Firstmed Blog

Erectile dysfunction, formerly called “impotence,” means that a man often can’t have an erection firm enough for sexual activity. Men with diabetes get ED (erectile dysfunction) three times as often as other men. If you think you may have ED, see your health care helper. Most cases can be treated or even cured. For example, a medical problem (such as high blood pressure) may be the cause and can be treated. Sometimes, drugs cause ED, in this case, you may be able to switch to some other drug.

ED Pills
Pills are the most common treatment for ED. Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) work by making muscles of the penis relax. Then more blood flows in. ED pills do not cause erections by themselves. A man must also be sexually excited. The erection-helping effects of ED pills last about 4 hours with sildenafil and vardenafil and 36 hours with tadalafil. You should not borrow these drugs from friends or buy them in internet. They should only be taken with your health care provider’s knowledge and oversight.

Some men should never take ED pills. These include men who should not have sex for medical reasons and men who take certain drugs or have certain medical problems. ED pills also have side effects. The most common are headache, flushing, upset stomach, vision changes, and erections that last longer than 4 hours.

Other ED Drugs
Alprostadil is an ED drug that comes in two forms. One form (Caverject, Caverject Impulse, or Edex) is injected into the side of the penis to increase blood flow and cause an erection within 5 to 20 minutes. Its effects last 1 hour or less. The most common side effect is pain. Other side effects include bruising, redness, numbness, bleeding, and irritation.

Alprostadil also comes as a pellet that is placed within the penis. An erection then starts within 8 to 10 minutes. It lasts 30 to 60 minutes. Side effects can include pain, aching, burning, minor bleeding, and redness. When a man has low levels of male hormones, a doctor may prescribe testosterone patches. These are worn every day. Too few studies have been done to know whether these patches work for ED. Injections of testosterone are also given for ED. The need for these can be determined with a blood test.

Other ED Treatments
Counseling. Stress, relationship problems, and other mental factors can cause ED. Also, a man with ED may become anxious about sex, making ED worse. So counseling may help even when ED has a physical cause. Vacuum device. This device is placed over the penis. Then air in the device is pumped out. Blood flows into the penis and causes an erection. An elastic ring then slides onto the penis to keep the erection going after the device is removed.

Surgery. Blood vessel surgery helps some men, such as those with penis injuries. This surgery cannot help most men with diabetes. In another type of surgery, implants are placed in the penis. Some implants are rods that make the penis always stiff. Other implants can be inflated to cause an erection when desired.

Don’t Lose Hope
In the past, many men just lived with ED. Today’s treatments mean that most men with ED can get their sex lives back. The most important step is the first one: seek help by talking to your health care provider.

The importance of smoking has recently been highlighted with regards to male impotence. The low level of awareness that impotence can be caused by smoking was iterated in a survey undertaken in 1999 by MORI whereby 88% of smokers do not list smoking as a risk factor for impotence and even when given smoking in a list of options of possible risk factors, two thirds do not identify it as a risk. It has been estimated that in the UK approximately 120,000 men between 30 and 50 are impotent as a result of smoking. Not only linked to erectile dysfunction, smoking can also lead to a reduction in the volume of ejaculate, a reduced number of sperm, abnormally shaped sperm and a reduction in the response to any fertility treatments undergone.

Cigarette smoke contains more than 4000 chemicals and many of these have been implicated as a cause of disease to the vascular (blood) system. With regards to the penis this directly impacts on the arteries and veins that supply blood to the penis. The importance is realised when looking at how an erection is achieved. During an erection, initially blood flow to the penis is increased leading to enlargement of the penile tissue that in turn compresses the veins preventing the immediate outflow of blood. Smoking can affect this is a number of ways.

Firstly, penile blood pressure has been found to be low in more than 20% of men with erectile dysfunction. This is related to atherosclerosis of the pudendal and common penile arteries (those that supply the blood to the penis). Atherosclerosis is when there is fatty deposits along the walls of arteries which in part can occur due to smoking and leads to a decrease in the blood flow through the artery.

In addition to this, there is also an effect directly related to the acute effects of nicotine. Nicotine causes the penile tissue to rapidly contract as a direct effect of the nicotine on the brain, which in turn restricts the arterial blood flow to the penis. This phenomenon is referred to as acute vasospasm. However, as this is a direct response to the nicotine in cigarettes immediate improvements is possible if smoking is stopped.

The third major effect smoking has on erectile function and dysfunction again relates to the blood supply to the penis, only this time the veins. Venous dilatation can occur as a result of the nicotine in the cigarettes meaning that the valve system that regulates the flow of blood is impaired and as a consequence blood flows out of the penis more quickly therefore making it difficult to get and maintain an erection. As this too is as a direct effect of nicotine, stopping smoking could lead to an immediate improvement.

I read a news item recently that brought up an interesting aspect to erectile dysfunction treatments. We all know that the discovery of Viagra sparked a sexual revolution by enabling men to have uninterrupted sex well into their twilight years, but what effect does this have on Women. Are elderly women happy about the fact that marriage is no longer a slide into the platonic? Are ED treatments contributing to marital infidelity?

