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Viagra Is Misunderstood
Despite Name Recognition
So How Do You Get It to Start Working?
Viagra gets the blood flowing, but your brain has to be in the mood as well. “The biggest misperception is that it changes your psychology and makes you want sex,” says the editor of MagicBluePill.com (http://www.magicbluepill.com/). which claims to document the experiences of real people who take Viagra. “But if you’re sitting talking to Grandma and you pop a Viagra, unless you have issues, nothing’s going to happen.”
Does Taking Viagra Make a Man More Virile?
Does Viagra Work for Everyone?
Who Is The Typical Viagra User?
What Happens if You Take Viagra and You Don’t Really Need It?
What Happens If a Woman Takes Viagra?
What Are the Most Common Side Effects, and Does Everyone Get Them?
What Types of Erectile Dysfunction Are Most Easily Treated With Viagra?
Does Viagra Work Differently Among People of Different Races?
Has Anyone Ever Died After Taking Viagra?
What Happens If I Take More Than the Recommended Dose?
Do the New Erectile-Dysfunction Drugs Work as Well as Viagra?
– Ms. Parker-Pope, who writes the Wall Street Journal’s weekly Health Journal column, served as contributing editor of this report.
Viagra: How Young Is Too Young?
From the WebMD Archives
Rafael Palmeiro seems an unlikely Viagra pitchman. The Texas Rangers slugger is only 37 and won’t admit to having erection problems, yet he recently agreed to appear in ads promoting the drug. The deal has made people wonder whether Palmeiro really represents men with erectile dysfunction. or whether Pfizer, the company that makes Viagra, wants to persuade young men to try it for fun.
It’s true that erectile dysfunction is more common in older men, but many potential Viagra users are hardly senior citizens: About 40% of 40-year-old men in the U.S. have some degree of erectile dysfunction. Most Viagra users today, according to Pfizer, are in their early to mid 50s. So it makes sense that the company would want to reach more men around Palmeiro’s age.
Urologist Myron Murdock, medical director of the Impotence Institute of America, says these men are likely to use Viagra because sexual performance is a high priority for them.
A younger man, Murdock says, “wants his V-12 Jaguar working just perfectly,” whereas an elderly gent may be content with less dependable erections. What’s more, the sexual partners of younger men “are more demanding of their performance,” Murdock says.
Pfizer denies that it’s promoting Viagra for recreational use. “We’ve consistently opposed that,” says spokesman Geoff Cook. Nevertheless, Murdock says it’s fine to pop the little blue pill to “optimize” your sexual performance.
We assume all young men have normal sexual functioning, “but they’re really not normal,” Murdock says. Hardening of the arteries. which restricts blood flow to the penis. can begin during the teen years, so that by the time a man is in his 20s, his ability to get and keep an erection has already begun to decline. Murdock says many men who seek Viagra for recreational use actually have minor erectile dysfunction.
There’s also some evidence that Viagra can shorten the time it takes a man to recover after sex and be ready for another round. This is called the “refractory period.” Normally it lasts 20 minutes or longer. One study, published in the journal Human Reproduction in January 2000, found that Viagra shortened the refractory period by about 10 minutes in healthy men .
What Viagra cannot do is increase your sexual appetite or make you ejaculate if you have problems reaching orgasm. Ira Sharlip, urologist in San Francisco, says you shouldn’t expect your erections to reach staggering new proportions, either. “I don’t believe that Viagra can increase an erection beyond 100% of normal,” he says.
“Viagra is a super-safe drug,” Murdock says, assuming you have a healthy heart and don’t take nitrates.
Nitrates include nitroglycerin — a drug that many men take for chest pain from heart disease — and “poppers.” Poppers are little vials of amyl or butyl nitrate. Breaking the vial releases nitrate vapor, which gives a brief high when inhaled. It’s most often used to enhance sexual pleasure, and mostly by gay men. Poppers are not all that safe to use on their own, and they’re especially dangerous when you’re on Viagra.
Nitrates widen blood vessels, and Viagra increases that effect. Mixing the two can cause your blood pressure to drop drastically. A sudden drop in blood pressure can make you pass out, and you may die if your blood pressure stays too low for too long.
