Experts: Pills Best for Erectile Dysfunction

May 24, 2005 - Erectile dysfunction? Try a pill first, experts say.

Viagra, Levitra, and Cialis are the mainstays of comedy monologues. And they should be the mainstay of serious treatment for erectile dysfunction, according to new treatment guidelines released today by the American Urological Association.

Doctors call the erection drugs "PDE5 inhibitors" because they target an enzyme called PDE5. The less PDE5, the more blood flow to the penis -- and the better the chance for an erection. They should work for most men with erection problems, says expert panel co-chairman Drogo K. Montague, MD, director of The Cleveland Clinic's center for sexual function.

"As many as 80% of men will benefit from oral PDE5 inhibitors," Montague says in a news release. "For those men who are not helped by these agents, one or more of the remaining treatment options are almost always successful."

So which erection drug is best? The expert panel doesn't say. There simply isn't yet enough data to make a meaningful comparison.

Patients who don't get help from an erection drug shouldn't give up right away. The problem might be as simple as learning to use the drug the right way.

But should erection drugs fail to work, several alternatives remain. These are:

• Urethral suppositories
• Penile drug injections
• Vacuum constriction devices
• Penile prostheses

The panel recommended against using:

• Trazodone
• Testosterone, in men with normal testosterone levels
• Yohimbine
• Herbal therapies
• Penile venous reconstructive surgery