Friday, January 31, 2020

Medications for the Treatment of Erectile Dysfunction

This is the last article on my series of list of medications for common ailments/diseases in the US. I hope you found the series informative.

Medications Used to Treat Erectile Dysfunction (ED)

Erectile dysfunction (ED) is the condition of not being able to get or keep an erection that’s firm enough for sexual intercourse. It’s often caused by an underlying health problem. The Urology Care Foundation estimates that this condition affects 30 million men in the United States. For some men, treatment with drugs may resolve their ED.

There are many types of drugs used to treat ED. Each drug works differently, but they all improve sexual activity by stimulating blood flow to the penis.

The most common ED drugs belong to a group known as phosphodiesterase type 5 (PDE5) inhibitors. They block certain enzyme activity that leads to ED.

If you have certain health issues, it may not be safe for you to take ED drugs. For instance, if you have heart disease, your heart may not be healthy enough for sex.

1. Alprostadil

Alprostadil (Caverject, Edex, MUSE) comes as an injectable solution and as a penile suppository. You’ll inject the solution directly into your penis 5 to 20 minutes before having sex. You can use it as needed up to three times per week. You should let at least 24 hours lapse between injections.

With MUSE (or Medicated Urethral System for Erections), the suppository should be administered 5 to 10 minutes before sex. It shouldn’t be used more than twice in a 24-hour period. The more common side effects of this drug include pain in the penis and testicles, as well as burning in the urethra.

2. Avanafil

Avanafil (Stendra) is an oral drug and a PDE5 inhibitor. You should take it about 15 minutes before having sex. Don’t take it more than once per day.

You shouldn’t use any PDE5 inhibitors if you’re also taking nitrates to treat heart disease. Examples of nitrates include isosorbide mononitrate (Monoket) and nitroglycerin (Nitrostat). Taking nitrates with avanafil can cause severely low blood pressure and even death. The more common side effects of this drug include:

headache
flushing, or the reddening and warming of your face
stuffy or runny nose
back pain
sore throat

3. Sildenafil

Sildenafil (Viagra) is also a PDE5 inhibitor. Viagra is only available as an oral tablet. You should take it only once per day, about 30 minutes to an hour before sex. The more common side effects of this drug include:

headache
flushing
stuffy or runny nose
back pain
upset stomach
muscle aches
vision changes, such as blurry vision and changes in how certain colors look

4. Tadalafil

Tadalafil (Cialis) is an oral drug that increases blood flow throughout your body. You take this PDE5 inhibitor about 30 minutes before sex, no more than once per day. It may work for up to 36 hours. The more common side effects of this drug include:

headache
flushing
stuffy or runny nose
back pain
upset stomach
pain in the limbs

5. Testosterone

Testosterone is the main sex hormone in the male body. It plays many roles in overall health. Testosterone levels naturally drop with age. This change can lead to ED and other issues, such as:

fatigue
low sex drive
reduced sperm count
weight gain

Doctors sometimes prescribe testosterone to treat ED. In fact, PDE5 inhibitors are most effective when used alongside testosterone therapy in men with a testosterone deficiency. However, the drug does come with risks. Testosterone can increase your chance of a heart attack or stroke. Because of these risks, the Food and Drug Administration (FDA)Trusted Source says that only men who have low testosterone due to certain health issues should use testosterone.

Your doctor will watch you closely if they give you testosterone. They’ll test the levels of testosterone in your body before and during your treatment with this drug. If your testosterone levels are too high, your doctor will stop your treatment or lower your dosage. Side effects of testosterone may include:

acne
male breasts
prostate growth
fluid retention that causes swelling
moodiness
sleep apnea, or interrupted breathing during your sleep

Testosterone for ED comes in many forms. The table below lists the forms of testosterone and their brand-name versions. Some forms may also be available as generic drugs.

