Once categorized as a purely psychological disorder, erectile dysfunction is now regarded as a physiological ailment through numerous coherent studies that can be treated with a variety of measures, including drugs, therapy, and even sound waves. According to Harvard Health Publishing, impotence is more common than expected, with a prevalence of up to 22% in American men, mostly in the older age groups.1 However, younger, seemingly healthy men are also at risk, considering the fact that the leading causes of Erectile Dysfunction are chronic diseases, capable of interrupting regular blood flow and nerve functionality, with examples including; diabetes, hypertension, multiple sclerosis, as well as hormonal imbalance.1
Viagra Not Working? This Guide Can Help You
Although very difficult for many men to accept and admit to erection problems, we are lucky to live in an age of pharmaceutical furtherance, providing us with medication that works for treating ED. Sildenafil, sold as the brand name Viagra among other oral medications in pill form were the first to rush to rescue men dealing with impotence. The prescription from doctors was just “take viagra (sildenafil), and that was the end of the treatment. However, similar to several other medications, there is no guarantee that the little blue pill of Viagra will work, so the question we are asking today is what should we do when we realize the problem is the viagra not working as it should.
If Viagra not working anymore…
A healthy erection is dependent on an uninterrupted blood flow to the penis, through the penile cavernous arteries, to fill the corpora cavernosa, therefore, causing the stiffening of the penile shaft. An erection is initiated with sensory and mental stimulation, with an emphasis on proper neural functioning. We cannot ignore performance anxiety and fatigue; however, physical irregularities are the primary causes of Erectile Dysfunction, therefore, medications such as Viagra or other brands of sildenafil, are prescribed to push past the abnormal blood circulation and increase blood flow to the cavernous arteries, working as a vasodilator. Besides Viagra’s prolonged onset of action, the crisis many users face revolves around the ineffectual aspect of sildenafil and its recommendations against use by men with severe cardiovascular ailments that might also raise the risk for heart issues.4 What ends up happening is Viagra not working anymore as it should for some men.
Testosterone is the key hormone produced by the Leydig cells of the testicles and is responsible for the normal growth and development of male organs and for maintenance of other sexual characteristics. During their late twenties, men begin to encounter the decline and imbalance of hormones, specifically testosterone. Depletion of testosterone, which is referred to as andropause is accompanied by several symptoms3:
- Increased body fat and loss of muscle mass
- Depleted bone mass and energy levels
- Hair loss
- Disturbed sleep patterns and mood swings
- Erectile dysfunction.
Such imbalance has a significant role in problems with sexual desire and performance. Although testosterone is an essential component of a healthy sex life, it is not a requirement for normal and consistent erections. Viagra cannot replace or maintain testosterone levels, meaning Viagra (and other Sildenafil brand names) will not work as a replacement for the natural urge or desire for sex. Patients should seek testosterone replacement or hormonal therapy instead in order to manage their sexual health.3
One of the topics that might be uncomfortable to discuss but are needed to manage ED, is the use of ED medication and contracting an STD. ED medication does not work as a protective barrier against STDs and everyone should practice safe sex regardless. Meanwhile, certain STDs can possibly lead to erectile dysfunction, making ED medication less effective. An example of the mentioned scenario is an individual who contracted Chlamydia, and did not seek proper medical attention, allowing the bacteria to grow and infect the prostate gland, leading to prostatitis. An important piece of advice is to know ED medication cannot be used and will not work for protection against STDs, and everyone should always practice safe sex.
