This is a false assertion that Dr. Pazona addresses more specifically.

Age Group Expected Efficacy Safety Considerations Notes
40-50 years High Generally safe, monitor comorbidities Regular health check, dose adjustments possible
51-65 years Moderate to high Increased risk of cardiovascular issues Screening recommended before therapy
Over 65 years Variable Higher likelihood of side effects Careful evaluation, start with lower doses

While these pills are not life-threatening or dangerous for the majority of people, he states that pre-existing heart conditions or going from inactivity to sudden high activity could be fatal. There is no doubt that a health professional should always be consulted prior to initiating any treatment.

  • Vascular Health: ED can be an early warning sign of heart disease.
  • Diabetes: A leading cause of ED due to nerve and blood vessel damage.
  • Neurological Disorders: MS, Parkinson's, and spinal injuries can cause ED.
  • Metabolic Syndrome: A cluster of conditions that increases ED risk.
  • Prostate Cancer Treatment: Surgery and radiation often cause temporary or permanent ED.
  • Depression: Both a cause and a consequence of erectile dysfunction.
  • Medications: Antidepressants, antihypertensives can cause ED as a side effect.

Headaches, flushing, and vision changes are potential side effects that can be expected. But those side effects are mild and tend to be transient. Nitrate use in patients with a history of heart conditions since the two combined can lead to severely low blood pressure.

The big four

Other external penile prostheses: Constriction rings are placed at the base of the penis to help stop blood from leaving the penis during sex, similar to the band used with a VED. They are beneficial for men who achieve erections but do not tend to maintain them. During intercourse, men may also use a penile splint, which is a device that supports and holds the penis in place and contains a quick-release mechanism for fast removal. Side effects of these devices may include bruising, rupture of blood vessels and aggravation of preexisting conditions, such as priapism (prolonged erection) and Peyronie’s disease (penile curvature). National Institute of Diabetes and Digestive and Kidney Diseases.

Maintain a healthy weight

Definition & facts for erectile dysfunction, July 2017. How cancer can affect erections, February 5, 2020. U.S. Department of Veterans Affairs, Whole Health Library. U.S. As much as pills may provide quick relief, Dr.

Product Dosage Quantity + Bonus Price
Levitra Generic40mg360 + 10 Pills704.99€ 671.42€
Kamagra Polo100 mg12 Pills60.21€ 57.34€
Viagra Generic25mg30 + 4 Pills47.97€ 45.69€
Levitra Original20mg92 + 4 Pills406.22€ 386.88€
Cialis Generic20mg30 + 4 Pills68.05€ 64.81€
Levitra Generic60mg120 + 8 Pills372.33€ 354.60€
Kamagra Soft Tabs100 mg180 + 8 Pills425.45€ 405.19€
Kamagra Gold50 mg20 Pills73.17€ 69.69€
Kamagra Oral Jelly100mg63 + 7 Sachets224.18€ 213.50€
Levitra Original20mg76 + 4 Pills344.39€ 327.99€
Cialis Generic5mg20 Pills41.99€ 39.99€
Viagra Generic150mg90 + 6 Pills147.18€ 140.17€
Priligy Generic Dapoxetine60mg60 + 8 Pills183.06€ 174.34€
Kamagra Soft Tabs100 mg12 Pills57.55€ 54.81€
Kamagra Effervescent Tablets100 mg63 + 7 Pills171.99€ 163.80€

Pazona advocates for a more comprehensive approach than just medications. Sure, pills can control the symptoms, but they do not treat the underlying issues like blood flow problems, low testosterone, etc. Such conditions may be identified after a thorough assessment by a urologist and incorporated into an appropriate management strategy. ED medications are generally safe and effective but work best when part of a broader health strategy. Personalized treatment is key: Consult a urologist to determine the best option for your unique needs. Don’t ignore the bigger picture: ED can signal underlying health problems like heart disease, so a thorough check-up is essential. As Dr. Pazona concludes this episode, he reminds the listeners that ED does not have a universal treatment. The appropriate solution entails medical expertise, the preferences of the patients, and a focus on overall health. For patients within the Nashville area, visit Pazona MD for help in further exploring your health. It’s true that ED may be a taboo topic for many, but it is also one of the most manageable conditions.