Preservatives like sodium nitrate — found in processed food — do not cause this problem, so you won’t die from eating a hot dog while on Viagra. Even so, it’s best to take it on an empty stomach. That way, the drug absorbs into your bloodstream faster. Wine may contain nitrates, but not the kind that cause problems with Viagra. It’s fine to play some Marvin Gaye on the stereo and sip a glass of Chardonnay, if that’s what puts you in the mood.
Although you may be tempted to order Viagra discreetly from one of the hundreds of Web sites that sell it, don’t. “It’s bad medicine,” Murdock says. You really must bring your doctor into your sex life if you want to use Viagra.
When you buy from an online pharmacy, you just have to answer some health questions before you proceed to the checkout page. If you answer honestly — and that might be a big “if” for those determined to get what they want — the questionnaire may catch some possible complications. But the pharmacists who fill your order don’t know your medical history, and no questionnaire can diagnose the root cause of your problem. Erectile dysfunction can have serious underlying causes, like diabetes. heart disease. liver disease, or thyroid disease.
Cook says Pfizer is opposed to Internet Viagra sales. “Our goal with any of our marketing is simply to reach men and encourage them to see a doctor,” he says.
It seems that Viagra can make sex better for women, too. Like the penis. the clitoris is erectile tissue — spongy tissue that becomes engorged with blood during sexual excitement. By increasing blood flow to the clitoris, Viagra may heighten a woman’s sensation and arousal. It also seems to increase vaginal lubrication.
Murdock says many couples like to heat things up by splitting a dose of Viagra. “It’s an interesting sexual situation,” he says. The recommended dosage for men is up to 100 milligrams per day, and that seems to be just as safe for women. Young people may get results from a smaller dose: As little as 25 mg may be enough.
The FDA has not approved Viagra for women, but Murdock says, “It’s just a matter of time.” He says he and other doctors who specialize in sexual medicine prescribe it to women, which is perfectly legal. Doctors are allowed to use their best judgment. Drug companies, however, can’t advertise any use that isn’t FDA-approved.
The studies being done to test Viagra’s safety and effectiveness in women have shown good results so far. “We’re cautiously optimistic,” Cook says.
Martin F. Downs is a health writer in New York City. He was formerly an editor at CBS HealthWatch. He has also written for Health.com, Salon.com, and POZ magazine and is the editor of the Alicubi Journal (alicubi.com).
В© 2002 WebMD, Inc. All rights reserved.
Addicted to Viagra: They should be at their most virile, but a growing number of young men canвЂ™t cope without those little blue pills
By Tanith Carey for the Daily Mail 21:54 GMT 03 Oct 2012, updated 00:31 GMT 04 Oct 2012
To the casual observer, bachelor Daniel Atkinson looks like any other healthy, athletic young man in the prime of his life.
Six foot tall with chiselled cheekbones and a trim physique, Daniel admits he never has any difficulty attracting the opposite sex.
But Daniel, 32, has a very intimate secret. When he wants to have sex with a woman, he needs up to two Viagra pills to perform.
The blue tablets, which are available on the NHS, have long been viewed as essential medication for men in their 50s, 60s and beyond.
But Daniel is one of a growing number of young males turning to the drug due to performance anxiety, triggered by a host of psychological issues from the proliferation of porn on the internet making вЂnormalвЂ™ sex seem boring, to financial pressures.
Viagra was even blamed for its part in the suicide of a 24-year-old writer earlier this year, after his girlfriend discovered he was secretly using it.
James AndrewsвЂ™s body was found on a railway line between Bristol and Bath on ValentineвЂ™s Day. An inquest into his death revealed how heвЂ™d rowed with girlfriend Eleanor Sharpe вЂ” a ballet dancer who appeared in the Olympic closing ceremony вЂ” over his use of the drug, despite the pair enjoying a вЂnormal physical relationshipвЂ™.
Daniel, now an entertainment promoter, was just 20 and on a weekend with friends in Amsterdam when he took his first pill. It was supplied to him by a friend, after he had picked up a girl.
Even though he had never had erectile problems, he was so impressed by the extra stamina it gave him he continued to take the drug with subsequent girlfriends.
On two occasions, he was even prescribed it by his GP, albeit with warnings about the long-term effects such as blue-tinged vision, heart problems and hearing loss.
Now Daniel says he always has a stockpile of the drug вЂ” on which he says he spends up to ВЈ1,000 a year вЂ” either by consulting private doctors or by picking up supplies when he travels to Spain for work.
