BY RALPH BLUM
many men who have trouble achieving potency— keeping an erection firm enough
for sex—erection dysfunction (ED) medications--Viagra, Cialis, Levitra--work
well and cause few side effects.
Sildenfil (Viagra), vardenfil (Levitra), and tadalafil (Cialis) are all
medications that reverse ED by increasing nitric oxide, a chemical naturally
produced by the body that opens and relaxes the blood vessels in the penis.
While helping to get and keep an erection, these medications do not increase
sex drive, and only cause erections if you are sexually stimulated.
In an article in My Generation magazine, Hal Ackerman wrote that after
12 months of hormone-deprivation therapy, his libido was totally gone, an empty
balloon, with the result that women whose bodies in the past would have
stimulated longing and desire, generated no more response than the sight of
uncovered furniture. However Ackerman claims that “via the miracle of modern
pharmacology” he was able to perform sex with his new girlfriend for her pleasure—though
with little personal gratification.
Although they work in similar ways, each of the ED medications has a slightly
different chemical make-up. These minor differences affect the way each
medication works, such as how quickly it takes effect and wears off, as well as
the potential side effects.
Viagra and Levitra can be taken without food, no more than once a day, about
30-50 minutes before sex, and are effective up to 5 hours. Cialis can be taken
as a small daily dose, anytime, with or without food, and is effective anytime
between doses. The 36 hour Cialis can be taken with or without food, no more
than once a day, about 30 minutes before sex, and is effective for up to 36
Not all men can take these ED medications. They may not be safe if you have any
kind of heart problems, high or low blood pressure that is not controlled, a
history of stroke within the last six months, eye problems, severe liver
disease, or kidney disease. Always check with your doctor, and be sure he knows
any other drugs you are taking as ED medications can interact dangerously with
a number of other drugs—including alpha blockers, antibiotics, anti-seizure
drugs, blood thinners, and various heart medications. And a final caveat: as I
wrote in a previous blog, if you have had a prostatectomy, ED medications only
work if the nerves located close to the prostate have not been removed or
Most men who take Viagra, Levitra or Cialis are not bothered by side effects,
but when they do occur they can include headache, flushing (Viagra and
Levitra), indigestion, stuffy or runny nose, back pain and muscle aches
(Cialis), temporary vision changes (Viagra and Levitra), and rarely, dizziness
or fainting. Also rarely, priapism (an erection that doesn’t go away) can occur
and requires medical treatment.
ED medications can be purchased over the Internet, but beware of scams. Check
to see if an online pharmacy is legitimate—never order drugs if the pharmacy
gives no phone number, if prices seem too good to be true, or if you are told
no prescription is necessary. Make sure you get the exact dose and type
prescribed by your doctor. And don’t be fooled into buying “herbal” or
non-prescription equivalents. They are not as effective, and some can contain
harmful substances. You may find yourself paying as much as $20 per dose. But
then some of us would consider the restoration of potency a bargain at twice