September 17, 2014
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Men's Health

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Medication recommended as first-line treatment for ED

Having problems with erectile dysfunction? Popping a pill may be your best bet at getting the boost you need, a panel of US experts has concluded.

The American Urological Association's (AUA) guidelines for the treatment of erectile dysfunction recommends doctors prescribe erectile drugs such as sildenafil (Viagra®), tadalafil (Cialis®) and vardenafil (Levitra®) as a first line-therapy for men who have problems achieving and maintaining erections. These medications are called PDE5 inhibitors, because they target an enzyme called PDE5, which restricts blood flow to the penis.

"Depending on the patient population characteristics, as many as 80% of men will benefit from oral PDE5 inhibitors," said Dr. Drogo Montague, director of The Cleveland Clinic's Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function and co-chair of the panel. "For those men who are not helped by these agents, one or more of the remaining treatment options are almost always successful."

Other therapies endorsed by the AUA included urethral suppositories, penile drug injections, penile prostheses, and vacuum devices. The panel recommended against penile venous reconstructive surgery and against using herbal therapies. It also did not recommend the medications trazodone and yohimbine, and testosterone supplements for men whose levels of the hormone fall within the normal range.

While accurate statistics are hard to come by due to the reluctance of some men to seek help, an estimated 52% of men between the ages of 40 and 70 have difficulties achieving or maintaining erections. Erectile dysfunction can be the result of a wide range of causes, including psychological issues, circulatory problems, and side effects from medications.

The new guidelines also specifically target men who have both erectile dysfunction and heart disease, because research has shown that the two conditions may share a common cause.

"Men suffering from ED often have cardiovascular disease," the news release says. "The guideline cites and supports the Princeton Consensus Panel's recommendation that men at high cardiovascular risk should not receive ED treatment until their condition has stabilized. Patients at low risk may be considered for first-line therapies."


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