Erectile dysfunction is one of the most common male sexual disorders. At its origin there may be several causes and identifying the specific one, case by case, can guide the choice of treatment.

Pharmacological therapy is one of the therapeutic options in the case of erectile dysfunction, as explained by Dr. Alessandro Pizzocaro, andrologist of the Endocrinology Unit of Humanitas.

The term erectile dysfunction indicates the inability to obtain or maintain an erection to complete sexual intercourse; in the first case, erectile dysfunction is complete, while in the second it is partial. This condition has a significant impact on a man’s quality of life and can affect his psychological and physical well being, with the risk of anxiety, depression and a reduction in self-esteem.

It should be noted that erectile dysfunction is not a disease, but the symptom of frequent diseases such as diabetes and cardiovascular diseases, and of testosterone reduction with increasing age.


The underlying causes of erectile dysfunction

The risk of erectile dysfunction is often associated with advancing age and related risk factors such as overweight, hypertension, diabetes, cardiovascular disease and testosterone reduction. Taking certain drugs may also have erectile dysfunction as a side effect, as well as surgery to treat prostate cancer.

Lifestyle also plays a role: smoking, overweight, excessive alcohol consumption, drug use and sedentary lifestyle are behaviors to be avoided to prolong sexual well being as long as possible.

Erectile dysfunction can also result from mood disorders, depression and anxiety, particularly in younger people. In many of these cases, treatment requires psycho-sexual counseling.


Drug therapy

“Medications can help to treat erectile dysfunction and allow the patient to obtain and maintain an erection. By acting on the muscles of the blood vessels and the penile microcirculation, in fact, they promote the flow of blood into the corpus cavernosum of the penis in the presence of an erectile stimulus. The drugs inhibit the enzyme phosphodiesterase 5 and act on a mechanism of natural erection.

They are taken orally and have few side effects. These are usually present in less than one in ten people and the most common are: heartburn, headaches, flushing, nasal congestion and muscle pain. These are disorders that, however, tend to regress over time with the intake of the drug,” explains Dr. Pizzocaro.


The need to consult a doctor

In Italy, taking these drugs requires a prescription, while – for example – Great Britain has announced that it wants to make over-the-counter one of the most common drugs against erectile dysfunction, in an attempt to prevent patients from buying illegal drugs.

“Although they are harmless drugs, with well-defined and easily identifiable contraindications, making 5-phosphodiesterase inhibitors over the counter could lead to an underestimation of the causes of erectile dysfunction, including cardiovascular risk, diabetes, and testosterone reduction. Sometimes, if not recognized and treated, these causes can lead to a reduction in quantity and quality of life. Therefore, before purchasing a 5-phosphodiesterase inhibitor drug, you should discuss it with your doctor or with your andrologist to find the correct diagnostic and therapeutic procedure. It is good to continue to explain to patients that buying DIY therapies online may be harmful because neither the quantity nor the quality of the drug are insured,” concluded the specialist.