Fildena: The Simpler Way to Treat Erectile Disfunction
Even though evolution is knocking on our door ever more strongly and technology has advanced a lot, we are still not able to completely cure certain diseases. One of them is erectile dysfunction, a health problem that affects millions of men around the world.
The good news is that we have developed several drugs that can increase the probability to achieve an erection. One of them is Fildena, an analogue of Sildenafil, the most popular pill in the world as symptomatic treatment for this disease.
Erectile Dysfunction: A Health Problem
In the last decade the number of people with erectile dysfunction has increased incredibly. This is mainly due to dietary changes and the deteriorated lifestyle we have today. Many of us do not exercise or prefer to eat less healthy foods.
The impact of lifestyle and diet on our ability to achieve effective and pleasurable erections is tremendous. On the other hand, concomitant diseases (such as hypertension, diabetes, etc.) also make the situation worse.
Many older adults with erectile dysfunction take many pills for the treatment of other diseases. Age is not a risk factor for developing this disease, the real problem is the action of other drugs on our bodies.
Some important studies have estimated that the number of young people with dysfunction has risen dramatically, reaching at least a 15% increase in the last decade. This study, conducted by the Boston Medical Group, found that one in four patients did not even reach the 40 years old.
This means that the way in which we have changed and adapted our lives to today's society is bad, and that we must start to change as soon as possible. In fact, the first step in the definitive treatment of the disease can be related to classic and important changes in our lifestyle.
What’s Going on In Our Body?
Although the reasons or causes may be diverse, the physiopathology of this disease has its origin in one molecule: nitric oxide. This is a natural vasodilator that increases the blood flow to your penis.
Let's explain it: erection is achieved under normal conditions thanks to the dilation of the blood vessels in the penis. In principle, the sexual stimulus (necessary to achieve an erection) triggers a powerful hormonal response that aims to increase the release of nitric oxide in our blood.
This molecule increases the diameter of the blood vessels, allowing more blood to reach the penis through the arteries. As a result, the veins also increase in size, increasing the volume of the corpora cavernosa (the portion of the penis that is enlarged).
So much blood reaches our penis that at one point the veins collapse under the pressure of the increased volume of the corpora cavernosa, preventing the return of blood and thus creating a cycle where only the penis grows more.
However, in a person who has erectile dysfunction things are a little different. To begin with, various pathologies or changes in lifestyle can deteriorate the internal layer of our arteries, where nitric oxide is synthesized and released.
This would cause endothelial dysfunction and we would not have what is necessary to vasodilate the corpora cavernosa of the penis. This is the real problem that lies behind erectile dysfunction, and is the main reason why Fildena works in our body as well.
How It Works - Mechanism of Action
Explained as simply as possible, Fildena skips several steps in the synthesis of nitric oxide and goes straight to the source. This drug can activate certain specific mediators that increase the synthesis of this fundamental molecule.
With the increase of the nitric oxide level we would already have a positive response, however, this is not all. The same intracellular mediators activated by Sildenafil can promote the relaxation of the smooth muscle (present in the cavernous bodies of the penis), preparing them to increase their size more easily.
In fact, the specificity of Fildena on all these cellular mediators makes the process of synthesis and release of nitric oxide increase up to about 80 times. However, of course, it has its limitations.
The only thing necessary for Fildena to have an effect is a sexual stimulus. This drug is a process enhancer, but it is not capable of initiating it on its own. If there is no sexual stimulus, there is no way to achieve an erection.
This is a frequent problem in those patients who do not know well the cause of their disorders and think that it is simply organic. When the cause is psychological (such as high stress loads), Fildena may not work properly. Stress blocks the perception of the sexual stimuli needed to initiate this effect.
How to Take Fildena
Most importantly, you should be under the supervision of a physician, as Sildenafil is still a medication that requires follow-up. In addition, Fildena may have some contraindications depending on your lifestyle or the diseases you have.
It is best to start with low doses of 25mg. These are ideal for patients with mild to moderate disease. Also, it is better to try low doses at first since we all react differently to the use of drugs. The same goes for Fildena.
