Medical Trerapy of Erectile Dysfunction

Sexual function is and important component of an individual's quality of life and subjective well being. In the field of erectile dysfunction (ED), we have witnessed the introduction of truly effective oral pharmacotherapy for this disorder. The marketing of the first oral phosphodiesterase (PDE) inhibitor (sildenafil, viagra®) in 1998 increased the public's awareness about sexual dysfunction and enlightened their perceptions about ED as a medical condition with distinct risc factors. Sildenafil has shown excellent effects in the treatment of ED patients with or without cardiovascular disease although the agent is contraindicated in patients taking nitrates. Sublingual (SL) apomorphine (uprima®) is a nonopioid, centrally acting dopamine agonist developed to treat ED. Three milligrams of SL apomorphine SL 3??has significant benefit for men with ED as measured by all currently acceptable erectile function endpoints of 'erections firm enough for intercourse'. Self-injection therapy (alprostadil, caverject® or trimix) is a very effective treatment option. In a short time, multiple agents (vardenafil, tadanafil, et al.) will be developed and introduced for management of ED. The impending approval of new treatment for ED will bring a plethora of choices for the physician treating ED. Primary care physicians will look to urologists as the experts in ED for information and guidance on which medication to use. It is therefore important that we keep abreast of developments in this rapidly evolving field of sexual medicine.