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March 19, 2001 (Orlando, Fla.) — OK, to recap: When Viagra was introduced, there were reports that the anti-impotence drug could be dangerous if taken by men with heart disease, particularly those who were on nitrate drugs. Those fears seem to be fading as recent research counters the early findings.

In fact, two new studies presented here Monday at the annual meeting of the American College of Cardiology (ACC) suggest that Viagra could help the heart and blood vessels work more effectively during times of physical demand, such as sexual erectile dysfunction new drugs
. What’s more, a third study makes the case that the drug may never have been as bad for the ticker as initially thought.

What this amounts to “is further evidence that Viagra is a very safe drug to use for most people,” says a member of the ACC panel that issued recommendations in 1999 on the use of Viagra in patients with heart disease.

“We used to think that it wasn’t a good idea to give it to men who were taking multiple drugs to treat high blood pressure, but now after our experience with millions of patients, the only absolute ed meds
is in men who are on nitrates,” says Adolph M. Hutter Jr., MD, professor of medicine at Harvard Medical School and a specialist in cardiovascular medicine at Erectile dysfunction treatment
General Hospital, both in Boston.

“Men should not use Viagra for 24 hours before or 24 hours after taking nitrates,” Hutter tells WebMD.

In the first study presented at the ACC conference, Charalambos Buy loss phentermine prescripti viagra weight
, MD, and colleagues from the University of New South Wales in Sydney, Australia, randomly assigned 27 men in their late 60s and 70s to receive either Viagra or an identical but inactive placebo. The researchers then looked at the stiffness of the men’s arteries — the stiffer the artery, the harder the heart has to work to pump blood out of its chambers.

They found the drug made the arteries erectile dysfunction pills
more flexible and lowered blood pressure both when the heart was at work and at rest. This led them to conclude that the drug “may contribute to improved exercise capacity of the patient during intercourse.”

In a separate study out of Brazil, researchers looked at 18 patients with erectile dysfunction and moderate congestive heart failure who were randomly assigned to receive Viagra or placebo. Within 60-90 minutes of taking the pill, the subjects were asked to walk for six minutes on a treadmill and then, after resting, to perform a standard stress test while being monitored for signs of problems.

The researchers found that in addition to being effective for treating erectile dysfunction in patients with congestive heart failure, Viagra also appears to increase exercise capacity. Despite concerns that it would cause dangerously low blood pressure by dilating blood vessels, they found that the men who took Viagra actually had the same blood pressures during physical exercise as the ones who didn’t.

“The study on congestive heart failure patients was very reassuring, because they had borderline low blood pressure, and that’s the group we were concerned about,” Hutter says. “It’s only a small number of people, but it’s very reassuring that not only can many of those patients use Viagra safely, but they actually benefit in terms of erectile performance and exercise capacity.”

The third study looked at about 5,600 British men for up to six months after they started taking Viagra.

“We didn’t find any evidence of increased death from heart attack in men who took Viagra in England,” says Saad A.W. Shakir, MD, a pharmacoepidemiologist at the University of Southampton, U.K.

The finding that Viagra may have a role in moderating the effects of exercise on heart disease actually is not so surprising, because the drug was originally developed for the treatment of chest pains due to angina pectoris, a condition caused by narrowing of the blood vessels that supply the heart.

Viagra causes smooth muscle in blood vessel walls to relax, theoretically allowing the vessels to expand and thereby carry a greater volume of blood. Although early clinical studies indicated that the drug was a bust for treating heart disease, many of the men who took part in the study were reportedly reluctant to return the pills, apparently because they worked wonders for another part of the anatomy.

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May 1, 2000 (Atlanta) — Move over guys. Another “men only” sign is coming down. Studies reported here at the world’s major urology conference suggest that the revolutionary male impotence drug Viagra may work for the other half of the population, too.

Experts warn that the studies, while interesting, offer no proof whatsoever that Viagra actually helps women. Such proof can be obtained only from larger studies. But two provocative studies of women with female sexual dysfunction show that by several measures, sexual satisfaction improves in some women who take the drug.

