Less than 10% of men suffer from Ejaculation Disfunction (ED) seek medical help. Faced with the ED, is often demoralized, or search miraculous treatments. There are countless folk remedies that must be considered with utmost caution and skepticism. Currently there are many very safe and effective treatments, but in no event magical.The modality of treatment is dictated by the specific problem that causes impotence. The first step is to define the cause, if possible, and then try the simplest and least risky. In summary, the therapeutic alternatives include one or more of the following.
1) Change lifestyle habits that affect the health of the arteries and veins: No smoking, moderate alcohol consumption and fat, get some exercise and learn to relax.
2) Change or reduce the drugs that cause impotence, as some antidepressants, diuretics and beta blockers
3) Psychotherapy and behavioral therapy. Regardless of the cause of ED is recommended for all patients some form of psychological therapy, behavioral, sexual or combination, usually assisted by her partner.
4) and transurethral injection therapy. It consists of injecting drugs in the erectile tissue to relax smooth muscles in the penis and allowing the erection to take place. It is indicated in some cases of ED. The drugs are usually injected associations papaverine-phentolamine, or alprostadil (prostaglandin E1). Adverse reactions are usually minor but may include prolonged and painful erections (priapism). An alternative to injections is a plastic device for applying these drugs through the urethra. Although safer and less expensive than surgical treatments, these therapies have a high rate of dropouts, as the loss of spontaneity makes you lose interest in the proceedings.
5) Oral medications. Current methods are drug therapy to improve flow in the penis providing erection. among them are:
- Sildenafil
- Vardenafil
- Tadalafil
- Apomorphine hydrochloride
- Yohimbine. Used as a folk medicine for years, there is now evidence that it can improve the power in one third of men with mild, especially in combination with the antidepressant trazodone.
- Hormone treatments. Testosterone therapy is indicated only in men with hypogonadism (low levels of male hormone). Can be used orally or in patches. Testosterone never not recommended for men with normal levels of male hormone, in the latter can improve sex drive, but at the expense of causing damage to the prostate and liver, sometimes irreversible. When the impotence is due to excessive levels of the hormone prolactin, may help the medicine bromocriptine.
- Other: They have been used with varying degrees of success, drugs such as pentoxifylline, naltrexone, an antidote for heroin and morphine, or the antihypertensive minoxidil.
The first three act similarly being PDE5 inhibitors. When stimulating the penis is secreted cyclic guanosine monophosphate (cGMP), and this substance produces an erection and maintains it. PDE5 is the product that degrades cGMP, then cancels the erection.
All products PDE5 inhibitors increase cGMP acting time and keeps better and longer erections.
From here there are differences between these medications by dose, onset of action, duration of effect, and the need for readministration. Vardenafil also does not interact with food, they do the other two.