вЂThe doctors there will prescribe them to you on the spot. Then you go to the chemist and get a supply. ThereвЂ™s always English people queueing who are after the same thing.вЂ™
Yet Daniel, who lives in London, is in despair over his reliance on the drug:
He says: вЂI diet, I exercise at the gym regularly and I am almost as fit as I was when I was a teenager. I love the company of women and always have. But now I am in my 30s, I have been exposed to so much sex, I sometimes find it hard to do without Viagra.
More than 70 per cent of male internet users aged 18 to 34 visit a pornographic site in a typical month
вЂNo matter how IвЂ™m feeling, whatвЂ™s going through my head, or how attracted to the woman IвЂ™m with, it makes no difference. Now, if I know IвЂ™m due to see a woman, I discreetly take two pills beforehand.вЂ™ By taking up to six tablets a week, Daniel is aware of the health risks.
The drug contains sildenafil citrate and works by improving blood flow in the penis. Daniel admits he sometimes experiences ringing in his ears. But despite the dangers, he feels as a single man he has little choice.
вЂI know itвЂ™s bad for my health,вЂ™ he says. вЂI can hear my heart palpitating when I take the tablets, and I come out in cold sweats. Sometimes the beating is so loud, I think I am going to have a heart attack. I need some help to stop.вЂ™
So why is a drug, once linked to greying, paunchy men past their prime, now taking over the sex lives of the young and seemingly virile?
WhatвЂ™s more, what does it say about our sexualised society where even the natural prowess of youth is not enough for the young men of today?
Harley Street psychosexual counsellor Raymond Francis says he sees about 15 men a month who feel dependent on Viagra. The average age is about 32 вЂ” his youngest client is just 27.
But Raymond, who is based at the Apex Practice, says: вЂI think this is just a small sample of the problem. These men donвЂ™t have any physical problems that would cause erectile difficulties. Instead they feel they need it because they are putting too many expectations on themselves вЂ” based on what they believe women want in the bedroom.вЂ™
In many cases, Raymond says his male patients have been influenced by seeing internet pornography from a young age. вЂSometimes these men will have deeply embedded and unrealistic expectations of the women they want to have sex with вЂ” or what they should be able to do.вЂ™
One such patient is Sam, 31, who was dependent on the drug throughout much of his 20s before he sought help two years ago.
Sam places the root of his problem on internet porn, which he says he started viewing when he was 12 вЂ” long before he lost his virginity. вЂSeeing all these studs going for hours on end seemed to underline what I couldnвЂ™t do,вЂ™ he says.
вЂI felt so ashamed. I once mentioned it to my GP but he was very unsympathetic so I never dared bring the subject up again with anyone. I started ordering them on the web, even though I was never sure what I was getting.вЂ™
But though Sam found the drugs nearly always helped him perform, ultimately they became a barrier to him finding a long-term, intimate relationship.
Sam says: вЂWhen I had a girlfriend, IвЂ™d take Viagra first thing in the morning, so IвЂ™d get the sex over and done with under controlled conditions.вЂ™
Keeping his reliance on the drug secret, however, placed unbearable pressure on relationships: вЂIt meant I could never fully commit emotionally because I couldnвЂ™t be honest about this most basic thing. My relationships never got off the ground. It was all getting so stressful I started avoiding sex. The women I met seemed so confident, I felt I couldnвЂ™t live up to what they wanted. I felt like a failure.вЂ™
It was when Sam fell in love with his new partner Emily after they met at a party that he realised he needed help.
вЂThe first time we slept together, I took it secretly, but the expectations were high because she was so special to me. So that time, even Viagra didnвЂ™t work. I could see she was worried and upset it was her fault, so I decided I had to be candid вЂ” and told her everything.вЂ™
Sam now has a normal sexual relationship with his partner. вЂIt took six months of counselling, but thanks to her, I found the courage to look at the underlying issues.вЂ™
Raymond says another common thing is men reporting they feel intimidated by the sexual confidence and demands of modern young women.
вЂWomen are now so empowered,вЂ™ says Raymond. вЂThey feel they have as much right as men to dictate the pace sexually. We are not just talking about girls who would once have been seen as promiscuous.
вЂThese days a professional career woman who has been brought up in a culture of success wants to exercise that freedom and strength in her sex life, too.
