Health @ Heart
Viagra: The Giant Miracle
How extensively has Viagra been prescribed to date?
Since we first reported on Viagra (Sildenafil Citrate) on the June 18, 1998 two months after it was introduced in the United States (approved in the Philippines September 1998), more than 150 million prescriptions for Viagra have been written so far by more than a million physicians for at least 40 million men in 120 countries around the globe. Nine Viagra pills are dispensed every second, or 540 tablets every minute, worldwide. The overall success rate has been outstanding, with very few minor and transient side effects and very few complications reported. It has been found to be a most effective medication used under the advice of a physician and taken properly according to the guidelines set by Pfizer, the manufacturer.
Is this drug only for men who are impotent?
No. Inability to have a sustained erection in man is not caused only by an organic disease. Psychological factors play a big role in male potency. Those under the usual stresses in life could develop a certain degree of impotence. Even men younger than fifty, who were otherwise healthy except for having ED (Erectile Dysfunction) have been benefited by Viagra in their ability to regain and maintain a normal potency. About 33% of men over 40 and as many as 15 million men in the US have erectile dysfunction.
How does Viagra help ?
The physiologic mechanism of male erection involves release of nitric oxide (NO) in the corpus cavernosum (core of the penile shaft) during sexual stimulation. NO activates the enzyme guanylate cyclase, which results in the increase level of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing more inflow of blood to engorge the male organ, causing erection. Viagra enhances the effect of nitric oxide by inhibiting an enzyme (PDE5) that degrades cGMP, thus helping maintain a higher level of cGMP in the corpus cavernosum.
Is Viagra sold over the counter?
No. This is a prescription drug. One needs to see a physician to be properly screened and advised about this medication, since there are possible side effects and complications.
What is the most serious reported complication of Viagra?
Deaths have been reported, but rather few compared to the volumes of Viagra taken in the world today. Medically, the incidence of this complication is considered low, and the drug is deemed safe by the medical community. Some of these deaths were from natural causes (like heart attack) which could have happened even without Viagra, since sexual activity in itself has some risk among those with untreated heart disease. Many of these deaths were found not to be directly related to Viagra, but rather due to the combination of Viagra and nitrates (heart medications that open up arteries) or due to misuse or abuse. The Pfizer warning is very clear and precise: Patients taking any form of nitrates must not take Viagra. Patients' failure to heed the guidelines and this warning has caused most of the deaths.
What are the side effects?
Some persons experience side effects and others do not. The most common side effects, which are temporary, include any of the following: headache, flushing, mild gastric distress, nasal congestion, urinary tract infection, mild blurring of vision, mild dizziness, and skin rash.
What is a penile prosthesis?
A penile prosthesis or implant is a tubular device inserted surgically into the shaft of the penis to "prop" it erect to enable impotent men to have sex. The implant causes the penis to stay erect all the time, which is not ideal. The "on-demand" type of implant can be inflated manually (in preparation for sex) but both these implants cause some discomfort, not to mention the fact that these require an operation, anesthesia, which is costly and has possible complications and sequelae.
Has Viagra lessened penile implant surgeries?
Yes, there used to be a lot of penile implant operations done to help men with impotence. Today, Viagra has "replaced" penile implants in majority of cases.
Does frequent use of Viagra cause "addiction"?
No, there is no proof that chronic use of Viagra causes addiction in the true medical sense of the word. There might be a sense of dependence on it before sexual activity, meaning the person might feel more secure with its use whenever sex is contemplated.
Is Viagra safe for those on other medications?
Except for medications containing nitrates (heart medications that opens up blood vessels like the coronary arteries), Viagra has been found to be safe when taken with other medications, like high blood pressure drugs, etc. However, we advise all our readers interested in Viagra to check with their physicians before taking it.
Can Viagra cause cancer?
Pfizer reports that Viagra is not carcinogenic in extensive laboratory studies done on this drug. There is no evidence either that the drug is toxic to embryo, or to fetus, or that it is teratogenic.
Does Viagra increase libido?
No, not directly anyway. There must be passion and stimulation between the partners involved before Viagra works. If there is no mutual attraction and desire, this drug will not work.
How long does the effect of Viagra last?
The recommended initial dosage of 50 mg tablet taken orally lasts more than 2 hours in most, and even longer in some men. In the morning after, some residual effect could still be present in most men regardless of age. After Viagra is ingested, the erection, which takes effect within an hour, is sustained until the sex act is completed, and gradually and normally subsides a few minutes thereafter. Any annoying distraction or any undesirable incident, before, during or after the sexual activity, will physiologically (and psychologically) discourage erection.
Is Viagra safe?
Yes, according to extensive scientific literature and medical experience. Taken properly under a physician's supervision, Viagra is safe. The person contemplating to take Viagra must first see his physician for a good medical checkup and advice. One needs a physician's prescription to purchase this medication, which is considered a wonder drug by the medical community.
(Dr. Philip S. Chua is Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, and is the Chairman of Cardiovascular Surgery of the Cebu Doctors' University Hospital in Cebu City. He is also the Vice-President for Far East Operations of the Cardiovascular Hospitals of America, a hospital builder in Wichita, Kansas. His email address is scalpelpen@gmail.com)