Erectile Dysfunction

Erectile dysfunction is a condition that affects the quality of life and relationships of men worldwide. The good news is that it can be fought and, in most cases, overcome. To triumph over it, we must first acquaint ourselves with the opponent in detail:

1. What is erectile dysfunction?
2. Causes and risk factors of erectile dysfunction
3. Treatment of erectile dysfunction
4. How do erectile dysfunction medications work?
5. Which active ingredient to choose?
6. Overview of the most popular erection medications
7. Contraindications and side effects of erection medications
8. Buying options
9. Brief summary in conclusion

What is erectile dysfunction?

Erectile dysfunction (ED) is a condition where a man cannot achieve or maintain a sufficiently firm erection for satisfactory sexual intercourse. It is a common problem that can affect men in various age groups but is more prevalent in older men.

Erectile dysfunction is a relatively common condition. According to some estimates, it can occur in up to 50% of men aged between 40 and 70 years. The frequency increases with age: while less than 10% of men at the age of 40 have ED, the percentage rises to up to 60% in men aged 70.

It is important to note that mild and occasional erection problems are common and do not necessarily indicate permanent erectile dysfunction. However, if erection problems persist, a solution should not be postponed. 

It is also crucial to be aware that erectile dysfunction can be a symptom of another health problem, such as cardiovascular disease or diabetes, so it is important to thoroughly investigate it.

Erectile dysfunction can have a significant impact on a man's quality of life. This condition can negatively affect self-esteem and self-perception, often leading to feelings of failure and shame. ED can also increase the risk of developing mental health problems, such as anxiety and depression, and can lead to concerns about sexual performance, further worsening the situation. All of this can disrupt physical health, emotional well-being, and social interactions, leading to a decrease in overall quality of life.

In the context of relationships, ED can create tension and emotional distance between partners. A man suffering from ED may feel incapable of satisfying his partner, leading to sexual tension, especially if the man avoids discussion. The partner of a man with ED may feel rejected or uncertain about how to help, leading to their own stress and anxiety. Open communication and appropriate treatment are crucial to addressing these issues. 

Erectile dysfunction is often colloquially referred to as impotence. However, it is not entirely the same. 

Causes and Risk Factors of Erectile Dysfunction

Sexual arousal in men is a complex process involving the brain, hormones, emotions, nerves, muscles, and blood circulation. Problems in any part of this system can lead to erectile dysfunction. Additionally, psychological stress can worsen this situation.

The causes of erectile dysfunction can be physical, psychological, or a combination of both. Most difficulties in achieving and maintaining an erection originate in physical causes such as heart and vascular diseases, high blood pressure, high cholesterol, diabetes, or obesity. Among the psychological causes, stress, anxiety, depression, and even relationship problems are most common. 

A man's age is likely the biggest risk factor, with erectile problems occurring more frequently in men after their forties.

Lifestyle significantly influences erectile dysfunction, as confirmed by numerous scientific studies and clinical research. In particular, the following areas are noteworthy:

1. Physical activity: Studies show that men who exercise regularly have a lower likelihood of experiencing ED compared to those who are inactive. Physical activity helps improve blood circulation and overall cardiovascular health, crucial for achieving and maintaining an erection. Physical activity is equally important for men with erection problems. A study titled "Erectile Dysfunction, Physical Activity, and Exercise", published in the First International Journal of Andrology, clearly demonstrated that regular physical exercise improves erectile function and shows a synergistic effect with medications commonly used in its treatment.
2. Smoking: Numerous studies indicate a causal relationship between smoking and erectile dysfunction, with smoking being a significant risk factor for ED. Smoking causes damage to blood vessels, affecting blood flow to the penis.
3. Alcohol: Excessive alcohol consumption can cause temporary or permanent erectile problems. According to the American Mayo Clinic, excessive alcohol intake is among the most significant risk factors. More details can be found in the article "Penis Health: Identifying and Preventing Problems".
4. Weight and obesity: Obesity increases the risk of developing ED as it can lead to various health issues, including heart diseases and diabetes.
5. Stress and mental health: Psychological factors such as stress, anxiety, and depression can contribute to ED.
6. Sleep: Sleep disorders, especially sleep apnea syndrome, may be associated with ED.

Treatment of Erectile Dysfunction

Erectile dysfunction is not a modern problem, but unfortunately, due to the influence of the fast-moving modern times, it occurs more frequently in men than it did in the past.

In historical texts from ancient Egypt and Greece, the first mentions of searching for natural remedies for ED can be found. Fortunately, times have progressed, offering much more effective treatment options than just the consumption of herbs, spices, and aphrodisiacs such as honey, dates, or milk, as was common in those times.

A groundbreaking milestone for the treatment of erectile dysfunction occurred in 1998 when Viagra, the first effective oral medication for ED, entered the market in the United States. Viagra, with its active ingredient sildenafil, was initially developed by the pharmaceutical company Pfizer for the treatment of angina pectoris (chest pain associated with coronary artery disease). However, during clinical trials, researchers discovered that sildenafil had only a minor impact on angina but could help induce erections in men.

