FirstMed Consulting Blog

So everyone’s heard of Viagra but few people are aware of exactly how big of an impact it has had on the treatment of erectile dysfunction and on shaping peoples ideas about erectile dysfunction. ED was previously associated with shame and secrecy. Viagra and its predessors Cialis and Levitra have taken the issue of ED out of the bedroom and into the public arena, ending the long-held taboo surrounding the topic of impotence.

So what if Pfizers never launched the ‘magic blue pill’. Lets take a quick glance at a parallel world where Viagra doesn’t exist and explore the treatment options available to the scores of men out there who suffer from ED prior to 1998.

Prior to Viagra, Yohimbine was the primary oral prescription for impotence. Marketed under the names as Yocon, Yohimex, Yohimbine Hydrochloride or Aphrodyne, yohimbine is modestly effective in treating erectile dysfunction. Made from the extract of the bark of a West African tree, yohimbine is among a class of pre-1938 remedies that are not regulated by the U.S. Food and Drug Administration for use in humans. Yohimbine increases both heart rate and blood pressure, even at low doses. It floods blood vessels in the genitals, and raises levels of the neurotransmitter norepinephrine, which stimulates areas controlling sexual response in the brain. Side Effects include Dizziness, headache, insomnia and nervousness. Large doses can increase blood pressure and heart rate

Alprostadil is another drug for erectile dysfunction. However, it’s not a pill. One brand, called MUSE, is an alprostadil pellet that you insert into the tip of your penis with an applicator. It widens blood vessels and relaxes smooth muscle tissue in the penis, allowing blood to fill the spongy tissue that makes the penis erect. Injections directly into the penis are another way to deliver alprostadil. Phentolamine and papaverine are additional drugs that are injected into the penis to treat erectile dysfunction. When injecting these drugs there is some risk that your erection may last too long, a condition that can require medical treatment.

Another treatment is a vacuum device, or “penis pump.” This is typically a clear plastic cylinder with a bulb or plunger and a constriction band. You put your penis in the cylinder and start pumping. The suction creates a vacuum, so blood rushes in to fill the spaces in the spongy tissue of the penis, creating an erection. The erection lasts only as long as the blood stays in, so you slide the band down around the base of your penis, trapping the blood. It’s safe to keep the band on for up to 30 minutes. These devices are available without a prescription, but it’s important to buy one from a reputable manufacturer. The device must include a safety control so you can’t harm your penis with too much suction.

Outside of surgery, those were the main treatments available to those suffering from ED but nowadays, a doctor’s first choice for treating erection problems is usually one of PDE5 inhibitors, Viagra, Levitra and Cialis. All three drugs work in similar ways. They don’t increase sexual desire. They make it physically possible to get an erection when you are aroused.