When Viagra arrived on the market 25 years ago, it seemed like a magical answer to a common problem: Simply take a pill and suddenly a man had no erectile dysfunction (ED) worries.
Although this iconic medication remains one of the most popular prescription drugs in the world, many men are finding that it often doesn’t deliver on the promises made in television commercials.
“We’ve found that Viagra is like any other medication – some patients do better with it than others,” says John Wheeler, M.D., urologist at the Loyola University Medical Center whose specialties include ED.
The problem is not only that Viagra does not work for everyone, sometimes men find that it becomes less effective over time, leaving them mystified and frustrated about what to do.
Although the manufacturers of ED drugs (including Viagra, Cialis, and Levitra) say they are effective 75 to 85 percent of the time, independent studies show the figure tends to be more in the 50 to 60 percent range.
Viagra works by increasing blood flow to the penis in men whose ED is caused by health conditions such as diabetes, coronary heart disease, and high blood pressure. Sometimes it stops working because a man builds a tolerance to it.
“It’s very common for the body to build up a tolerance to drugs,” said Dr. Wheeler. “The body gets used to it, and it takes more and more to work.”
Some men are also not able to take Viagra or the similar ED drugs due to certain medical conditions, including severe heart disease, a recent heart attack, stroke, irregular heart rhythms, uncontrolled high or low blood pressure, severe liver or kidney disease, or eye problems, such as retinitis pigmentosa.
Here are steps recommended by Dr. Wheeler if Viagra doesn’t work:
· Make sure that Viagra targets your specific ED problem. Viagra does not correct for a lack of sexual desire, for instance. If you just don’t feel like having sexual relations, low testosterone may be the problem. Your doctor can give you a simple blood test for this hormone.
· Make sure you are getting the actual drug. The best way to avoid counterfeit Viagra is by purchasing or ordering it only from state-licensed pharmacies. Discount Internet pharmacies are notorious for selling fake ED drugs.
· Try one of Viagra’s competitors, Cialis or Levitra. These drugs work by slightly different mechanisms. “Some ED medications work better for some people than others,” said Dr. Wheeler. Switching can also be helpful if drug tolerance is the problem.
· Stop smoking. Nicotine is a vasoconstrictor, which means it hampers blood flow to all the organs, including the penis. “If young men realized that they were going to lose their erection when they were older, they would never start smoking,” said Dr. Wheeler.
· Check with your doctor. The underlying cause of your ED – like diabetes, heart disease, or high cholesterol – may have worsened and require more aggressive treatment.
· Don’t rush things. ED drugs work in conjunction with sexual arousal, a fact that is too often forgotten. Longer foreplay can work wonders. “Spouses can be enlisted in helping train their husbands to do this, and they are usually very happy to help,” Dr. Wheeler said.
· Don’t despair. If ED drugs don’t work, there are alternatives, including medical devices and injectable drugs. “Some of these may seem to hamper spontaneity, but the men who use them find they work very well,” Dr. Wheeler said.
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