After you try the 25mg, depending on the effect you got, we recommend that you increase to 50mg if you have not had a satisfactory effect. The less dose is necessary to achieve satisfactory erection, the better.
On the other hand, it is important to be predictable with the effect of Fildena. You should take the tablet 30 minutes to 1 hour before you start sexual intercourse, preferably with a full glass of water. Depending on your experience, you can modify the doses and previous intervals to suit your needs.
If you do not achieve the effect you want, and have a healthy heart and no cardiovascular risk factors, you can increase the dose of Fildena to 100mg. Conversely, if 50mg was too much, you can decrease the dose again to about 25mg and stay there. You can even go down to 12.5 if you are too sensitive to the medication.
On the other hand, if the effect does not last as long as you want, you can decrease the "waiting time" (after taking the pill and before starting to have sex) to about 15 minutes. Also, you should only take sildenafil when you are going to have sex and no more than once a day, or at least wait 18 hours for a new pill.
You should not do any heavy control activity within hours of taking Fildena. This medicine can cause mild vision problems and dizziness that may affect your work performance and concentration, so you may be putting others at risk besides yourself.
Finally, if you are taking any other kind of therapy (medical, especially antiretrovirals) we recommend you go to your doctor and ask if you are in condition to take this pill. Remember, like all drugs, Fildena has certain contraindications and cases where its consumption is counterproductive.
It is important that you keep in touch with your family doctor while taking Sildenafil. Only he should supervise and fully control the interactions of the drug and your health.
Debunking a Myth: Only for the Elderly?
Popular belief leads us to believe that older adults will always have problems having sex, and they don't. Aging affects many areas of our bodies, but in theory, it doesn't affect the performance of sexual functions.
However, then why do so many elderly have trouble achieving satisfactory erections? What brings them all together? Well, there are several causes, and all are related to each other, but most importantly, they can all be treated symptomatically with Fildena.
The first, and perhaps the most relevant, is that older adults usually take several different kinds of pills to treat a set of chronic diseases that tend to recur at that age. Both the medication and the underlying disease are important causes of dysfunction.
The most important thing is to keep the state of our endothelium in line: the healthier it is, the better it will perform. For this it is crucial that we maintain a good state of health, based on healthy habits and a balanced diet, especially for each person.
The secret to reaching adulthood with a good sexual performance is that: maintaining an active life with balanced meals. This will not only prevent cardiovascular or chronic metabolic diseases that often affect us, but will also improve endothelial function and allow a healthy and consistent performance.
All the drugs created have side effect, there is no exception. Some people are more sensitive than others, so they may appear more potent or severe. On the other hand, not everyone develops these negative effects and the percentages are quite low, otherwise this drug would not have come on the market.
The most frequent effects are those related to blood pressure. Sildenafil acts through nitric oxide, diverting a large amount of blood to the penis, but also the lungs, so it can lower our pressure a little. This would cause some typical side effects such as headache and dizziness.
On the other hand, it is also possible to have some effect on the nose and face. Since it is a vasodilator, both arteries and veins (from various sectors of our body) can increase their blood flow and volume, causing congestion of the nose and facial redness.
As for the gastrointestinal symptoms that are frequent in this type of person, there is diarrhea, nausea and vomiting. These are symptoms that can appear with the consumption of any medication, but they are a little more frequent in people who take Fildena.
Other fewer common effects are related to several different systems. The most frequently affected is the eye system, where vision impairment has been the focus of several research studies by the FDA and other major organizations.
Among the vision-related side effects, we have blurred vision and even eye pain. Some older studies claim that sildenafil could cause a bluish tint to the eyes.
However, they all conclude one thing: the side effects caused on the eyes are not significant, so it is possible that you will continue to use sildenafil naturally and there is a low possibility of them occurring.
Other effects that are atypical, but at the same time related to lowering blood pressure by redistributing the flow are palpitations. To restore blood flow, your heart speeds up and begins to contract a little faster than normal.
Finally, it is important to watch out for very prolonged erections. Usually, the effect of the pill is no more than 4 hours, and erections do not last long once they are achieved. If any abnormalities occur, consult your doctor as soon as possible. This is an effect that can be prevented if you start taking Fildena in small doses, as recommended in the previous section.
