If erection problems could be caused by a
prescribed medication, it may be possible to change
the dose or try another medication. Do not change or stop taking any medication
without first talking with your health professional.

Medication Choices

Commonly used oral medications include:

• Ed meds
  5 inhibitors (PDE-5
  inhibitors) such as Viagra, Levitra, and Cialis.

Other medications that may be used include:

• Injected medications.
• Ed meds
  alprostadil (MUSE).

Hormones and other medications may be prescribed for
men who have low
testosterone or high
prolactin levels.

Some men have tried
yohimbine-a prescription medication that should not be
confused with the dietary supplement yohimbe-to treat erection problems.

For more information on medication choices, see:

Should I use phosphodiesterase-5 inhibitors
(such as Viagra, Levitra, or Cialis) for erection
problems?

Should I use injections for erection
problems?

What To Think About

PDE-5 inhibitors and heart problems

Health experts have debated the use of PDE-5 inhibitors in men
with heart disease, because deaths have been reported after use of Viagra. The
1999 American College of Cardiology/American Heart Association (ACC/AHA) Expert
Consensus Document noted that PDE-5 inhibitors may be dangerous for people
who:³

• Have
  coronary artery disease (CAD).
• Have
  heart failure and low blood pressure.
• Are
  taking many different drugs for
  high blood pressure.

However, several more recent studies have reported that some
men with heart problems may be able to take PDE-5 inhibitors safely. Talk to
your health professional about whether PDE-5 inhibitors are appropriate for
you.

• One study found no evidence of increased
  risk for
  heart attack or CAD in men who use Viagra.⁴
• Another study in men with CAD reported that
  Viagra does not lead to heart attack and that heart attacks and other
  cardiovascular problems reported after taking Viagra may be related more to the
  physical activity of intercourse than to the medication.⁵
• A study of 35 men found that Viagra is safe for
  men with moderate heart failure.⁶

Sexual activity is exercise. If you have a heart condition and
have not been sexually active for a while, talk with your health professional
to make sure you can engage in sexual activity safely.

PDE-5 inhibitors should never be used if
you may need to take a
nitrate-containing medication, such as erectile dysfunction drugs
.
Taking nitroglycerin and a PDE-5 inhibitor within 24 hours of each other may
greatly lower your blood pressure, which could lead to a heart attack,
stroke, or death.

If you are taking a PDE-5 inhibitor and are going to have a test
for heart disease, be certain your doctor knows you are taking it. You should
not take a PDE-5 inhibitor for 24 hours before the test. If you develop a
problem during the test, nitrate-containing medications such as nitroglycerin
may be used.

Although oral medications for erection problems can be purchased over the Internet, you should still talk with your health professional before using this medication. This is especially important if you have a heart problem.

If you are using a combination of drugs for high blood pressure,
PDE-5 inhibitors could result in low blood pressure (hypotension). Also for
this reason, you should not take alpha blockers-used to lower blood pressure
and to treat an enlarged prostate-with these medications without talking to
your health professional; the combination could cause a dangerous drop in blood
pressure.

Although the antidepressant medication trazodone has been used
for treating erection problems, there is no current evidence that it is
effective for this purpose.¹

May 22, 2007 — Medications commonly used to treat erection problems in men
may also relieve the bothersome urinary symptoms associated with an enlarged
prostate gland, researchers say.

Studies on the topic were presented this week at the annual meeting of the
American Urological Association in Anaheim, Calif.

“Before, we looked at these two conditions as two different
diseases,” says Kevin McVary, MD, professor of urology at Exercise and health

University Feinberg School of Medicine in Chicago, who moderated a press
briefing.

But in the past three or four years, he says, the thinking among urologists
has changed.

Sexual performance in men seems to decline as their prostate enlargement
becomes more severe, experts have begun to notice. Doctors also notice
that men with milder prostate problems often have less erectile dysfunction
(ED) than do those with moderate or severely enlarged prostates and urinary
symptoms.

“These two diseases — erectile dysfunction and the lower urinary tract
symptoms associated with benign prostatic order viagra on line
— are probably
linked,” McVary says.

Conditions Increase With Age

Prostate problems and ED problems both tend to increase with age. About 31%
of men aged 50 to 59 have an enlarged prostate (also known as benign prostatic
hyperplasia or BPH); 44% of those 70 and older have an enlarged prostate,
according to the National Institutes of Health. As the gland enlarges, it
constricts the urine-carrying tube called the urethra, making it difficult to
empty the bladder.

