Our men’s health service offers effective treatments for male-specific conditions such as premature ejaculation, hair loss and erectile dysfunction. Our pharmacists are here to help with advice, support and explain what treatments are available. The first of our three articles looks at erectile dysfunction.
What many people don’t realise about erectile dysfunction is just how common it is. In the UK alone, it is thought to affect at least 50% of men during some point in their later lives.
- 70% of men never seek advice for sex-related conditions.
- ED is common in older men, but also affects younger men
- Treatment is available direct from our pharmacists
When two people engage in sexual intercourse, a series of chemical reactions take place inside the body. In men, these reactions cause blood to rush to the penis, so it stiffens and grows in size, producing an erection.
Some men may find increasing difficulty in getting erections as they approach middle age. But this does not just apply to older men, many young men can also encounter the problem too. In any case where erectile issues occurs, the problem is called erectile dysfunction.
Why does this happen?
The condition can occur for a range of different reasons. Sometimes a medical condition may restrict blood flow to the penis, such as diabetes or high blood pressure. Lifestyle factors can also restrict circulation and contribute to the problem, such as a poor diet, alcohol consumption or recreational drug use. Other cases of erectile problems may be caused by psychological or emotional issues, such as stress or anxiety.
It can also be associated with other types of sexual dysfunction, such as premature ejaculation. However, it is important to recognise the difference between these conditions, as they are not always present in unison and treatment options for them are not the same.
Can medication help?
Fortunately, erectile dysfunction is now easily treatable. Popular medicines like Cialis, Levitra, Viagra and generic Sildenafil work by allowing for the easier facilitation of blood flow to the penis, by assisting those blood vessels which act as a gateway to open and stay dilated.
There are two different types of erectile dysfunction medication: oral tablets, and applicable devices.
Tablets are the most common option
Viagra alone has been prescribed in over 20 million cases worldwide – because the tablets are small, convenient, and can be taken in advance of intercourse. All oral tablets we sell come in different strengths. Which strength you are issued with depends on what you’ve taken before, and your general health.
There are two main classes of medicine that can help to treat erectile dysfunction (or ED): ‘PDE5 Inhibitors’, which are pills like Viagra; and ‘Prostaglandins’, which may be injected into the base of the penis, such as Caverject, a urethral suppository, such as MUSE, or a cream which is inserted into the urethra with a plunger, such as Vitaros.
Their mode of action is to help increase the flow of blood to the penis, to enable stronger and longer-lasting erections when sexually aroused.
These types of medicines are prescription-only, and are only available through the NHS in certain cases. In other cases, a private prescription will be required for their purchase. This can be obtained as part of our Men’s health service.
Our private pharmacy service offers Viagra, Cialis, Levitra and generic tablets including sildenafil and tadalafil, which are oral tablets containing PDE5 inhibitors.
We also offer Vitaros. However, Caverject and MUSE are not currently available to buy through our service.
How do they work?
Both types of drugs aim to increase blood flow to the penis, but they do so in slightly different ways:
PDE5 is the name given to an enzyme which determines when blood vessels narrow and dilate; and this enzyme can sometimes restrict the passage of blood into the penis. PDE5 Inhibitors limit the activity of this enzyme, enabling blood to flow more easily to the penis, thereby relieving symptoms of impotence. PDE5 Inhibitors are the active ingredients in Viagra, Levitra and Cialis.
Prostaglandins are important hormone-like compounds that do a lot of work inside the body. For instance, when you suffer an injury, prostaglandins are responsible for alerting you to it, by sending pain signals to the brain from the affected area. Medicines such as Caverject and MUSE contain alprostadil, an agent which mimics these natural hormones, allowing for greater sensitivity. This agent both enables those vessels letting blood into the penis to dilate; and encourages blood vessels allowing blood to exit the penis to narrow, keeping blood in the penis and helping it to stay erect.
What are the side effects?
Side effects vary within medicines of the same class, so it’s important to always read the patient information leaflet provided with your medicine. If you’re unsure, or think you might be experiencing a side effect, it is vital to talk to our pharmacist immediately.
Can I take them with other medications?
Both PDE5 Inhibitors and Prostaglandins can interact with a range of different medicines, so it is essential to inform your doctor of any medicines you are currently taking, or illnesses you have previously suffered from. Do not start or stop taking any medicines before checking with your doctor or pharmacist first. This includes prescription medicines, non-prescription medicines, and remedies.
Other types of treatment
There are several non-medicinal options available to those who prefer not to take prescription drugs, or have found them to be unsuitable, including: vacuum constriction devices (pumps), prostheses or, in rare cases, surgery.
Natural or ‘herbal’ remedies are a hot topic of discussion when it comes to erectile dysfunction. However, their success has been much debated, with some saying that they may improve sexual performance, but several studies refuting that they make any difference at all.
What’s the difference between the medications?
The main difference between the medications is their method of application, and their duration of function. In addition, some are branded and some are generic.
Oral tablet treatments, like Viagra, Levitra, Sildenafil or Cialis, are a convenient way of relieving symptoms, especially if this is the first time you’re trying the medication. Tablets typically take at least 30 minutes to work, so would need to be taken in advance of sex.
Non-tablet treatments include injections and urethral systems. Injections, such as Caverject, are injected into the base of the penis, and work almost immediately. Please note, we do not provide Caverject through our service.
Alternatively, urethral systems, like MUSE, are inserted into the tip of the penis. These tend to work quicker than oral tablets, but are not usually recommended unless you’ve already tried a tablet and found it to be ineffective. Please be aware that you cannot purchase MUSE from our service.
Should I take Viagra, Cialis or Levitra?
All of these drugs are known as ‘PDE5 Inhibitors’, and work in the same way although some get to work faster than others, and some stay active for longer than others.
Viagra typically takes 30-60 minutes to work, and lasts for around 4 hours. (Sildenafil contain the same ingredient, and typically produce similar results.)
Cialis can take one or two hours to work, depending on which dose you use, but can remain active for up to 36 hours afterwards.
Levitra takes 30-60 minutes to have an effect, and stays active for about 5 hours.
Which medicine you choose to purchase depends on what you may have used before, your health, when you feel most comfortable taking the medicine, and how long you want it to last for. All of these medicines should only cause erections when you are sexually aroused.
Are there different side effects?
Every medicine has different side effects, so it’s important to always read the patient information leaflet provided with your medication. If you’re unsure, or think you might be experiencing side effects, it is imperative to talk to a doctor or pharmacist immediately.
Is it right for me?
Our pharmacists are here to help determine whether the medication is suitable for you.
Call in to your local Dears Pharmacy for support and advice in our locations in Edinburgh & Fife.