Erectile Dysfunction is very prominent in men with diabetes. The incidence rate of ED increases with age from 5% in men age 20 to 75% in men over age 65.4 The primary cause of impotence in diabetic men is due to the decrease in the blood flow and nerve damage in the penile area as a consequence of diabetes. Many diabetic patients have successfully been treated with Viagra since 1998, followed by Cialis, Levitra, and Stendra ever since. However, diabetic patients might also fail to enjoy the therapeutic advantages of such oral medication after building resistance or from the very first pill. Around 50 percent of men with Type 1 diabetes and 60 percent of Type 2 diabetic patients have reported improved erectile conditions.4
Meanwhile, Viagra stops working in a huge portion of diabetic men, primarily due to the damaged blood vessels and nerves caused by diabetes, preventing Viagra from increasing blood flow. The absorption and systematic flow of the medicine after ingestion is also altered in diabetic patients, making it more difficult for the drug’s action mechanism to work its biochemical effect. Many diabetic patients will report little or no difference in erection habits even after using Viagra and similar products.4
Using a Low Dose or Using it Incorrectly
It is very important in ED care to realize that the correct method of use and dosage is the key to Viagra working as desired.7 This translates to taking Viagra or Levitra at least an hour before engaging in sexual activity for it to be working properly. Professional medical advice also emphasizes that the drug must also be taken on an empty stomach preferably or avoiding a heavy meal prior to taking the medication, in order to maximize uptake. Treating ED with any medication has to be a medically reviewed decision.
Alcohol intake must be reduced to a minimum if you take viagra, since alcohol decreases the blood flow and circulation, making a dose of Viagra less effective. Sufficient stimulation is also another recommended approach to working the most out of your ED medication.6
Typically, urologists prefer to start the patient with the lowest dose, since daily administration can lead to improved blood flow to the penile area on a regular basis. Also, this method of administration may guide the doctors to determining the appropriate amount needed to treat ED, without the risk of overdosing. Similarly, a very low dosage might also not have the desired impact on the erections, causing many users to believe Viagra doesn’t work and seek other treatment options that actually work. They fail to try, a higher dose or just manage the prescribed dose of the current medication with the help of a medical professional.
Giving Up Early On It
It is logical and recommended to try a certain medication a few times and for a longer period before moving on to the next if it’s not working at first. The chances of error and incorrect use might make it difficult to see results after first use, so, the user must be patient and allow several attempts before believing there’s a problem with the Viagra.6 A correct explanation for lack of results after the initial use could be the inappropriate dose, forgetting to take Viagra on an empty stomach, or expecting to get an erection immediately after ingestion.
If Sildenafil (Viagra) isn’t working for Erection Problems, What other ED Treatment Options Are Out There?
As mentioned, we do live in a world driven by pharmaceutical advancements, and there is no reason to give up hope of finding treatment for such a common disorder. Multiple treatment options for ED are available even with situations of Viagra not working as it should. It is important to realize some individuals might be more responsive to certain treatment options compared to others, due to certain underlying conditions, physiological differences, or severity of their ED.7
Other Options For Treating ED When Viagra Won’t Work
Considered a very effective but often under-utilized treatment for Erectile Dysfunction, ICP involves an injection of a combination of FDA-approved vasodilators into the spongy tissue of the penis, using an auto-applicator. This combination causes an expansion of the penile arteries and penile tissues, resulting in increased blood flow to the penis. An erection typically develops within minutes. The erection feels perfectly natural and normal; however, it will not subside after ejaculation until the effect of the medicine wears off. In rare cases side-effects of ICP include penile bruising, pain or tenderness, scarring, and a prolonged erection (known as a priapism). Boston Medical Group physicians have developed a unique approach to this method that has been effective for thousands of patients. Because it is applied locally and is non-systemic, it is often recommended for heart conditions like heart disease, diabetes, high blood pressure, or other illnesses in men. In the last 15 years ICP has re-emerged as a treatment option for men who do not respond to well-known oral medications for ED. Many men prefer to use ICP over other methods given it is a medically reviewed procedure and record of safety, quality, and highly predictable results.
Hormonal Replacement Therapy
Some men experience a condition called andropause, similar to menopause in women, which can be caused by low testosterone. Symptoms can include, but are not limited to, feelings of sluggishness, fatigue, poor sleeping habits, weight gain, low sex drive, or erectile dysfunction. For the appropriate candidate, hormonal replacement therapy can be valuable in reversing these symptoms and even improve libido (sexual drive).
Blood tests are required for the purpose of diagnosis, monitoring the treatment effectiveness, as well as any other adverse side-effects.
For men who can otherwise tolerate the side-effects of Oral Medications but want a more potent and faster acting solution. These tablets have the same contraindications and side effects as standard Oral Medications but due to faster absorption they have a faster onset of response.
Platelets are components of blood that contains a number of growth factors which have the ability to promote the repair and healing of damaged or injured tissue throughout the body.
