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Causes of erectile dysfunction
The erection is a complex interaction of nerves, blood vessels and hormones. Erectile dysfunction can therefore have many causes. It’s often down to one Impeded blood circulation as a result of vascular deposits in the penile muscles. On the one hand, it is possible that too little blood reaches the penis because the supplying arteries are “calcified”. The other possibility is that the blood drains too quickly through the veins. That In both cases, the blood volume in the penis is insufficient to maintain an erection.
Other possible causes that can cause erectile dysfunction are:
- Persistently high blood sugar (diabetes mellitus)
- high blood pressure
- testosterone deficiency
- Stress, problems in the partnership, anxiety disorders or depression
- drug side effects, e.g. B. in medicines for depression 
Effect of PDE-5 inhibitors on erectile problems
Since the blood vessels in the penis are narrowed when the penis is not erect, the cavernous bodies, a vascular network that fills with blood, contain only a small amount of blood. During sexual arousal, muscle cells release a chemical called cyclic guanosine monophosphate (cGMP). This relaxes the smooth muscles in the blood vessels, allowing more blood to flow into the cavernous bodies and the penis becoming stiff.
drugs containing PDE-5 inhibitors, inhibit phosphodiesterase-5 (PDE-5). This is an endogenous enzyme. Normally, it breaks down a certain messenger substance that is produced more intensely during sexual arousal and increases blood flow in the penis. If the effect of the enzyme PDE-5 is now inhibited by taking the drug, more messenger substance remains. the Penile blood flow increases and an erection occurs or persist longer.
PDE-5 inhibitors only work when there is a corresponding sexual stimulus. The drug has no effect on the patient’s sense of pleasure .
PDE-5 Inhibitors: Tadalafil, Sildenafil and Vardenafil
There is different types of PDE-5 inhibitors, which differ mainly in their duration of action. Of the active ingredient sildenafil was approved as the first PDE-5 inhibitor. After the original drug’s patent expired in 2013, there are several generic versions of the drug on the market, copies of preparations from other manufacturers with the same ingredients.
Other approved in United Kingdom are PDE-5 inhibitors Vardenafil (Levitra) Tadalafil (Cialis) and Avanafil (Spedra) authorized. Each of these preparations is considered to be comparatively effective and suitable for the majority of users.
The Long Term: PDE5 Inhibitor Tadalafil (Cialis)
Of the Active ingredient Tadalafil is the main component of the sexual enhancer Cialis. The preparation is available in the dosages 2 mg, 5 mg, 10 mg and 20 mg. For occasional use, the recommended dose is 10 mg Tadalafil. If no effect is achieved with 10 mg, the dosage can be increased to 20 mg. Long-term medication to maintain potency is possible with 5 mg Tadalafil. It is the only PDE-5 inhibitor approved for long-term treatment.
The main difference of this drug compared to other PDE-5 inhibitors is the duration of action. The sexual enhancers sildenafil, vardenafil and avanafil must be taken 30 to 60 minutes before sexual intercourse in order to have the best possible effect. Their effect lasts four to five hours. Tadalafil can be taken with or without food 30 minutes before sexual activity be taken. the The effect lasts for 24 to 36 hours after a single dose on [3,4].
The Fastest: PDE-5 Inhibitor Vardenafil (Levitra)
Shortly after tadalafil was launched in 2003, the German pharmaceutical company Bayer announced the active ingredient vardenafil. The PDE5 inhibitor is marketed under the trade name Levitra in 5 mg, 10 mg and 20 mg dosages. It has been repeatedly reported that, compared to other PDE-5 inhibitors, the preparation faster onset of action and fewer side effects Has. Studies and testimonials have shown that some patients report positive effects after just 10 minutes [5,6].
The best known: PDE-5 inhibitor sildenafil
The best-known active ingredient in the class of PDE-5 inhibitors is sildenafil. It was first registered in 1998 and has been since Prescribed by the millions for erectile dysfunction. Doses of 25 mg, 50 mg and 100 mg are available, with 100 mg being the maximum daily dose.
On average, the effect of Sildenafil occurs approximately 25 minutes after ingestion. However, taking the drug 40 to 60 minutes before sexual intercourse is recommended. The highest drug concentration in the blood is reached after 60 minutes .
Side effects and interactions of PDE-5 inhibitors
With all PDE5 inhibitors, the following more common side effects can occur, mild to moderate: headache, dizziness, flushing, nasal congestion, nausea, vomiting, and a feeling of fullness. Pain in the extremities has also been observed with tadalafil. Keep in mind that every user can react differently to the drug.
