In order to be able to make an informed decision on whether or not Viagra is the way you want to treat your erectile dysfunction, you need to have a full understanding of what Viagra -- officially known as sildenafil -- is, and of how it works. It may surprise you to learn that the medication wasn't even originally intended to treat erectile dysfunction.

In the 1980s, in Great Britain, researchers began studying the properties of a new molecule: sildenafil. It had originally been unsuccessfully tested in cardiology as a dilator of blood vessels. Sildenafil proved to be of no use to cardiac patients, and the tests were discontinued. However, much to their surprise, researchers found that many of the patients asked to continue the medication. Why? When questioned, these cardiac patients, many of whose vascular problems had caused erectile dysfunction as well, admitted that they had experienced significant improvement in their erections. This observation eventually led to European clinical tests on men with erectile dysfunction.

At the 1996 annual congress of the American Urological Association, the first results of this new medication under research for the treatment of erectile dysfunction were presented. The first results in clinical research showed sildenafil to be particularly effective in men with mild physical ED. A program of worldwide research with clinical trials was undertaken, and in 1998, under the brand name Viagra, sildenafil was made available to the general public.

Viagra and the Clinical Trials

Viagra has been studied extensively in clinical trials, at doses of 25 mg, 50 mg, and 100 mg. It has been clearly demonstrated to improve erections. Viagra was evaluated in 21 randomized double-blind, placebo-controlled trials of up to six months. In these trials, Viagra was studied in more than 3,000 patients between the ages of 19 and 87, who had had erectile dysfunction for an average of five years. More than 550 patients were treated for longer than one year. Clinical testing occurred in a "real world" setting.

The efficacy of Viagra was demonstrated in all 21 studies. In clinical trials, patients receiving Viagra reported a 78 percent improvement in erections versus 20 percent for a placebo pill. (Note the high placebo percentage, indicating that a significant number of patients didn't need Viagra or any other medication to overcome their ED.)

Though manufacturer Pfizer claims that the word Viagra was chosen at random, and Alond was almost chosen as the product name, the word does seem particularly rich in connotations. "Niagara" springs to mind immediately, bringing forth visions of rushing, explosive power. Niagara Falls is also, of course, the classic destination for honeymooners, so there is a subtle implication that Viagra can revive those feelings couples had during their honeymoon. "Vigor" also comes to mind -- as in young, healthy men with vigorous erections.

Viagra is not an aphrodisiac. It has no effect on sex drive or libido. Thus it cannot cause an erection in the absence of stimulus: it doesn't send the message for an erection to occur, nor does it create extra blood to make the penis that much harder. So while the drug does facilitate an erection, it does not necessarily enhance one. It won't increase pleasure beyond what is felt during normal, healthy intercourse. If a man does not have erectile dysfunction, Viagra will have no effect on his erection. Similarly, a patient who has achieved success with a 50 mg dose of Viagra will find no additional benefits from a 100 mg dose. Picture a dam where the wheels that open the floodgates have rusted shut. Viagra is simply the grease that frees those wheels up and allows the water to come pouring through. It doesn't turn the wheels of its own accord, doesn't force the floodgates open any wider than they would normally go, and doesn't generate any additional water. It simply allows the dam to function as it normally would -- and for most men with ED, this is certainly enough.

Contraindications

No doubt you have heard the reports of hundreds of deaths linked to Viagra. At last count 220 deaths had been associated with Viagra in some way, and by the time you read this the number will have climbed further. While investigators are still determining what role Viagra played in these deaths, one thing is overwhelmingly clear: for a large group of men with erectile dysfunction, taking Viagra could cost them their lives. 

Pfizer does not dispute this and warns that Viagra is absolutely contraindicated in patients taking nitrates in any form and at any time. There are 125 drugs currently on the market that contain nitrates, which are commonly used to treat hypertension -- high blood pressure. They work by dilating blood vessels, thereby lowering blood pressure. Viagra potentiates this effect, causing a feeling of sickness and, more importantly, a potentially dramatic drop in blood pressure. Think of a hose that is widened so that the water flows smoothly out of the end, but then is widened again, so much that only a trickle now comes out, and none gets to your flowers.

Disturbing Trends

As a medication, Viagra has been a clear success. It has lived up to Pfizer's claims, and, when the instructions on how to use it are followed to the letter, it seems to cause only minor side effects (its long-term effects will not be known for years). As a social phenomenon, however, Viagra comes dragging many question marks.

Clearly too many men are dying due to Viagra. True, they ignored (or never saw) warnings about mixing Viagra with nitrates and other drugs, or they ignored their own cardiovascular condition. But ED is a powerfully emotional issue, so it may not be fair to tell these men, "Here is a medicine that will allow you to have sex again, but it may kill you." It is a bit like putting a pie in front of a three-year-old and saying, "This is for later; you can smell it, but don't eat it now." We know that temptation and desperation are regularly going to triumph over common sense in these situations.

The desire to obtain Viagra anonymously, due to the embarrassment many men with ED feel, has driven an explosion of online pharmacies that may ultimately prove to be far more damaging than Viagra could ever be. The best of these "pharmacies" ask a few questions about your situation and other medications you may be taking; the worst are set up overseas, beyond the regulatory power of the United States, and for the right price will simply ship you whatever prescription medicines you want. In one case, the physician approving prescriptions for a domestic online pharmacy was found to be a retired veterinarian living in Mexico. And, though these online pharmacies have become vastly more popular due to Viagra, they also prescribe a host of other potentially dangerous drugs, including Demerol, Propecia, and Xanax.

Obviously, if many men begin obtaining Viagra without proper overseeing by qualified physicians, and without essential preliminary and follow-up physical exams, the death toll will rise dramatically. This is why it would be so much better for the word to get out that ED can usually be successfully treated with completely natural physical, behavioral, and psychological methods.

The Bottom Line

A great deal of progress has been made in the pharmacological treatment of erectile dysfunction, and Viagra is the greatest leap forward that field has ever taken.

So let us give Viagra its due: it is a step forward, and for some men it is indeed the answer. But there is still a 20 to 50 percent chance of failure from treatment with Viagra, depending on the origin of the erectile difficulty. It is not a panacea, even for men not interested in addressing the underlying causes of their ED.

More importantly, good sex does not happen on its own. Yes, the penis is the focus of therapeutic attention. But the penis is connected to a body, which has a brain, and frequently that body is associated with another body -- a partner. Regrettably, this is often forgotten in ED treatments. Restoring erectile function is one thing. For restoring good sex, it is essential to address personal and emotional factors in the sufferer, as well as conflicts in his relationship with his partner -- all of which may be instrumental in causing or maintaining the present erectile disorder. Often sex therapy can be extremely useful, with or without the use of natural or pharmaceutical "helpers". It is important not to neglect this ever-present component.

Article Source:

The Viagra Alternative: The Complete Guide to Overcoming Erectile Dysfunction Naturally
©1999, by Marc Bonnard, M.D.

Reprinted with permission of the publisher, Healing Arts Press, a division of Inner Traditions International. http://innertraditions.com.

For more info or to order this book.

About the Author

MARC BONNARD, M.D. is a psychiatrist specializing in sex therapy and he is a graduate of the French Association of Acupuncture. He runs a private clinic near Bordeaux, France where he focuses on healing the whole person with treatments ranging from herbs to homeopathy, acupuncture, diet, yoga exercises, and the introduction of new sexual techniques. He lectures throughout Europe on the topic of erectile dysfunction.