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 It
has been estimated that up to 30 million men in the U.S. suffer
from sexual dysfunction (impotence). Until recently, sexual dysfunction
has been effectively treated with injections, surgery, and other
procedures, many of which are painful and embarrassing. In March
1998, the FDA announced that Viagra ® a new drug from Pfizer, Inc.,
has been approved as treatment for male sexual dysfunction. In clinical
trials, up to 80% of men found that it improved their erections!
 Viagra
has a funny history. It was originally being studied for use as
a drug for high blood pressure and angina. It wasn't terribly successful,
but when men refused to give their samples back, the researchers
suspected they were onto something!
 So
how does it work? Viagra enhances the natural response to sexual
stimulation by blocking the effect of an enzyme. By blocking the
chemical that breaks down cyclic guanosine monophosphate (cGMP),
Viagra helps to relax smooth muscle cells, thus increasing blood
flow to the penis and making it much easier for a man to get and
maintain an erection.
 Viagra
is taken approximately one-hour before sex. Sexual stimulation is
still required to get an erection, but often times, less than would
be normally required. It is effective for about 4 hours. It is recommended
that it not be used more than once a day.
 The
most common side-effects noticed were mild headache, facial flushing,
and/or upset stomach. With larger doses, some men developed a very
unusual side-effect: a color shift towards blue, making green and
blue indistinguishable. Because Viagra does not cause an erection
but simply makes it easier to get one, the most dangerous side effect
of injectables (which do cause an erection) is avoided. Injections
can cause a condition known as priapism where a man cannot lose
his erection. This is a very dangerous condition that must be treated
immediately, and can lead to permanent damage. Given that no chemical
is being injected, Viagra also does not lead to scarring.
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One point that needs to be emphasized is that difficulties with
getting an erection occur to almost all men, at least some of the
time. However, Viagra is designed for the approximately 140 million
men worldwide affected by long-term erectile dysfunction. In studies,
the drug was effective across patients with erection problems attributed
to diabetes, prostatectomy, spinal cord injury, psychological, and
other causes. It is not meant to be used casually and men should
be carefully evaluated for underlying medical/psychological causes.
Indeed, it is my concern that this drug will be given to men who
really need relationship or personal counseling. Thus, many men
will not get the help they really need. Difficulties with erections
are often merely a symptom of underlying problems. If doctors merely
hand out a pill, they will be doing men and their partners a great
disservice.
 The
other interesting thing about Viagra (that no one is mentioning
for fear that the drug will be abused), is that in many men, the
drug allows them to maintain an erection even following multiple
orgasms. So, in a sense, Viagra may eventually be useful for treatment
of premature ejaculation. As a matter of fact, if this really works,
it will be premature ejaculators who win out -- they still maintain
their erection, but get to have more orgasms! Another implication
is that for men who have partial erections, or easily lose their
erections, this drug may make it easier for them to use condoms
and have safer sex. Given the incredible risks some men take in
not using a condom, this would seem to me to be a legitimate use
for the drug.
Viagra
is prescription only, so you need to consult your doctor. Viagra
is expensive treatment, but still much cheaper than most of the
other forms of treatment such as MUSE, injections, or vacuum pumps.
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