I am seeking expert insight regarding the clinical use of pharmacologic agents intended for sexual stimulation, particularly within the context of treating erectile dysfunction. My primary focus is on agents such as phosphodiesterase type 5 inhibitors and emerging alternatives that may offer distinct pharmacodynamic profiles. In particular, I would appreciate a discussion on the following points:
- Comparative efficacy and safety between established PDE5 inhibitors and newer classes of agents, especially concerning long-term administration versus on-demand use.
- The impact of patient-specific comorbidities (e.g., cardiovascular disease, diabetes mellitus) on the selection and dosing strategy of these medications.
- Mechanistic differences in formulations that may affect onset of action, bioavailability, and patient tolerability.
- Potential interactions with adjunctive therapies currently under investigation or in clinical use related to sexual stimulation and overall sexual function.
Any insights or references to recent peer-reviewed studies would be highly beneficial for evaluating the nuances involved in optimizing treatment strategies.