Testosterone form	Brand names
Transdermal cream	First Testosterone Cream 2%
Transdermal gel	AndroGel, Fortesta, Testim, and Vogelxo
Transdermal patch	Androderm
Transdermal solution	None (only available as generic)
Topical gel	AndroGel and Natesto
Nasal gel	Natesto
Oral capsule	Testred
Oral tablet	Android 25
Mucoadhesive film that dissolves under your gums	Striant
Pellet implant	Testopel
Solution for intramuscular injection	Depo-Testosterone and Aveed

6. Vardenafil

Vardenafil (Levitra, Staxyn) is an oral drug and a PDE5 inhibitor. You take it as needed 60 minutes before sex. You can take this drug up to once per day as recommended by your doctor. The more common side effects of this drug include:

headache
flushing
stuffy or runny nose
back pain
upset stomach
dizziness

7. Vitamins and supplements for ED

There are many vitamins and supplements on the market that claim to help ED. Some promise better sexual function as well as increased energy and vitality. However, these supplements usually don’t work. They may also be unsafe.
Some supplements that are marketed as “natural” may even contain drugs. ED supplements can still interact with other medications you’re taking. They may also cause side effects. Talk to your doctor before using any vitamins or supplements for ED.

Before you take ED medications

Not everyone with ED needs to take medications. If you think you have ED, see your primary care doctor. They’ll give you a physical exam and request certain lab tests, as well as a complete medical and psychosocial history.
They may also refer you to a mental health professional, who can help you manage performance anxiety or relationship issues related to your ED.

ED caused by underlying conditions

Your ED may be caused by untreated diabetes, high blood pressure, or another issue. Treating that condition first may improve your ED symptoms.

ED caused by medications

ED may also be caused by other medications you’re taking. These may include drugs used to treat:

high blood pressure
heart disease
depression
seizures
cancer

Your doctor can review the drugs you’re currently taking. They may make some changes that can improve your ED.

ED caused by lifestyle choices

Sometimes lifestyle choices can contribute to ED. Adopting healthy habits may help improve your symptoms. Try avoiding smoking, maintaining a healthy weight, getting regular exercise, and keeping your alcohol intake in check.

Source: https://www.healthline.com/health/erectile-dysfunction/medication-list#work-with-your-doctor

Meanwhile, enjoy this photo from the Internet

Peter Peppers

Also enjoy this video,
https://youtu.be/7KqlAMqkxt0

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Highlights of My Professional Career

In my more than 40 years of professional career, I have experienced both working rank and file, as well as supervising the work of subordinates. I have worked in four private firms and the Federal Government, the Food and Drug Administration (FDA), where I retired. I enjoyed the challenges and difficulties of both types of job situations. This is the highlights of my work experience story.

My first job after completing my doctorate degree was a Chemist for Chemagro Corporation in Kansas City, Missouri. It was a subsidiary of Bayer Corporation, a German conglomerate. I worked for the analytical chemistry department comprised of about fifty people; half that number was either chemists or biologists. My specific task was to develop analytical methods for the detection of pesticide residues in plant and animal tissues. I worked on my own, similar to six other bench chemists, and we all reported to the same supervisor.

The firm sponsored my visa conversion from a student to a permanent resident, and I was able to legally work and reside in the United States with my family. The company generously took care of its employees. At the end of each successful year, everyone received a 13th month salary bonus. The employees and their families celebrated wonderful annual Christmas parties in a downtown Kansas City hotel, with dancing and free drinks for the whole night.

Inasmuch as I enjoyed and loved working for Chemagro for five years, I found a new job which offered a substantially higher pay. Due to my exemplary work performance, my supervisor preferred and lobbied for me to stay with the company. I had to turn him down because they could not match the package presented by my new employer. It was also a chance for me and my family to move and live in the US west coast, where the mild winter climate is bearable compared to the Midwest.

My next job was at the agricultural research division of Shell Development Company in Modesto, California. I was a Research Chemist, and again I worked individually, same as five other chemists who all reported to a supervisor. My specific duty was similar to my previous job. I worked for them for five years, until the company decided to get out of the pesticide business. They closed their research facility affecting the jobs of more than 200 employees.

My third industrial job was with the agricultural research division of Stauffer chemical company, located in Richmond, California. I was a Senior Research Chemist doing the same project as my two previous jobs. I worked for twelve continuous years for the company, with outstanding annual job performance. I became a Principal Research Chemist, the highest attainable non-supervisory position.

One day in 1986, my supervisor informed me that my job had been eliminated, and I had one day to vacate the facility. It was the most dreadful lay off experience in my life. I felt anger, sadness and humiliation to be dismissed from work with one day notice, after all the years of hard work invested for the company. This was an unforgettable incident and was the gloomiest point in my professional career.
The company terminated sixty research employees, who were upset of the bad news.

