Testosterone supplements may be used for cases where there is a hormonal deficiency. However, usually the cause is lack of adequate penile blood supply as a result of age-dependent damage of inner walls of blood vessels. Previously, medical substances (e.g. apomorphine) were directly injected into the erectile tissue of penile shaft to treat impotence. In some cases a penile implant (penile prosthesis) could be advised.
Treatments (with the exception of testosterone supplementation, where effective) work on a temporary basis: they enable an erection to be achieved and maintained long enough for intercourse, but do not permanently improve the underlying condition.
Erectile Dysfunction can in many cases be treated by drugs taken orally, injected, or as penile suppositories.
When these methods fail, a purpose-designed external vacuum pump can be used to attain erection, with a separate compression ring fitted to the penis to maintain it. These pumps should be distinguished from other "penis pumps" (supplied without compression rings) which are claimed to increase penis length if used frequently, or vibrate as an aid to masturbation.
More drastically, inflatable or rigid penile implants may be fitted surgically. All these mechanical methods are based on simple principles of hydraulics and mechanics and are quite reliable, but have their disadvantages.
In a few cases there is a vascular problem which can be treated surgically.
PDE5 Inhibitors
The prescription PDE5 inhibitors sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) are prescription drugs which are taken orally.
Bremelanotide
The experimental drug Bremelanotide (formerly PT-141) does not act on the vascular system like the former drugs but increases sexual desire and drive in male as well as female. It is applied as a nasal spray. Bremelanotide works by activating a part of the brain. It is awaiting FDA approval.
Ginseng
A double-blind study appears to show evidence that ginseng is better than placebo.
Enzyte
Enzyte is a product that has been advertised by saturation coverage on television channels such as Court-TV. However, the Center for Science in the Public Interest (CSPI) has filed a complaint with the Federal Trade Commission (FTC) about Enzyte for deceptive advertising. It is manufactured by Berkeley Nutritionals, which is alleged to be the subject of an investigation by the Attorney General of Ohio and the defendant in class-action lawsuits.
Enzyte is a supplement that claims to increase the male libido or frequency of erections of the penis. Commercials for Enzyte are shown regularly on television. These commercials feature a man named Bob who never stops smiling, apparently because he had taken Enzyte and improved the size of his sex organs. The commercials are riddled with symbolic phallic imagery, e.g. golf clubs, remarkably tall glasses of iced tea, and a hose spraying barely a trickle of water (carried by someone who doesn't use Enzyte).
The effectiveness of Enzyte is in dispute. Some medical professionals in fact advise against taking Enzyte, saying that it can lead to damage. The Center for Science in the Public Interest have urged the Federal Trade Commission to disallow further television advertising for Enzyte due to a lack of proper studies supporting claims. Enzyte maker Berkeley Premium Nutraceuticals, Inc., is currently under a class action lawsuit for false advertising.
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