Erection problems

In the case of erectile dysfunction, sexual enhancers are most often prescribed in the form of tablets. Preparations such as  Viagra, Levitra, Cialis, and Spedra are so-called phosphodiesterase-5 inhibitors, PDE-5 inhibitors for short. The active ingredients are called sildenafil, vardenafil, tadalafil, and avanafil. They expand the vessels in the penis and thus promote increased blood flow. Erectile function is improved. Probably the biggest advantage of Cialis compared to 비아그라 is its duration of action. Viagra only works for up to four hours, while Cialis can take effect for up to 36 hours. The effect of Levitra, on the other hand, lasts a maximum of five hours. 

Impotence: treatment with drugs

But not all men can access potency pills from the pharmacy. If, for example, other medications are taken, dangerous interactions can occur with them. The tablets should also not be prescribed for heart problems, liver diseases, and allergies to the active ingredients used. And sometimes the drugs just don't have the desired effect.

Viagra Alternative #1: SKAT 

The erectile tissue auto-injection is the oldest form of treatment against erectile dysfunction. It was around long before 비아그라 구입 hit the market in 1998. Here, the affected person injects the vasodilating active ingredients about 20 minutes before sexual intercourse directly into the erectile tissue of his penis. The exact application is first practiced together with the urologist in order to reduce fears and insecurities about the injection.

"SKAT requires a certain amount of self-control," says Dr. Wolfgang Bühmann, urologist and spokesman for the Professional Association of German Urologists (BDU). "Not every man wants to use an injection on the penis. This is initially deterrent and therefore requires careful monitoring and instruction by a urologist."

After that, it is not a problem for most men. Because the needle is very thin, most men don't find the injection painful, according to the expert. The erection lasts between 30 to 60 minutes.

Viagra Alternative #2: MUSE

Another method is the drug urethral system (MUSE): In this case, those affected inject a small gel depot into the urethra with a disposable applicator. The agent thus reaches the cavernous bodies via the blood vessels and increases the blood flow there. After about 15 minutes, the erection occurs, which also lasts for 30 to 60 minutes. "MUSE is effective for most men. However, the man may experience pain or a burning sensation in the urethra," says Bühmann.

Viagra Alternative #3: Vacuum Pump

Vacuum pumps are a gentle method of treating erectile dysfunction. A cylinder is slipped over the penis and a vacuum is created. This expands the erectile tissue and allows blood to flow in more easily. Once the erection is established, a rubber ring is placed around the base of the penis. This prevents the blood from draining out again. After 30 minutes, the ring must be removed again.

"A vacuum pump is a good choice, especially for men who feel uncomfortable at the thought of medication, injections, and gel depots," says Bühmann. "But the ring can cause slight pain when ejaculating. In addition, the method sometimes seems a bit non-erotic due to the necessary mechanical manipulation."

Viagra Alternative #4: Penile Prosthesis (Surgery) 

If the remedies already mentioned do not help against the erection problems, there is the possibility of an operation as the last step. Here, the doctor implants a cavernous prosthesis made of silicone into the penis, which replaces the body's own cavernous bodies. A small pump is also inserted into the scrotum. The erection then comes about as follows: The liquid, which is in a small reservoir in the lower abdomen, is pumped into the silicone erectile tissue. The resulting erection can be maintained indefinitely.

"This intervention should be well thought out," Bühmann points out. "Once the operation has been performed, the other methods can no longer be used because the erectile tissue is damaged. If the material is rejected by the body, there is no alternative."