Erectile Dysfunction Solutions
Erectile dysfunction is met quite often. Its incidence in population depends on men’s age. Erection disorders in men at thirty in average are exposed in almost 16 per cent of cases, whereas at forty they reach 39 per cent, at fifty – 67 per cent, and at seventy – 83 per cent. Etiology of ED is varied and multifactor, although its organic forms prevail. PDE5 inhibitors introduced in practice in 1996 made a real revolution in ED therapy. Initially developed for atherosclerotic cardiovascular disease, these medications turned out to be able to improve erectile functioning; and therefore, they were used in this capacity henceforth.
Action mechanism of PDE5 inhibitors is based on hydrolysis blockage of cyclic guanosine monophosphate which results in growing concentration of cyclic guanosine monophosphate and activation of cyclic guanosine monophosphate-dependent protein kinase with subsequent phosphorylation of ion channels. As a consequence, calcium concentration in smooth muscle cells decreases leading to their relaxation. PDE5 inhibitors promote erection development under the impact of endogenous nitrogen oxide which is produced from nerve endings and endothelial cells stimulating cyclic guanosine monophosphate synthesis by means of enzyme, guanylate cyclase. Relaxation of smooth muscle cells leads to enlargement of arteries and sinuses of cavernous bodies which provides flow of arterial blood essential for erection.
Experimental Data on Levitra
Levitra is PDE5 inhibitor which is more selective and stronger than sildenafil. It absorbs fast after peroral intake; and effect starts in 15-25 minutes and lasts up to 8-12 hours, as opposed to Viagra acting only 4 hours. Thus, a patient doesn’t depend on the time of Levitra intake, since it has a long-term effect. Pleiotropic effect of Levitra allows men to use it for not only ED therapy, but also other disorders. Unfortunately, there is very little information about long-term usage of PDE5 inhibitors and their impact on various organs and systems.
Vardenafil influence on erectile function is studied rather well. Safety and efficiency of vardenafil in real clinical practice were proven, in particular, by large international open trial with participation of almost 74 thousand men from forty-seven countries of Europe, Latin America and Asia-Pacific Region. Men suffering from various levels of ED had also arterial hypertension, diabetes, lipid storage disease, and cardio-vascular diseases.
Proportion of patients taking vardenafil was rather high regardless of ED degree. Improvement of erectile function was observed in 97% of patients with mild dysfunction, 96% – with moderate, and 86% – with severe. The improvement occurred in case of any present pathology. More than 90% of patients reported that they were quite satisfied with vardenafil effectiveness and announced their intention to continue its administration upon the trial termination. These data testify the efficiency of vardenafil in ED treatment under real-life conditions. It may be used in the capacity of first choice medicine in ED therapy of patients with somatic pathology.
More vital information: How Levitra Is Different from Other PDE5 Inhibitors
Disorders Accompanying Impotency
Patients with different forms of ED are widespread factors of cardio-vascular risk. ED is connected with a wide range of diseases having one and the same vascular basis. The main mechanism of erectile dysfunction in the majority of cases is endothelial dysfunction, i.e. insufficient vasodilation in response to endothelium-dependent stimuli of entire vascular net and penis arteries. Due to such tight connection with cardio-vascular diseases, it is important to estimate if patients with ED are able to suffer from cardio-vascular disease including hypertension or myocardial ischemia.
On the other hand, it is important to decide whether stimulation of sexual activity increases cardio-vascular risks in patients requiring ED therapy or not. It should be taken into account that many medicinal products used for treatment of cardio-vascular diseases (including hypertension) may aggravate sexual function. Hypertension treatment should not be terminated, since it may affect sexual function. Thus, it is important to apply alternative antihypertensive remedies with due regard to individual particularities of a patient and minimal side-effect on sexual ability. It is essential to remember that PDE5 inhibitors, such as vardenafil are well-combined with antihypertensive therapy and are generally well tolerated even in case of arterial blood pressure drop up to 90/60 mm Mercury.
Erectile dysfunction is connected not only with cardio-vascular pathology, but also with diabetes, dyslipidemia, obesity, depression, chronic obstructive pulmonary disease and disorders of lower urinary tract. Some of the afore-mentioned accompanying diseases may be a primary cause of erectile dysfunction. ED is a sensitive indicator of cardiac failure and early marker of coronary artery disease (among patients with CAD, ED frequency reaches 75%).
Besides, ED may be an indicator of various diseases including hypertension and diabetes. In accordance with this fact, it is recommended to conduct thorough medical examination of patients with ED in order to expose the disorder and start treatment course as soon as possible. And to the contrary, patients with cardio-vascular patholoty, diabetes, obesity, depression may have non-diagnosed ED, early exposure of which allows not only eliminating any erectile issues, but also start necessary treatment of basic disease.
Related news: Erectile Dysfunction as a Common Diabetes Symptom
Levitra Versatile Impacts
High co-morbidity of erectile dysfunction explains necessity to conduct research studies designated for examination of Levitra action on various organs and systems. First of all, vardenafil impacts on arterial blood pressure, frequency of cardiac contractions and electrophysiology of heart were studied.
Erectile dysfunction is directly connected with risk factors of cardio-vascular and other accompanying disorders. In view of the potential risk connected with sexual activity in patients suffering from coronary artery disease, main principles of estimation and treatment of patients with various cardio-vascular diseases and erectile dysfunction were developed. These principles were updated in 2006 where modern data about the effects of new PDE5 inhibitors, in particular vardenafil were taken into account. Thus, sexual activity is safe for majority of patients suffering from coronary artery disease. Nevertheless, it is essential to estimate thoroughly the presence of cardiac risk factors (such as obesity, hypertension and hyperlipidemia). Along with that, it was recommended considering the matter of possible substitution of nitrates with vardenafil during the treatment of acute coronary syndrome.
Thus, CAD is not a counter-indication to vardenafil usage. Food and Drugs Association considers PDE5 inhibitors to be effective remedy for treatment of cardio-vascular and vascular pneumopathy disorders. PDE5 inhibitors appeared to have protective action on myocardium preventing from its hypertrophy, slowing down apoptosis and enhancing tolerability to ischemia. PDE5 inhibitors are successfully applied for treatment of idiopathic pulmonary hypertension.
Vardenafil has a considerable potential for enlargement of indications to application. Available data demonstrate that therapeutic potential of vardenafil is spread on myocardium, coronary and peripheral arteries, inflammation mechanisms, oxidative stress, thrombosis, fibrosis and processes of restoration of neurologic patients.
Vardenafil improves cardiac output, enhance and prolong hemodynamic effects of nitrogen oxide in patients with cardiac congestive cardiac failure. Dyslipidemia often accompanies erectile dysfunction. According to research study, vardenafil appeared to be effective in men with dyslipidemia regardless of statins therapy. Also, erectile dysfunction is often registered in patients suffering from diabetes. Levitra improved erection in such patients. The results of eight randomized controlled studies confirmed efficiency and safety of ED therapy in these cases.