The importance of choice for individuals and couples
Individuals and couples will have their own preference for a particular therapy, as it may suit their own sexual lifestyle. The majority of men will select a PDE5 inhibitor as their first treat’ ment of choice. Although the three currently available drugs in this class share a common mode of action, there are subtle pharmacO’ kinetic differences among them that may be of importance to the couple that is unrecognized by the physician. The most obvious difference among them is that tadalafil has a much longer half’ life and duration of effect than sildenafil and vardenafil (about 17 hours, compared with about 4 hours). Preference studies show conflicting results w i t h each of the three drugs being most frequently preferred in different studies. However, it is clear that if men are given a choice of PDE5 inhibitor, they will express a preference for one. Perhaps the best approach is to allow men to t ry more than one and find which suits them best.
Couples will sometimes select other options as first choice: VTD and sex therapy are perfectly reasonable options, as their use is more or less without risk. Couples indicating a first preference for injections, transurethral pellets, or even implants should be carefully counseled about the risks and benefits of each option and encouraged to at least try lower’risk alternatives. Ultimately, the couple should be allowed to make an informed choice regarding their treatment option.
Tags: Class Share, Couples, Duration, First Choice, Half Life, Health Problems, Implants, Informed Choice, Majority Of Men, Many Men, Orgasm, Pde5 Inhibitor, Pellets, Preference Studies, Ry, Sex Therapy, Sexual Behavior, Sexual Excitement, Sexual Lifestyle, Sildenafil, Suits, Tadalafil, Treatment Option, Vardenafil, Vtd