Persistent or recurring ED is typically a problem of middle or old age, but doctors say it affects an increasing number of younger men. A 2013 study published in the Journal of Sexual Medicine noted that 1 in 4 men under the age of 40 who sought help for ED actually suffered from the condition. Almost half had severe ED. ED can be devastating to men regardless of their age and should always be taken seriously. The Massachusetts Male Aging Study, widely considered a landmark piece of research, showed ED to be more common than suspected. It is estimated that more than 300 million men globally will suffer from the condition in 2026. According to a renowned doctor who treated patients at one of the Cardiovascular and Sexual Health Clinic, estimates that ED is a cardiac risk factor in 10 % – 20 % of patients who do not have other risk factors for heart disease.
Understanding Erectile Dysfunction Beyond the Surface
Erectile dysfunction also known as Impotency or ED, is the inability to achieve or maintain erection during sexual intercourse. It is mostly associated with aging but it is not something that only affects older people. Erectile dysfunction often has more than one cause. Many diseases can cause blood flow problems, damaged nerves, muscles, etc. which can impair erectile dysfunction. Some of the other causes are:
- Nerve Injury:
- There can be some physical injuries sustained on the penis, spinal card, bladder, prostate or pelvis that needs to be treated. Also, a large group of men who have had a surgery or radiation treatment for prostate cancer are at a high risk for Erectile dysfunction.
- Unhealthy lifestyle:
- This includes smoking, excessive alcohol consumption, obesity and not exercising.
- Mental health:
- Depression, stress and anxiety surrounding sexual failure can also lead to erectile dysfunction.
- Medications:
- Some of the medications including anti-depressants can usually cause sexual side-effects.
- Hormonal issues:
- Very few cases of erectile dysfunction result from low levels of male hormone, testosterone.
Standard Erectile dysfunction Solution:
Doctors generally prescribe oral medications (PDE5 inhibitors) as the first line treatment for ED. Some of the most commonly prescribed medications are Sildenafil (Cenforce, Kamagra), Tadalafil (Tadalista, Tadarise), etc. Make sure to consult your healthcare provider before starting any medication. Although oral ED medications are estimated to help 70% of men who try them, some may require a stronger dose of medication than that is available orally.
Additional Erectile Dysfunction Solutions:
- Injection therapy for erectile dysfunction
A urologist may recommend a medication that is delivered directly to the penis through injection therapy. The doses can be increased, as needed, by your doctor. Injection therapy is FDA-approved for erectile dysfunction. The man injects the prescribed medication into the side of the penis. The medication helps increase blood flow to the penis. Another way medication can be delivered locally is through a suppository or intraurethral agent. The man (or his partner) inserts the thin applicator a centimeter into the urethra and injects a pellet-sized bead of the drug. The medication dissolves and dilates blood vessels in the penis.
How long until it takes effect?
– 5 to 15 minutes
How long does an erection last?
– 60 minutes
- Vacuum devices for erectile dysfunction
A vacuum device does not involve medication. It is, however, more cumbersome and less discrete. The device costs between $200 and $400. A man or his partner places it over his flaccid penis. It creates negative pressure to draw blood into the penis to create an erection according to physicians. A ring then needs to be placed at the base of the penis to keep blood within the erectile bodies; once removed, the erection will subside.
How long until it takes effect?
– 5 minutes
How long does an erection last?
– An erection may last more than an hour; however, to minimize the risk of penile injury, the ring should be removed within one hour.
- Penile implant surgery for erectile dysfunction
When other methods are not working, your urologist may suggest a penile implant, which is an outpatient procedure-you can go home the same day. According to healthcare experts, because this option can restore spontaneity and is reliable in most cases, the patient satisfaction rate is high.
As with any surgery, there are risks such as the chance of infection, but there is another factor men need to consider. During the surgery, which takes about an hour, the doctor makes an incision in the scrotum, or base of the penis, and measures the appropriate implant length.
The urologist then installs the device (usually an inflatable implant) that sits inside the scrotum, plus a reservoir that holds the fluid (salt water solution) in the lower abdomen. The fluid functions like blood flow, filling the erectile bodies. The man controls it with a pump that’s placed in the scrotum (a button causes the fluid to flow in and out as desired).
How long until it takes effect?
– Following surgery, men can resume sexual activity within six weeks.
How long does an erection last?
– There are no time limits.
In the end, if any-erectile dysfunction solution you choose depends on the right method for you.
History of Tadalista (Tadalafil)
Tadalafil was discovered first in the 1990s for the treatment of Cardiovascular diseases. But during its clinical trials, it was found out that the drug showed Erectile dysfunction as a major side-effect. This shifted the focus of development towards Erectile dysfunction. Later in 2003, Tadalafil was approved by the US FDA for the treatment of Erectile dysfunction. Tadalafil is the generic version of the drug Cialis, marketed by the company Eli Lilly.
How does Tadalafil work?
- Sexual Stimulation:
- There is release of Nitric Oxide (NO) in the penile tissue during Sexual arousal.
