Erectile Dysfunction: Vivus' Stendra Can't Stop Cialis

Jordo is a member of The Motley Fool Blog Network -- entries represent the personal opinion of the blogger and are not formally edited.

For most men, erectile dysfunction is perhaps the most feared physiological condition. Men who report sexual difficulties report being bothered by the inability to get an erection or to maintain it long enough to perform intercourse. Erectile dysfunction is one of the most socially sanctioned psycho-physiological conditions and unfortunately even to this day it remains misunderstood or stigmatized.

While a variety of medical issues such as cardiovascular disease, diabetes, neurological conditions, hormonal imbalance and side effects of drugs can cause erectile dysfunction, psychological conditions such as anxiety and mood spectrum disorders tend to be overlooked. Most depressed men report reduced libido and inability to sustain erections for a long time. Depressive disorders entail automatic negative thoughts, which are self-defeating, globalized and internalized.

Most men who experience erectile dysfunction attribute their depression to sexual dysfunction. In reality, it is quite possible that they experience sexual difficulties because of depression or anxiety. Moreover, antidepressants and benzodiazepines can cause loss of libido, delayed ejaculation, anorgasmia and erectile difficulties on a temporary basis. Those who are prescribed SSRIs frequently report sexual difficulties. While these drugs are meant to elevate one's mood, paradoxically they interfere with a person's sex life causing him further distress.

I know of psychiatrists who use phosphodiesterase type 5 inhibitors along with antidepressants in order to help men overcome their anxieties related to sexual performance. Most of the times, these drugs do work. Of these, Pfizer's (PFE) Viagra, Eli Lilly's (NYSE: LLY) Cialis and GlaxoSmithKline (GSK) and Bayer's Levitra were the drugs that were most commonly prescribed by physicians to treat erectile dysfunction. Apricus Biosciences (APRI) has announced Vitaros, a topical cream that is applied on the penis to initiate an erection. This drug may be useful to those who do not tolerate oral medications.

Eli Lilly's Cialis is very popular among men, mostly because of its 36-hour effectiveness. It is because of this lengthy period of effectiveness that Cialis is known as the 'Weekend Pill' and advertised as such. I know of men who have begun to date, interact with their partners effectively and felt that their quality of life increased significantly thanks to Cialis. Though Cialis works similar to Viagra or Levitra, Cialis helps men to maintain spontaneity of sexual intercourse because of its lengthy period of effectiveness.

For the last decade or so, Cialis, Levitra and Viagra have been prescribed to men depending on how they react and how they tolerate each of these medicines, and of course depending on personal preferences. A fortnight ago, the FDA cleared Vivus' (NASDAQ: VVUS) Stendra, which is the first erectile dysfunction treatment to be announced in the last ten years or so. The monopoly of the triad may be shaken by Stendra, which is Vivus' sole product in the market.

If you were wondering what makes Stendra different from the other three drugs available, the answer is fast action. Vivus' Avanafil is being touted as the fastest of the four available erectile dysfunction drugs at the moment. While Stendra purportedly acts faster than its 3 competitors, the basic mechanism of action is the same. While Viagra works in 30 minutes to an hour, Stendra will work in just about 15 minutes, which suggests that men do not have to plan to have intercourse.

However, all this talk of spontaneity is rather confusing as Cialis already offered that spontaneity to men anyway, and also features a very long period of effectiveness, lasting for 36 hours. With that in mind, I seriously doubt claims of Stendra being a competitor to any of the 3 drugs that physicians have already been prescribing. It does not hurt to have a 4th drug that works similarly and has similar or less side effects when compared to the rest of them available in the market.

Physicians may find Stendra useful when certain men do not respond to any of the erectile dysfunction treatments used until now. It is too early to assume that Stendra will somehow affect Eli Lilly's stock by acting as a competitor. We need to remember that Cialis has the lengthy effectiveness advantage that even Viagra and Levitra do not possess. Cialis will continue to be popular among men who do not like to plan sexual intercourse and prefer being ready always.

Psychological causes behind erectile dysfunction need psychotherapy and possibly pharmacotherapy as depression or anxiety disorders are suspected. Along with pharmacotherapy, erectile dysfunction drugs may be prescribed for immediate cessation of sexual dysfunction which exacerbates psychological difficulties in an already disturbed patient.

Physicians and psychiatrists prefer to prescribe Cialis to depressed individuals who seek erectile dysfunction treatments. The unofficial theory behind this preference is that Cialis stays in the body for a longer time, allowing men to experience erections on demand for almost 36 hours, leading to improved confidence and lowered self-defeating thoughts. Viagra or Levitra which stay in the body for a shorter time do not help depressed men to remain sexually confident for longer periods of time. This tendency of prescribing Cialis over other ED drugs will certainly boost its sales in spite of any new drug such as Stendra. Eli Lilly has little to fear about when it comes to staying in the erectile dysfunction treatment business.

In the next few months, I believe Eli Lilly's sales will not be affected by Stendra. Physicians, psychiatrists and urologists will continue to prescribe Cialis to men with erectile dysfunction and the sales will remain pretty much the same. If Viagra and Levitra could not affect Cialis' sales, Stendra certainly will not be able to do much. Moreover, doctors take a lot of time to start prescribing a particular drug to their patients, if it's new. Cialis has been around since 2003, and has millions of satisfied users, and the doctors know it for a fact.


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