Are physicians already offering Viagra cure dysfunction erectile to women? “They certainly can, and they do, and they are now,” the co-author of one of the studies, Jennifer R. Berman, MD, tells WebMD. “There are a number of prescriptions that have been written for women — I don’t have the number, but it is not small,” she says.

Mariann Caprina, spokeswoman for Pfizer, the manufacturer of Viagra, says that more information on women and Viagra may be reported at a medical conference later this month. “Right now, it isn’t indicated for women, and we’re certainly not going to recommend it until we have some data,” she tells WebMD.

Irwin Goldstein, MD, who co-authored the study with Berman, warns that it doesn’t prove anything. He points to a study in Europe in which seven out of 10 women with sexual dysfunction said a pill improved their sex lives. What the women didn’t know was that it was a sugar pill and had no effective ingredients. Goldstein says, “women who have sexual dysfunction in the year 2000 must have a full clinical and psychological evaluation. … By 2005 or 2006 we should understand much more. But we don’t know this yet and to discuss Viagra is premature.”

Laura A. Berman, PhD, Jennifer Berman’s sister and erectile dysfunction help
at Boston University Medical Center, notes that the erectile dysfunction meds
— surgical removal of uterus, or womb — appears to be a risk factor for sexual dysfunction. She says surgeons might cut through as-yet unidentified nerves and/or blood vessels that could be important for sexual arousal. The Bermans, Goldstein, and their colleagues enrolled 35 women, on average about 50 years old, who had hysterectomies at least two years previously. After the operation, these women found they lost much of their ability to feel sexual sensations.

After taking Viagra, these symptoms dramatically improved. Before taking Viagra, all the women reported low sexual sensation and no orgasms. After taking Viagra, 27 of the 35 women had improved sensation and 29 had orgasms. Sexual desire, pain or discomfort during sex, and lubrication of the vagina also improved in more than half the women who took Viagra.

A second, very small study tested Viagra in 16 women with sexual dysfunction. University of Maryland researcher Toby C. Chai, MD, and colleagues used a alternative herbal search viagra
noninvasive device to measure blood flow in the genital area. They then gave the women two identical bottles of three pills — one containing 100 mg Viagra and one containing identical sugar pills — and told them to take one pill at least an hour prior to sex.

The results were dramatic for every measure of sexual function. Viagra improved sexual experience, sensation, and lubrication in 10 of the 16 women, and it increased the ability to achieve orgasm in nine of them. Only one woman said the sugar pills had the same effects. “Some women with sexual dysfunction will respond to Viagra,” Chai tells WebMD. “However, the drug doesn’t seem as effective for women as it does for men.”

Even more important than the Viagra studies — if less dramatic — were several conference reports of studies about what sexual dysfunction in women actually is. Jennifer Berman notes that between 30% and 60% of U.S. women report some form of sexual problem. But whether this represents true dysfunction or just dissatisfaction remains unknown.

“There is a school of thought that says the standards of sexuality in the U.S. are dysfunction pill
, in much the same way that we have an unrealistic standard for body image,” Laura Berman tells WebMD. “That is not to say that there are not many women out there with real problems.” Only now, notes Jennifer Berman, have women felt able to discuss their sexuality with their physicians.

Goldstein notes that scientific study of sexual dysfunction in women began only recently. “We’ve been doing this for two years — a short time,” he says.

A large proportion of sexual dysfunction in men is caused by problems with blood vessels, which inhibit erection. Goldstein notes they don’t see as many of these problems in women. Most female sexual dysfunction is hormonal or caused by problems with the nervous system. Having children can play a role as well, he says. “Postdelivery the vagina recovers from this 10-pound item coming through it, but all functions are not always restored.”

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Aug. 5, 2004 — Erectile dysfunction apparently isn’t just an older man’s problem anymore. Young men, even some who are pills
, are leading the surge in Viagra use.