- cGMP Production:
- Production of cGMP is stimulated by the Nitric Oxide. cGMP is an enzyme that promotes smooth muscle relaxation and contracts the blood vessels which increases blood flow in the body.
- PDE5 Action:
- The PDE5 enzyme usually breaks down cGMP which subsides the erection.
- Tadalafil Inhibition:
- Tadalafil inhibits the activity of PDE5 enzyme which limits the breakdown of cGMP and helps in maintaining elevated levels of this molecule in the penile tissue.
- Enhanced Erection:
- Higher cGMP levels enhance the effects of NO, leading to prolonged smooth muscle relaxation and improved blood flow, facilitating an erection.
Adverse Effects:
Common Adverse Effects
- Headache: Headaches induced by tadalafil range from mild to severe and are generally transient.
- Dyspepsia: Dyspepsia is a frequent reaction characterized by indigestion, heartburn, and abdominal discomfort. Tadalafil’s relaxation effect on gastrointestinal smooth muscles is thought to contribute to these symptoms.
- Back Pain and Myalgia: Many patients complain of musculoskeletal discomfort, particularly in the back and muscles. While the exact mechanism is unclear, it is thought to be related to the effects of tadalafil on smooth muscle tissue.
- Nausea
- Light-headedness
- Flushing
Severe Adverse Effects and Potential Injuries
- Nasal obstruction
- Hypotension: Vasodilation of vascular smooth muscle can lead to modest reductions in blood pressure of about 7 mm Hg in systolic and 5 mm Hg in diastolic pressure, and this effect can last up to 12 hours.
- Limb Pain: Pain in the legs and arms is less common but can cause discomfort.
- Vision Changes: Tadalafil can cause blurred vision or alterations in color vision. Although it is uncommon, it can cause sudden vision loss in one or both eyes, which can lead to permanent blindness.
- Hearing Loss: Sudden decrease or loss of hearing, sometimes accompanied by ear ringing and dizziness, is a rare but severe side effect. This can lead to permanent hearing impairment.
- Priapism: It is one of the most dangerous and serious side effects, characterized by a prolonged, painful erection lasting more than 4 hours. To stop permanent injuries to the penis, immediate medical attention is required.
- Gastroesophageal Reflux Disease (GERD): Tadalafil can cause worsening of acid reflux symptoms.
- Rash and Hypersensitivity Reactions: Skin reactions, including rash and urticaria (hives), as well as more severe swelling of the lips, tongue, or throat, can cause respiratory distress if severe.
Contraindications
Medications:
Tadalista should never be used with the following medications:
– Nitrates and nitric oxide: These are the most life-threatening contraindications. It can cause a drastic drop in blood pressure.
– Guanylate cyclase stimulators: Drugs such as riociguat which is used to treat pulmonary hypertension in the arteries should be avoided.
– Other ED medications: Do not use Tadalista with other PDE5 inhibitors or any other ED treatment without consulting a doctor.
Health Conditions:
Tadalista is generally not recommended or requires extreme caution and medical supervision in individuals with certain medical histories:
- Cardiovascular issues:
- Recent heart attack (within the last 3-6 months).
- Recent stroke (within the last 6 months).
- Severe heart problems,
- Hypertension
- Hypotension
- Life-threatening arrhythmias or unstable angina.
- Severe liver or kidney impairment.
- Eye disorders: Individuals with a history of optic neuropathy or rare inherited eye diseases.
- Bleeding disorders (e.g. hemophilia) or active stomach ulcers.
- Blood cell disorders:
- Sickle cell anemia
- Multiple myeloma
- Leukemia
- Anatomical deformation of the penis
- Known hypersensitivity: An allergic reaction to sildenafil or other excipients in the tablet.
Consulting a physician before selecting your daily medication should be practiced on a regular basis.
Toxicity
Signs and Symptoms of Overdose
In cases of tadalafil overdose, which can exacerbate common adverse effects like hypotension, headache, dizziness, and, in rare instances, priapism. There is no specific antidote for tadalafil.
Management of Overdose
The management of Tadalafil overdose focuses mainly on supportive care, with prompt medical attention plays a pivotal role. Patient recovery is supported and there is reduction in the risk of complications associated with the overdose when there is early intervention practiced. If the overdose is seen soon after ingestion, gastrointestinal decontamination may be considered. Activated charcoal is often used in such cases to limit further absorption of the drug from the digestive tract.
Treatment is largely associated with relieving symptoms. Low blood pressure may be managed with IV treatments and in more severe cases, medications that support low blood pressure may be required. One of the most serious complications is Priapism which is characterized by prolonged erection, requires urgent medical attention, often involving aspiration of blood from the penile tissues or administration of sympathomimetic medications. Careful monitoring should be practiced throughout the treatment. For the treatment of Tadalafil overdose- supportive care, which involves examining vital signs, maintaining fluid balance and electrolytes, ensuring proper hydration, offering oxygen and ventilation assistance if required are followed.
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References:
https://www.yalemedicine.org/news/erectile-dysfunction-solutions