As early as 1996, Pfizer obtained a patent for sildenafil, granting exclusive rights for a certain period to manufacture and sell sildenafil as a substance for the treatment of erectile dysfunction. Thanks to this exclusive right, Pfizer could significantly influence the market until the patent expired, allowing the entry of generic versions of this medication (generic sildenafil or generic Viagra). This led to a decline in prices and market share for Viagra. Pfizer's patent for sildenafil expired in some European countries in 2013.

Following the success of sildenafil in treating erectile dysfunction, other medications with active ingredients and a similar mechanism of action to sildenafil, but with different pharmacokinetic properties, entered the market. Here are a few of them:

1. Tadalafil (Cialis): Introduced in 2003, its main advantage is a longer duration of action, lasting up to 36 hours. For this reason, it is sometimes referred to as the "weekend pill." In our e-shop, products like Vidalista 20 and Tadalis represent Cialis.
2. Vardenafil (Levitra, Staxyn): Also introduced in 2003, Valif is a popular generic alternative.
3. Avanafil (Stendra): This is the newest medication in this group, approved in 2012. At the moment, our e-shop does not have a generic version with avanafil.

In addition to oral tablets, there are other treatment options for erectile dysfunction. 

How do erectile dysfunction medications work?

Sildenafil, tadalafil, vardenafil, and avanafil are so-called PDE5 enzyme inhibitors - they slow down its activity. The PDE5 enzyme is naturally present in the body, and its task is to control blood circulation. Sometimes, increased activity of this enzyme can reduce blood flow to the penis, resulting in erectile dysfunction. By slowing down the activity of the PDE5 enzyme, the mentioned active ingredients facilitate the relaxation of muscle walls and blood cells around the penis. This allows for improved blood flow to the penis and ensures a consistent erection.

It is important to emphasize that although all these active ingredients work similarly, they have different dosages, onset of action, and duration of effect. Patients should always consult with their doctor about their choice of medication, considering potential interactions with other drugs and possible side effects.

And what about safety and effectiveness?

The process of approving a new medication is carefully designed to ensure the safety of using a specific active ingredient. Furthermore, the safety and effectiveness of the active ingredients for erectile dysfunction have been confirmed by numerous independent studies. Many of these studies are now available online, such as the 2002 study titled "Sildenafil for male erectile dysfunction - a systematic review and meta-analysis", which confirmed, based on a sample of 6659 men, that "sildenafil improves erectile function and is generally well-tolerated."

Reliable information can also be obtained from the websites of reputable institutions that have long been involved in the treatment of erectile dysfunction, such as Mayo Clinic, Cleveland Clinic, or the American National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Which Active Ingredient to Choose?

Although sildenafil, tadalafil, vardenafil, and avanafil work in the same way, are comparably effective, and similarly safe, each of them differs slightly from the others. They vary primarily in the onset of action, duration of effect, and potential side effects. It is advisable to consult with a doctor about the suitability of their use, or carefully read the package insert to avoid potential issues.

Sildenafil
Onset of action: 60 minutes
Duration of effect: 4-5 hours

Tadalafil
Onset of action: 30 minutes
Duration of effect: up to 36 hours

Vardedafil
Onset of action: 25-60 minutes
Duration of effect: 4-5 hours

Avanafil
Onset of action: 15-30 minutes
Duration of effect: over 6 hours

Another guideline is the amount of active ingredient contained in the preparation. With a lower content of the active ingredient in one dose, the risk of side effects decreases. Therefore, it is better to start with a lower dose (sildenafil 100 mg, tadalafil 20 mg, vardenafil 20 mg). Alternatively, compare different preparations with different active ingredients to find out which one suits you best.

Medications for the Treatment of Erectile Dysfunction

Similarly to sildenafil, for other active ingredients whose patent has expired, both original drugs such as Viagra or Cialis and their generics are available on the market. This includes sildenafil generics, tadalafil generics, vardenafil generics, and avanafil generics.

A significant advantage of generics is that they are considerably cheaper while maintaining the same properties and effects as the original drugs. They can also be discreetly ordered online without a prescription, as is the case in our online shop.

Sildenafil is available in the form of traditional tablets, gel, chewable tablets, or effervescent tablets dissolved in water. Among the most well-known sildenafil generics are Kamagra products in various forms, such as classic tablets like Kamagra 100 and Kamagra Gold, oral gel – Kamagra Oral Jelly, chewable candies Kamagra chewable, or effervescent tablets Kamagra effervescent. Other popular products with sildenafil include Cobra Red, chewable tablets Kingmaster, and products from the manufacturer Centurion Laboratories – Cenforce 100, Cenforce 150, and Cenforce 200.

Tadalafil has the longest effectiveness among erectile dysfunction medications. Tablets with tadalafil are available with varying amounts of the active ingredient, with the most popular being:

• tadalafil 20 mg – Vidalista 20, Tadalis SX, Vidalista CT
• tadalafil 40 mg – Vidalista 40, Tadarise 40
• tadalafil 60 mg – Vidalista 60

Tadalafil can also be purchased in the form of a fruity-flavored gel in the product Apcalis Oral jelly.