Contraindications - When not to take Fildena?
It is important that you go to your doctor in advance to assess your condition and if there is a problem with the consumption of this medication. It is necessary that you have some basic health examinations before you start taking Fildena.
All drugs in the world have contraindication, depending on the patient. Even Tylenol, a common drug to treat fever, has basic indications such as allergy to the component of the formula. Therefore, evaluate with your doctor what would be the contraindications for your case. Some of the most relevant for Fildena are.
Allergy to the components of the formula is one of the classic contraindications of any drug. There are people who do not support the effect of this molecule or who interact in a different way. Although cases are few, it is important to highlight this.
When a substance is allergic, we can have different types of reactions. The first, and most frequent, is a generalized redness that is also known as "skin rash". Although not lethal, it is an important indication of allergy.
On the other hand, there may be more severe allergic reactions such as "wheal" all over the body. In addition, it can progress to angioedema and breathing problems. Each of these reactions should be studied and treated immediately. If you notice any, do not hesitate to consult your doctor.
There are many diseases that may be a relative or absolute contraindication to the use of Fildena. Among these, we have cardiovascular problems, especially those who have had a recent heart attack or have heart rhythm disorders.
Those who handle low blood pressure naturally may also have certain problems using this drug. Remember that Fildena is a hypotensive drug par excellence, so you could have serious complications if you manage low blood pressure.
On the other hand, this drug has a renal elimination and hepatic metabolism. This means that you cannot use it if you have a problem in either of these two organs. Among the patients included in this group we have those with renal or hepatic failure, cirrhosis, complicated diabetes, etc.
Finally, the biggest and most obvious contraindications are serious health conditions where the use of any medication beyond the treatment of the basal disease is not recommended.
This is a medication that was always designed for use by adult men, therefore, it is not indicated for children under 18 years of age or women. It is important to note that the way women's sexual system works is different, so it would not be helpful.
This medicine does not influence any psychological factors but creates physical changes in men. For this reason, it will not produce any aphrodisiac effect in women, but will cause complex problems that are related to pulmonary alterations or other disorders.
If a child takes this medication, refer him or her to a doctor for treatment as soon as possible. Erections in children, who are more sensitive to formula, tend to last much longer and usually require some special medication in order to quell the effects of sildenafil.
Fildena: The Definitive Treatment?
Although for years Sildenafil has proven to be an ideal and exclusive component for the treatment of erectile dysfunction, the truth is that it is not a definitive cure but a symptomatic treatment.
This means that we would only be treating the symptoms of erectile dysfunction, but not the origin of the disorder. To do this, your doctor will need to perform several different tests aimed at finding out what the original cause is.
The first step would be to find out if it is organic or if it is a psychological problem. This can be differentiated based on previous behaviors you have. For example, if you naturally wake up with erections, the cause is most likely psychological. In this area, stress loads and some recurring thoughts such as "not enough" for sex are most common.
On the other hand, as mentioned above, the most frequent causes are organic and have almost no relation to age. It is most likely that there is some underlying disease (especially one that affects the cardiovascular system and endothelial function) or that we simply have an unhealthy lifestyle.
Whatever the case, there is a high possibility of returning to our normal conditions simply with the right treatment and practical lifestyle changes that will allow us to improve our performance.
If the problem is a medication that you cannot stop, then the most important thing is that you continue to take sildenafil as long as you continue to take the medication. Once you are finished with the basal treatment, you can stop taking sildenafil progressively, not suddenly.
Interactions of Fildena
The last important point of this article, where we seek to reveal in detail each of the characteristics of this drug and the situation surrounding it, are the known medical interactions.
In this case, we refer to how Fildena can have contact with other drugs or molecules at the same time and have different effects. We mentioned before that drugs could be the origin of the disease, so it is important to know how Fildena could interact with them.
Some of the most important interactions have to do with drugs related to nitric oxide. For example, drugs for high blood pressure, such as nifedipine, have a mechanism of action that depends almost entirely on that molecule.
