In varying degrees, erectile disorders affect more than 100 million men worldwide. From temporary debasement to definitive powerlessness, for every disorder – and for each of its causes, today there is a cure.

Depending on the cause, a patient can either fully recover from ED or have its symptoms alleviated and controlled by intake of oral drugs. Cialis (tadalafil) is the only oral drug with proven efficiency in reversing the condition and providing a full recovery when taken as a therapy course in the dose of 5mg. Other oral drugs like the legendary Viagra (sildenafil), its closest analog Levitra (vardenafil), stronger doses of Cialis and a novelty addition to the family of PDE5 inhibitors where all of the mentioned drugs belong, Spedra (avanafil) provide a temporary relief and are taken as needed. These drugs can only address ED where the condition is not caused by a problem with blood vessels.

The therapeutic use of hormones involves the use of testosterone only and only in cases where a real deficiency is demonstrated, in order to restore a correct balance.

In cases where erectile dysfunction is likely to be psychogenic, psychosexual intervention is indispensable in order to identify and remove the factors that caused it. There is no doubt as in the premise that psychosexual therapy is fundamental even in cases of organic or mixed dysfunction as it is able to reduce the state of anxiety and discomfort.

Intracavernous pharmacotherapy is invasive, as it involves the injection of vasoactive drug into the corpus cavernosum of the penis, resulting in an erection. The therapeutic pharmacological substances used are Prostglandine and Papaverine. Their use is indicated, in cases of failure of oral therapy or in re-education after radical prostatectoia surgery.

Surgical therapy is indicated only in patients in whom medical therapy has failed. Surgery involves inserting hydraulic prostheses into the corpora cavernosa.

While patients with erectile failure, which occurs when the blood cannot get in or stay long enough in the penis to cause or maintain an erection, already have 3 drugs at their disposal (Viagra, Levitra, Cialis), a new “facilitator” recently was recently added. Spedra containing a new molecule, avanafil joined the therapeutic arsenal of PDE5 inhibitors available for ED treatment. All the drugs feature three different molecules: sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil, as mentioned before, in Spedra. There has been another oral drug, udenafil (Zydena) formulated recently for the use in impotence, but it has not been approved by the FDA and is still used in a limited number of countries.

The main difference between the available medications is the so-called ”therapeutic window”, or the duration of drug action. Viagra, Levitra and Stendra all remain effective during 4 hours or slightly more, subject to difference from patient to patient and from one occasion to another. Cialis remains active for 36 hours and sometimes slightly more than that, this is why it is called ”the weekend pill” by the media. Stendra has more impactful action with a quicker onset.

All of the above mentioned ED drugs are available in generic forms, and those generics can have meaningful differences in onset time, impactfulness and therapeutic window. The key to understanding which is which is generally this: orodispersible tablets and oral gels have a shorter onset time, pills with stronger doses address full impotence or work in cases where smaller doses do not yield the desired effect, and combinatory pills address two problems at once, basically what we are talking here is ED aggravated by premature ejaculation.

You need to have a physical or telemedicine doctor examination to help you choose the correct drug and the right dose. Ask more questions if you have any!

Hi, the possibility of occasional erection deficits is normal, also considering your age. In his case, it would seem that in one incident our of about 4 you does not consider your erection satisfactory. Let me not again that it is quite normal that with advancing age the erection decreases and also that the erection does not have the same intensity for the duration of the relationship because the erection oscillates physiologically. Rather than relying on self-medication, it may be useful to ask a urologist / andrologist for a consultation, who will certainly be able to investigate these occasional erection losses and possibly suggest the most appropriate therapy.