New research indicates that the use of Viagra skyrocketed 312% among men aged 18-45 between 1998 and 2002. There’s also been a twofold increase — 216% — among men between ages 45 and 55, says Tom Delate, PhD, whose research analyzed data on medical insurance claims by some 5 million patients across the country.

“We tried to see if these patients had an underlying medical condition and we couldn’t identify one in the majority,” says Delate, director of research for Express Scripts, Inc., a St. Louis-based firm that conducts pharmaceutical research for insurers, managed care organizations, and other companies.

“What we found was that problems typically seem to start in a man’s 40s and affected only about 40% of the men in these age groups.”

Enhancer Rather Than Remedy?

Does this suggest a growing trend in using the drug for recreational rather than medical purposes — such as for a sex enhancer?

“That would be my guess,” Delate tells WebMD.

While Delate notes that men older than age 56 continue to fill the lion’s share of dysfunction female male sexual treatment for Viagra, his study — published in the August issue of the International Journal of Impotence — also shows a 13% increase in Viagra prescriptions for women between ages 18 and 45. While some studies indicate that Viagra can increase sex drive and satisfaction levels in women, especially before menopause, this is not a consistent finding.

Delate also finds that two in three prescriptions came from primary care ed pills
, rather than urologists.

“One suggestion about what may be going on: It could be that patients are coming in, asking for the drug, and the prescriber wants to please the patients and meet their ed tablets
,” he tells WebMD. “It could be the primary care physician doesn’t have a lot of time to spend with them, and may not be asking questions.”

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July 10, 2000 — In the two years since it rocketed onto the market — and
became, almost overnight, a household word — the impotence drug Viagra has
helped men with erection problems enjoy satisfying sex. The little blue pill
fired the male erectile dysfunction medication
with the notion of an enduring and youthful virility
that could last into the golden years.

But truth is, Viagra is not the sexual cure-all that many men who have
problems with erectile dysfunction believed it to be. As many as two in five
men who try the drug don’t get the desired results. And at least 39 Viagra
users have died, mostly men who were also taking other drugs, or who had
serious heart disease (see the November-December 1998 issue of Clinical
Dysfunction pills
).

No wonder that early reports of another, perhaps better, drug were so
tantalizing — both to the media and to men who got no generic soft tab viagra
from
Viagra. The very name of the new drug — Uprima — conjured up images of
supremacy and conquest.

Then, last week, came the news that threw a splash of cold water on these
oh-so-fond hopes: TAP Pharmaceuticals, the maker of Uprima, unexpectedly –
perhaps temporarily — withdrew its application for approval by the Food and
Drug Generic overnight viagra
(FDA).

Why did the company pull a product that just weeks ago had been widely
expected to gain FDA approval and give Viagra a run for its money in the
billion-dollar impotence market? Experts speculate that the agency may, in
fact, have been poised to reject the drug’s application or to severely restrict
its recommended use. The reason: serious questions about the drug’s safety at
higher doses and its efficacy at lower ones.

Before submitting its application to the drug agency, TAP Pharmaceuticals
tested Uprima on more than 2,700 men in final clinical trials. The experience
of two of those men, interviewed by WebMD, offers a glimpse at the drug’s
possibilities — and drawbacks.

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Aug. 18, 2000 — The impotence treatment Viagra might seem an unlikely drug to find at nightclubs or raves, the all-night dance parties popular with teens. But experts say Viagra has begun making the club scene — especially as an adjunct to ecstasy and “poppers,” a combination that is questionable at best.

One rave fan says the combination of Viagra and ecstasy makes some sense. “Ecstasy makes it so you can’t get an erection,” says Soren Roinick, a Boston-based member of the group DanceSafe, which promotes “healthier” raves. At the same time, he says, it’s not as if every raver’s got his hand out for a little blue pill. “Ecstasy lowers all your aggression, including your sexual aggression,” he says. “You might bond with someone per se, but generally, people at raves are not going home and sleeping with someone.”

