Impotence pills – part II
FOR much of his life, a man takes his sexual performance for granted, so when he finds he can’t rise to the occasion it’s a frustrating and stressful experience.
lf the condition persists it’s called erectile dysfunction and may lead to depression and marital difficulties.
In most cases it is due to a physical factor such as high blood pressure, high cholesterol, smoking and diabetes – as well as a natural decline in sexual energy as men get older.
But now pills are available to help and there are several to choose from, as Dr Miriam explains.
VIAGRA was the first pill for erectile dysfunction and there has been a lot of hype about it – some true, some untrue.
Many men think Viagra increases sexual desire – it doesn’t.
It increases sexual response in those who have the capacity to respond, and the effects last for four to six hours.
For Viagra to work, a penis has to have adequately healthy nerves and arteries. A man of 80, for example, is bound to have some hardening of arteries even in the penis.
It may be worth a try if you have diabetes, but only half the diabetic men in tests had improvement in their erections.
Similarly, if your pelvic nerves or pelvic arteries have been damaged by an accident or by surgery, Viagra may not bring about an improvement. Here the success rate is only 40 to 50 per cent.
Is Viagra safe?
MANUFACTURERS say it shouldn’t be taken with heart drugs which include nitrates.
There are also side effects. The US Food and Drug Evaluation reported the most common were headache, flushes, upset stomach, stuffy nose, urinary tract infection, visual changes and diarrhoea.
STAY SEXY FOR HOURS
CIALIS is a new treatment but it isn’t an aphrodisiac and won’t increase sex drive.
It works in the same way as Viagra by helping blood vessels in the penis relax, allowing blood to flow in, resulting in an erection.
For Cialis to be effective, sexual stimulation is needed. Men who don’t have erectile dysfunction shouldn’t takeit. Both Cialis and Viagra appear to be similar in how effective they are, but Cialis works for up to 36 hours. This doesn’t mean a a man has an erection for 36 hours, because it only works when he is sexually stimulated. But he doesn’t have to worry about the effect wearing off quickly, so sex can be more spontaneous.
Cialis isn’t affected by food so it can be taken with a meal and remain effective.
In three studies between Viagra and Cialis, conducted in Sweden, Germany and the US, more than two thirds of men preferred taking Cialis.
It was also tested on about 350 men with diabetes and was effective in restoring erectile function in just over half of them. In men without diabetes it was effective in 80 per cent.
Cialis is available in two strengths – 10mg and 20mg. The maximum dose is one tablet per day to be swallowed at least 30 minutes before having sex.
Cialis is generally well tolerated but side effects can include headache and indigestion.
Less common side effects can be facial flushing, stuffy nose, muscle aches, dizziness and backache, all generally mild to moderate and short-lived.
As with Viagra, men taking medicines containing nitrates in any form shouldn’t take Cialis, to avoid a drop in blood pressure. Nitrates include the heart medicine nitroglycerine – GTN – and the long-acting nitrates used to treat angina.
Fatty food’s a disaster
LEVITRA allows some men to achieve erections 10 minutes after it’s taken, but normally leave 25 to 60 minutes before sexual activity. The effect lasts five hours.
Like the others, Levitra isn’t an aphrodisiac and its action is affected by eating a high-fat meal but not by drinking alcohol.
It comes in three dosage strengths – 5mg, 10mg and 20mg. Usual starting dose is 10mg with a maximum of one tablet per day.
Levitra is generally well tolerated but side effects may include headache, flushing, runny nose and indigestion, though these are generally mild to moderate and short-lived.
Men taking medicines containing nitrates in any form shouldn’t take Levitra.
TRIED’N TESTED
UPRIMA contains apomorphine and is a more old-fashioned treatment for erectile dysfunction.
You place the tablet under the tongue where it dissolves in about 10 minutes. If the tablet is swallowed whole, it won’t be effective. It isn’t an aphrodisiac so sexual stimulation is needed.
If you have any of these conditions you can’t take it: your partner is breastfeeding, you have unstable angina, you’ve had a recent heart attack, you have low blood pressure and any other medical conditions which make sexual activity dangerous.
If you get any side effects, speak to your doctor. Only your doctor should increase the dose.
Private practice
ALL drug treatments for erectile dysfunction are generally available on prescription for one treatment per week.
If you feel you need more tablets talk to your doctor.
Cialis and Levitra are also available more frequently by private prescription.
When you go private there may be a charge for the doctor’s time and you will have to pay for the prescription and the drug itself.
FOR further reading, Family Health, by Dr Miriam Stoppard, is available from Mirror Direct on 0870 07 03 200, price pounds 22.50 including postage and packing.
DRUGS for erectile dysfunction are available under the NHS only for men being treated for:
Prostate cancer (or if they have had prostate glands removed), kidney failure, spinal cord injury, diabetes, multiple sclerosis, single gene neurological disease, spina bifida Parkinson’s disease. polio, severe pelvic injury or radical pelvic surgery.
Men who were already receiving drug treatment for erectile dysfunction on Sept 14, 1998.
MAKE YOUR CHOICE
PILLS for erectile dysfunction are known as PDE5 inhibitors as they help to relax blood vessels in the penis, enhancing blood flow to it, causing an erection.
CIALIS LEVITRA VIAGRA
ONSET OF 20-60 mins 10-60 mins 20-60 mins ACTION
LENGTH OF 36 hours 5 hours 4-6 hours ACTION
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