Erectile Dysfunction (ED) affects a significant number of men in the United States, with approximately 30 million men experiencing its effects. Studies have shown that the prevalence of ED increases with age, with 40% of men affected at age 40 and nearly 70% affected at age 70.
Currently, the initial treatment options for ED involve phosphodiesterase inhibitors (PDE5i) such as Sildenafil (Viagra) and Tadalafil (Cialis) used as monotherapy. However, around 40% of men are not satisfied with the results of monotherapy. There are several reasons why monotherapy may not be effective. In this article, we will discuss three common reasons why sildenafil or tadalafil may not be effective for treating ED when used alone.
1. Underlying Cardiovascular Disease (CVD): Erectile dysfunction can often be the first sign of an underlying cardiovascular disease. The smaller arteries in the penis can become blocked more quickly than larger arteries, leading to compromised blood flow. This can serve as an early warning sign of plaque build-up in larger arteries supplying blood to the heart and brain.
2. Inappropriate Use: Patients with ED may not receive adequate education on the proper use of sildenafil or tadalafil. This can include not receiving the highest recommended dose or not taking the medication at the appropriate time before sexual activity. Proper education and dose adjustment are crucial for optimizing outcomes in ED patients.
3. Misdiagnosis: Some patients may be misdiagnosed with non-responsive ED when they have other underlying conditions such as hypogonadism (low testosterone) or hyperprolactinemia (high levels of prolactin). These patients may benefit from hormonal treatment to improve erectile function.
It is important to identify the underlining cause of ED as well as reasons for treatment failure to improve sexual function and quality of life in men. In addition, combination ED therapy such as
may be a suitable option for men who are non-responders.
Proper education and diagnosis will improve the overall well being of men who suffer with ED adding life to years and years to life.
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