Erectile dysfunction is a multidimensional but common male sexual dysfunction that involves an alteration in any of the components of the erectile response, including organic, relational and psychological. Defined as difficulty in getting or keeping an erection firm enough for sexual activities, it affects people of all ages but is especially prevalent in men aged 40-70.

Image Credit:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027992/

More worrying is the recent discovery by researchers that the problem is on the rise and affects 15% of the world’s population yearly. Over 150 million men worldwide were estimated to have been affected by erectile dysfunction in 1995, projected to rise to 320 million by 2025.

Erectile Dysfunction is directly associated with Cardiovascular Disease. Men with erectile dysfunction have an increased risk of all-cause mortality odds ratio and cardiovascular mortality. Additionally, they are 1.33-6.24 times more likely to have benign prostatic hypertrophy than those without the problem and 1.68 times more likely to develop dementia.

How can men overcome erectile dysfunction?

Understanding the pathophysiology of erectile dysfunction is essential to understand the problem better. Penile erection occurs after sexual stimulation when nitric oxide is released from non-adrenergic noncholinergic nerve fibers. Acetylcholine is released from parasympathetic cholinergic nerve fibers in the CNS.  the result of the ensuing signaling pathways is increased cyclic GMP (cGMP) concentrations, decreased intracellular Ca2+ levels, and smooth muscle cell relaxation, causing blood to fill the lacunar spaces in the corpora cavernosa and erection of the penis. The process is reversed as cGMP is hydrolyzed by phosphodiesterase type 5. Erectile dysfunction occurs when these processes are interrupted due to physical, psychological, or stress factors.

Image Credit:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027992/

How to overcome erectile dysfunction

 – Exercising

 – Alcohol Abstinence

 – ED Medications

 Exercising

Physical activity has proved to be a protective factor against erectile problems, primarily due to vascular dysfunctions. Exercising, especially in the form of Kegels, targets the muscles of your pelvic floor, found in the pelvic floor of the pelvis. The pelvic floor comprises a group of ligaments and muscles that, in addition to keeping the muscles in place, grants stability to the organs in and around it.

Factors like age, obesity surgery, long duration of sitting, a sudden increase in activity levels, and stress impact the tightness of the floor and compress the artery providing blood to the penis, subsequently initiating erectile problems. Alternatively, if the pelvic floor is weak, the outflow of blood isn’t prevented, and an erection can’t be maintained.

Image credit:https://www.healthymale.org.au/news/male-pelvic-floor-muscles-erectile-dysfunction

In a study conducted to evaluate the importance of exercising in ED conditions, a systematic review was performed of research articles specifically investigating physical activity as a possible treatment of erectile dysfunction. The review included research about the dysfunction from physical inactivity, obesity, hypertension, metabolic syndrome, and cardiovascular diseases. All available studies from 2006 through 2016 were checked for the predetermined inclusion and exclusion criteria to analyze the levels of physical activity needed to decrease the problem of ED.

Ten articles met the inclusion criteria, all suggesting various levels of physical activity needed to decrease the symptoms of erectile dysfunction for men diagnosed with the problem. The results of the review provided sufficient research evidence for conclusions regarding the levels of PA necessary to decrease

The study concluded that  40 minutes of aerobic exercise of moderate to vigorous intensity four times per week and weekly exercise of 160 minutes for six months contributes to decreasing erectile problems in men with ED caused by physical inactivity, obesity, hypertension, metabolic syndrome, and cardiovascular diseases.

Before initiating the exercises, it is important to ascertain with your physiotherapist whether your problem is due to a weak pelvic floor or an overactive pelvic floor and start exercising based on the information.

Alcohol Abstinence

Alcohol interferes with the messengers in the brain that tell the penis to fill with blood. It can also happen because alcohol can reduce the production of testosterone. Animal studies have proved that acute alcohol administration can activate the cAMP pathway, positively affecting erectile function. In contrast, chronic alcohol administration can change the ultrastructures of the corpus cavernosum and suppress Nitric Oxide expression, leading to erectile problems.

(A) Changes in plasma alcohol concentration after alcohol administration. (B) ICP/MAP percentage changes during cavernosal nerve electrical stimulation after alcohol administration. *Significant difference from the control group (p<0.05). ICP/MAP: intracavernosal pressure/mean arterial pressure.

