Oral Medication

Sildenafil (Viagra) was approved by the FDA in 1998 and represents a new milestone in the field of Erectile Dysfunction (ED). Sildenafil works by increasing blood flow to the penis, as well as causing penile muscles to relax. It does not initiate an erection, but enhances penile flow in response to sexual stimulation by counteracting the chemical in the body that diminishes an erection. Sildenafil is effective regardless of the cause of the Erectile Dysfunction, including hypertension, coronary disease, prostate cancer, diabetes and depression. Yohimbine (a vasodilator) is present in some over-the-counter medication has been of very limited efficacy.

The antidepressant drug Trazodone, taken one hour before sexual activity, has been found to prolong erections in men who are able to obtain, but not maintain an erection during intercourse. Trazodone, however, is much less effective than Sildenafil.

Topical / Intraurethral Agents

MUSE (Medicated Urethral System for Erection) contains a prostaglandin cream that's applied into the opening of the urethra just before intercourse and has produced good results in clinical trials. This cream is a vasodilator, meaning that it causes blood vessels to widen - encouraging blood flow into the penis. However, since the FDA approved this method in November 1996, patient response has been limited. Although many men will have partial erections in response to this drug, most men do not have a full erection. The medication often stimulates a feeling of warmth or burning in the penis.

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