For men who haven't had success with oral treatments, there are other alternatives. One highly effective treatment -- given by injection -- is called Caverject. This requires the man or his partner to inject the medicine into his penis near where it attaches to the body. Injecting medications into the penis can make some men cringe. In others, it is a difficult and discouraging process to go through. But for many it has meant the return of a satisfying sex life. The dosage of these injections has to be carefully adjusted for individual men. It is extremely dangerous to experiment with somebody else's injection prescription. There's also a system called MUSE (medicated transurethral system for erection). The man inserts a small pellet filled with the same medicine in Caverject directly into the urethra, the hole at the tip of the penis. Once inserted, the medication spreads through the penis tissues, producing an erection. As with injections, many men find this to be a highly satisfying means of restoring their sex lives.
The major side effect of MUSE and Caverject is pain in the penis. Although it was once considered a last resort, vacuum constriction and external erection devices are actually preferred by a small number of erectile dysfunction sufferers. Most vacuum devices consist of a chamber in which the penis is inserted, a pump to create the vacuum that will draw blood into the penis, and constriction rings that are fastened over the base of the penis once it is erect. The design of external erection devices tends to be more varied. Both of these technologies have been helpful to some. Remarkably, they've only gained acceptance in the medical community in the past 15 years, but the American Urological Association now promotes them as viable alternatives for treating erectile dysfunction. And then there are implants. These come in two basic types: inflatable and flexible. Both require surgery. Men and their partners tend to be highly satisfied with the results.
Inflatable implants consist of fluid-filled rods (placed in the penis), a pump (placed in the scrotal sac), and a reservoir (placed in the abdomen). Pushing the top of the pump fills the rods with fluid and offers erection on demand; pushing the bottom of the pump deflates the penis. This type of implant has a lifetime of about six years. Flexible implants are semi-flexible rods that allow the penis to be bent down after intercourse. This type of implant can last a lifetime but sometimes wears out. Both types of implants can have problems. There always are risks from surgery, and about one in 20 men report pain or discomfort after getting the implant.
FDA Approves Low Daily Dose of the ED Drug for Men Who Anticipate More Frequent Sex. Men taking the erectile dysfunction drug Cialis may now take a low dose of the drug on a daily basis.
The FDA has approved once-daily use of Cialis in a dose of 5 milligrams or a new 2.5-milligram dose for the treatment of erectile dysfunction (ED).
Once-daily Cialis "may be most appropriate for men with ED who anticipate more frequent sexual activity (e.g. twice weekly)," states a news release from Eli Lilly and Company, which makes Cialis.
"For other men, Cialis taken as needed -- the previously approved dosing regimen -- may be most appropriate," the drug company notes.
The FDA approved the once-daily Cialis dosing plan on based three studies in which 2.5-milligram or 5-milligram daily doses of Cialis trumped a placebo pill. In those studies, men took Cialis every day without regard to the timing of their sexual activity.
The FDA first approved Cialis in 2003 in doses of 5 milligrams, 10 milligrams, and 20 milligrams.
First there was the little blue pill. This year it has two companions: The little orange pill, and the almond-shaped, yellow pill.
Men with erectile dysfunction now have three drugs to choose from -- Viagra, Levitra, and Cialis. If that's news to you, you must not have turned on a television set or opened a magazine in the last few months. Everywhere you look, it seems, there are famous athletes singing the praises of their drug-restored virility. It's hard to remember the no-so-long-ago time when "erectile dysfunction" were words no man dared speak.
Does one drug work better than another? That depends on the man.
All three drugs work the same way, says urologist Gerald Brock, MD, associate professor at St. Joseph's Health Center in London, Ontario, Canada. Brock is past chair of the Canadian Male Sexual Health Council. He's treated many patients with Viagra and, in clinical trials, with Cialis and Levitra.
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Kalpesh M. Sharma
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