About the Author

Because it can be an embarrassing topic, few people discuss erectile dysfunction (ED). Balls Deep is where Dr. Joe Pazona and Cat Williams discuss and explain everything there is to know about the topic while keeping it funny and educational. This is a must-listen episode if you have ever wondered what goes into ED medications like Viagra and Cialis. Dr.

4 Commonly Used ED Medications

Pazona kicks things off by talking about how sildenafil (branded as Viagra) came into being. Initially developed to treat pulmonary hypertension (a condition involving high blood pressure in the lungs), researchers stumbled upon its ability to enhance erections during clinical trials. People didn’t notice much improvement in their breathing but were ready to receive their prescriptions for other “pleasurable prospects.” Thus, in the 1990s, the world’s first ED pill was made — a medication that changed how everyone viewed this problem. To put it simply, ED medications consist of a class of drugs known as PDE5 inhibitors. These medications allow erections to be achieved by stopping the circulation of a chemical in the body that permits blood vessels to expand and fill with blood. Now, thanks to the insights from Dr. Pazona and his team, men all over the world can approach the topic with confidence and humor — and maybe even a little hope. Learn more about erectile dysfunction and how Pazona MD can help. Disclaimer: This podcast is for informational purposes only and does not substitute professional medical advice. Always seek the guidance of your healthcare provider for any medical conditions. Sildenafil citrate is a PDE5 inhibitor that may be used to support erectile function and may help manage pulmonary arterial hypertension. Skip to content Our Erectile Dysfunction (ED) MedicationsSildenafil CitrateTadalafilPhenylephrine HCLAlprostadil / Papaverine HCL / Phentolamine Mesylate (TriMix)Papaverine HCL / Phentolamine Mesylate (BiMix)Testosterone Cypionate / DHEA Grapeseed OilTestosteroneAbout Erectile Dysfunction (ED)CausesHormonal and Nonhormonal CausesHormonal CausesPsychological CausesAdditional Physical Causes of Sexual Dysfunction:Additional Psychological Causes of Sexual Dysfunction:Oral TherapiesInjectionsAlprostadilBiMix (Papaverine HCL /Phentolamine Mesylate)TriMix (Alprostadil/Papaverine HCL/Phentolamine Mesylate)BHRTCommonly Asked Questions About Erectile DysfunctionHow can we help you? Erectile dysfunction (ED) is defined as difficulty achieving or maintaining an erection sufficient for sexual intercourse. The condition becomes more prevalent with age and is thought to affect more than 50% of men in the US, aged 40 -70. ED can be exacerbated by low libido, a condition where there is little to no desire for sex.

How are oral ED drugs different?

But, as Dr. Pazona stresses, it only works if you’re “in the mood.” These drugs do not make the penis become erect on its own, these drugs allow the body to respond to other forms of sexual stimulation more easily. Viagra (sildenafil) and Cialis (tadalafil) are the most well-known ED medications, but they work differently: Viagra: Usually taken when needed about an hour before action. The effectiveness of Viagra is 4-6 hours. It’s great for planning ahead, but be careful not to eat a heavy meal, as it can delay its effects.