Common symptoms of BPH include weak urine stream, leaking or dribbling,
feeling that the bladder hasn’t emptied completely after voiding, and more
frequent urination.

Medications are prescribed to relieve the symptoms. Some medications work by
relaxing the muscles at the neck of the bladder and prostate; others inhibit a
hormone that contributes to the growth of the gland.

Erectile dysfunction, defined as an inability to get or keep an erection, is
experienced by 20% to 46% of men aged 40 to 69, according to the NIH.
Medications to treat erection problems help increase blood flow to the penis
when a man is sexually stimulated.

Cialis Study

A once-a-day dose of Cialis helped men with erectile dysfunction and
moderate to severe urinary tract symptoms due to an enlarged prostate improve
sexual functioning, says Marc Gittelman, MD, a urologist in Aventura, Fla., and
a study researcher.

Of the 281 men who enrolled in the study, “81% were sexually active, and
they were in their low 60s,” he says. All had moderate to severely enlarged
prostates and urinary problems; 68% of the sexually active men had a medical
history of erectile dysfunction. Gittelman’s team assigned about half to take
placebo and half to take Cialis.

At the end of 12 weeks, men who took Cialis — first 5 milligrams a day and
then up to 20 milligrams — had significantly higher scores on a standard index
of erectile function, he says.

He especially wanted to see if they were as likely to do well if their
urinary problems were severe as opposed to moderate. “They are equally
generic tadalafil softtabs
likely to respond to a dose of Cialis,” he says.

The study was funded by Lilly, which is the maker of Cialis.

In another study, 223 men aged 45 to 64 who had urinary symptoms due to an
enlarged prostate were assigned either to a group given 10 milligrams of
Levitra twice daily for eight weeks or a placebo for the same time period.

Compared with placebo, treatment with the ED drug significantly improved the
men’s quality-of- life scores and their reports of urinary obstruction and
irritation, says Boris Schlenker, MD, a urologist at
Ludwig-Maxmillians-Universitaet Hospital in Munich, Germany, who presented the
data. Erectile function improved in those who took the ED drug.

“Levitra is a promising new drug for men with lower urinary tract
symptoms, but we need long-term data on how it might affect the progression of
the disease,” he says.

The Viagra Study

In a third study, McVary assigned 369 men aged 45 and up who had both
erectile dysfunction and lower urinary tract symptoms to take either 50
milligrams of Viagra every night, 50 milligrams of Viagra an hour before
planned sexual activity, or to take a placebo. The dose increased to 100
milligrams after two weeks.

When he evaluated their erectile function and urinary symptoms, he found 73%
of the men with severe symptoms improved to having mild or moderate symptoms at
the end of the study.

“The changes in prostate symptom scores were dramatic,” he says.
“They compete with alpha blockers.” Alpha blockers are one type of drug
commonly prescribed to treat urinary symptoms associated with an enlarged
prostate. The more severe the urinary symptoms, the greater the
relief, he says.

The study was funded by Pfizer, which is the maker of Viagra.

“This really is cutting-edge,” says Gittelman.

The experts aren’t sure if the ED drugs will eventually supplement or
replace drugs used for urinary problems associated with an enlarged prostate,
or if new formulations might be developed to deal with both conditions.

Some men on the ED drugs did report side effects, says Schlenker, with the
most common in his study being headache.

It’s not known exactly why the ED drugs also help the urinary symptoms,
McVary says. By increasing blood flow to the pelvic area, the ED drugs may help
relax the bladder enough to relieve the urinary problems.

Medication Choices

Estrogen. If you only have vaginal
dryness and irritation (and not other symptoms such as hot flashes), you can
use a limited amount of
estrogen in a cream, tablet, or ring in the vagina.
The daily estrogen makes your tissue less thin and sensitive and more moist.
Many women find that using a cream or tablet twice a week is enough. This may
increase vaginal tone and lubrication, which will decrease
vulvar dryness, irritation, and shrinkage (atrophy).

If you also have other
menopausal symptoms that affect physical and mental
well-being, talk to your health professional about taking daily (systemic)
estrogen therapy.
Estrogen can increase the blood flow in the
vagina, as well as reduce hot flashes and other
symptoms of
menopause.
Estrogen therapy or
drug for treatment of erectile dysfunction
therapy can be oral (pills),
vaginal, or transdermal (with a patch). In a small number of women, hormone
therapy causes heart disease, breast cancer, dangerous blood clots, stroke, and
dementia. Talk to your health professional about whether this therapy is right
for you.