One of the chemists was distressed and expressed his outrageous anger by threatening the company and its workers. He told his supervisor of his intention to bomb and burn down the laboratory. He was immediately escorted by the security staff out of the building and into his car. He was informed to leave behind his personal belongings; they will be mailed to his residence. He was warned never to show up again near the company premises or risk getting arrested.

My supervisor was kind and allowed me to take my time to pack up my belongings. It took me two days to clear up my workplace, after toiling for a long period in the same jobsite. We were provided clerical help and office space, in preparation to look for another job, such as updating our resumes, and using the computer and copy machine. We were given six weeks of separation pay plus benefits.

Fortunately, with the help of a friend who is a Church parishioner, I found another job thirty days after leaving Stauffer chemical company. He hired me as a senior research chemist and as a group leader with two technicians to supervise. It was in the same field as my expertise in my previous three jobs spanning the last twenty one years. My new employer was Chevron Chemical Company, and which was located in the same area as my former employer.

This job gave me the introduction and basic knowledge of managing the work of subordinates. I worked for Chevron Company for four and a half years. The company decided to consolidate their research facilities in Texas, and lay off all its research employees. This time I had enough distress and agony from working, and eventually getting laid off from several private companies. To avoid going through any more miserable layoffs, I made a vow that I would never again work for a private company.

In my work experiences, there were noticeable and unavoidable jobsite occurrences. One can never miss the office romantic relationships between co-workers, both illicit and permitted. Though it was frowned upon, there was a boss and staff relationship, which was used as a ploy to get ahead in the company. Some relationships had chemistry, no pun intended, but some never worked out. Oftentimes, there was a sense of distrust among bench chemists for some workers who unjustly obtained preferred work assignments.

Some employees resorted to bribing superiors to get special privileges, such as being able to attend choice conferences and meetings in exciting venues or locations. Likewise, politics was always present at the worksites. It was during an era when various forms of harassment, equal opportunity and discrimination laws were not yet enforced in the workplace. Occasionally, an unexpected chemical explosion happens in a laboratory setting, where luckily no one got seriously hurt.

In the three private companies I worked for, I was able to publish scientific journals for some of the research studies and analytical methods which I developed for the respective companies of Chemagro, Shell Development and Stauffer.

After deciding and making a vow to avoid working in the private sector, I made my new goal which was either to work for the state of California, or the Federal government in Washington, D.C. Four months after I lost my job in Chevron, I was lucky and joyful to be hired by the Food and Drug Administration as a review chemist in the fall of 1990.

In 1994 I was promoted as an Expert Research Chemist with a GS-14 rating. My expertise was on Anti-malarial and Anti-parasitic drug products. In 1997, I was again deservingly promoted to Chemistry team leader, supervising the work of six Chemistry reviewers including five with doctorate degrees.

As team leader, I was responsible for prioritizing, assigning, and assuring the technical accuracy of all chemistry, manufacturing and control issues for all new drug applications submitted to the Division of Anti-Infective Drug Products, Center of New Drugs.

It was part of my responsibility to give advice, instruct and promote high morale and teamwork in my group. My work in the FDA is confidential, until the drug patent on the products I worked on has expired. There are manufacturing supplements that I have approved that are now open for the public in the Internet.

In 1998, I won the Equal Employment Opportunity (EEO) Award. The citation reads, “For outstanding accomplishments in fostering the objectives of the EEO Program by hiring minorities and encouraging their professional growth while providing excellent leadership.” I have received numerous certificates of appreciation, awards in leadership and communications, commendation for teamwork and excellence in the accomplishment of the FDA mission. I have also received several letters of appreciation from private industry for my review work.

There are many good things working as rank and file while enjoying doing one’s job individually. It is a humbling, satisfying and productive experience, if one can work in harmony with one’s immediate supervisor. Working individually develops one’s skills in goal setting and scheduling. But in general, the financial rewards are less than a person who has supervisory responsibilities.

Managing the work of others has its challenges. Moreover, it develops one’s skill in handling and developing people, and the compensation rewards and benefits are better. Due to additional duties, responsibilities and leadership, supervisory work can be more stressful than working as a subordinate. However, supervisory jobs give one more personal growth and satisfaction, based on my personal experience. My work in FDA as a team leader managing the work of six scientists had been the happiest and rewarding work experience in my career in Chemistry. You might also like: