Can a little blue pill make you a man again? Many patients who find themselves suffering from erectile dysfunction (ED) are too shy to go to the hospital or find it too troublesome to go to the doctor, so they go to the pharmacy to buy Viagra (PDE5 inhibitors), but patients often find that they cannot achieve the desired results, why is this? In fact, the causes of ED are complex and usually multifactorial. Penile erection is a complex vascular activity under neuroendocrine regulation, and this activity requires close synergy of neurological, endocrine, vascular, penile corpus cavernosum and psychological factors, and is affected by multiple factors such as systemic diseases, nutrition and medication, and abnormalities in any of these areas may lead to ED. 1, the principle of erectile dysfunction treatment The treatment of ED should be clearly defined before the treatment of its underlying diseases, predisposing factors, risk factors and Before treating ED, the underlying diseases, predisposing factors, risk factors and potential causes should be clarified, and the appropriate treatment plan should be determined after a comprehensive medical examination. In particular, it is important to differentiate between ED caused by psychological factors, medications, or poor lifestyles, which may be improved through counseling or removal of the relevant factors. Organic ED or mixed ED is usually treated with medications. 2. Pharmacological treatment of ED Now as the first choice of treatment or PDE5 inhibitors: easy to use, safe, effective, easy to be accepted by most patients. The commonly used PDE5 inhibitors include sildenafil, tadalafil and vardenafil. 3 kinds of PDE5 inhibitors have basically the same pharmacological mechanism of action, which can enhance erectile function only after enough sexual stimulation after oral intake, and the overall effectiveness rate is about 80% for ED patients. When taking Viagra, it is important to know its precautions in order to better achieve the therapeutic effect. (1) the concept of time “Viagra” and other drugs, after oral intake of a certain period of time to reach the blood concentration of sildenafil, for example, the gastrointestinal absorption time of about 30-60 minutes, the duration of efficacy of 4-6 hours. The ideal time to have sex is 1-4 hours after taking the drug, and many patients are affected by the effect due to poor time management. (2) enough sexual stimulation Many people think that as long as the drug will have an erection, in fact, this is not the case, after taking the drug but also have enough sexual stimulation, the drug can play a role in the effectiveness of the treatment of ED is not to take a piece of medicine, all is well, need to have a certain sexual stimulation, so the wife’s cooperation is crucial. (3) Insufficient dosage Many men reduce the amount of the drug on their own due to the fear of dependence on Viagra, in fact, in the first three times of use, it is advisable to take the full amount of the drug, so as to ensure that the drug’s effect, is conducive to helping the user to build confidence. For patients with erectile dysfunction caused by psychological factors, the dosage can be gradually reduced later, and finally even no longer need to take the drug. (4) should not take the patient For some patients, if only psychological ED, taking “Viagra” can be cured; but a part of the patient, is a serious organic lesions, the patient can only rely on the need to take medication to live a sex life, the patient strictly abide by the doctor’s instructions to use the drug, so that the implementation of a “plan Patients strictly follow the doctor’s instructions to use drugs, so as to implement a “plan” of treatment, and in the treatment according to the efficacy of continuous adjustment of the treatment program, to achieve the best therapeutic effect. In addition, patients with severe organic ED, due to serious damage to the tissue structure or nerve function of the penile corpus cavernosum, these patients are ineffective in oral drug therapy and need penile prosthesis implantation. In addition, sex itself consumes physical strength, moderate to severe cardiovascular disease patients should not take “Viagra” to try to have sex, it is recommended that the cardiology department to treat cardiovascular problems first. ED is a chronic disease that affects both physiology and psychology, a pill alone is not enough, or need to be treated under the guidance of a doctor in order to achieve and maintain a firm erection hardness, and restore a satisfactory sex life.