Erectile Dysfunction Drugs & ED Therapies
If testosterone replacement therapy (TRT) treatment for low T does not solve a patient’s ED, our medical providers at Low T Center may recommend one of a few prescription erectile dysfunction drugs, such as tadalafil (the generic equivalent of the brand name CialisTM) or sildenafil (the generic equivalent of the brand name ViagraTM). Tadalafil and sildenafil are oral medications that are in a class of drugs called phosphodiesterase-5 (PDE5) inhibitors. Basically, they inhibit an enzyme (the PDE5 enzyme) from destroying the body’s ability to allow the penis to fill with blood and persist.
There are some differences between tadalafil and sildenafil. Tadalafil remains in your system for up to 18 hours, so it can be taken daily without worry for timing of sexual activity. Sildenafil will remain in your system for only 4-6 hours, so timing of sexual activity must be considered. Some studies indicate that tadalafil also may help alleviate an enlarged prostate.
Side effects of tadalafil:
The most common side effects of tadalafil are:
- Facial flushing (reddening)
- Headaches
- Stomach upset
- Diarrhea
- Flu-like symptoms
- Nausea
- Low blood pressure
- Blurred vision
- Changes in color vision (inability to distinguish between blue and green)
- Abnormal ejaculation
- Priapism, or an erection that lasts more than four hours that can damage the penis
Side effects of sildenafil:
The most common side effects of sildenafil:
- Facial flushing (reddening)
- Headaches
- Stomach upset
- Diarrhea
- Nasal congestion
- Nausea
- Dizziness
- Inability to differentiate between the colors green and blue
- Rash
- Urinary tract infections (UTIs)
- Priapism, or an erection that lasts more than four hours that can damage the penis
Your Low T Center provider will discuss each medication, and their potential uses and side-effects with you in detail during your visit.
You can learn more about these drugs at www.fda.gov/drugs
PT-141 Peptide Therapy
If tadalafil and sildenafil have limited effect eliminating a patient’s ED, the medical providers at Low T Center may recommend PT-141 peptide (bremelanotide).
Peptides are amino acids that serve as building blocks for proteins in the body. Each peptide serves a specific purpose and supports specific functions within the human body. While tadalafil and sildenafil work through the cardiovascular system to increase blood flow to the penis, PT-141 is a melanocortin which works through the nervous system to increase sexual arousal and desire in the brain. In some persons, this peptide can provide the desire and motivation for sexual activity, along with the ability to achieve an erection.
Patients utilizing this therapy inject PT-141 subcutaneously (in the fat layer) under the skin, typically in the abdomen or the thigh, about one hour before sexual activity. The most common side effects include:
- Nausea and vomiting
- Flushing (skin turning red)
- Injection site reactions
- Headache
Your Low T Center provider will discuss different ED drugs, and their potential uses and side-effects during your visit to help find custom treatment solutions for you.
TriMix Injections
If tadalafil, sildenafil and PT-141 are not effective in treating ED and sexual dysfunction, our medical team at Low T Center may recommend what is often considered the most powerful class of anti-erectile dysfunction medication, called TriMix. The components of TriMix –papaverine, phentolamine, and prostaglandin E1 – on their own are indicated for a wide variety of conditions. By combining them to treat erectile dysfunction, TriMix has become an additional resource for patients when other therapeutic options have failed to deliver the desired result.
Papaverine causes blood vessels to expand and produces an erection by allowing for increased blood flow to the penis. Phentolamine relaxes and dilates the blood vessels of the penis and elevates cardiac output. Prostaglandin E1 relaxes the penis’s blood vessels and dilates cavernosal arteries (dilation of the cavernosal arteries is accompanied by increased arterial inflow velocity and increased venous outflow resistance, allowing for more blood into the penis and less blood out).
TriMix is administered as a penile self-injection, and while this thought can be intimidating to some men, the majority of patients report satisfaction with this ED therapy’s effectiveness.
Side effects may include:
- Mild to moderate pain during injection
- A small amount of bleeding at the injection site
- Painful sensation with an erection
Call your healthcare provider if you notice any redness, lumps, swelling, tenderness, or curvature of the erect penis.
If you’re a candidate for ED drugs, your Low T Center will discuss medication options, their uses, and side effects in detail during your appointment.
ED Treatment at Low T Center
Our team is here to help you address your whole health. If you have symptoms of erectile dysfunction, schedule a comprehensive health assessment today to discuss your symptoms and treatment options. Our medical providers work with you to help find treatment solutions tailored to your lifestyle and health goals.