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Sexual dysfunctions may begin early in a person's life, or they may develop after an individual has previously experienced enjoyable and satisfying sex. A problem may develop gradually over time, or may occur suddenly as a total or partial inability to participate in one or more stages of the sexual act.

The causes of sexual dysfunctions can be physical, psychological, or both. Psychological factors include both interpersonal problems and psychological problems within the individual, such as depression. Physical factors contributing to sexual dysfunctions include drugs alcohol, nicotine, narcotics, stimulants, antihypertensives, antihistamines, and some psychotherapeutic drugs ; injuries to the back; problems with an enlarged prostate gland; problems with blood supply; nerve damage as in spinal cord injuries ; disease diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis ; failure of various organ systems such as the heart and lungs ; endocrine disorders thyroid, pituitary, or adrenal gland problems ; hormonal deficiencies low testosterone, estrogen, or androgens ; and some birth defects.

Sexual dysfunctions are generally classified into 4 categories: sexual desire disorders, sexual arousal disorders, orgasm disorders, and sexual pain disorders. Sexual arousal disorders in men include erectile dysfunction, which involves partial or complete failure to attain or maintain an erection adequately for intercourse. Patients suffering from erectile dysfunction generally respond well to medication of the phosphodiesterase type 5 PDE5 family.

In addition to erectile dysfunction patients, it has been found that many consumers of PDE5 are physically healthy men, with no pathological sexual problems, who are aiming to improve the quality of their sexual performance by enhancing extent and duration of erection. Systemic exposure AUC increases proportionately with doses from 2. The increase in C max is slightly less than proportional over that dose range. During once-daily 20 mg dosing, steady-state plasma concentrations were attained within approximately 5 days and the degree of drug accumulation was 1.