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Viagra (Sildenafil) is an oral drug that is used for treating impotence (or erectile dysfunction the inability to attain a penile erection). It is in a class of drugs called phosphodiesterase inhibitors (PDE-5 inhibitors) that also includes: Tadalail (cialis), Vardenafil (levitra, staxyn ODT), Avanafil (Stendra). It has been estimated that impotence affects approximately 145 million men in the world. Over half of all men with impotence are though to have some physical (medical) cause. The remainders are believed to have psychogenic causes of impotence. Medical causes of impotence including diabetes and blood circulatory, neurological, or urological conditions etc.

Penile erection is caused by the engorgement of the penis with blood circulation. This engorgement occurs when the blood vessels provide blood to the penis increase the delivery of blood and the blood vessels carrying blood away from the penis decrease the removal of blood circulation. Under normal conditions, sexual stimulation leads to the production and release of nitric oxide into the penis of a man. Nitric oxide then activates the enzyme, guanlate cyclase, etc which causes the production of cyclic guanosine monophosphate (cGMP). It is the cGMP that is mainly responsible for the erection by affecting the amount of blood that the blood vessels deliver and remove from the penis. Viagra inhibits an enzyme called phosphodiesterase-5 (PDE5) which destroys the cGMP. Thus, Viagra protect the destruction of cGMP and allows cGMP to accumulate and persist longer. The longer cGMP helps the more prolonged the engorgement of the penis. The Food and Drugs Administration (FDA) approved Viagra in March 1998.

 

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Viagra improve the effects of the blood pressure lowering medications. It also improve the blood pressure lowering effects of nitrates, for example , insosorbide dinitrate (isordil), isosorbide mononitrate (Imdur, ismo, monoket), nitroglycerin (nitro-dur, transdermnitro) that are used primarily for treating angina. Patients taking nitrates should not receive Viagra. Patients should  not comnine Viagra with other PDE5 inhibitors{ (for esample vardenafil (levitral, tadalafil (cialisl)}. Cimetidine (Tagamet). Erythromycin, ketoconazole (nizoral), itraconazole (sporanox), atazanavir (reyataz), and mibefradil (posicor) can cause marked enhance the amount of Viagra in the body of a person. Patients taking these drugs should be observed carefully if sildenafil is used.  It is expected that rifampin will decrease blood levels of Viagra and probably lower its effectiveness.

 

 Erectile dysfunction (ED) and its Causes:

 Erectile dysfunction is when a man has persistent problems achieving and/or sustaining an erection. A patient of erectile dysfunction can make sexual intercourse impossible without treatment. Erectile dysfunction can first emerge in man as early as 38 according to the Massachusetts male aging study on sexual dysfunction. They also found that an approximately 18 to 30 million men are affected by erectile dysfunction.

Mechanics behind erectile dysfunction- when blood fills two chambers in the penis (known as the corpora cavernosa) an erection occurs. This causes the penis to expand and stiffen, much like a balloon as it is filled with water. The process is triggered by nerve impulses from the brain and genital area of a patient. Anything that interferes with these impulses or restricts blood flow/circulation to the penis can result in erectile dysfunction.

Low testosterone (Low T) - while low T isn’t the only cause of erectile dysfunction, the two do seem to be connected. However, the connection between low testosterone and erectile dysfunction is complicated to understand. Researchers believe two are connected because they both seem to coincide as a man ages. However, some people with low testosterone continue to produce healthy erections.

Diseases that can lead to ED- the link between underlying chronic disease and erectile dysfunction is most striking with diabetes experience erectile dysfunction. Nevertheless, good blood sugar control can minimize this risk of erectile dysfunction.

 In addition, the following four main diseases can lead to erectile dysfunction by interfering with blood flow or nerve impulses throughout the body of a person. Cardiovascular disease, atherosclerosis (hardening of the arteries), kidney disease, multiple sclerosis etc.

Lifestyle can cause ED- lifestyle choices, such as smoking, alcohol abuse, and obesity can impair blood circulation and lead to erectile dysfunction. Smoking, excessive alcohol drinking and drug abuse may damage the blood vessels and reduce blood circulation to the penis. Smoking makes persons with atherosclerosis even more vulnerable to erectile dysfunction. Smokers have almost two times the risk of erectile dysfunction compared with nonsmokers. Being overweight and getting too little exercise also contribute to erectile dysfunction diseases. Peoples who exercise regularly have a lower risk of erectile dysfunction.

Surgery and medications can cause ED- surgical or radiation treatments for prostate cancer, bladder cancer, or prostate enlargement (BPH) can sometimes damage nerves and blood vessels near the penis. Occasionally, the nerve damage is permanent and the patient needs treatment to achieve an erection. Sometimes, surgery causes temporary erectile dysfunction that improves on its own after 10 to 20 months.

Many medications can cause or contribute to erectile dysfunction, such as certain blood pressure drugs, antidepressants, and tranquilizers etc. people with erectile dysfunction should talk with their doctor if they feel a prescription or over-the-counter drug may be causing erectile problems.

Physiology and erectile dysfunction can cause ED- it is common for men with erectile dysfunction to have an underlying physical basis for it, particularly in older men. However, psychological factors may be present in 15% to 25% of men with erectile dysfunction. Experts report shows stress, depression, poor self-esteem and performance anxiety can impair the ability to have an erection dysfunction. These factors can also make erectile dysfunction worse in men whose sexual dysfunction stems from something physical.

 

Erectile dysfunction(ED) lab Tests and Treatment:

Many lab tests can be helpful in diagnosing male sexual problems in a very effective and reliable way. Measuring testosterone levels can determine whether there is a hormonal imbalance, which is often linked to lower the desire. These tests may reveal underlying medical causes of erectile dysfunction- blood cell counts, cholesterol levels, blood sugar levels, liver function tests etc.

Treatments- often men with erectile dysfunction are able to improve sexual function by making a few lifestyle changes. Stopping smoking, reducing weight, stopping alcohol and exercising regularly can help by improving blood flow. If you feel a medication could be contributing to erectile dysfunction, talk to your doctor about the medicines.

Oral drugs for diagnosed ED- while popularized in the media, Viagra are not the only erectile dysfunction drug. Other erectile dysfunction drugs include:- Cialis, Levitra, Staxyn, Stendra etc.These drugs work by increasing blood flow to the penis during arousal and are taken 30 to 50 minutes before sexual activity. They should not be consumed more than once a day. Cialis medicine can be consumed 36 hours before sexual activity and also comes in a lower, daily dose. Staxyn dissolves in the mouth. All require a doctor’s prescription for safety.

 

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