Image Credit:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419118/

In a study conducted to determine the relationship between erectile problems and alcoholism, one hundred and four subjects with alcohol use disorder and complaints of ED meeting the inclusion and exclusion criteria were recruited into the study after taking written informed consent. The subjects were assessed at baseline and after three months of abstinence from alcohol with IIEF-5 and a specially designed pro forma. Wilcoxon signed-rank test was used to evaluate the change in ED after three months of abstinence. A Chi-square test was done to assess the associations, and binary logistic regression was done to determine the significance of variables after three months of abstinence Improvement in ED occurred after three months of abstinence from alcohol. Its association between sociodemographic and clinical variables was assessed and found to be correlated.

Of the 104 subjects, 88.5% showed improvement in the problem after three months of abstinence. Wilcoxon signed-rank test showed significant improvement in ED after three months of abstinence. A significant association was found between age, alcoholic liver disease, total duration of drinking, and the number of standard drinks per day with ED after three months of abstinence.

The study concluded that in the absence of other systemic conditions, abstinence from alcohol could solve the problem of erectile problems to a significant extent.

ED Medications

Medications or ED pills belong to the phosphodiesterase-5 inhibitor group of medications and work on inhibiting the phosphodiesterase enzyme that relaxes muscles and increases blood flow to the penile region for achieving and sustaining erection.

Viagra or Sildenafil Citrate is one of the most common ED pills used to manage erectile functions and has an impressive success rate of more than 70%. In addition to Viagra or Sildenafil, other ED drugs available in the United States include avanafil, tadalafil, and vardenafil, all of which improve blood supply to the penis in combination with sexual stimulation and help in achieving a quality erection. Viagra is the brand version of Sildenafil Citrate, but generic Sildenafil is also available by Kamagra Australia and is a cost-effective version of the drug.

Despite the availability of several ED pills of various forms, Sildenafil remains the most popular medication. In a clinical study conducted to determine the efficacy and safety of Sildenafil, in a 24-week dose-response study, 532 men were treated with oral Sildenafil (25, 50, or 100 mg) or placebo. In a 12-week, flexible dose-escalation study, 329 men were treated with Sildenafil or placebo, with dose escalation to 100 mg based on efficacy and tolerance. After this dose-escalation study, 225 of the 329 men entered a 32-week, open-label extension study. In the last four weeks of treatment in the dose-escalation study, 69 percent of all attempts at sexual intercourse were successful for the men receiving Sildenafil, compared with 22 percent for those receiving placebo. Headache, flushing, and dyspepsia were the most common adverse effects in the dose-escalation study, occurring in 6 percent to 18 percent of the men. Ninety-two percent of the men completed the 32-week extension study.

The study concluded that Sildenafil is an effective, well-tolerated medication for erectile dysfunction. Other studies have mentioned the efficacy of Tadalafil and Vardenafil being equivalent to Sildenafil, but further research is required before arriving at definite conclusions.

Key points

• Medications are some of the most effective ways of dealing with Erectile Dysfunction.
• Apart from medications, exercise, and alcohol abstinence are equally crucial in dealing with the problem.
• Viagra and other Sildenafil ED pills like Kamagra are popular ED pills preferred by a large percentage of the ED population.
• Physician advice and prescriptions are required before using medications for Erectile Dysfunction.

Reference

https://pubmed.ncbi.nlm.nih.gov/35236641/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419118/

https://www.healthline.com/health/erectile-dysfunction/exercises#:~:text=Exercise,-Research%20indicates%20that&text=It%20may%20be%20particularly%20effective,running

 

 

Introduction

Erectile Dysfunction is a common sexual disorder with a multidimensional aspect involving changes in the erectile response of the individual because of systemic or psychological conditions. Defined as an inability to achieve or maintain an erection sufficient for satisfactory sexual performance and affects people of all age groups but is especially evident in the age group of 40-70. It is essential to understand the pathophysiology of erection and erectile dysfunction to understand Kamagra 100mg better.

Pathophysiology of erection and erectile dysfunction

Erection can be safely considered to be a neurovascular event of the human body that depends to a significant extent on sexual stimulation, a combination of hormonal and psychological conditions. Once an individual has been sexually stimulated, the brain releases neurotransmitters from its nerve terminals that relax the endothelial cells of the penis. This relaxes the arterial muscles and arterioles supplying the erectile tissue composed of elastic fibers, collagen fibers, smooth muscles, arteries, and veins and facilitates the erection

 image credits:https://www.semanticscholar.org/paper/Physiology-of-penile-erection-and-pathophysiology-Dean-Lue/6544d6ba195cdd7797f7f3cd6dded2731666deaa

The penis tends to stay in a flaccid or soft state until its muscles are contracted. Smooth muscle contraction is regulated by adrenergic control, intrinsic myogenic control, and endothelium-derived contracting factors of the system. Upon sexual stimulation, an erection occurs after nitric oxide (NO) is released from non-adrenergic non-cholinergic (NANC) nerve fibers, and acetylcholine is released from nerve fibers.

