While a new erection enhancer is coming soon to pharmacies, erectile dysfunction experts point out that these tablets are not intended for men worried about the breakdown.
After 40 years, one in three men afterwards would be affected by an erection problem according to epidemiological data, that is to say more than 2 million French victims of this disorder which deeply affects the sexual life. While patients affected by this erectile failure which occurs when the blood cannot arrive or stay long enough in the penis to cause or maintain the erection, already have at their disposal 3 drugs (Viagra®, Levitra®, Cialis®) , a new “facilitator” is soon arriving in pharmacies. From April 7, Spedra® containing a new molecule, avanafil, will therefore join the therapeutic arsenal of PDE5 inhibitors available to the 600,000 French people already under treatment. Why actor provides an update on erectile dysfunction medications.
Who is affected by the treatments?
“Of the 2 million men who have erectile dysfunction, there are not 2 million who suffer from it and not all of them want treatment,” said Professor Stéphane Droupy, urologist at the University Hospital of Nîmes. In men for whom erectile dysfunction is medically proven and who are potentially affected by drug treatments, the main indication remains suffering and the need to get out of it. Then, to identify those who are affected by these drugs, it is important to differentiate between simple sexual breakdown and true erectile dysfunction. “Erectile dysfunction is defined by something that is repeated every time there is sexual intercourse for at least 3 months,” explains Professor Droupy. It is not necessarily a total absence of erection, but every time the man wants to have sex, he does not have a sexually satisfactory erection ”.
Faced with a complaint from a patient, the doctor then tries to establish a diagnosis and find the origin of the erectile dysfunction, whether physical or psychological. He alone will decide whether or not to prescribe a PDE5 inhibitor.
Listen to Prof. François Giuliano, urologist and andrologist at Raymond-Poincaré hospital in Garches: ” The doctor does an investigation to find the potential or proven causes of the dysfunction, and only then does he suggest a PDE5 inhibitor. “
How do these drugs work?
All drugs in this therapeutic class (PDE5 inhibitors) work in roughly the same way for erectile dysfunction. None of them increase libido If the erection difficulty is there, no doubt, the pills will not work. On the other hand, Viagra®, Levitra®, Cialis® and Spedra® will improve and prolong the natural erection. Without triggering the erection, these drugs all allow, in the face of sexual stimulation, that the duration and quality of it is more satisfactory.
“Inside the penis, the cavernous tissue, which is a kind of sponge, will relax at the time of erection to allow blood to enter and swell it,” explains Professor Droupy. These drugs therefore promote the relaxation of this sponge while allowing more blood to stay in the penis for longer ”.
However, if overall all the drugs have an equivalent effectiveness, the Menarini laboratory which markets Spedra promises a faster effect compared to other treatments. “Probably, it has a start of effectiveness a little faster than the others, a duration of action beyond 6 hours compared to 4-5 hours for Viagra and Levitra”, specifies Professor Giuliano. However, for the latest arrival as for the others, all the experts agree that they do not work in some patients.
Listen to Professor Thierry Lebret, urologist and secretary general of AFU: “We have failures with those who have had a radical prostatectomy or certain diabetics, but for them we have other treatments such as injections or prostheses”.
What are the contraindications and side effects?
Overall, all the drugs in this therapeutic family have the same formal contraindication. They cannot be combined with a drug from the nitro derivative class, that is to say a molecule prescribed against angina pectoris.
In addition, some categories of men cannot take it. “These are the men who have unstable cardiovascular or neurological disease, patients who had a heart attack or stroke less than 6 months ago or who have severe heart failure. “, explains Stéphane Droupy. In reality, these are all patients for whom physical activity and therefore sexual activity poses a risk. But if a patient can climb two floors without stopping, he is therefore capable of having intercourse and therefore potentially treatment of the PDE5 inhibitor type. Regarding the side effects of these drugs, even if the laboratories will make their difference, for the experts, all these drugs have the same overall tolerance, with the same most frequent side effects.
Listen to Professor Stéphane Droupy, urologist at the University Hospital of Nîmes : ” The most common effect is headache, the feeling of having a stuffy nose which occurs in about 10% of people at the start of treatment and over time it is less common. “
Pills for minor breakdowns or severe disorders?
“There is no such thing as a miracle pill, but in practice these are drugs that are effective in around 70% of men, of course depending on the degree of severity of the erectile dysfunction,” explains Stéphane Droupy. So overall when Viagra hit the market, it was a real revolution because we had nothing at all to treat them easily ”. With the arrival of a new treatment, announced with an even faster duration of action than the others, some men, without pathological problems, could be tempted to want to try to counter the anxiety of the small breakdown. The specialists point out that these drugs should be reserved for the men reached by a true erectile dysfunction. Extending these tablets to the general public could even be dangerous, they conclude.
Listen to Professor Thierry Lebret : ” All men have a sexual breakdown one day and it should not be treated pharmacologically. In the majority of cases, the breakdown is psychogenic and there is a risk in taking these drugs. “
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