Archive for the ‘viagra’ tag
Viagra and erections: Do the benefits persist?
When Viagra (sildenafil) burst on the scene in 1998, it was a revolutionary development. Within months, it became clear that the drug could help about 70% of men with erectile dysfunction. Within a year, the medication had established an enviable safety record, even for men with stable heart disease (though it should never be used by men taking nitrates in any form or by men with unstable cardiovascular problems).
These early observations have held up, but as Viagra has settled into the mainstream, doctors are starting to ask how it affects men who have used it for several years.
Choice of ED Rx now a matter of patient preference
…But open discussions of sexual dysfunction have led to ‘hucksterism’ and false claims
Phosphodiesterase type-5 (PDE-5) inhibitors have revolutionized the treatment of erectile dysfunction and have proven to have both important clinical and social effects. They have moved discussions of sexual dysfunction from the closet to the examination room, not to mention the television set, where the topic is openly discussed in commercials and on talk shows.
“These new medications have really lessened the taboo that once surrounded the subject. The trends [in ED treatment] are more open discussion and less hesitation by family doctors to discuss this,” said John J. Mulcahy, MD, professor of urology at Indiana University Medical Center, Indianapolis.
Several studies introduced at the annual meeting of the European Association of Urology congress in Vienna last month compared the efficacy of sildenafil citrate (Viagra) with that of two new PDE-5 inhibitors — tadalafil (Cialis) and vardenafil (Levitra).
Viagra: what every physician and patient shouid know
Viagra, an oral drug taken one hour prior to sexual activity, improves erectile function in the majority of men with erectile dysfunction who receive it. It is not an aphrodisiac and therefore will not work without sexual stimulation. The drug is absolutely contraindicated in patients on organic nitrates, as this combination can lead to severe drops in blood pressure. Patients with heart disease, suspected heart disease and riskfactors for heart disease should discuss with their physicians the safety of resuming sexual activity. A cardiac work-up, including exercise treadmill testing, should be considered in appropriate patients.
Introduction
On March 27,1998, the FDA approved sildenafil (Viagra) as the first oral agent for the treatment of male erectile dysfunction. This new drug has received wide coverage in the media and on talk shows and has spurred an entire generation of new jokes; most importantly, however, it has awakened the public consciousness to the problem of erectile dysfunction (ED). This issue is now being discussed openly by patients, spouses and healthcare providers. The purpose of this article is to describe ED, and to discuss the various treatment options and the efficacy and warnings regarding this remarkable new drug.
What to do if Viagra won’t do
Erectile dysfunction (ED) — impotence — is an extremely common problem that affects up to 22% of American men, mostly in the older age groups. Once considered primarily a psychological disorder, it is now clear that most cases of impotence have a physical basis. The leading causes are the chronic diseases that damage blood vessels and nerves vital for normal erectile function; diabetes, atherosclerosis, and hypertension head the list (see last month’s Harvard Men’s Health Watch). The medications used to treat these problems and other ailments can also contribute to impotence. Hormonal abnormalities are less common, but they are particularly important to detect since they can be corrected. That’s also true of the psychological problems that cause up to 15% of impotence; table 1 summarizes some of the differences between psychological and physical impotence.