Erectile Dysfunction Drugs - Viagra, Levitra

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Expert Offers Basics on Erectile Drugs

The Orange County Register, California

"Levitra or Viagra?"

He asked her with a wink.

"Don't bother," she replied, "There's Lunesta (a prescription sleep aid) in your drink."

Adree Sexauer of Gilbert, Ariz., won my ninth annual International Longevity Light Verse contest last year with those four lines taunting both the expectations and the dread posed by erectile dysfunction medications.  (I launched the verse contest, by the way, to celebrate the dilemmas that aging presents.)

Like most witty verses, there's much truth behind the joke.

Before Viagra, erectile dysfunction was a fact of life for many men, a condition of aging few talked about, in private or in public.

Today, every 4-year-old knows what the television ads are touting.

"There is so much marketing and public conversation today, it is a very different situation," says Dr. Aaron Spitz, a urologist and assistant clinical professor at the University of California-Irvine.  "We used to be very solicitous of patients, a sort of "don't ask, don't tell."  Now patients frequently tell us."

Q: So, can every man take these medications?

A: With certain exceptions, yes.  These drugs are very safe.  So safe, in fact, I can conceive of them as being over-the-counter some day.  But I think it's nicer if men see a doctor before starting.  They may have something else going on that is dangerous or improvable that they would mask taking Viagra.  Like diabetes, for example.

Outside of that, the only health risk is taking these drugs in conjunction with nitroglycerin or medications with nitroglycerin.  That could result in a rapid and dramatic drop of blood flowing through the heart.

Q: Wow.  No risk to the pills and no permanent side-effects.  Sounds like a magic potion for all guys.

A: Well it is except it doesn't work for everybody.  There are a lot for whom it doesn't work and it's frustrating for these guys.

The only thing worse than erectile dysfunction is a treatment that doesn't work.  Then a guy really feels stuck.  He's not getting any and that's even more depressing.

Q: Are there other remedies?

A: Yes, and they can help.  There are injectible medications that were around before Viagra and they are even more potent and more successful.

There is a vacuum device that can be used for about a minute and a half and then removed and that has no side-effect.  There are surgical implants.  For some men, their hormones are imbalanced.  Restoring testosterone can make everything OK.

Q: What about men who have had prostate canc?

A: They are one of the biggest user groups we see.  Viagra will work for many of these men.  Men who have had surgery that spared the nerves are often given daily doses of Viagra to try to improve the inherent recovery, to improve the blood flow to some degree.  That results in a healthier penis to respond to nerve stimulation.

Q: Let's get to basics.  How do these drugs work?

A: When there is sexual desire, certain nerves in the brain begin firing signals to the end of the penis.  Chemicals cause the blood flow to the penis.  At some point, other chemicals naturally pop up to turn the switch off.

In a normal, healthy male with normal circulation, the switches work at the right time.  But an older man with poor circulation may have the "off" switch come on too soon.  It's like filling a bathtub.  The water comes out strong and fills it fast.  A weak stream of water takes longer to fill the tub.  Viagra stops the chemicals that turn the "off" switch.

Q: Are men ever too old to have sex?

A: I'm sometimes asked if sex could be dangerous to a frail person.  The exertion of sex is about the same as climbing two flights of stairs.  It's very rare to have a patient who would be put in that danger by the sex act itself.

Q: Some women don't think Viagra is such a gift.

A: I'm not a sex therapist. Sometimes restoring sex has no value to a couple and sometimes it does.

Q: How long do these medications "take" and are the ones sold over the Internet just as good as the ones you prescribe?

A: Viagra takes about an hour to work and lasts four to five hours.  It's best on a light stomach.  Cialis, by comparison, takes two hours and lasts 36 hours.  It doesn't matter if you eat or not.

Buying these drugs over the Internet exposes you to the risk of getting counterfeit medications.  That's widespread throughout Asia.  A good counterfeit may still work but there is no quality control and you run the risk of getting unsafe chemicals.

Q: Let's go back to that verse - the one about Lunesta, a sleeping agent - in connection with these ED medications.  Will a sleeping pill "stop" the ED drug?

A: Viagra does not give you an unwanted erection.  If you do not enhance your mood, if you have no sexual desire whatever, if you don't change how you are feeling in the brain, nothing will happen.

(Contact the writer, (949) 679-6913 or jghaas@cox.net)

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