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Dr. Clete Kushida, president of the American Academy of Sleep Medicine, which publishes the journal Sleep, told Reuters Health the study relies on sound reasoning and is generally well done. However, echoing Pollm?cher's critique, he notes that the criteria of restless legs syndrome changed after the 2002 survey, which could affect how meaningful the results are.
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While many substances are touted as aphrodisiacs, the modern age of pharmacotherapy began in 1993 when the injection of papaverine, an alpha-receptor blocker that produces vasodilatation, was shown to produce erections when injected directly into the corpora cavernosa. Soon afterwards, other vasodilators, such as PGE1 and phentolamine (Regitine), were demonstrated to be effective either as single agents or in combination.
Both partners and men with ED need to try to remember that ED is most often a treatable physical condition. The first step to treatment, however, is trust and a willingness on the part of both partners to discuss the situation with each other, and with a physician.
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Sildenafil (Viagra) was the first oral phosphodiesterase type 5 (PDE5) inhibitor approved by the FDA in the United States for the treatment of erectile dysfunction (it is not approved for women). Sildenafil inhibits PDE5, which is an enzyme that destroys cGMP. By inhibiting the destruction of cGMP by PDE5, sildenafil allows cGMP to accumulate. The cGMP in turn prolongs relaxation of the smooth muscle of the corpora cavernosa. Relaxation of the corpora cavernosa smooth muscle allows blood to flow into the penis resulting in increased engorgement of the penis. In short, sildenafil increases blood flow into the penis and decreases blood flow out of the penis.
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