Still, researchers have taken note of the phenomenon. The practice of combining Viagra and ecstasy is mentioned in an article on the health risks of raves by Erica Weir, MD, a resident in community and family medicine at McMaster University in Hamilton, Ontario, in a recent issue of the Canadian Medical Association Journal. And in a letter to the British Medical Journal last year, researcher Judith Aldridge of the University of Manchester wrote that her study of 2,000 people found Viagra was being sold illicitly in English nightclubs within weeks of becoming available in that country.

Many nightclub-goers interviewed by the British researchers reported having taken Viagra along with illicit drugs and alcohol. The combination with “poppers” — vials of amyl nitrate or isobutyl nitrite sometimes used illicitly as an aphrodisiac — is particularly worrying, Aldridge writes: “Both drugs dilate blood vessels, which can result in a dangerous drop in blood pressure and possibly heart attack or stroke.”

In the U.S., Roinick says he has seen Viagra use at raves on the West Coast — though nothing too extensive — and suggests it’s probably more common with older crowds at sadomasochistic offshoots of the dance parties. “Normally, raves are a positive-vibe kind of place,” Roinick says. “There’s a big drug scene that’s not part of the rave scene.”

Still, there’s little doubt those positive vibes emanating from some of these dance parties have something to do with drugs — in particular ecstasy, also known as MDMA. Roinick, who admits to being an occasional ecstasy user, says there’s a good reason young people are attracted to the drug: “It just makes you feel really, really happy.”

But there’s little that’s happy about the ultimate effects of ecstasy, one expert says — and, although it’s not entirely clear what happens when people take it along with Viagra, the results of mixing Viagra and poppers are definitely grim.

Ecstasy “is a bad, bad, bad drug, no matter what you read” says Wilkie Wilson, PhD, professor of pharmacology at Duke University Medical Center in Chapel Hill, N.C., and co-author of Buzzed: The straight facts about the Most Used and Abused Drugs. The drug, Wilson says, may very well have a long-term effect on mood. “What happens is, as we age, we lose serotonin function. So if you’re kicking off a bunch of it when you’re young, the end result is depression.”

Roinick says the common “cure” for ravers who feel depressed after taking the drug is to lay off ecstasy for a couple of weeks to give the brain time to recover. But Wilson says some studies have shown there is no such thing as recovery from ecstasy — and further, that the drug can dangerously increase both body temperature and blood pressure.

Viagra, on the other hand, can cause a decrease in blood pressure, and Wilson says he can’t say whether combining the two drugs is necessarily dangerous. But psychiatrist Marshall Forstein, MD, medical director of Mental Health and Addiction Services at Boston’s Fenway Community Health Center, warns that it’s a bad idea.

“A lot of the ecstasy is not pure,” he says. “It’s a mix of different amphetamine salts. But even so, ecstasy affects the liver metabolism of Viagra … they inhibit enzymes which metabolize each other.” That can cause a potentially dangerous rise in blood levels of each drug. ” He also says there have been reports of strokes in people who take the two drugs together.

As for using Viagra with poppers, which are particularly popular in the gay community, there’s no uncertainly as to the dangers. “The risks with the poppers is serious,” Forstein says. “They lower blood pressure dysfunction pill
.”

So why would someone want to take these two drugs together? “Poppers dilate blood vessels. So they make people get a rush,” he explains. “The problem is, many men become sexually dysfunctional with constant use and that’s when there’s a tendency to want to use Viagra.” Even men who don’t intend to use the two drugs together can get into trouble in clubs, where vials of poppers sometimes get shoved under unsuspecting nostrils, Forstein says. Men who have used Viagra hours earlier can be affected, since the erection drug stays in the body for such a long time.

In an article distributed by the Canadian Press news service, a spokesman for Viagra levitra vs cialis
Pfizer says the company warns against using Viagra with poppers or ecstasy. “Viagra is not an aphrodisiac and has no effect on libido,” says Don Sancton, director of corporate affairs for Pfizer, Canada.

