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[6] First-line pharmacological treatments include phosphodiesterase type 5 (PDE5) inhibitors, which are licensed, well-studied medications: Sildenafil (Viagra): Typically effective within 30-60 minutes, lasting 4-6 hours [7] Tadalafil (Cialis): Longer duration of action (up to 36 hours), also available as daily low-dose formulation [8] Vardenafil (Levitra): Similar efficacy to sildenafil with slightly different pharmacokinetics Avanafil (Spedra): Take approximately 30 minutes before sexual activity

In practice, counseling is most effective when focused on defining the specific agent, route of administration, source reliability, and timing relative to surgery rather than debating unproven efficacy claims

Genetic variants including GIPR rs1800437 , GLP1R rs6923761, FTO rs9939609, and MC4R rs17782313 relate to the biological pathways these medications act on

However, the optimal choice depends on specific concerns and may involve combining different peptides for synergistic effects, which is part of the personalized approach at Pulse & Remedy.

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Start with lower concentrations to assess tolerance, then increase if needed