Warnings for PDE-5 Inhibitors apply to Patients with cardiovascular disorders. In combination with so-called nitrate preparations or other NO donors, such as molsidomine, it is strongly discouraged to take PDE-5 inhibitors. Concomitant use with PDE-5 inhibitors can lead to life-threatening circulatory collapse. Patients with more severe eye disorders (eg, retinitis pigmentosa) are also contraindicated and not suitable for taking PDE-5 inhibitors [2,8].
Natural sexual enhancers as an alternative to PDE-5 inhibitors
In addition to chemical PDE-5 inhibitors, there are natural alternatives to increase potency. Some natural sexual enhancers contain combinations of active ingredients that produce the same effect as PDE-5 inhibitors. These contain, among other things, ginseng, maca and yohimbine. In order for these to be effective, cyclic guanine monophosphate (cGMP) must be released. This messenger substance gives the order to relax the smooth muscles in the erectile tissue. As a result, the veins dilate, blood rushes into the cavernous bodies, and the penis becomes hard.
PDE-5 Inhibitors in Food
In addition to over-the-counter natural sexual enhancers, there are potency-enhancing foods. the Amino acid L-arginine is said to have positive effects on erections. It is found in a variety of foods:
- Cereals such as wheat and oats
- fruit (bananas, strawberries)
- Vegetables (tomatoes, peppers, spinach, cauliflower, broccoli, etc.)
- Fish (tuna, salmon, sardine)
- Nuts and seeds such as hazelnuts, peanuts, almonds 
Buy PDE-5 inhibitors
To one To buy PDE-5 inhibitors, you need a prescription in United Kingdom, against which you can get the preparation displayed in the pharmacy. This is because PDE-5 inhibitors can have side effects and therefore need to be taken correctly to minimize the risks of such. The prescription requirement is regulated in Section 48 of the Medicines Act.
There are many men who are ashamed of their erection problems and therefore want to avoid visiting the doctor and going to the pharmacy. Here offers Medicade is a discreet and safe way to get a doctor’s prescription for a suitable preparation via online diagnosis if there is an indication.
Thats how it works:
- Complete the online medical questionnaire.
- The medical questionnaire will be checked by a cooperating doctor.
- If there are no contraindications, you will be issued a prescription for a PDE-5 inhibitor, which will be forwarded to our partner pharmacy
- Your medication will be dispatched discreetly within two to three working days by our partner pharmacy.
Prices for PDE-5 inhibitors
The sexual enhancers Tadalafil, Sildenafil and Vardenafil are available on Medicade in different pack sizes and dosages.
PDE5 inhibitors are used to treat erectile dysfunction. Common sexual enhancers are sildenafil and vardenafil (Levitra). After taking the tablet, the drug acts after 30-60 minutes for a maximum of five hours. Tadalafil (Cialis) also works after 30 to 60 minutes, but has a much longer duration of action at 24 to 36 hours. In addition, the sexual enhancer in the lowest dose of 5 mg tadalafil is also suitable for the long-term treatment of erectile dysfunction.
You can get a prescription to buy PDE-5 inhibitors at the pharmacy from your doctor or you can buy them online through Medicade.
What drugs are PDE-5 inhibitors?
PDE-5 inhibitors are drugs to increase potency, which contain active ingredients from the group of PDE-5 inhibitors. These include Viagra (Sildenafil), sildenafil generics, Levitra (vardenafil), vardenafil generics, Cialis (tadalafil), tadalafil generics and Spedra (avanafil).
How dangerous are PDE-5 inhibitors?
PDE-5 inhibitors should always be taken in consultation with a doctor and in the right dosage to reduce possible risks. PDE-5 inhibitors should not be taken if you have cardiovascular diseases or if you are taking nitrates. Side effects such as headaches, blurred vision, dizziness may occur.
Which PDE-5 Inhibitor Works Best?
Any PDE-5 inhibitor works equally well for erection problems. However, you may respond better to a particular drug. Some PDE5 inhibitors, such as tadalafil, work longer and can be taken long-term, while others work very quickly but only for a few hours, such as vardenafil.
What do PDE-5 inhibitors do?
PDE-5 inhibitors help relax smooth muscle in blood vessels to increase blood flow. They do this by blocking the enzyme phosphodiesterase-5 (PDE-5 for short). Taking PDE-5 inhibitors increases the concentration of the messenger substances, which leads to longer-lasting erections.
What is the best over-the-counter sexual enhancer?
You cannot buy sexual enhancers with PDE-5 inhibitors in United Kingdom without a prescription. According to §48 of the Medicines Act, the active ingredient is subject to prescription. Before you can buy the drug in the pharmacy, you must have a prescription issued by your local doctor or via online diagnosis.
The explanations and lists of possible treatment options are purely informative and do not replace consultation with your doctor or the explanations about the intake, mode of action and side effects from the product-specific leaflet.