No one can say at this point the extent of drug-mixing going on in the nightclub and rave scene — and, in particular, the use of Viagra there. Conrad Roberson, of the Drug Identification section of the Georgia Bureau of Ed pills
, says it’s unlikely authorities would take much notice of the illegal possession of Viagra when they’re arresting someone for the far more serious offense of possessing ecstasy. And because Viagra falls outside the list of federally “controlled” substances, its use is not of legal concern to the Drug Enforcement Administration.

But according to one advocate, the very nature of the rave culture is not conducive to the widespread use of Viagra.

“The rave community is not a super, highly charged sexual community,” says Jennifer Keys, media representative for DanceSafe’s Seattle, Wash., office. “It’s supposed to be based on mutual self-respect. There are very few rapes at raves. You’re much more likely to have that at rock concerts.”

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Aug. 30, 2000 –The popular drug Viagra has improved the lives
of millions, but regular exercise could make it obsolete, according to a report
in the journal Urology.

In the first study of its kind, researchers showed that
physically active men have a lower risk of developing erectile dysfunction (ED)
than inactive men, even if they don’t begin exercising until midlife. But
impotence sex
, the study found that reducing tobacco and alcohol use and losing
weight in midlife didn’t reduce a man’s risk of developing erectile
dysfunction.

“Our study showed that men who burn 200 calories a day,
often by walking briskly for about two miles, can lower their risk of ED
significantly,” says study co-author Irwin Goldstein, MD, a professor of
urology at Boston University School of Medicine. “And men who burn more
than 200 calories a day can lower their risk even more.”

Defined as the inability to have or maintain an erection,
erectile dysfunction affects over half of all men between 40 and 70 years of
age, but isn’t necessarily part of aging.

For their study exploring the effects of lifestyle changes on
ED, Goldstein and colleagues interviewed nearly 600 healthy men ranging from
40-70 years of age. After their body mass was calculated, the participants were
polled about their physical activity, smoking habits, alcohol use, and sexual
function. Eight years later, the process was repeated.

Unlike regular exercise, smoking cessation, alcohol reduction,
and weight loss in midlife didn’t reduce the risk of developing erectile
dysfunction, according to the study. “This suggests that midlife changes
are too late to reverse their effects,” Goldstein cautions, “and
highlights the importance of adopting healthy behaviors early in life.”

One of the major causes of erectile dysfunction is hardening of
the arteries, which reduces the amount of blood that can enter and enlarge the
penis. “That’s why we say that good heart health is needed for good
sexual health,” says William Steers, MD, professor and chairman of urology
at University of Virginia in Charlottesville.

“In fact, ED may be an early warning sign of a future heart
attack or stroke,” Steers tells WebMD. “So think about some other ways
to reduce your risk of heart disease and diabetes,” he urges. For example,
men should:

  • Stop smoking erectile dysfunction
    and cigars
  • Get their blood pressure under control
  • Reduce dietary fat to lower their cholesterol
  • Lose excess weight for their height
  • Limit alcohol to one or two drinks a day

But even men who get started on a healthy lifestyle early in
life may experience impotence occasionally. “Generic pills viagra
factors like
depression and anxiety can put the brakes on sexual function, but stress is
probably a bigger issue,” says Drogo Montague, MD, director of the Center
for Sexual Function at Ohio’s Cleveland Clinic and chairman of the American
Urological Association’s ED Guidelines Panel. “It can even lead to
persistent difficulty, so look for ways to relax and clear your mind.”

He also advises that men looking to avoid ED:

  • Get adequate sleep to reduce fatigue
  • Plan some time together with their partner, away from the kids
  • Avoid alcohol before sex

Also, “a common cause of permanent impotence is physical
trauma like spinal cord injuries and pelvic fractures, so remember to wear your
seat belt,” Montague says.

The study was supported by the National Institutes of
Health.

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March 24, 2005 — Web sites touting herbal “Viagra” for erectile
dysfunction draw criticism in a new British study.

It’s easy and confidential to find such sites, say the researchers. But
“patients should be cautious as safety and
reliability of this approach is poor,” they write.

