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ED drugs not working? You may not be using them right

Men who don't have success with popular erectile dysfunction drugs may be using them incorrectly, suggests a new study from Spain.

NEW YORK (Reuters Health) - Men who don't have success with popular erectile dysfunction drugs may be using them incorrectly, suggests a new study from Spain.

Of 172 men who were not properly using their erectile dysfunction (ED) drugs, 88 responded to the medicines after they were re-educated about the treatments.

"The idea came to us when we saw that a lot of patients sent to our specialized unit to try a different treatment for ED were not taking the PDE5i under optimal conditions," Dr. Borja Garcia Gomez told Reuters Health in an email.

Gomez is an author of the new study from the Hospital Universitario 12 de Octubre in Madrid.

PDE5i - short for phosphodiesterase type 5 inhibitor - is a group of drugs that includes Viagra and Cialis. The pills work by blocking the effects of a certain enzyme to allow increased blood flow to the penis.

When ED drugs don't work, it may be due to men not using the drugs correctly or their bodies not responding to the treatment.

Past studies have suggested that re-educating men who don't respond to ED drugs increases the number who see an effect.

For the new study, published in Urology, Gomez and his colleagues recruited 250 adult men from their clinic between January 2010 and June 2011.

All of the men had ED and reported that their drugs were not working.

The researchers used a survey to measure the severity of the men's ED on a scale from 0 to 25, with higher scores marking better function. The men were also interviewed to determine if they were properly using their medications.

The men had an average ED score of 13, which is classified as moderate ED.

Of the 250 men recruited, 172 were not taking their medications under the "best conditions."

For instance, some hadn't tried using the drugs on an adequate number of days. Others weren't taking the maximum dose or hadn't tried a second PDE5i if the first didn't work.

Those who were found to not be taking their drugs correctly were offered a re-education program. For various reasons, 57 men declined the program.

After going through a session describing how to properly use the ED drugs, 88 of the 115 men began responding to them. Their ED scores improved to above 24.

"Every patient should ask his doctor how to take the drug properly, and confirm if he is doing so, before looking for a different treatment," Gomez said.

He added that doctors should also take a few minutes to properly explain the drugs to their patients.

Dr. Joseph P. Alukal, from the Departments of Urology and Obstetrics and Gynecology at NYU Langone Medical Center in New York, said the new findings weren't surprising.

"Lots of people don't know how to prescribe or take these drugs," Alukal, who wasn't involved in the study, told Reuters Health in an email. "I try to educate both patients and providers about these kinds of pitfalls."

Men who have tried using the drugs correctly and continue to have trouble with ED should see a urologist for a more in-depth look into the problem, he added.

SOURCE: Urology, online April 16, 2014.