Erectile Dysfunction Health Center

There are a number of treatments for erection problems. But phosphodiesterase-5 inhibitors (PDE-5 inhibitors), such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), are generally tried first because of the success rate, ease of use, and convenience of these medicines. If you have already tried one of these medicines and it has not worked for you, see your health professional.

Consider the following when making your decision:

• PDE-5 inhibitors (such as sildenafil [Viagra], tadalafil [Cialis], and vardenafil [Levitra]) may not be an option if you have heart disease that may require you to take nitroglycerin or other medications containing nitrates.
• If you and your partner have decided that sexual intercourse is an important part of your relationship, you may want to use PDE-5 inhibitors. About 80% of the men who use PDE-5 inhibitors have an erection and successfully have intercourse.¹
• The decision about whether to treat an erection problem is often based on your and your partner's preferences.

What is an erection problem?

An erection problem (also called erectile dysfunction and sometimes impotence) refers to a man's consistent inability to get or maintain an erection sufficient to have satisfactory sex. It does not mean a lack of sexual interest or desire or the occasional difficulty achieving or maintaining an erection that affects all men at some time in their lives.

What causes an erection problem?

The cause of erection problems may be physical (such as an injury to the nerves or loss of blood flow to the penis) or psychological (such as anxiety or depression). Medicines you take for other conditions, alcohol consumption, smoking, or illegal drug use can cause erection problems.

Certain conditions may affect blood flow or the nervous system, increasing the risk for erection problems. These include diabetes, high blood pressure, high cholesterol, atherosclerosis, multiple sclerosis, and Parkinson's disease.

Erection problems can occur at any age but are more common in older men, who often have additional health problems or who may be taking medicines that can interfere with normal erectile function. Treatment of erection problems in older men can be as effective as in younger men.

Why treat an erection problem?

The decision about whether to treat an erection problem may not be as straightforward as the decision about whether to treat many other medical conditions. An erection problem is not life-threatening, yet it can seriously affect your emotional health and sense of self-worth. It also can make it difficult to father a child, if that is your desire. So the decision about whether to treat an erection problem is often based on personal preference.

Very often, this decision is also based on how intensive or invasive the treatment is and its chance of succeeding. Medicines can make treating an erection problem simple and convenient. Still, you should think carefully about whether you want to treat your erection problem before committing to trying one of these medicines.

Your choices are:

• Use a PDE-5 inhibitor (such as sildenafil [Viagra], tadalafil [Cialis], and vardenafil [Levitra]).
• Try counseling or sex therapy.
• Seek other ways to express intimacy.

The decision about whether to use PDE-5 inhibitors takes into account your personal feelings and the medical facts.

These personal stories may be helpful in making your decision.

Use this worksheet to help you make your decision. After you and your partner complete it, you should have a better idea of how you feel about taking a PDE-5 inhibitor. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

Use the following space to list any other important concerns you have about this decision.

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to use or not use a PDE-5 inhibitor.

Check the box below that represents your overall impression about your decision.

• Erection Problems (Erectile Dysfunction)
• Tests for Erection Problems

Citations

1. Lue TF, Broderick GA (2007). Evaluation and nonsurgical management of erectile dysfunction and premature ejaculation. In AJ Wein, ed., Campbell-Walsh Urology, 9th ed., vol. 1, pp. 750–787. Philadelphia: Saunders Elsevier.