вЂIn just one or two generations, there has been a turnaround. Before, it was always the expectation that the man was the predator. Now ladette culture has turned that on its head. Faced with this pressure, young men bring performance fears to the bedroom long before any sex takes place.вЂ™
One such sexually confident woman is Nicola, an attractive finance worker in her late 20s who admits it was partly the sexual demands she put on her partner which helped trigger the anxieties that contributed to his impotence.
вЂWhen the sex wasnвЂ™t great, I was honest about how frustrated I was from the outset, which made the problem worse,вЂ™ she says.
вЂWe tried Viagra, but it felt like a planned event. So now I donвЂ™t want him to tell me if heвЂ™s taken it or not. I just want to think the sex was naturally great.вЂ™
Nicola says her attitude to sex is typical of her generation, and many of her girlfriends are reporting similar problems in the bedroom.
She says: вЂWomen our age probably do have more of a sexual past. IвЂ™ve had 15 partners, while my partnerвЂ™s only had five, so thatвЂ™s another layer of pressure on him. Because IвЂ™m quite skilled sexually, he probably wonders where I learned it from and how he compares.вЂ™
Another reason male patients in their 30s turn to Viagra is the pressure on them to produce babies within a strict timeframe.
Raymond says: вЂThese are men in conventional partnerships where the woman has chosen to defer birth until her career is established and then finds it difficult to get pregnant.
вЂThese men feel pressured to perform at a prescribed time and the sex becomes mechanistic, rather than borne out of passion and desire. The pressure on the man becomes horrific and he feels he needs to have Viagra up his sleeve.вЂ™
The NHS spends around ВЈ58 million a year handing out more than ВЈ17 million repeat prescriptions for impotence drugs.
At the moment, only men with health conditions вЂ” prostate cancer, diabetes, multiple sclerosis or kidney failure вЂ” that are known to reduce their sex drive are supposed to get them for free, though many psychosexual counsellors say it is being given to younger men with no physical reasons for impotence.
Managers at several NHS trusts are encouraging doctors to limit the number of tablets handed out to cut costs.
As the drugвЂ™s manufacturer Pfizer points out, the drug should be taken only with a prescription from a healthcare professional and used according to the guidance on the label. It says studies have found it is not physically addictive. But even if the addiction is all in the mind, there is no doubt the drug is distorting lives.
Over the past six years, Janice Hiller, a clinical psychologist who heads the Sexual Health Psychological Services team at Goodmayes Hospital in Essex, says she has seen an increase in the number of male patients dependent on Viagra. Her youngest patient has been 22.
Janice blames the trend on an increasingly sexualised society and the unrealistic expectations raised by the internet.
She says: вЂYoung men feel women expect sex very early on in a relationship, perhaps on the first or second date, and that creates performance anxiety if they are not really confident.
вЂAfter they have been exposed to a lot of internet porn, the major stimulus for men can become the pornographic image rather than the girl they are with. That can be damaging. These images go round in their heads and they then cannot become aroused with a real girl.
вЂUsually men seek help when they meet a woman they really like and are desperate for it to work. In those cases, we have to talk about how the length of a sex session is not the most important thing for women, and how they really want all sorts of other things in a relationship, too.вЂ™
For married couples, the discovery that a husband is secretly taking Viagra can also be devastating, says Janice.
вЂWomen who do find out often feel they have become unattractive to their partners,вЂ™ she says. вЂViagra is enormously helpful if used in a managed, thoughtful way among those who need it. But in younger men it does not solve a problem. More often than not it adds a new level of anxiety.вЂ™
Chartered Clinical Psychologist Dr Abigael San, who has treated patients caught in a circle of Viagra use, says: вЂThese younger men believe they are only satisfying a woman because they are using the drug. The solution becomes the problem.вЂ™
The taboo around Viagra use among young men is so great that despite the embarrassment factor, Daniel is speaking up because he feels itвЂ™s time the issue was more openly discussed.
вЂI am not ashamed of my dependence вЂ” I know so many guys my age with the same issues who started off using it recreationally and now find it hard to stop.
вЂI think many of us wish weвЂ™d never taken it that first time. I, for one, would love to be free of it.вЂ™
The Apex Practice: 020 7467 8536, theapexpractice.org. Some names have been changed.
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