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Since the advent and commercial availability of Sildenafil Citrate (Viagra«) in 1998, the market for treatments for erectile dysfunction has grown to become worth about $2 billion worldwide per annum. That is now projected to grow to $4 billion per year by the year 2004 and to an astonishing $6 billion per year by 2006! (1)
How effective is sildenafil (Viagra)?
A. The inflatable implant has the significant advantage of allowing an instant erection. The disadvantage is the inherent complexity of a mechanical device. When a problem occurs, surgery is needed to fix it.
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Extensive testing required
Diagnosis Just a decade or 2 ago, the routine evaluation of erectile dysfunction consisted of an exhaustive biochemical screening panel, psychological assessments and occasional vascular testing. This approach was justified as reasonable at the time, because the treatment options available were invasive. In contrast, current recommendations for management rely on history-taking and basic screening tests. The Canadian Urological Association has recently developed an algorithm for the management of erectile dysfunction that supports this approach.28
Common Sense Measures
Kidney disease Do you: Smoke Drink alcohol Use recreational drugs How often do you exercise?
Treatment Oral therapy
To test the seat, the firm consulted with Robert Kessler, MD, professor of urology at Stanford University Medical Center in Palo Alto, Calif. In March 1999, Kessler recruited 25 cyclists. Each one regularly rode at least six hours weekly, and all had suffered from perineal pain, numbness, and erectile dysfunction. The cyclists used the new seat for a month and then shared their results.
Medications such as erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), ritonavir (Norvir), and indinavir (Crixivan) can slow the breakdown of tadalafil. Therefore men taking these medications should not take more than 10 mg of tadalafil and should not take tadalafil more frequently than every 72 hours.
The cardiac effects associated with sildenafil have been studied extensively. Sildenafil is absolutely contraindicated in patients taking nitrates such as nitroglycerin or isosorbide. This is because sildenafil, like the other PDE-5 inhibitor medications, can potentiate the vasodilatory effects of the nitrate-based medication, resulting in an exaggerated vasodilatory effect that is potentially dangerous. Patients with serious cardiac disease, with exertional angina, or taking multiple antihypertensive medications are advised to seek the advice of a cardiologist before beginning therapy with sildenafil. A number of studies examining the cardiac effects of sildenafil have conclusively shown that no adverse consequences exist under normal circumstances.
Reality: Although ED is most common in men 65 and older, it can occur at any age. Statistics show that the majority of men experience erectile problems at some point in their lives, and 10 percent of the entire male population has persistent ED, according to the American Medical Association. Because diseases such as diabetes and heart disease interfere with blood flow and increase the incidence of developing ED, men who develop these conditions, no matter how young they may be, are more likely to experience erectile dysfunction.
Myth #2: Erectile dysfunction should just be accepted as a natural part of the aging process.
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"What I see as a problem is the public has been educated to believe that good sex requires an erect penis that stays hard through the entire sexual encounter," Shaw tells WebMD. "This definition of good sex changes the basic nature of an encounter from intimacy and pleasure to achievement and performance."
Here are some questions to ask your doctor (e.g., urologist) about impotence. Print this page, check off the questions you would like answered, and bring it with you to your doctor's appointment. The more you and your partner know about erectile dysfunction, the easier it will be to develop and follow a successful treatment plan.
No reports on long-term use
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