essentially PDE5 based medications - Viagra, Cialis and Levitra do have differences in dosages, absorption rates and duration:
| CIALIS | LEVITRA | VIAGRA | |
| Manufacturer | Lilly Icos | Bayer | Pfizer |
| Introduced | Feb 2003 | April 2003 | March 1998 |
| Dosage | 10mg,20mg | 5mg, 10mg,20mg | 50mg,100mg |
| Repeat | Dose cannot be repeated for up to 2 days | Dose can be repeated daily | Dose can be repeated daily |
| Absorption Rate | 15-20 Minutes | 40 Minutes | 40-60 Minutes |
| Duration | 24-36 Hours | 5-6 Hours | 3-5 Hours |
| Side Effects | Headache, Myalgia, Heartburn (dyspepsia), Mild Back Pain | Headache, Facial Flushing, Heartburn (Dyspepsia), Nasal Congestion | Congestion, Diarrhoea, Facial Flushing, Headaches, UTI's (Urinary Tract Infection), Bluish Vision, Heartburn (Dyspepsia) |
| Contra-indications | Nitrate-Based Medicines, Angina, Hypertension, Hypotension | Nitrate-Based Medicines | Nitrate-Based Medicines |
| More Information | Lilly | Bayer | Pfizer |
Another medication is also sometimes used by men with impotence. It is a liquid medication injected directly into the penis or inserted into the urethra as a suppository. The generic name of this medication is alprostadil, but it is also sold under several trade names.
Impotence Cures
Besides medication, other treatments are available for men suffering from impotence. These alternative treatments are especially important for men who cannot take medication due to other medical conditions or more important medications that are contraindicated with PDE5 inhibitors. Following are some of the most common non-pharmaceutical treatments for impotence:
Counselling
Men whose impotence is caused by psychological factors may benefit from counselling by a medical doctor specialising in psychological disorders. Psychological treatments may consist of psychotherapy, reading books on sexuality or practising sexual communication skills with a partner.
Vacuum Devices
Also known as the penis pump, a penile vacuum device helps to increase blood flow to the penis by dilating the blood vessels. Once an erection is achieved, it is sometimes maintained by using an elastic band around the base of the penis.
Penile Implants
Prosthetic devices can offer a permanent solution for men suffering from chronic or severe impotence. Several different types of penile implants are available. Some are semi-rigid, whereas others can be filled pneumatically or hydraulically.
Surgery
Some men suffering from impotence may benefit from surgery to improve blood flow to the penis or to correct other conditions that may be causing the problem.
Investigating the causes of Impotence in Men
The Co-operative Doctor can provide you with a safe and effective way to obtain treatment for Impotence, although this should not act as a replacement for your own doctor. Blood pressure problems, diabetes and circulatory problems can all manifest themselves as erectile dysfunction, so you should really consider a visit to your own doctor if symptoms develop or get worse over a period of weeks or months - or suddenly without an emotional trigger. Your doctor will be able to perform some simple tests to ensure that you are fit and healthly.
Starting treatment
Like any medication, finding out which impotence medication will suit you can be a case of trial and error. Although you are free to select any medication that our doctors prescribe, it is recommended that you start with a lower dosage treatment first. Each of the medications has it's own characteristics and so one type may be better suited to you, and work better than another.
You can order more than one variety of medication - but it is very important that you do not take Viagra, Cialis or Levitra together and should ideally leave 24 hours (36 with Cialis) inbetween taking different impotence medications.
We provide online consultations with UK GMC registered doctors. If you are suitable, a prescription will be issued online. The Co-operative Doctor will then arrange for your order to be delivered to your chosen address by overnight delivery.
Genuine medication is dispensed by The Co-operative Pharmacy. Deliveries are in discreet packaging and sent by your chosen method.
