Viagra

Fifty-Plus Fitness Library

VIAGRA, An Update

by Herman Mueller

It is estimated that some 30 million men suffer from some degree of ED. ED is medical shorthand for Erectile Dysfunction, and to plunge right into the topic ,"is defined as the consistent inability to get and/or maintain an erection sufficient for satisfactory sexual activity."

Anything that affects the health of the blood vessels--arteries and veins--can be associated with ED. In addition, depression, certain medications, and surgery or injury that interrupts the connection between the central nervous system and the penis have been associated with ED. Smoking, alcohol or drug abuse, and stress may also be associated with ED.

One thing that doesn’t cause ED is age! It’s true that ED is more common in older men, but mostly because they are more likely to have one or more of the foregoing conditions associated with ED before they undertake the program. Although older men should expect some changes in how their bodies function sexually, ED doesn’t have to be accepted as an inevitable part of aging. Sexuality, the study says, doesn’t have an expiration date.

Viagra was administered to over 3700 patients, from 19 to 87 years of age in worldwide clinical trials; 550 of the patients were treated for more than a year.

Two criteria provided the main thrust of Pfizer’s Viagra potency research and trials. "(1) the ability to achieve erections sufficient for sexual intercourse and (2) the maintenance of erections after penetration."

Viagra achieves its desired effect by "producing smooth muscle relaxation...allowing inflow of blood" into the penis. "It has no effect in the absence of sexual stimulation." This latter should be comforting to readers contemplating a trip to Japan. They can board the rush hour subway in Tokyo without fear of inadvertently pressing against a scented geisha; supposedly, one might also enter the mixed couples hot bath, serenely confident that no naughty little member will suddenly pop up to embarrass them.

Viagra is not a White House "Miss-Currie-send-in -Miss Lewinsky-and-get-Congressman Smith-on-the-line" type of deal. The Viagra user has to monitor his libido. It takes approximately 30 to 120 minutes for Viagra to kick in, with happy time arriving, on average, in about 60 minutes. Moreover, this effect, I’m sorry to report, is based upon the eager suitor being "in a fasting state". Another unfortunate and little reported effect is that "when Viagra is taken with high fat meals, the rate of absorption is reduced."

I had some difficulty with the study’s report on alcohol. In one place it says "lifestyle factors such as smoking, alcohol or drug abuse, and stress may also be associated with ED". I take "abuse" in this context to mean heavy drinking. Elsewhere the study says that "in healthy volunteers with mean maximum blood alcohol levels of 0.08" there was no drop in the effectiveness of Viagra.

The pragmatic romantic, if there could be such a person, will craft his rendezvous then with this knowledge firmly in hand. Knowing that a lavish meal will delay the onset of the pill’s effectiveness, he will dawdle with his amorata over the dessert; extend it even longer with after-dinner drinks, all in an attempt to make room for the pill to act. Remembering that tests prove the potency of the silver bullet is most effective in the fasting state, a fit 50+er will take his lady for a fast jog, say five miles, around the track and if she is a joy through strength type, too, a couple of fast laps around the pool or what say, a quick twenty on their bikes, and then, if he has artfully popped his pill at the outset of this exercise routine, he might hopefully have worked off most of the turgid effects of the heavy dinner. Off they scamper to that consummation which is devoutly to be wish’d.

Some precautions. Pfizer recommends that potential Viagra users weigh their medical history carefully and have a thorough physical to diagnose the type of ED they may have and its underlying causes before embarking on the program. "There is a degree of cardiac risk associated with sexual activity," the study underlines, "therefore, physicians may wish to consider the cardiovascular status of their patients prior to initiating any treatment for erectile dysfunction." Pfizer goes on to say Viagra "was effective in a broad range of ED patients, including those with a history of coronary artery disease, hypertension, depression, coronary artery bypass graft, radical prostatectomy" and a string of other maladies. Pfizer Studies also listed some transient abnormalities related to color-vision, i.e., loss or inhibition of the ability to discriminate between green and blue and /or increased sensitivity to light. Viagra has no effect on bleeding time when taken alone or with aspirin.

Among those conducting a rising chorus of dissent against Viagra’s safety is Dr. Sydney M. Wolfe of the Public Citizen’s Health Research Group. He claims that the instructions for using Viagra fail to adequately warn about the possible effects of the drug on patients who have certain heart or cardiovascular conditions. "Viagra," he says, "affects blood vessels in many parts of the body. These effects are very worrisome. He and others believe that Viagra was "dangerously rushed" to market. The Food and Drug Administration has been petitioned to reconsider the risks associated with Viagra. At this writing there have been at least 39 deaths among Viagra users.

My own highly esteemed Palo Alto internist, Gary D. Zweig, MD., who was kind enough to peruse this piece before publication, further cautioned that "many physicians feel that Viagra is contraindicated in those taking long acting nitrates because the combination of the two medications may cause severe low blood pressure. Complications, " he said, "may arise as a result. "

There are, however, for the wary, wistful senior several other non-medical alternatives to Viagra. A 17 square foot outcropping of rock that looks like a giant toad squats above Alcala de la Selva, a little mountain hamlet in Spain. You could join the Sunday night torch light parade; touch it three times by moonlight, you don't even have to kiss it, voila! your conjugal bliss is restored. And then there's King David's servants; they suggested a neat cure for his royal affliction (1Kings, chap. 1, vs 2-4): "a young virgin to stand before the king... and cherish him.. and lie in his bosom, that my lord the king may get heat."

You might try it. It can't hurt