Platelet-Rich Plasma is prepared by taking a small sample of blood and subjecting it to centrifugation (spinning the blood sample at a high rate of speed), which separates red blood cells and white blood cells from the remaining plasma. The remaining plasma is “packed” with platelets that remain behind, hence the term Platelet-Rich Plasma (PRP).
Once PRP is collected and injected into the “injured” tissue, PRP releases growth factors which then trigger the natural healing process.
Penile surgery and such procedures are often termed as last resort, and are advised to be considered only after all other treatment options are exhausted without success and consulting with a urologist or similar medical expert.
In this surgical procedure, semi-rigid rods or inflatable prostheses are inserted in the erectile tissue of a man, after removal of the mentioned tissue of a man. The placement of an implant requires permanent injury and adjusting of the erectile tissue of the penis, and this makes the treatment irreversible, without the guarantee of success.
Arterial and Venous Surgeries
Approximately 2% to 5% of patients are candidates for vascular reconstructive surgery, which includes arterial bypass and venous ligation. Risks include those related to other major surgical procedures. Boston Medical Group physicians do not perform these surgeries.
With the introduction of ED treatments, some had to find a way to be treated without the use of medication or surgery. Non-invasive, medically reviewed treatment options are available to those who prefer long-term results.
RejuvaPulse™ is a completely non-invasive therapy that uses pulsed sound waves to deliver energy to targeted penile tissue which activates the body’s own healing and regenerative properties. This results in healthy, new blood vessels, increased blood flow, and stronger, firmer erectile performance. RejuvaPulse™ is generically referred to as Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) or simply Shockwave Therapy.
RejuvaPulse™ therapy breaks up micro-plaque; repairs aged blood vessels, and stimulate the growth of new vessels, a process called neovascularization. After a series of six to twelve treatments of about 20 minutes each, RejuvaPulse™ therapy results in penile rehabilitation, regeneration, and rejuvenation.
Vacuum Suction Device
A VSD is a battery or manually-operated cylindrical pump which fully encloses the penis. When activated, it creates a vacuum by sucking air out of the sealed chamber, which draws blood to the penis. A firm rubber ring is placed around the base of the penis to trap the blood in the erectile chamber, which keeps the penis firm. Disadvantages can include incomplete erections, discomfort, and the time required for operation, but VSDs are often valuable when used along with other treatments, like ICP.
What if the Root of Your Erection Problems are Psychological and not an issue with drugs?
As mentioned before, ED is also impacted by psychological factors, a cause that is too many times discarded after Viagra has stopped working. Anxiety and depression is very common among men who report erectile dysfunction or similar problems. Psychological pressure can influence sexual stimulation, causing discomfort or lack of response to stimuli.5 Performance anxiety and stress may be responsible for the lack of effect that Viagra has in many men. An important and forgotten piece of advice is to be comfortable mentally as well as physically during sexual activities for Sildenafil-based medications to work. Lifestyle changes that keep you healthy through exercise and taking care of your mental health can be natural solutions to ED, in that regard.
Psychological Help And Other Wellness Treatments if Viagra Not Working
Sex therapy is often the treatment of choice for patients with psychological Erectile Dysfunction. It demands the cooperation of the sexual partner, multiple sessions, possible lifestyle changes, and an experienced sex therapist for the best results.
Despite the psychological and physiological factors affecting impotence, it is very important to try different treatment options and find the right fit with the help of a doctor. Many factors such as diet, weight, incorrect use, low dosage, Low-T, diabetes, and giving up early will make it slightly difficult to experience the best of the available treatment options.2 It is vital to follow the correct instruction for use, in order to maximize the effect of medication.
Diabetes and Low testosterone both affect the body of a man in ways that might interfere with the action mechanism of certain medical products. Sexual desire, which is regulated by a hormonal balance in any person and testosterone in a man, is an important factor which pills like Viagra and Cialis cannot regulate. Be more attentive to underlying conditions which make it difficult for Viagra and similar products to work.2 As mentioned before, if Viagra doesn’t work, there are plenty of other treatment options available. Contact Boston Medical Group for professional medical advice and to learn more about the multiple treatment options provided for erectile dysfunction, premature ejaculation, and low testosterone levels.
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