They’re particularly concerned that some sites may not provide all the facts
about the products or warn patients to get their heart checked out.

Erectile
dysfunction (ED) may be a sign of heart disease or blood vessel
problems.
These conditions could go undetected and untreated in
patients using herbal treatments, say the researchers. Without knowing the
ingredients or side effects of such treatments, patients could unwittingly put
their health at risk.

ED Affects Millions of Men

Erectile dysfunction (ED) affects nearly 30 million men in the U.S., say the
researchers. ED may stem from physical or psychological issues or a combination
of both factors. It doesn’t mean that men lack desire or sexual interest, and
it’s not a normal, occasional problem. Instead, ED is a man’s consistent
inability to maintain an erection to have satisfactory sex.

The risk of erectile dysfunction increases with age:

  • About 40% of men in their 40s report at least occasional problems getting
    and maintaining erections.
  • 52% of men between ages 40 and 70 report erection problems.
  • About 70% of men in their 70s report erection problems.

Doctors can prescribe treatments to help, but many men don’t discuss ED with
their doctors. “It is estimated that close to 90% of ED sufferers are still
reluctant to visit their family doctors because of embarrassment,” says the
study.

With Internet access common, some men may go online to look for solutions.
But they may not always get what they bargained for, the study suggests.

Looking at 33 web sites selling herbal substitutes for Viagra, the
researchers spotted red flags including:

  • No information from medically trained staff (79% of the sites)
  • No statement that the site’s information doesn’t replace medical advice
    (76% of the sites)
  • No warning about ED-associated heart disease (None of the sites posted this
    warning.)
  • No information about contraindications (64% of the sites)
  • No information on side effects (79% of the sites)
  • Lack of referenced information (82% of the sites)
  • Lack of disclaimers (67% of the sites)
  • No information about ingredients (30% of the sites)
  • No information on pills
    of the herbs (18% of the sites)

“All sites fell short of the Health on the Net requirements,” says
the study.

The Health on the Net (HON) Foundation is a medical and health web site
accreditation organization supported by the World Health Organization. HON
provides standards that it recommends health information web sites adhere
to.

What’s in the Bottle?

Herbal treatments aren’t regulated by the government. The most common
ingredients cited in the study were yohimbe,ginseng, and ginkgo
biloba.

Yohimbe can cause headaches, sweating, and high blood pressure, making it
herbal impotence treatment for patients with heart and cheap generic viagra
disease, say the
researchers. Reports of diarrhea, vomiting, headaches, and allergic skin
reactions have been linked to gingko biloba, they say.

That’s not to say that those herbs might not have an effect on ED. But the
pros and cons of any treatment — herbal or not — should be made clear, the
study suggests.

Health experts recommend that patients tell their doctors about any
supplements they take (including herbal products and vitamins). That could help
avoid interactions between treatments.

Herbal or Not?

Two years ago, the FDA cracked down on a supposedly all-natural herbal
treatment marketed to men and women to enhance sexual experience. The FDA
learned that the product, called Vinarol,Vinarol, actually contained Viagra’s active
ingredient, says the study.

“It is unknown how many other treatments for ED marketed as
“herbal” supplements actually contain active and potentially dangerous
compounds,” write the researchers, who included Ramesh Thurairaja of the
urology department at England’s Bristol Royal Infirmary.

The study appears in the March/April issue of the Erectile dysfunction meds
Journal
of Impotence Research
.

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April 1, 2005 — Fourteen men reportedly have had vision loss while taking the erectile dysfunctionerectile dysfunction drug Viagra, say ophthalmologists at the University of Minnesota.

The men lost only part of their vision. Cases appear to be very rare.

Most of the affected men had other health problems and the structure of their optic nerve (the nerve that handles vision) raised their risk of the condition.

“The number of cases is extremely small,” says Howard Pomeranz, MD, PhD, who details seven of those cases in a new report. The condition is called sildenafil citrate and discount anterior ischemic optic neuropathy (NAION).

