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Let's Talk Sex
February 1, 2011

Viagra, Cialis and Levitra

Welcome to the 1990s and welcome to the new sexual revolution age with the advent of Viagra, Cialis and Levitra. These medications single-handedly revolutionized the sex industry and the medical treatment of male impotence. These medications have a similar way of working and hence a similar side effect profile.{{more}} So, if you are afraid of Viagra giving you a “heart attack”, then you should be afraid of all the others doing so. A lot of men come to the office and when Viagra is mentioned, they say “Na, Doc, I ain’t want no heart attack drug. Wat about “Cialis” and my response is: “Sir, they will both cause heart attacks.”

If you remember in my article on male erection, I mentioned that the body has a very powerful substance that causes a natural erection. The nerves of the penis and some of the cells in the blood vessels release this substance. This substance works on the wall of the blood vessel causing it to open up and increase the amount of blood flowing into the penis thus causing an erection. The substance is called nitric oxide (NO). The body has to get rid of NO and it does so by using another substance called PD5. Viagra and its brothers stops PD5 from working, so they are called PD5 inhibitors. If you inhibit PD5 then you prevent NO from being destroyed. If you stop NO from being destroyed then it accumulates in the tissues where it is secreted, thus making the erection harder and treating the impotence.

Viagra, Cialis and Levitra all work the same way. When they were initially released, a good few men died from heart attacks and the medications were wrongly blamed. There were 2 main reasons why men had heart attacks. Firstly men with severe heart disease who had impotence, took the tablet, got a good erection, had sex and suffered a heart attack in the process, because they were simply too unfit for any kind of extreme physical activity. They failed to heed the warning that all patients with severe heart disease should, i.e. avoid strenuous physical activity, and sex is strenuous physical activity. These men remind me of people who drive average family cars like race cars, taking 90 degree corners at 70 mph without braking and cannot understand why they crashed. The second reason is more preventable, as it is predictable. People using certain type of medication for heart disease called nitrates should not use Viagra or Cialis or Levitra as these tablets cause a drop in the blood pressure (they were initially developed for high blood pressure in the lungs). Heart tablets also cause a drop in the blood pressure and they use a similar method to Viagra and its brothers; so, using them together causes a profound drop in the blood pressure that the body cannot recover from. The heart and the brain do not get enough blood and suffer a heart attack or a stroke. In both scenarios, the men have heart disease, so it should come as no surprise that they should not be using Viagra.

Viagra causes a good erection in up to 80% of men using it. These men have diabetes, hypertension, high cholesterol, mild to moderate heart disease, surgery, and emotional and psychologic problems. In short, men with a wide range of problems who also have impotence can use Viagra. Cialis and Levitra can sometimes help those who are not helped by Viagra, and those who have side effects with one may not suffer the same side effect with the others. Men who use herbal and other OTC preparations without help will generally get help from Viagra and men who normally are fit and can walk for 200 yards easily should have no ill effects using Viagra, once they are not taking nitrates for heart disease. I repeat Viagra does not cause heart attacks in normal men, even those in their 70s and 80s. For all practical purposes, the common side effects of Viagra include headaches, heartburn, some nasal congestion, and muscle aches and these occur in less than 10% of men. Rarely, fainting and temporary blurring of vision may occur, but stopping Viagra and switching to one of the brothers usually resolves these. Viagra should not be used with alcohol or other OTC stimulants. Double dosing is not advised, because of the risk of priapism and sometimes hypotension. Most readers will remember priapism from a few weeks ago. It is advisable to use these medications with a snack or a glass of juice, and not a big or fatty meal, as it prevents the medications from being taken up from the intestines. Over the next two weeks I will be looking at OTC and herbal remedies.

For comments or question contact:

Dr. Rohan Deshong

Tel: (784) 456-2785

email: deshong@vincysurf.com

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