How Our Conversations Begin
A common consult with a new male client often goes like this.
Man sitting in the chair opposite me, and I ask: “What did you book this consult for today?”
Man looks at feet and says: “I think I have erectile problems.”
Me: “No problem. This is a common issue, did you know that 1 in 3 men over 45 have this issue and the probability gets higher as men age. Even young guys commonly have this issue. What have you tried so far?”
Man: ”I tried Viagra and it didn’t work.”
Me: “Did you wait one hour after taking it before stimulation?”
Me: “Did you know it works much better on an empty stomach?”
Man: “No, I took it after I took my partner out for dinner.”
Then, I start explaining how these medications work, what the difference is, and how to properly see if they will work for him before moving on to other solutions.
Below is a brief explanation of the correct way to trial these medications.
Penis Pills/ Oral Strips /Troches
Most of us have heard of penis pills as they are always “popping up” in movies.
There are 4 main oral medications:
- Vardenafil (Levitra); and,
These can be presented in different ways - capsules, tablets, troches, and oral strips. They are all the same medication or a combination of the above, only the delivery method is different.
The oral strips and the troches are absorbed in the mouth and thus go straight to the bloodstream so may bypass some side effects such as reflux (but not always) and can be quicker acting.
If you see advertisements for new oral strip technology, this is not a new medication just a new delivery method.
Countries have different approval systems around medications. Not all the forms (troches/ strips/gels) are available everywhere. In many countries, a prescription from a health professional is required to access these medications but, in some places, this is over the counter.
My opinion is that no one should EVER try these medications without consulting a health professional as there are contraindications (some life-threatening) to taking PDE 5 medications and these need to be checked first.
Urban Myth About Penis Pills
You would have heard the urban myths around these medications so let's talk about them. Viagra hit the market in 1998 and may never have been discovered if not for one dutiful/observant nurse.
The researchers who discovered it weren’t even looking for it. Sildenafil, the active ingredient in Viagra, was originally developed to treat cardiovascular problems and was meant to dilate the heart’s blood vessels.
The research went well - except for one weird thing… When the nurses went to check on the men enrolled in the study, a lot of them were laying on their stomachs. The story goes that one very observant nurse reported this, saying the men were embarrassed [because] they were getting erections. It appeared that the blood vessels dilating were not just those in the heart but also those in the penis and thus, improving erections.
The sildenafil was working—but in the wrong part of the body. And with that, the magic blue pill was born.
The drug that makes Viagra work, Sildenafil, is now also used for pulmonary arterial hypertension.
This isn’t that abnormal. Often side effects turn out to be useful.
Penis Pills and Blood Flow Explained
So how do these medications get the blood flowing into your penis? Basically, they cause the vessels to vasodilate (a fancy name for open up) and the blood flows in.
When the penis is full, the blood is trapped, and an erection occurs. When it is time to go down, the penis produces a chemical called PDE 5 which causes vasoconstriction (fancy word for squeezing smaller) and the blood flows out.
PDE 5 medications such as Viagra, Cialis, Spedra and Levitra slow down the production of PDE 5 so erections can be sustained longer.
There are two reasons why you would take these medications:
- The first is less well known and that is to keep your penis healthy, oxygenated, and the tissues perfused.
- The second is the reason we all know which is to get an erection to have intercourse.
These medications ONLY work when your nerves that innervate erections are at least partially functioning. Therefore, they won’t work for people immediately following prostate cancer surgery or other men who have had surgery, trauma, illness (such as Diabetes) or radiation to this pelvic region which has damaged the nerves.
This is important: the nerves need to be functioning a bit for these to work.
As we discussed previously, there are 4 different ones.
Everybody is an individual and what works for one person will differ for the next person.
If you have tried these medications in the past and one of them worked better for you and didn’t cause unpleasant side effects, then use this one and forget the rest. If you have never tried any, give them all a crack and figure out which one agrees with your body.
To try any of these pills, make sure you get the proper prescription and advice. We offer telehealth consults for patients who are not in Perth. Just send your enquiry to email@example.com.