“The likelihood of this happening in an individual is pretty small. It’s a question of weighing the relative risks,” Pomeranz tells WebMD. He suggests that men taking or considering Viagra might want to check with their doctors about any risks.

Pomeranz adds that he’s also heard of three similar cases with another erectile dysfunction drug,erectile dysfunction drug, Cialis. “I don’t know of any with Levitra yet,” he tells WebMD.

The Maker of Viagra Responds

Viagra has been used by 23 million men, says Daniel Watts, a spokesman for Pfizer, which makes Viagra. He says that 103 clinical trials of Viagra have not had any reports of NAION.

“We would say that there does not appear to be sufficient evidence to suggest a single discount generic levitra online viagra
association of these events with Viagra therapy,” says Watts. “We rest with all the data and will continue to monitor the database.”

“I have no reason to doubt their statement,” says Pomeranz. Still, he says that problems not seen in clinical trials later show up after a drug has been widely used for some time.

Pomeranz - in his new report — describes seven new cases since his last report in 2001. He says he’s seen most of the 14 patients himself over the years. The study appears in the Journal of Sildenafil citrate soft tab March issue.

The seven men experienced partial loss of central and/or peripheral vision, says Pomeranz. The loss wasn’t total, meaning the men didn’t go blind, but it was “permanent in all cases,” says Pomeranz. One man described it as “a shade coming down,” according to the report.

One man had problems in both eyes; in the rest of the men, only one eye was affected, says Pomeranz. The men said the problems started within 24-36 hours of taking Viagra, according to the study.

Risk Factors

The men were all 50-69 years old. Almost all had health problems including high blood pressure, diabetes, high cholesterol, and/or a history of smoking, Pomeranz tells WebMD.

A rare structural problem in the optic nerve was also noted.

“One of the major risk factors identified in this paper was the small cup-to-disk ratio of the optic nerve,” says Pomeranz. “We know that a relatively small percentage of the population as a whole has this small cup-to-disk ratio.” That could raise the risk of NAION. The cup-to-disk ratio is a way doctors measure the small indentation where the optic nerve connects to the retina in the back of the eye. This can be measured during an eye exam.

“One thing people could do is see if they have this risk factor and decide sildenafil citrate 100mg,” says Pomeranz. He also advises patients to consult a doctor about any eye problems, “viagra generic drugs
optic nerve problems.”

About 15% of people with NAION in one eye eventually develop it in the other eye, he notes.

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March 29, 2004 — Men have high book guest order viagra
of Viagra, and if the drug fails them the effects can be devastating to their ego, a new study suggests.

Researchers found that men are more distressed about erectile dysfunction than previously thought, and the media frenzy surrounding the launch of Viagra has cialis vs viagra
raised their expectations of treatment.

The study shows that impotence has a considerable impact on men, “with most more deeply shocked than generally realized, their masculinity and self-esteem being particularly affected.”

When treatment with Viagra was successful, men’s self-confidence surged. But if the drug did not work on the first try, the study showed the psychological blow was severe and led to depression in some cases.

Impact of Erectile Dysfunction

Researchers say much attention has been given to the causes of erectile dysfunction, but little is known about the impact of the disorder and its subsequent treatment.

In this study, published in the current issue of the British Medical Journal, researchers interviewed 40 men who attended a men’s health clinic in the U.K. and were prescribed Viagra for erectile dysfunction. The average age of the participants was 52.

The study shows the most common initial reaction to erectile dysfunction was a sense of emasculation.

“For many men, the ability to perform sexually and to satisfy their partner was an important maker of their masculinity,” write researcher John Tomlinson, of the Men’s Health Clinic at Royal Hampshire Country Hospital in Winchester, U.K., and colleagues.

This decline in self-confidence not only affected their sexual relationships, but it also had a negative effect on day-to-day relationships with co-workers and friends. Many men said they felt “old before their time.”

Impact of Treatment With Viagra

Most of the men had first heard about Viagra on television or in newspaper articles and had high expectations of the drug before taking it. Researchers found many men expected to gain an instant erection easily and immediately before sexual intercourse.

