Promising Methods in The Treatment of Erectile Dysfunction
A decade is a long enough period for medicine, especially nowadays, when science and technology are developing at a record fast pace. In this regard, we bring to your attention an overview of how, from 2010 to 2020, the methods for treating erectile dysfunction changed, what was invented.
Erectile dysfunction associated with age-related changes in the male body
Traditionally, when talking about erectile dysfunction, people mean a decrease in the ability of a man to achieve an erection. However, for some reason, treatment recommendations usually apply to middle-aged men, while this problem also often affects older men. They also suffer from a decrease in potency and strive to improve it. Of course, there is no universal recipe for dealing with such a manifestation of aging as a decrease in sexual function, but recently the American College of Physicians (ACP) has developed guidelines for the use of testosterone treatment in adult men with age-related low testosterone by intramuscular injections. More about this method can be read on the link
This treatment method is more than promising, because it is not associated with the use of classical PDE-5 inhibitors, which often have a negative effect on the cardiovascular system of elderly men and also do not affect the level of libido, therefore, do not have a significant effect on erectile dysfunction caused by hormonal changes. It should be noted that in men aged 60 - 80 years, testosterone loss reaches from 20 to 50%, which is associated with many changes in the body, in addition to lowering the level of potency, such as decreased muscle mass, weakness, mood changes, etc.
Despite the fact that treatment of erectile dysfunction with testosterone looks like an attractive option, it has serious drawbacks, as you can read in the article https://www.nature.com/articles/s41443-019-0131-1. Among them are allergic reactions, a rise in hematocrit, and the most serious is an increased risk of developing prostate cancer. It should be noted that in case of impaired potency due to a decrease in testosterone levels (not only in the elderly, but also in young and middle-aged men), the first-line measures are not hormonal drugs, but a lifestyle change – smoking cessation, increased physical activity, exercises, normalization of diet. It’s impossible to be healthy without following these simple basics, and medications can be bring more harm than good. To date, there has been no evidence of the safety and feasibility of treating ED with TTh. Additional studies are needed, preferably long-term, with the ability to assess the delayed effects of such therapy.
Development of Studies
According to the data provided in the article, the majority of studies related to improving methods of combating erectile dysfunction, including in patients with diabetes mellitus, were conducted in the USA (by a large margin in the first place), Italy and Germany. These included comprehensive studies of Vardenafil, Sildenafil, Tadalafil, and testosterone-based drugs. Much attention has been paid in a number of studies to the combination of drugs against erectile dysfunction with other medicines and to the reduction of the severity of side effects. All issues related to the development of more advanced methods of treating ED are more than promising and are actively funded by various medical organizations.
Erectile Dysfunction and Atherosclerosis
As recently as 2019, evidence was found that erectile dysfunction may be the first sign of coronary artery disease (CAD), which appears in men earlier than shortness of breath, arrhythmia, and hypertension. This is an important discovery, which in the future can expand the method for the diagnosis of coronary heart disease, which often proceeds in a latent form and is difficult to diagnose, especially given the fact that men rarely go to doctors until they become completely ill and require serious treatment. Previously, it was only stated that in patients with coronary artery disease, potency disorders were more often observed than in men without this cardiac pathology.
New Use of Nitroglycerin
Nitroglycerin (glyceryl trinitrate), which has an antianginal, vasodilating and coronary dilating effect and is traditionally used to treat coronary heart disease, was proposed in early 2020 as a second-line drug for the treatment of erectile dysfunction. This is due to the fact that first-line drugs (PDE-5 inhibitors) are far from effective in all cases. Although they satisfactorily affect approximately 70% of patients, the remaining 30% also require adequate therapy. Nitroglycerin has proven to be quite effective on the mechanism of erection. However, at the moment, a serious obstacle to the widespread use of this drug against ED is a large number of side effects from the cardiovascular system, up to fainting and myocardial infarction. At the same time, the use of local preparations based on nitroglycerin, such as a gel for application to the penis, have an incomparably weaker effect on potency, therefore, they cannot be a substitute for the use of nitroglycerin inside.
Another trend that developed in the 2010s is the simultaneous treatment of benign prostatic hyperplasia and erectile dysfunction, which became possible after the approval of the FDA Tadalafil as an anti-BPH drug. Treatment of exactly BPH before the start of dealing with the reduced potency problem itself is no more widely used, because Tadalafil provides an effective way to kill two birds with one stone.