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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.
What about psychological therapy?
There is a strong culture of silence and inability to discuss the matter. In reality, it has been estimated that around 1 in 10 men wil experience recurring impotence problems at some point in their lives.
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Erectile dysfunction. The Medicated Urethral System for Erections (MUSE) is a small suppository placed into the urethra with this device. The suppository is very small, and patients often question whether anything is in the device.
Talk therapy: During therapy, a licensed and trained mental health care professional helps you identify and work through issues related to depression. Types of talk therapy include couples therapy, individual therapy, and group therapy.
Hormonal Disorders (pituitary gland tumor; low or abnormally high levels of the hormone testosterone).
Sildenafil can cause hypotension (abnormally low blood pressure that can lead to fainting and even shock) when given to patients who are taking nitrates. Therefore, patients taking nitrates daily, even patients taking nitrates only once a day, should not take sildenafil. Nitrates are used most commonly to relieve angina (chest pain due to insufficient blood supply to the heart muscle because of narrowing of the coronary arteries); these include nitroglycerine tablets, patches, ointments, sprays, and pastes, as well as isosorbide dinitrate, and isosorbide mononitrate. Other nitrates such as amyl nitrate and butyl nitrate also are found in some recreational drugs called "poppers".
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