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Viagra: The Magic Pill or Pandora's Box?

American men, and now some women, are still enamored with Viagra. Since its market release in April 1998, more than 3 million prescriptions have been written for this new oral medication for the treatment of impotence. Nearly 70% of men using the little blue pill report improvements in their sexual functioning.

Although the pill works wonders for many men and their partners it is important that men don't have unrealistic expectations about the medication. The drug is not a love potion or an aphrodisiac and men need to know all of the pluses and some of the minuses of the medication. Impotence is not a consequence of the aging process although the problem is more common in older men compared to younger men. Most men in their senior years can expect to engage in sexual intimacy but when a man is having a problem there is usually some underlying problem.

The common causes of impotence include: diabetes, heart conditions, including high blood pressure and high cholesterol, surgical procedures on the prostate, bladder and colon, side effects of medications, stress, anxiety and depression are also associated with impotence.

At the moment the preferred treatment for impotence is Viagra. It is easy to administer and very effective in the vast majority of cases.

Viagra works by causing a chemical reaction in a man's body, making it easier to for him to obtain and maintain an erection. A more technical explanation is that when a men becomes sexually aroused, his brain sends a message to the nerves in his penis. Nitric oxide is then released into the inner chambers of the penis. Viagra promotes the action of nitric oxide causing the arteries to relax and fill with blood. As the penile tissue relaxes and expands, it presses on the elastic outer layer, squeezing the veins shut and trapping the blood inside the chambers of the penis producing rigidity.

For best results, men are advised to wait an hour or two after eating before taking Viagra. The medication is most effective on an empty stomach so the body can absorb it faster. Some couples fear a loss of spontaneity since Viagra must be taken in advance. Planning for sex can build anticipation and make it even better.

The results from taking Viagra are noticeable in as little as 30 minutes. One of the lagniappe or benefits is that many of the men claim the effects last throughout the night, so there's no need to rush to sexual intimacy before the pill wears off.

Not a solution for all men

Having prescribed Viagra more than several hundred times in the last six months, I am encouraged by the patient feedback. I have seen relationships that were going sour because of sexual problems come together as a result of using Viagra. Viagra is not a solution for all men with erection problems. It will not work for a men with severe damage to the penile tissues such as diabetics and men with severe heart disease. Men using nitrate medications, such as nitroglycerin, are also barred from suing Viagra. Combining these drugs with Viagra can lower the blood pressure to dangerous levels. The Federal Drug Administration reported 69 deaths from men taking nitrate medication with Viagra. A last group warned to steer clear is men with retinal eye problems. Research is currently underway to determine Viagra's effect on the retina.

While physical risks need to be considered, they shouldn't scare men away who would otherwise be good candidates for the treatment. The Federal Drug Administration continues to support its initial statement on the safety of Viagra with most side effects no more serious than indigestion, flushing and headaches.

It is estimated that one man out of 50,000 will have a heart attack during intercourse. It must be kept in mind that 60 and 70 year old men cannot perform as if they were 30 or 40 with or without Viagra. My rule of thumb is that if a man can easily walk up two flights of stairs without chest pain, then he is going to safely be able to use Viagra.

What the medication cannot do

Like any new wonder drug, men tend to place unreal expectations on a pill. The medication is not a panacea for a troubled marriage. Complex psychological factors play a big part with erection problems. If the desire or sex drive is not there, Viagra will not work. Performance pressure, poor communication in a relationship and problems at work can aggravate erection problems. If you don't address these issues it is unlikely that Viagra will be a solution.

Impotence can precipitate into a major communication breakdown in a short period of time. A typical situation is for a man to be ashamed of his inability to perform and withdraws from his partner. He fears putting himself in a position where he might fail so he avoids intimacy entirely. Meanwhile, his partner feels rejected, neglected and full of self-doubt even challenging the man about having another sexual partner or concerns about her own attractiveness and femininity. This can result in the partner withdrawing from the relationship. This is why open, honest communication between a husband and wife goes a long way in resolving impotence. Argumentative and critical behavior are fuel for sexual problems.

The partner can play a key role in solving sexual problems. It is not unusual for the woman to take the first step toward treatment of impotence. A man may be reluctant to seek help. The partner can encourage her husband to seek treatment, and find the right doctor. The woman's support can go a long way to jump starting a healthy sexual relationship.

Preventing impotence

Certain lifestyle factors can put you at risk for impotence. Cigarette smoking, drug abuse, even stress can affect your ability to perform normally. Some recent research has also implicated the bicycle seat as a cause of impotence. It appears that the bike seat may place pressure on the blood vessels that supply the penis and can impair the blood supply to the penis. However, if the man stops biking or switches to "double bun" seat that takes the pressure off of the blood vessels to the penis, the impotence subside.

Because erection problems stem from circulation problems, the same advice for maintaining a healthy heart applies to maintaining a healthy life style. This includes exercise, a balanced diet and controlling high blood pressure.

If a man is experiencing any type of erection problem, the most comforting point to remember is that now, more than ever before, most cases of impotence can be successfully treated. No man in 1999 needs to suffer the tragedy of the bedroom.

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