Testosterone. This hormone may play a part
in a woman’s sex drive and generic line viagra
. The ovaries make
ca condition impotence
throughout a woman’s lifetime. Women have
the most testosterone in early adulthood; testosterone levels drop by half
between the early 20s and the early 40s.

In women who have their ovaries removed (oophorectomy),
testosterone drops by 50%.¹⁰ If you have had an
oophorectomy, your health professional may suggest trying
testosterone therapy. But the U.S. Food and Drug
Administration (FDA) has not approved any testosterone therapy for women.

What To Think About

The methyltestosterone-estrogen formula called Estratest is
not approved by the FDA. The company that makes it
markets it for moderate to severe
menopausal symptoms. It is also prescribed to some
menopausal women to improve sexual desire and
response. But Estratest is made with
methyltestosterone, which the body uses differently than testosterone. It does
not directly raise the amount of testosterone in your body. And, taking a
testosterone by mouth does put you at risk for problems with your liver and
possibly your heart. Using a patch or cream does not.

At this time, there is no testosterone pill, patch, or cream
approved for women-those made for men have too high a dose for women. Side
effects of too much testosterone include acne, facial hair, and loss of hair
and a deepening of the voice, which may be permanent.

No studies have looked at the benefits and risks of taking
testosterone for longer than 6 months. The long-term effects of testosterone
therapy in women are not known.¹⁰

Sildenafil (Viagra) is used to treat
erectile viagra soft tab
in men. The maker of this
medicine has decided not to market it for improving women’s sexual desire and
arousal. This was based on research showing that sildenafil was not effective
for most women. The maker has commented that women’s sexuality is a complex mix
of physical, emotional, and relationship factors, and it is not as simple to
treat with a medicine as male erectile dysfunction is.¹¹

Currently no medications are approved by the FDA to treat female
sexual problems, although several paths are being studied, including
stimulation of certain molecules (receptors) in the brain and increasing blood
flow to the genitals. It is still too early in the process to know whether any
of these medications will prove to be effective and safe treatment
options.¹²

Seek care immediately if you have taken
phosphodiesterase-5 inhibitors (such as Viagra,
Levitra, or Cialis) in the past 24 hours and are having chest pain. Tell your
health professional you are taking this medication. Do
not use any form of nitroglycerin if you have chest pain and have taken
Viagra, Levitra, or Cialis in the past 24 hours.

Call a health professional if erection problems occur with:

• Any type of injury to the back, legs, buttocks,
  groin, penis, or testicles.
• A loss of pubic or armpit hair and an
  enlargement of the breasts.

Make an appointment to see a health professional within 1 to 2
weeks if an erection problem occurs more than 25% of the time and the
problem:

• Occurs with a persistent
  backache.
• Occurs after you start taking a new medication or change
  the dose of a medication.
• Is affecting your self-image or sense of
  well-being.
• Has not improved despite self-care.

If your erection problem is occasional, there is no reason to call
your health professional. If it occurs frequently but does not bother you or
your partner, you may or may not choose to call your doctor. However, an
erection problem that develops suddenly may be a sign of a disease; it is
recommended that you see your doctor.

Watchful Waiting

Watchful waiting is a period of time during which you and your
health professional observe your symptoms or condition without using medical
treatment. A single episode of an erection problem is often a temporary and
easily reversible problem. Do not assume it will happen again. If possible,
forget about it and expect a more successful experience the next time. If you
or your partner is concerned about it, talk about the problem and openly
discuss your fears and anxieties.

If self-care has not helped after 2 weeks and you are concerned
about your inability to have an erection, see a health professional who has
experience in dealing with erection problems.

Who To See

Some health viagra lawsuit
, including doctors and mental health
professionals, may not feel erectile dysfunction medication
discussing sexuality and erection
problems. Ask your health professional if he or she feels comfortable with and
has experience in working with men who have erection problems.

The following health professionals can evaluate symptoms of
erection problems:

• Family medicine
  doctor
• Internist
• Nurse
  practitioner
• Physician assistant
• Urologist

If it is possible that a psychological problem is erectile dysfunction drugs
to
your erection problem, your doctor may refer you to a health professional such
as a:

• Psychiatrist.
• Ed tabs
  .
• Certified licensed social
  worker.
• Counselor with special training in sexuality or
  relationship problems.

To prepare for your appointment, see the topic Making the Most of Your Appointment

Nov. 16, 2005 — A drug called Revatio may help treat an brand generic online viagra
condition called pulmonary arterial hypertension.