Medication May Not Be the Solution

Cialis: Commonly called the “weekend pill,” Cialis lasts up to 24 hours and can be taken as low daily doses. This option does give more spontaneous options but will not be enough for patients suffering from severe ED. Dr. Pazona discloses that most men tolerate Cialis better than other ED medications, but responses and feedback are not the same across the board. One of the main causes for the ineffectiveness of pills in some men can be attributed to severe vascular damage. This can be problematic because sexuality is important for overall health and wellbeing. There are three types of possible ejaculation problems: premature ejaculation, delayed or inhibited ejaculation, and retrograde ejaculation. Premature ejaculation is defined as reaching orgasm too early, before, or soon after penetration. Delayed or inhibited ejaculation is when orgasm is reached too slowly or not at all. In retrograde ejaculation, patients ejaculate into the bladder rather than through the penis. Typical sexual responses are complex interactions of the mind, nervous, circulatory, and hormonal systems. Male sexual problems like erectile dysfunction can be caused by physical or psychological reasons or a combination of those issues. Tadalafil is a PDE5 inhibitor that may help increase smooth muscle relaxation and blood flow. Phenylephrine is used as a rescue medication for priapism. It works by tightening blood vessels in the penis so the trapped blood can drain, helping the erection go down.

What Is Trimix?

Department of Health and Human Services, My Health Finder. Heart-healthy foods: shopping list, September 19, 2023. Drugs that may cause erection problems, January 1, 2023. Managing male sexual problems related to cancer, February 5, 2020. Safety and efficacy of inflatable penile prostheses for the treatment of erectile dysfunction: evidence to date.

Prevention Tips

NIDDK LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Sinusoidal obstruction syndrome (veno-occlusive disease), May 4, 2019. External penile rigidity devices - class II special controls guidance document for industry and FDA staff, December 28, 2004. Import alert: detention without physical examination of external penile rigidity devices, May 19, 2023. Penile curvature (Peyronie’s disease), August 2019. Tri Mix penile injection combines alprostadil, papaverine, and phentolamine which may offer a fast‑acting option that supports stronger and more reliable erections when oral medications are not achieving desired results.

Frequently Asked Questions and False Beliefs

Pazona strongly advises against seeking treatments from non-specialist “men’s health” clinics. If mismanagement of dosing or technique occurs, a common complication would be priapism — this is where an erection can last more than four hours. Dr. Pazona advises most people to seek the care of a board-certified urologist for their medical needs. The primary concern regarding ED medications is that they can cause heart attacks or strokes. Papaverine and phentolamine (Bi Mix injection) relaxes cavernosal smooth muscle to enhance penile blood flow and promote tumescence. A testosterone cypionate/DHEA grapeseed oil injection combines long‑acting testosterone with DHEA, a hormone that the body can naturally convert into other hormones. Testosterone is a sex hormone that plays a number of important roles in reproductive health and general wellness in both women and men.

Speak to your provider about ED

In such circumstances, injections may be an option. Dr. Pazona reassures patients that the procedures are painless, quick, and successful for a great number fildena tablet of people. In essence, the treatment involves administering medication directly into the erectile tissue, bypassing the need for systemic absorption. However, Dr. Erectile dysfunction can be the result of one or more of the following: hormonal imbalances, conditions affecting blood flow and circulatory mechanisms (neurogenic), diseases impacting nerve signaling (neurogenic), or due to outside medications or substances (iatrogenic). There may be psychological factors as well. As male patients age, testosterone levels typically decline and may negatively impact libido.

  • Future Formulations: Research into quicker-dissolving tablets or sublingual strips.
  • Gene Therapy: Experimental approach aiming for a longer-term solution.
  • Stem Cell Therapy: Investigational treatment to repair damaged tissues.
  • New Drug Targets: Research focusing on pathways beyond PDE5 inhibition.
  • Topical Gels: Development of effective transdermal delivery systems.
  • Improved Safety Profiles: Goals for drugs with fewer side effects and interactions.
  • Personalized Medicine: Tailoring treatment based on genetic markers.

