An Overview of Western Medicine Impotence Treatments

From pills to pumps there have been a wide array of methods devised to treat sexual impotence among males. Here, we take a clinical look at a variety of such remedies, revealing how they work and analyzing their effectiveness…

Prescription / Oral Medications

Representing a new milestone in the treatment of Erectile Dysfunction (ED), the drug Sildenafil was approved by the FDA in 1998. It works by increasing blood flow to the penis while causing penile muscles, oddly enough, to relax. It does not initiate an erection, but rather enhances penile response to sexual stimulation by counteracting the chemical in the body that diminishes an erection. Most impressively, Sildenafil is effective regardless of the cause of the Erectile Dysfunction, whether it be hypertension, coronary disease, prostate cancer, diabetes and depression.
 
The natural herb Yohimbine (from tree bark) is present in some over-the-counter ED medications but has been of very limited efficacy. It is a vasodilator, meaning that it causes blood vessels to widen, encouraging blood flow into the penis.
 
The antidepressant Trazodone, when taken one hour before sexual activity, has been found to prolong erections in men who are able to obtain, but not maintain, an erection during intercourse. It is, however, much less effective than Sildenafil.

Prescription Topical & Intra-urethral Agents

MUSE (Medicated Urethral System for Erection) is a prostaglandin cream that's applied into the opening of the urethra just before intercourse. It, too, works as a vasodilator. In clinical trials it produced encouraging results. However, since the FDA approved this method recently, patient response has been limited. Although men have reported partial erections in response to the drug, most did not achieve a full erection. The medication often stimulates a feeling of warmth or burning in the penis.

Vacuum Devices

This is the least invasive method of all, involving no medication or surgery whatsoever. It works by placing a cylinder with an attached pump over the penis. The pump creates a vacuum in the cylinder, which pulls blood into the penis to initiate an erection. The cylinder is then removed and a constriction band is simultaneously placed at the base of the penis, causing the erection to hold.
 
This method works well with the majority of men who are not able to achieve or maintain an erection due to vasculogenic factors. In fact, it has proved to be effective in more than 90 % of related cases. The erection occurs quickly and may last for long periods of 20 minutes or more.

Hormonal Therapy

This form of therapy is strictly recommended in very limited circumstances, for cases of hypogonadism (a pathological decrease in the levels of testosterone) only. Through this method, testosterone is artificially replaced by intra-muscular injections or by skin patches applied to the shaved scrotum. Levels of testosterone considered normal are reached very quickly, and effects of improved sexual libido and erectile function may be felt after a few days. Male hormone replacement therapy seems to have other beneficial effects, particularly in elderly man. They’ve reported feeling healthier and more energized with an improved ability of mental concentration.
 
However, testosterone replacement therapy is more dangerous than its female counterpart with its use of estrogen. Its clinical use is warranted only after a certain age, and only then when the absence of prostate disorders are ascertained through a thorough prostate examination including ultrasound, rectal touch, and clinical history review. The measurement of PSA levels, abnormal concentrations of antigenic factors in the blood when prostate cancer is present, is also necessary before approving treatment.