This increases the concentrations of cyclic Guanosine Monophosphate ( an intracellular messenger responsible for penile vascular tone with a decrease in the levels of intracellular Ca2+ levels that relax the corpus cavernosum ( tissue constituting the bulk of the penis ), subsequently regulating a successful erection. During this time, the subtunical venules are compressed to cause venous occlusion. Hydrolysation of the cGMP concentrations as a result of pathophysiological conditions reverses the erection cycle and improves venous outflow resulting in symptoms of erectile dysfunction.

Mechanism of action of Kamagra Sildenafil 100mg

Buy Kamagra 100mg tablets is a generic version of Sildenafil that is a selective inhibitor of cyclic GMP-specific phosphodiesterase PDE enzymes. Sildenafil is highly selective on PDE 5 and PDE 6 enzymes compared to PDE 1, 2, 3, and 4. PDE 5 plays an important role in metabolizing cyclic GMP in the corpus cavernosum, the sponge-like region of the erectile tissue responsible for the vascular process during an erection. When sexual stimulation causes the local release of Nitric oxide, inhibition of PDE 5 by sildenafil causes increased levels of cyclic-GMP in the corpus cavernosum, resulting in smooth muscle relaxation and, subsequently, a successful erection period uninterrupted by physiological problems.

Image Credits:https://www.frontiersin.org/articles/10.3389/fonc.2021.627229/full

Kamagra is the recently introduced derivative of Sildenafil and shares the same pharmacological properties and therapeutic properties as Sildenafil and Viagra. In addition to managing conditions of erectile dysfunction, it facilitates the vascular health of individuals on a lower dose and improves their stamina with exercising capacity. Kamagra is available in strengths of 50 and 100mg, of which physicians initially advise lower doses before switching to higher strengths of the medication.

What do studies say about Kamagra 100mg?

In a study conducted to assess the tolerability and efficacy of Sildenafil initiated at a 100-mg dose in men with ED,  selected participants were approved for the study. Inclusion criteria had subjects that had received six or more total doses of a phosphodiesterase type 5 inhibitor and were randomized to 8 weeks of a double-blind, placebo-controlled (DBPC)study. There was a fixed-dose treatment of 50 or 100 mg sildenafil or placebo followed by four weeks of open-label flexible-dose Sildenafil 50 or 100 mg. Efficacy, tolerability, treatment satisfaction, and other parameters were compared to reach a conclusion regarding the efficacy of Sildenafil in terms of dose and placebo treatment.

The results proved a statistically significant improvement in patient outcome in both 50mg and 100mg doses of Sildenafil as compared to placebo. 56% of men on a 100mg dose reported a decrease in anxiety regarding their erectile status as compared to 39% using 50mg of the medication. Changes in functional scores from baseline were not statistically significant in either strength. Treatment satisfaction and sexual experience scores were improved with 100mg of Sildenafil. Adverse events did not increase on increasing the strength of the medication.

What can go wrong with Kamagra 100mg?

 The problem in using Kamagra 100 lies less in the strength of the medication than in the availability of genuine versions for supply to the patient. Statistics have shown approximately 2.5 million people in Europe and America are exposed to illegally obtained Sildenafil, which, when used injudiciously, can lead to several adverse reactions ranging from ineffective treatment to permanently impaired erectile function. Spurious Sildenafil further adds to the problem. An analysis of spurious Sildenafil derivatives has found inconsistent doses of pharmaceutical ingredients with other added contaminants, including talcum powder, printer ink, and even commercial paint, that can prove lethal to the patient. In one analysis, only 10.1% of the samples were included in the ingredient contents. Counterfeit Sildenafil not just poses a threat to the individual’s health but even impacts the progress of the healthcare system.

Conclusion

Kamagra 100 mg can effectively curb your problem of erectile dysfunction, provided it is used judiciously. Using Kamagra 100 improves erectile dysfunction problems to a satisfactory extent by improving the user’s stamina and self-esteem. Care should be taken to ensure its authenticity for patient safety.

References

https://www.semanticscholar.org/paper/Physiology-of-penile-erection-and-pathophysiology-Dean-Lue/6544d6ba195cdd7797f7f3cd6dded2731666deaa

https://pubmed.ncbi.nlm.nih.gov/19817982/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2387281/