Using drugs like this and Fildena together could cause a dramatic drop in blood pressure that would have counterproductive effects. We recommend that you see your doctor before trying a similar combination.
In addition, there are several drugs that can alter liver and kidney function. If you alter the way your liver processes drugs, you may cause a harmful buildup of Fildena when you take it. For this reason, we recommend that you be careful and evaluate each of the medications you are going to take beforehand.
On the other hand, recreational drugs are totally contraindicated with the use of Fildena. Despite the famous myth that "Sildenafil helps you fight the side effects of drugs", the truth is that it is not true. This type of combination can bring serious health problems.
Whatever the case, the best advice before using Fildena is to consult your doctor to find out if you are a good candidate. If you are, this is one of the most effective medications available, so there will be no major problems.
Classification and the most common causes of ED
|ED Option||Most common diseases||Driving gear|
|Hormonal disorders||Primary and secondary hypogonadism; hyperprolactinemia; hyperthyroidism||Decreased libido and deficiency of central and / or peripheral NO production|
|Metabolic disorders||Metabolic Syndrome, diabetes||Decreased libido, development of endothelial dysfunction|
|Cardiovascular disorders||Coronary heart disease, obliterating atherosclerosis of the lower extremities, atherosclerosis of other locations; arterial hypertension, arrhythmias of various origins, congestive cardiovascular failure||Decreased arterial flow or endothelial dysfunction; veno-occlusion failure|
|Cavernous||Penis injury; Peyronie's disease; cavernous fibrosis||Fibrosis of the tunica or cavernous tissue|
|Neurogenic disorders||Stroke, Parkinson's disease, traumatic brain injury, multiple sclerosis||Insufficiency of central and / or peripheral NO-ergic mechanisms of initiation of erection; interruption of afferent and / or efferent pathways involved in erection|
|Professional defeat||Vibration disease due to local and general vibration (primarily general), cold angioneurosis, peripheral anhydistonic syndrome with ultrasound, lumbosacral radiculopathy with pelvic disorders, the effects of chronic intoxication with mercury, lead, benzene, vinyl chloride, synthetic rubber products||Occupational lesions are multifactorial lesions - the development of endothelial, vascular dysfunctions is observed, the development of neurogenic and depressive disorders is possible|
|Drug damage||Antihypertensive drugs, primarily from the group of β-blockers, psychotropic drugs, antiandrogens; alcohol, smoking||Suppression of central erection mechanisms, decreased libido, alcoholic polyneuropathy, endothelial dysfunction|
|Psychogenic damage due to exposure to chronic stress||Anxiety, depression, chronic stress due to problems of interpersonal relationships at work or in the family, fear of failure||Decreased libido, insufficient or impaired production of NO in the central nervous system|
Erectile Dysfunction: Understanding a 21st Century Problem
Erectile dysfunction is a pretty major health problem. In the last decade, the numbers have increased dramatically. There are even up to 15% of new cases on young people (under 40) who seem to be experiencing this disease.
This disorder is nothing more than the inability to achieve or maintain an erection, based on unsatisfactory sexual intercourse. This term only involves one disorder per se, but does not specifically address the cause, within which there are several different ones.
While this is a benign health problem, the impact on the individual who suffers from it is quite high, especially in the psychological sphere. Without a doubt, erectile dysfunction is an illness capable of altering our quality of life, and the interpersonal relationships we maintain.
Types of Dysfunction
The first step, in order to properly talk about erectile dysfunction, is to know the different types that exist trying to associate them with the most frequent causes. So far, we can divide them into three main groups:
While not the most common, this type of erectile dysfunction is quite complex. The most important trigger is stress, where unhealthy levels can block the connection between the stimulus and our sexual organ, preventing erection from appearing.
Although it is easy to diagnose, since many times patients continue to have morning erections and only get blocked when having sex, the treatment does involve several steps.
These are the most common. Several different factors are involved here, but the most important condition is vascular (related to blood flow and the release of mediators needed for erection).
Other systems that can be affected (and cause erectile dysfunction) are the neurological and endocrine systems. Hormonal disorders also make erection difficult. Finally, local problems (trauma) are also listed.
