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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

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Glucagon-like peptide-1 (GLP-1)-based therapies, such as semaglutide and tirzepatide, have transformed obesity management, producing weight loss that narrows the gap with metabolic surgery at the same time as reducing the risk of obesity-related complications [2]