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Erectile Dysfunction

Erectile Dysfunction. Stephen Mark Christchurch. Normal erectile function: Physical and Psychological factors. Erectile function is about performance. Erectile dysfunction is common. Causes of Erecitle dysfunction. Performance anxiety. Heart and Vascular disease. Depression. Diabetes.

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Erectile Dysfunction

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  1. Erectile Dysfunction Stephen Mark Christchurch

  2. Normal erectile function: Physical and Psychological factors

  3. Erectile function is about performance

  4. Erectile dysfunction is common

  5. Causes of Erecitle dysfunction Performance anxiety

  6. Heart and Vascular disease

  7. Depression

  8. Diabetes

  9. Drugs: over 200 drugs antihypertensives heart medication antidepressants alcohol

  10. smoking Stopping smoking does improve erectile function

  11. Effective treatment is available: at a cost…... Reducing risk factors and psychological treatment has little effect

  12. Drug therapy: PDE5 Inhibitors 10 years since launch NZ: 150,000 units ( 4 tablets) annually 61% market share

  13. Background Original drug developed for BP Patented 1996 1999-2001 over $1 billion sales First drug direct to patient advertisement Online prescription 10X Off patent 2011

  14. Viagra is effective! …other uses… Sports performance Altitude sickness Jet lag Prevent plant wilting

  15. Contraindications PDE5 Inhibitors Recent MI/CVA Patients on nitrates Unstable CV disease Liver disorders

  16. Drug dosing Initial dose 50 mg Increase to 100mg if not effective By 4th dose standard effect Delayed absorption by alcohol and fatty foods

  17. Is Viagra effective in men without ED Definitely safe EAU 2008 Placebo controlled RCT in men without ED Men have a “real” benefit in quality and durability of erections

  18. Second generation PDE5 inhibitor

  19. Cialis Longer acting… up to 48 hours Less effect with alcohol and fat 31% market share

  20. Marketing ED drugs Controversial Improved patient awareness More open discussion Intrusive

  21. Levitra Similar to Viagra minimal marketing 7% market share

  22. Online sales Little info significant fraud more than 10X prescription sales

  23. Injectable agents Alprostadil/Caverject or other mixtures direct vasodilators over 80% effective poor long term use Post radical prostatectomy

  24. Vacuum devices Improves poor quality erection useful aid uncomfortable

  25. Penile Prosthesis Expensive so low utilisation Use: trauma, post radical Excellent results

  26. The End

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