There is also a chance that both problems are included and cause erectile dysfunction. Within this group are those diseases that have a primary psychiatric component, but also cause secondary organ problems.
Elderly and Erectile Dysfunction
For many, it's normal to associate these two things; to think that older adults will always have trouble getting an erection, but that's not the case. This is just a myth that has spread and is born of ignorance.
Age does not bring about problems in achieving an erection. Our sexual apparatus, in theory, is always in good condition. However, aging brings with it much more than simple wrinkles and senile spots.
The cardiovascular problems that come with age, especially some chronic diseases such as hypertension and arterial calcification, are the real causes of erectile dysfunction in the elderly. In addition, another group may be affected by other things.
For example, older adults also tend to use many pills in order to treat other chronic concomitant diseases, such as diabetes. These medications may also have a depressant action that prevents erection from being achieved.
About 52% of patients suffering from this disorder are between the ages of 40 and 70, but the rest are outside these extremes. It is certainly an important disease in that group, but it is not directly related to age. Being healthy will always be the best alternative.
Diagnosis of Erectile Dysfunction
The diagnosis of this disorder must be based on two key things: the first is to determine if an organic problem really exists (differentiating it from psychological causes) and the second is to look for the biological cause.
The first level requires a guided interview with a general practitioner, or preferably, a psychiatrist who can differentiate the two problems and give a clear answer. If doubts remain, a psychological evaluation could be performed, and stress management therapies attempted. However, all this is personalized and will depend exclusively on the patient and the doctor.
On the other hand, as for the second diagnostic level, it is necessary to carry out several studies, both basic and advanced, in order to give an accurate diagnosis. Among the most recommended tests we have the physical examination, where the doctor will look for any important local problem.
On the other hand, we have the routine tests that should be performed on all patients and these consist of analytical and chemical (blood) determinations: glucose levels and other metabolic characteristics, as well as testosterone levels.
The latter hormone can be of great importance in young patients, in whom the disease is rarer. Other studies would include a blood count, liver function tests and some other hormone tests.
Treatment of erectile dysfunction may involve several different steps depending on the cause of your disorder. The truth is that there are some general measures, involving exercise and changes in diet, which are useful and applicable to almost any type of patient and are really effective.
First, there is the symptomatic treatment where Sildenafil and all its analogues stand out. This has been the most effective drug and used worldwide for the treatment of erectile dysfunction at any point.
Since it came out to the market, it spread all over the world and it is not for less since its mechanism of action allows the treatment of several different causes, but only in a symptomatic way. Other similar drugs such as vardenafil and tadalafil are also effective.
Still, you need to be evaluated by your doctor before you try any of the medications listed above. We recommend that studies be conducted and that you start with very low doses so that you know the extent of their effect.
Other treatments that have also proven effective have to do with apomorphine, for example, which attacks through the neurological system, where it boosts brain stimuli and thus excitation. However, it is contraindicated in patients who cannot have sex.
The second line of treatment involves more invasive measures. Here we highlight intracavernous therapy, where some drugs are administered (through an injection) to the penis. Although it is effective, it may have some unwanted side effects such as priapism and fibrosis, so it cannot be used in just any patient.
Other versions of the same drug include a capsule that can be administered through the urethra, which releases its contents into the corpora cavernosa. This is an alternative for patients who do not want to inject, although it is not as effective.
We also have vacuum devices. These are not usually recommended for younger people, although in older people they are. This is a special tube with a suction and vacuum creation mechanism that helps to achieve an erection. It also has a special rubber ring that is placed at the base of the penis to maintain it.
Finally, if none of the above works, you will have to undergo surgery. For this disorder, there are two important surgeries: revascularization (used in patients with cardiovascular problems) or implanting a penile prosthesis.
Prevention of Erectile Dysfunction
As we mentioned, one of the most important characteristics of erectile dysfunction is that it affects the endothelium and is strongly linked to our habits and the lifestyle we lead. Therefore, the best way to prevent it is to attack each of these milestones. Within the recommendations we have:
There are a lot of studies linking erectile dysfunction to smoking. As we well know, the compounds that are housed within it hinder the ability of our endothelium to function, preventing the release of important factors such as nitric oxide, one of the main agents of erection.