Patients with pulmonary hypertension have elevated blood pressure in the pulmonary (lung) blood vessels. The condition often arises from lung problems, but some cases are without a known cause. It can result in heart failure and early death.

Unfortunately, most of the medications that are used to treat this serious condition are not easy to take and are given by IV, injection, or inhalation — with real risks of unwanted side effects.

Revatio has the same active ingredient — sildenafil — as Viagra. Revatio and Viagra are made by Pfizer.

Pfizer funded the new study, which appears in The New England Journal of Medicine. Pfizer is a WebMD sponsor.

The researchers included Nazzarene Galie, MD, of the buying online story viagra
institute at Italy’s University of Bologna.

Walking Test

The study lasted for 12 weeks. It included 278 patients with pulmonary hypertension. The patients lived in the U.S., Mexico, South America, Europe, Asia, Australia, South Africa, and Israel.

Three times daily, the patients took Revatio (20, 40, or 80 milligrams) or an empty drug (placebo) orally. That was in addition to any other standard pulmonary hypertension medications.

The big question was how far patients could walk in six minutes. That’s an important exercise test for patients with pulmonary hypertension. The farther patients can walk, the better.

Walking Farther

All of the patients taking Revatio walked farther at the end of the study:

• 20-milligram group: Walked about 148 extra feet (a 13% increase).
• 40-milligram group: Walked about 151 extra feet (a 13% increase).
• 80-milligram group: Walked about 164 extra feet (nearly a 15% increase).

Higher doses didn’t bring a notable increase in distance walked, the researchers report.

Patients were then allowed to take Revatio for up to a year; 230 did so. The researchers looked at the walking tests of 222 of those who were only taking Revatio as treatment. After a year, they walked about 167 extra feet, on average, compared with the beginning of the study.

How Patients Fared

Most of the patients included in the study had milder stages of pulmonary hypertension. Few cases worsened, regardless of treatment type, the study shows.

Patients taking Revatio weren’t any more or less likely to have their symptoms worsen during the trial.

The study wasn’t designed to see if Revatio helped patients live longer. Four died during the study. No deaths were judged to be linked to the erectile dysfunction new drugs
, write the researchers.

Side effects seen with Revatio were mild or moderate and included headache, flushing, muscle pain, and diarrhea, report Galie and colleagues.

July 24, 2006 — Like Viagra before it, a drug once studied to treat heart problems may help treat sexual dysfunction. But this time it’s being tested exclusively for women.

A new study shows that a modified version of the experimental heart drug Candoxatril was effective at increasing blood flow to the vagina in animal tests.

If further research confirms these results in humans, the drug may be used to treat female sexual arousal disorder (FSAD).

Researchers say an estimated 40% of women suffer from FSAD or other forms of sexual dysfuction, such as low libido or pain during intercourse.

Candoxatril went into clinical trials in the 1990s as a heart failureheart failure erectile dysfunction
but has since become the focus of efforts to develop a medication to treat female sexual arousal disorder.

How the Drug Works

Candoxatril is one of several compounds that targets levels of vasoactive intestinal peptide (VIP), which controls blood flow to the vagina. Researchers say decreased blood flow to the vagina is thought to be a key factor in female sexual arousal disorder.

An enzyme called NEP degrades VIP in the body, and Candoxatril works by blocking NEP.

In a new study, published in the Journal of Medicinal Chemistry, viagra for woman study
altered the molecular structure of Candoxatril in order to focus the drug to treat female sexual arousal dysfunction.

In animal tests, researchers at Pfizer Global Research and Development in the U.K., found the new compound effectively blocked NEP, took effect quickly, and the effect lasted for a viagra vs levitra
short time.

They say the results suggest that the drug might have similar effects in humans, but further research is needed.

Nov. 7, 2005 - The drug made famous for its treatment of erectile dysfunction appears to have another therapeutic use.

A study in the journal Circulation suggests Viagra could help treat a circulatory disorder called Raynaud’s phenomenon, which affects about 5% of the population. Raynaud’s phenomenon can be associated with other diseases such as lupus.

Raynaud’s phenomenon causes episodes of numbness, tingling, and pain in the fingers and toes, as well as skin sores or gangrene in severe cases. The attacks are spawned by spasms in small blood vessels in response to cold temperatures or emotional stress.

These spasms cause blood vessels to constrict and compromise blood flow to distal areas such as toes and fingers. The disorder is sometimes treated with ed meds
to relax the blood vessels, but this is not always successful.

