In 1988, when the first oral drug for erectile dysfunction (ED), Viagra (sildenafil), was introduced into clinical prescriptions, it marked a major step forward in the treatment of ED. More recently, many other treatments for ED are still being tried diligently, for example, from vacuum negative pressure suction devices sold over-the-counter to surgical prosthetic implants, and the use of various suppositories. I. Oral medications. Viagra, cialis (tadalafil) and elidel (vardenafil) increase blood flow to the penis by relaxing the smooth muscle of the cavernous body of the penis thereby causing an erection. The effectiveness of these inhibitors of phosphodiesterase (referred to as PDE-5i) has been well documented. Dr. Irwin Goldstein, chief of the Division of Sexual Medicine in San Diego and editor-in-chief of the Journal of Sexual Medicine, says that these ED medications have good therapeutic effects in 70% of ED patients, allowing the penis to achieve sufficient hardness for sexual activity. Generally, these drugs have a good safety profile, and their side effects include headaches, nasal congestion, indigestion, and blue vision, but they are mild and “some of the safer drugs on the planet,” Dr. Goldstein commented. If you are taking ED drugs, be sure not to use nitrates at the same time, such as nitroglycerin pills for chest pain or recreational addictive ecstasy, because their combined effect can cause a dramatic drop in blood pressure or even lead to a heart attack. Second, injectable drugs. If oral medications don’t work, your doctor may recommend injectable medications, which are injected directly into the root or side of the penis through a fine needle, or suppository medications that are placed into the urethra. Injectable drugs are hormone-like synthetic drugs of prostaglandin E1 that work similarly to ED pills. To enhance the effective action of the drugs, some injectable drugs are mixtures of prostaglandin E and other drugs, such as the vasodilator poppy bases and the a-blocker phentolamine. Your doctor will teach you to use these injectable medications yourself at home. Third, suppository medications. For those who do not like or are afraid of self-injection, a suppository drug called MUSE, which contains prostaglandin E, can also be used, although it is thought to be less effective than injectable drugs, “which are injected directly into the penis, whereas suppositories need to be placed in the urethra and absorbed through the latter, thus losing some of their effectiveness. “, said Dr. Ridwan Shabsigh, chief of urology at McMenamins Medical Center and professor of clinical urology at Columbia University in New York. Both of these methods have similar major discomforts, and users often claim that injectable drugs or suppositories deprive sexual spontaneity because of the time that must be spent preparing and administering them for this purpose. Fourth, negative vacuum pressure suction devices. The negative pressure vacuum suction device for the penis is in Austin. Ball’s film was ridiculed, but this device has a good effect of increasing blood flow to the penis and is available over-the-counter and relatively inexpensively. The device pulls blood into the erectile tissue by pulling the air out of the tube, and the penis remains erect after the tube is removed, and it is a good idea to put a tightening ring around the root of the penis to increase the effect. Fifth, “cock ring” (tightening ring). Wearing a “cock ring” at the root of the penis can slow down the blood flow to the penis. The ring does not increase the blood flow to the penis, but once an erection is achieved (e.g., through a negative vacuum pressure suction device), the ring can prolong the erection. The restraint ring should not be used for more than thirty minutes and should be removed immediately if you feel chills/numbness in the penis or pain in the genital area. VI. Implants. The technology for penile implants is improving all the time, and Dr. Shabsigh says, “They are comparable to implants used in other parts of the body (such as pacemakers). The inflated implant is connected to a hydraulic pump buried in the scrotum to inflate or weaken it. 2. Tough implants: Tough implants are semi-rigid, bendable bars that are implanted into the penis and controlled by hand to achieve erection or weakness. Seven, surgery. Angioplasty surgery, although rarely used, can be a last-resort solution for some patients, says Dr. Shabsigh: “Some patients can benefit from angioplasty surgery, but it is effective in less than 1 percent of ED patients. This is similar to coronary artery bypass surgery, which only a very small number of doctors in the United States are able to perform.”