Do not abuse alcohol
Another big contender for an erection is alcohol. The effects of this drink, especially when they are excessive, are immediate. In this case, there is no way to properly process sexual stimuli and arousal, so there is no possibility of achieving an erection.
In addition, when alcoholism becomes chronic, endothelial dysfunction can also occur, which would cause the same effect as smoking. The worse your health is and the more alcohol you drink, the less likely you are to get an erection.
It is important to exercise to prevent many diseases, especially those related to the cardiovascular system and metabolism. By preventing them, we are indirectly preventing the appearance of erectile dysfunction.
In addition, when we exercise, we are also improving vascularization in general. With this, the grams that reach more blood to our penis and further facilitate the erection. The healthier the body, the easier it will be to achieve an erection.
Control your weight
Weight gain is a critical factor in measuring your estimated survival. Some serious diseases, such as diabetes, can be triggered by lack of body weight control. The main condition of diabetes is disorders of the vascular system, so prevention is ideal.
Erectile dysfunction is a serious disorder that can have multiple causes, but which is undoubtedly closely linked to our general state of health. Preventing it is easier than treating it, although the medications available, such as Sildenafil, are very effective.
Pulmonary Hypertension: A Hidden Disease
Pulmonary arterial hypertension affects the right (or left) circulation of the heart. Unlike conventional arterial hypertension, in this case the capillary system of the lungs is strongly affected. The small arteries contract very strongly and do not allow the heart to function properly. The heart must pump more to the lungs to get oxygenated blood.
This results in the progressive failure of the heart muscle, which progressively enlarges in order to overcome the high pressures generated in this vascular system.
This disease, despite being rare, represents a challenge for doctors because of how complicated its treatment can be. Unfortunately, some of the subtypes of pulmonary hypertension cannot be cured.
Causes of Pulmonary Hypertension
There are several reasons why this disorder may occur. However, the most important are those that have no obvious cure or can only be treated with a transplant.
- Idiopathic: This group includes unknown causes. Many scientists believe it is related to a mutation in a specific gene, so it is also known as "hereditary".
- Left Heart Disorders: Left dysfunctional problems (ventricular hypertrophy, arterial hypertension, insufficiency, etc.) bring as a late complication pulmonary hypertension.
- Pulmonary: some pulmonary diseases can also be the origin of this disease. In this case, some complicated chronic diseases such as COPD and pulmonary fibrosis stand out.
- Other Disorders: there are several diseases and complications that can reach this point of pulmonary hypertension. Some examples are metabolic diseases, such as storage diseases, sarcoidosis, some coagulation problems, etc.
Symptoms of Pulmonary Hypertension
The truth is that in the early stages of this disease there are no obvious symptoms. It may even be years before some of the manifestations are present. This is a serious problem since it is usually advanced by the time the most important symptoms are observed.
Some of the most frequent are:
- Dyspnea: At the beginning it can be only under high demand (like when you exercise), however, it can progress gradually until reaching the dyspnea at rest, the most serious state.
- Fatigue and Weakness
- Edema: due to congestion over the pulmonary system, water from the blood begins to leak and accumulate in various spaces such as the ankles, legs, lungs, etc.
- Tachycardia and palpitations
Diagnosis and Treatment
Since it is a rare disease, the diagnosis is usually made by rule out. This means that many tests must be done before the disease can be found and then the cause of the disease.
Some of the evaluations performed are a good physical examination (especially auscultation with a stethoscope and observation of clinical signs), blood tests, Doppler echocardiography, x-rays, catheterization, etc.
In terms of treatment, some medications have been shown to be effective in specifically dilating the pulmonary vessels. Within this select group, sildenafil stands out, which has a vasodilatory effect on the penis, but also has a high power on the lungs.
In addition, other medications can be added such as oxygen, diuretics, anticoagulants, other vasodilators such as nifedipine, etc. Surgical treatments, such as lung or heart/lung transplants, may even be considered.
By: Dr. Sheldon Pike