The Viagra study involved 18 patients (mostly women) whose Raynaud’s symptoms were not responsive to viagra vs cialis therapies. While taking Viagra twice a day for four weeks, the patients experienced improved blood flow in the capillaries and fewer Raynaud’s attacks. Symptoms improved and the duration of attacks was also shorter. In those who had skin sores, the ulcers began to heal visibly.

These effects did not occur while patients were taking a placebo. At the end of the study, 16 of the participants asked to continue taking Viagra off-label (that is, for a purpose other than its Ed tabs
use).

Viagra causes blood vessels to dilate in a different way from other best price generic viagra or cialis
drugs, which may explain why it helped Raynaud’s patients who didn’t respond to standard treatments. The researchers conclude that drugs like Viagra could offer “a promising new approach in patients with microcirculatory disorders.”

Although Viagra has risk for serious side effects such as heart attack, stroke, and vision loss, none of the study participants reported any such adverse effect. The side effects reported by study participants included headache, muscle pain, flushing, mild nausea, dizziness, and nasal congestion.

One of the researchers has served as a consultant and speaker for Viagra’s manufacturer, Pfizer. Pfizer is a WebMD sponsor.

Feb. 23, 2006 — Researchers in the U.K. have a new theory to explain the cause of Crohn’s disease, and they say medications like the erectile dysfunction drug Viagra may prove useful for treating the bowel disorder if they are right.

In Crohn’s disease, chronic inflammation causes ulcers within the digestive tract that can lead to severe gastrointestinal symptoms, including abdominal pain, persistent diarrhea, and rectal bleeding.

The most widely accepted theory is that an overactive immune system causes the damaging inflammation. But researchers from the University College London say the opposite appears to be true.

They believe a ed meds
immune response triggers the bowel inflammation that leads to Crohn’s disease. Their research appears in the Feb. 25 issue of The Lancet.

1 Disease, 2 Theories

The prevailing theory of Crohn’s disease is that the body’s immune system reacts abnormally in people with the disorder, producing chronic inflammation that leads to bowel injury.

Tony Segal, professor of medicine at University College London, explains the weak immune system theory like this: “The wall of the bowel is normally an effective barrier against the bowel contents, but sometimes the barrier is broken by an infection or injury and the bowel contents, which include large numbers of bacteria, penetrate into the bowel wall.

“Normally, an acute inflammatory response would kick in to remove the bacteria and return the condition of the bowel to normal. But in Crohn’s disease, we think that the acute inflammation fails to kick-start, leaving bacteria to fester in the bowel wall which, in turn, triggers chronic, secondary inflammations.”

Segal and colleagues conducted a series of small experiments that measured white blood cell production in response to intestinal and skin trauma in both Crohn’s patients and healthy patients. With inflammation, white blood cell numbers are expected to rise. In one experiment, researchers injected a killed gut bacteria into the forearms of patients and healthy over the counter erectile dysfunction drug
to study blood flow and immune response.

They found that the Crohn’s patients produced viagra generic brand
lower levels of white blood cells and proteins involved in inflammation, compared with people without the disorder.

Segal tells WebMD that people who carry a gene that has been linked to Crohn’s disease may be especially vulnerable to getting the disease if they have weak immune systems.

He added that drugs like Viagra, which open the blood vessels and increase blood flow, may help.

The Viagra Response

The researchers tested this theory by treating 10 Crohn’s patients with 50 milligrams of Viagra after injecting them with the killed gut bacteria. They found that blood flow to the infected area improved.

“Increasing blood flow is an important part of the inflammatory response, and that is why this drug may work,” Segal says. “But we don’t yet know if this will give rise to successful treatment. We need to study this further to find out.”

Segal and colleagues are among a growing number of researchers suggesting that a weak immune system, rather than an overactive one, is largely responsible for Crohn’s disease, says University of Chicago associate professor of medicine Sunanda Kane, MD.

She adds that the new research adds dysfunction erectile pill
to the theory but does not prove it.

“This is a little more evidence that maybe we have been barking up the wrong tree,” she tells WebMD. “The idea that we should be strengthening the immune system — rather than suppressing it — sounded a little crazy at first, but the evidence continues to come in. But we still have a long way to go to really understand what causes Crohn’s.”

Biologic agents that stimulate a specific part of the immune system are now being tested in Crohn’s patients. If such treatments prove effective, Kane says doctors would have an effective alternative to steroids, which work well for many patients but have many side effects.

“For decades now suppressing the immune system with steroids has worked, and we will continue to do so until we find generic viagra pay with online check
that work for everybody and are risk-free,” she says.