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Dr. med. Fabienne Gretener

Werdegang

Januar 2024 bis heute
Oberärztin SenoMed AG
Schwerpunktsweiterbildung gynäkologische Senology

März 2023 – Dezember 2023
Oberärztin, SenoMed AG Bern 20%

Januar 2023 – November 2023
Assistenzärztin Psychiatrie, Klinik Meissenberg Zug

Januar 2021 – November 2022
Assistenzärztin Gynecology und Geburtshilfe, Bürgerspital Solothurn

November 2019 – Oktober 2020
Assistenzärztin Gynecology und Geburtshilfe, Kantonsspital Aarau

Januar 2017 – Juli 2019
Assistenzärztin Gynecology und Geburtshilfe, Kantonsspital Olten

Paul Laszlo Bernhard

Werdegang

Jan 2024 bis heute
Facharzt SenoMed AG – Brustzentrum Bern Biel

Aug 2019 – Dez 2023
Oberarzt Frauenklinik und Brustzentrum Bürgerspital, Solothurn, Schwerpunktweiterbildung operative Gynecology und Geburtshilfe sowie Senology

Mai 2019 Facharzttitel Gynecology & Geburtshilfe

Apr 2016 – Jul 2019
Arzt in Weiterbildung, Inselspital Bern, Universitätsklinik für Frauenheilkunde

Dez 2014 – Apr 2016
Arzt in Weiterbildung, Kantonsspital Baden

Sep 2012 – Sep 2014
Arzt in Weiterbildung, Universitätsklinikum Carl Gustav Carus, Dresden

Feb 2012 – Sep 2012
Arzt in Weiterbildung, Universitätsfrauenklinik Leipzig

Nov 2011 Approbation zum Arzt

2005 – 2011
Studium der Humanmedizin an der Charité, Universitätsmedizin Berlin

Dr. med. Patrizia Sager

Werdegang

Okt 2023 bis heute
Leiterin Weiterbildungsstätte gynäkologische Senology

Feb 2018 – bis heute
Leiterin Brustzentrum Bern Biel
Practiceinhaberin SenoMed AG

Nov 2017 – bis heute
Belegärztin Salem-Spital Bern

Jan 2013 – Okt 2017
Leitung Senology Brustzentrum Frauenklinik Universitätsspital Insel, Bern

Jan 2012 – Dez 2012
Oberärztin Gynecology / Geburtshilfe, Frauenklinik Universitätsspital Insel, Bern

Nov 2010 – Dez 2011
Leitende Ärztin Gynecology und Geburtshilfe, Frauenklinik Rheinfelden (DE)

Nov 2009 – Okt 2010
Oberärztin Gynecology und Geburtshilfe, Kantonsspital Liestal

Jan 2009 – Okt 2009
Oberärztin i.V. Gynecology und Geburtshilfe, Regionalspital Interlaken

Jun 2008 – Dez 2008
Assistenzärztin Gynecology und Geburtshilfe, Regionalspital Interlaken

Aug 2007 – Mai 2008
Assistenzärztin Gynecology und Geburtshilfe, Universitätsspital Zürich

Feb 2007 – Jun 2007
Oberärztin Gynecology und Geburtshilfe, Universitätsspital Groote Schuur, Kapstadt, Südafrika

Jan 2004 – Dez 2006
Assistenzärztin Gynecology und Geburtshilfe, Regionalspital Thun

Jan 2003 – Dez 2003
Assistenzärztin Chirurgie und Orthopädie, Regionalspital Thun

Schulen, Studium & Diplome

2023
Schwerpunkt gynäkologische Senology

2014
Diplom Senology SGGG

2013
Diplom Senology: European Academy of Senology

2010
FMH Gynecology und Geburtshilfe inkl. Schwerpunkt operative Gynecology

2003
Promotion

2002
Staatsexamen in Humanmedizin

1996 – 2002
Humanmedizinstudium Universitätsspital Basel

Mitglied- und Partnerschaften

  • Schweizerische Gesellschaft für Gynecology und Geburtshilfe SGGG
  • Schweizerische Gesellschaft für Senology SGS
  • Mitglieder Arbeitsgemeinschaft Gynäkologische Onkologie AGO, Schweiz
  • European Academy of Senology EAoS
  • SAKK Project-Group breast cancer
  • Schweizerische Gesellschaft für Ultraschall in der Medizin SGUM
  • Verbindung der Schweizer Ärzte und Ärztinnen FMH
  • Society of women in senology SWIS
  • Vorstandsmitglied Ärztenetzwerk Bern