Viagra for the Treatment of Erectile Dysfunction
When it comes to prescription drugs, few have enjoyed the kind of
fanfare and fame that Viagra (
sildenafil) has. Since hitting the market in late 1998,
“the little blue pill,” as it was famously marketed by Pfizer for some
time, has revolutionized the way in which erectile dysfunction is
treated. Before
Viagra, the only viable and reliable way to treat
certain types of ED was through a painful injection straight to the
penis. That solution never really caught on, but Viagra certainly did.
Several similar drugs have become available since, but none has come
close to matching Viagra’s popularity or general ubiquity. Viagra is
such a mainstay now that most people have little or no idea about how it
actually works, and many take it for granted. Like any drug,
significant research led to its development, and certain precautions are
in order for those who use it to treat erectile dysfunction.
What is sildenafil, and how does it work (mechanism of action)?
Viagra (
sildenafil) is an oral drug that is used for treating impotence (or erectile disfunction, ED, the inability to attain or maintain a penile erection). It is in a class of drugs called phosphodiesterase inhibitors (PDE-5 inhibitors) that also includes
- vardenafil (Levitra, Staxyn ODT), and
It has been estimated that impotence affects 140 million men worldwide. Over half of all men with impotence are thought to have some physical (medical) cause. The remainder are believed to have psychogenic causes of impotence. Medical causes of impotence include diabetes and circulatory, neurological, or urological conditions.
Penile erection is caused by the engorgement of the penis with blood. This engorgement occurs when the blood vessels delivering blood to the penis increase the delivery of blood and the blood vessels carrying blood away from the penis decrease the removal of blood. Under normal conditions, sexual stimulation leads to the production and release of nitric oxide in the penis. Nitric oxide then activates the enzyme, guanylate cyclase, which causes the production of cyclic guanosine monophosphate (cGMP). It is the cGMP that is primarily 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 prevents the destruction of cGMP and allows cGMP to accumulate and persist longer. The longer cGMP persists, the more prolonged the engorgement of the penis. The FDA approved Viagra in March 1998.
How long until Viagra takes effect?
Generally Viagra requires 30-60 minutes to take effect, therefore take Viagra at least one hour before you intend to have sex. However the length of time Viagra takes to work can be affected by food, alcohol and sexual stimulation.
- Food: Eating any meal before you take Viagra will cause the medicine to take effect more slowly. Fatty meals can make it harder for Viagra to enter the bloodstream. Ideally you should take Viagra on an empty stomach. This doesn’t mean starving yourself. Just leave two hours after eating before taking Viagra.
- Alcohol: Drinking more than one or two units of alcohol will make Viagra less effective. Excessive alcohol can compromise erections regardless of erectile dysfunction.
- Sexual Stimulation: Viagra requires arousal and sexual stimulation to take effect. It won’t give you an erection on its own.
There is no point using
Viagra if you don’t use it correctly. Below we answer some key questions that should help you get the maximum results from the little blue pill.
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