Men who were successfully treated with Viagra experienced a boost in self-confidence.

But if the drug failed to work on the first try, the psychological blow was severe. Most tried the drug again, but a second failure just confirmed their negative feelings.

Researchers found all the men who thought the treatment had been ed pills
expressed a considerable degree of treat erectile dysfunction the best, and they often attributed it to the media hype that raised their expectations of Viagra.

Many also thought the treatment was unsuccessful because it took the spontaneity out of their sex or because their sex life now depended on medical treatment.

Researchers say the findings suggest that health-care providers need to be sensitive to the effects of erectile dysfunction as well as the impact of its treatment.

“Erectile dysfunction has a major psychosocial impact on men, and health erectile dysfunction advices
might well also anticipate an impact on personal relationships,” write the researchers. “The media have had a major effect on expectations of the effects of Viagra, and in retrospect, less sensational reporting would have lowered those expectations to the patients’ benefit.”

SOURCES: Tomlinson, J. British Medical Journal, March 29, 2004; vol 328.

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Oct. 21, 2003 (Salt Lake City) — With prostate cancer treatment success often comes at a heavy price: erectile dysfunction. But, a new study shows that Viagra will work in nearly 70% of the men who have online sildenafil citrate erectile dysfunction for years to come.

Michael Zelefsky, MD, of Memorial Cialis viagra wirkung
Cancer Center, N.Y., tells WebMD that the radiation-associated erectile dysfunction usually “begins about six months after they have concluded therapy, but it can occur at any time during or after treatment.” He says that he has already reported that “about 70% of men initially respond to Viagra. However, they didn’t know if the response would be durable.”

In the new study, which was presented at the 45th Annual Meeting of the American Society for Vardenafil hci Radiology and Oncology, Zelefsky and his colleagues studied the “durability” of response by following 360 men with radiation-induced erectile dysfunction who initially responded to the drug. He followed the group for an average of nearly four years after their surgery to see if they were still taking Viagra for erectile dysfunction.

The results, he says, were surprising. “I didn’t really expect them to still be taking the drug and I expected that for many men the effect would diminish with time.” But after almost four years, 96% of the men who initially responded to Viagra were still taking the drug and all but six of those men said the drug was still effective.

All of the men in the study had prostate cancer that was confined to the prostate gland. They received radiation therapy by either external beam treatment or by brachytherapy, in which radioactive “seeds” implanted in the prostate deliver radiation directly to the tumor.

The external radiation is done while the patient lies in a special box that allows multiple radiation beams to be directed directly to the prostate gland from all sides, while the rest of the body is protected from the radiation.

Prostate cancer is mainly found in older men. After prostate cancer has been diagnosed, tests are done to determine if it has spread outside the gland. Because there are different erectile dysfunction help
available, determining how much the cancer has spread this will help in deciding what treatment is best for the cancer.

Surgery to remove the cancer is one option that is used to treat prostate cancer. Radiation is another therapy used in treating this cancer. Erectile dysfunction can occur in men treated with either one of these treatments.

Zelefsky says the men who reported that Viagra stopped working were those who were treated with extremely high-dose external radiation.

Richard Valicenti, MD, associate professor radiation oncology, at Thomas Jefferson University Hospital, in Philadelphia, tells WebMD that the study is “important since it shows that treatment with Viagra can deliver a durable response.” But Valicenti, who wasn’t involved in the study, says that he, too, is a little surprised by the results, especially because of the fairly large range in the length of treatment and because drug tolerance is common.

“We don’t really know how often they are taking the drug. We know that with repeated use tolerance develops for many drugs and we expect it for this drug as well,” he says.

If tolerance does develop, the new erectile dysfunction drug, Levitra, could be an option says Zelefsky. He says his group is conducting a study with this newly approved drug but notes that it will be sometime before the results are available. Meanwhile, he says that he is trying Levitra in men who don’t initially respond to Viagra.

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