Erectile dysfunction refers to an inability to maintain an erection to have sex. In many cases, ED is a sign of an underlying health condition that needs to be treated. For example, erectile dysfunction is a common symptom for men who have diabetes. About 50-80% of men who have diabetes experience erectile dysfunction. How severe ED is depends on the individual, but for all cases there is help in the form of prescription medications in combination with lifestyle changes.
Causes of Erectile Dysfunction
Although the problem of male sexual dysfunction may seem simple, the male process of sexual arousal is actually a complex process involving the brain, hormones, nerves, and more. Stress can exacerbate ED, as can other psychological and physical conditions. Diabetes, heart conditions, obesity, substance abuse and smoking, and other chronic conditions can all be underlying causes of erectile dysfunction.
Some lifestyle changes that can help improve erectile dysfunction include not smoking or drinking excessively, getting regular exercise, eating healthy, and properly managing chronic conditions. Even with changes to lifestyle, however, many men still need the help of prescription medications.
Compounding Medication for Erectile Dysfunction
Compounding pharmacies have become an essential part of healthcare for men experiencing erectile dysfunction. While there are some drugs that are commercially available, a compounding pharmacy can often provide higher-strength medication or combination medications that target multiple aspects of the condition.
Drugs that have been prescribed to treat erectile dysfunction include:
Sildenafil – The drug found in the brand-name medication Viagra has been the mainstay drug therapy for ED for many years. After it was FDA-approved, sildenafil was prescribed to over 20 million men. There are other drugs that can be as effective or even more effective than sildenafil, but it remains a popular choice due to its commercial availability.
Tadalafil – Found in the brand-name medication Cialis, tadalafil is another popular choice for men seeking help with ED. Tadalafil can be prescribed to be taken on a daily basis, not just “as-needed.” This allows more freedom and spontaneity as it does not need to be taken right before having sex.
Apomorphine – Apomorphine was briefly put forward for FDA approval but the application was not completed. Research has shown that apomorphine can benefit ED and may have a synergistic effect when combined with a medication like tadalafil.
Oxytocin – This hormone plays an essential role in bonding and socialization. It is connected to sexual response in both men and women. For men, research shows it may play a role in the complex chain of reactions that causes erections.
Nitroglycerin – A nitric oxide donor that can be applied in the form of a topical cream to the head of the penis. This has been shown to be an effective method that reduces the risk of systemic effects.
Sildenafil and tadalafil are both what are known as phosphodiesterase type 5 (PDE5) inhibitors. This drugs help improve blood flow to the penis by helping to enhance the effects of nitric oxide and increasing cyclic guanosine monophosphate in the smooth muscle cells. The cascade of effects helps prolong an erection. PDE5 inhibitors are still the most commonly prescribed medications for ED. However, new combinations are being made by compounding pharmacies that are becoming popular.
The result of taking apomorphine is similar to a PDE5 inhibitor in that it helps relax smooth muscle to improve erections. However it seems to work by stimulating dopamine receptors in the hypothalamus. Like with tadalafil, there is a cumulative effect in using it on a daily basis. Men who take these medications on a daily basis find improved erections after repeated sexual attempts over several weeks.
Compounded ED Medications
A compounding pharmacy can provide drugs like apomorphine and hormones like oxytocin in combination sublingual tablets with the popular PDE5 inhibitors. One combination that is more frequently being prescribed is an apomorphine, tadalafil, oxytocin tablet. These broad-spectrum tablets are not commercially available and can only be obtained from a compounding pharmacy. With a combination of lifestyle changes, management of health conditions, and the use of compounded prescription drugs, most men can find help for their erectile dysfunction.
It should be noted that ED drugs should never be combined with each other. Even using a cream along with an oral tablet can result in serious adverse effects. Always consult with your doctor before starting a new ED treatment.
Compounded treatments for erectile dysfunction: a common complication of diabetes. – International Journal of Pharmacy Compounding
Phosphodiesterase-5 (PDE5) Inhibitors In the Management of Erectile Dysfunction – Pharmacy & Therapeutics