Phosphodiesterase type 5 inhibitors (PDE5)
Phosphodiesterase type 5 inhibitors (Viagra/ Cialis/ Levitra) improve the autonomic neurological impulse to the cavernosal tissue of the penis. In short, it improves the nerve input to the vascular tissue of the penis.
In order for oral medication to be effective, it requires an intact nerve supply. Therefore it won’t be as effective post radical prostatectomy where the autonomic nerves have been interfered with. Likewise, it’s also less effective in patients with diabetes because the condition tends to affect the small nerves supplying the vascular tissue of the penis. These medications are generally very safe.
The phosphodiesterase type 5 inhibitors that Dr Campbell prescribes at his Gold Coast clinic are Sildenafil, commonly known as Viagra, Vardenafil, commonly known as Levitra, and Tadalafil, commonly known as Cialis.
Cialis is slightly different in terms of its longevity. In most instances, the effects of the medication will last for thirty-six hours and could, therefore, be taken on a Friday night and still be effective on a Sunday morning. Patients are encouraged to try each of these medications in turn as we all have variable responses both in terms of side effects and efficacy – everyone processes and absorbs medications differently.
These drugs are currently being reformulated by compounding pharmacists as lozenges for oral mucosal absorption, which improves their speed of onset of action to five minutes. This is because it is absorbed through the lining of the mouth as opposed to a gastrointestinal absorption, which requires forty-five minutes to an hour before there would be a reasonable effect.
These medications require normal stimulus such as intercourse or masturbation to achieve an erection but they can decrease the refractory time (that is the time from when you ejaculate to being able to obtain another erection). Most of the patients that Dr Campbell treats at his Gold Coast clinic have explored oral therapies prescribed by their GP quite extensively prior to their visit and schedule a consultation to discuss more elaborate treatments.
It is not uncommon for a patient to report positive effects with one oral medication and not another for no reason other than physiological differences, which is why you may need to trial more than one of these medications.