Products with vardenafil and avanafil are not as widespread as products with sildenafil and tadalafil, and there are far fewer of them on the market. In our online shop, you can find the vardenafil generic Valif 20.

Contraindications and Side Effects of Erectile Dysfunction Medication

The treatment of erectile dysfunction represents a significant advancement in the field of men's health and quality of life. Although active ingredients like sildenafil, tadalafil, vardenafil, and avanafil have brought hope and relief to many men, it is important to emphasize that they are not suitable for everyone. Just like with all medications, there are certain contraindications and side effects that need to be considered before using them.

Specific contraindications depend on the particular medication and its active substance. Some general contraindications apply to all these substances, and you should not take them if:

1. You are taking nitrates (such as nitroglycerin, isosorbide dinitrate), nitric oxide-releasing drugs (such as isoamyl nitrite), or angina medications (such as nitrates or nitric oxide donors).
2. You have recently experienced a cerebrovascular accident (stroke) or a heart attack or suffer from another serious heart condition.
3. You have low or high blood pressure.
4. You suffer from severe liver or kidney disorders.
5. You have a rare eye disorder (such as retinitis pigmentosa) or experience vision loss due to non-arteritic anterior ischemic optic neuropathy (NAION).
6. You are taking certain other medications, such as riociguat, some high blood pressure medications, HIV medications, and certain antifungal medications.
7. You are allergic to the active substance contained in the chosen medication or to other components of these medicinal products.
8. You suffer from a rare disorder such as Peyronie's disease, sickle cell anemia, or multiple myeloma, which can affect the body's response to these medications.
9. You are already taking another medication for the treatment of erectile dysfunction.

Possible side effects include:

• Headaches
• Stuffy nose
• Impaired vision (blurred vision, blue vision)
• Hot flashes
• Dizziness
• Nausea
• Back pain
• Priapism (Priapism is a prolonged and spontaneously persistent erection, usually very painful. If an erection lasts longer than 4 hours without sexual stimulation, seek medical attention immediately. If priapism is not treated promptly, it can lead to permanent damage to the penis and permanent loss of potency).

Concurrently using erectile dysfunction medication with other drugs requires approval from your treating physician due to possible contraindications.

Buying Options

Medications for erectile dysfunction can be purchased at traditional brick-and-mortar pharmacies with a prescription or online, often without a prescription. In addition to this advantage, online purchasing offers many other benefits. However, it is crucial to be cautious and always choose a trustworthy and verified online shop for buying products like Kamagra or any other. What are the advantages of online purchasing?

1. Discretion in purchase: Erectile dysfunction is a sensitive topic, and many men feel uncomfortable visiting a pharmacy. Online shopping offers much more privacy.
2. Purchase without a prescription: Online shops, like ours, offer purchases without a prescription.
3. Anonymous delivery: Orders from our online shop are shipped in unmarked packages – without the name of the shop or any indication of the package's contents.
4. Convenience: You can order products from the comfort of your home and have them delivered to your doorstep.
5. Wider selection: E-shops offer a broader selection of brands and generic versions of drugs, providing more options to choose from.
6. Significantly lower prices: Thanks to lower operational costs, e-shops generally offer better prices than brick-and-mortar stores. Additionally, in physical pharmacies, mainly expensive original products are available, while on the internet, you can find equally effective but much cheaper so-called generics.
7. Availability of information: Quality e-shops are also known for providing detailed information about the offered preparations, their effects, and side effects. This can help patients better understand their medications and the problem itself.
8. Speed and flexibility of delivery: Delivery of the order can be done within a few days.

Brief Summary in Conclusion

Erectile dysfunction (ED) is a serious health problem that can affect men in various age groups, but its occurrence increases with age. ED can be associated with a range of physical and psychological factors, including cardiovascular diseases, diabetes, stress, and lifestyle.

Thanks to advances in medicine, especially since the introduction of Viagra in 1998, we now have several medications that offer men hope for improving this condition. Sildenafil, tadalafil, vardenafil, and avanafil, although working through a similar mechanism, may have different side effects and contraindications.

With the expiration of patents on original drugs, many generics have emerged, offering the same effectiveness at a lower cost, and they can be purchased online without a prescription. E-shops provide the option of convenient, discreet, and often cheaper purchases, but it is essential to choose reliable and verified sellers.

Author: Christian Fischer

Sources:
https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776
https://my.clevelandclinic.org/health/diseases/9121-sexual-dysfunction 
https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction 
https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline
https://onlinelibrary.wiley.com/doi/10.1111/and.13264 
https://pubmed.ncbi.nlm.nih.gov/?term=smoking+and+erectile+dysfunction 
https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/penis-health/art-20046175
https://pubmed.ncbi.nlm.nih.gov/?term=treatment%20for%20erectile%20dysfunction 
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/211714
https://www.webmd.com/erectile-dysfunction/default.htm
https://emedicine.medscape.com/article/444220-overview?form=fpf