For some women, the Viagra experience is far from mind-blowing. The little blue pill may make men “feel like they’re 20 again”, but what happens when a man has the erection of a 20-year-old. Does he still want a fiftysomething-year-old body? A man can pop a Viagra, but there is no equivalent for a woman. If she is going through menopause, her body probably cannot keep up. This causes resentment on both sides. Women withdraw, and men look around.

According to some women on the 50’s dating scene, most men that age are not interested in dating anyone unless they’re at least 10 years younger than them. Thanks to Viagra (and a healthier bank book than their younger counterparts), the man of the house now has the ability and the desire to woo a younger woman who can keep up with him. Highly regular sex is just not the natural thing for women of a menopausal age. Even with artificial help, it simply isn’t comfortable, certainly not for hours.

Men, if you take Viagra or another erectile dysfunction drugs? What effect has it had on your relationship? Let us know if you agree with these reports of the ill-effect the drug is having on married life.

I was reading an article about, Who Wants To Be A Millionaire host, Chris Tarrant’s messy divorce in the Daily Mail today and it struck me how the concept of Viagra is still sensationalist new fodder, even after all these years.

The article entitled Violence, Viagra and the truth about the war of the Tarrants, describes how revelations regarding Chris’s use of the ‘magic blue pill’ had been made public by his estranged wife.

She went into excruciating detail about Tarrant’s sexual problems, pouring scorn on her husband’s love-making skills, claiming that he was “clumsy and naive in bed” and had relied on Viagra for four years because he “couldn’t get it up”.

Obscene mudsling aside, one thing about the article that did strike me however, was the description of how she found out that her husband was taking Viagra. She described how when she found a packet of Viagra in the bin, Ingrid at first thought it must belong to her son Dexter. “I was very upset that he hadn’t talked to me about it,” she confirms. “Couples are supposed to be able to talk about everything, and I was so worried about him. I believe he has been popping the pills for years.”

So it goes to show that even the most wealthy and famous and seemingly unselfconscious have difficulties speaking to their partners about ED.

In a rare case of technology to the rescue, it has been proposed that erectile dysfunction drugs such as Viagra may have the unintended beneficial side effect of reducing the lethal pressure on declining populations of endangered species around the world. The decimation of some species, such as tigers and rhinos, has been linked to the continuing popularity of centuries-old sexual and other medicinal folk remedies. Traditional medicine has often relied on a bizarre mix of animal parts to cure ailments ranging from gout to erectile dysfunction. Preparations containing tiger bone, tiger penis, crushed sea horse and rhino horn are all processed throughout the world as aphrodisiacs. This folk-medicine industry is known to supply much of the incentive for poachers who are slaughtering animals in places as widely separated as Africa, North America and Asia. But if men switch from traditional remedies to drugs such as Viagra that may be changing, and a wide range of animal species that have traditionally been sought for their virility enhancing properties may be offered a new lease of life.

In Chinese Traditional Medicine, animal parts - known in East Asia as pu foods - are reputed to endow a man with the potency of the animal itself, or with the potency implied by the shape of the appendage, explaining why you never see ‘Hair of gerbal‘ claiming to have virile qualities. Most of the medicines are manufactured in China and are sold in markets worldwide. While the illegal trade in raw products of endangered species is an undisputed problem, some experts are not holding much hope for a Viagra revolution, noting that the animals’ parts are marketed for much more than aphrodisiacs. According to the World Wildlife Fund (WWF), only a “fringe culture” in Asia seeks tiger genitals and rhino horn as aphrodisiacs. Other animal body parts have a variety of uses in legitimate Chinese medicine, particularly tiger bone. They are used as cures for everything from arthritis to pimples.

Others argue that Viagra may be too expensive for Asian and African markets. However, it is important to remember that traditional remedies are expensive aswell. For the small segment of the Asian population that can afford such expensive traditional remedies, Viagra should be comparably cheap. Despite its high price, the demand by Asians for Viagra is considerable, if media reports are to be believed. Impotence has been estimated to affect half the men in Asia aged between 40 and 70. Reportedly, the tablets fetch $300 a piece in China’s black market. Viagra pills smuggled into South Korea cost around $25 a tablet.

The fact is that prior to the commercial availability of Viagra in 1998, no product in any medical tradition had been proven to be an effective and non-intrusive treatment of erectile dysfunction. In this way it has mass appeal across all traditions. Whether this will eventually have a positive impact on endangered animals is as yet interesting speculation.

Sexuality and reproduction are fundamental elements in human interaction and society worldwide. Accordingly, most religions have seen a need to address the question of a “proper” role for sexuality in human interactions. Different religions have different codes of sexual morality, which regulate sexual activity or assign normative values to certain sexually charged actions or thoughts. The views of religions and religious believers range widely, from holding that sex and the flesh are evil to the belief that sex is the highest expression of the divine. Some religions distinguish between sexual activities that are practiced for biological reproduction (sometimes allowed only when in formal marital status and at a certain age), and other activities practiced for sexual pleasure. Some religions view certain types of sexuality as “immoral” such as homosexuality. In light of the fact that sexuality is such an integral part of religious discussion, where does the issue of erectile dysfunction treatments such as Viagra, fall in relation to religious belief and doctrine. This article looks at the impact the issue of Viagra has had in relation to some of the major religions of our time.

While more liberal branches of religious organisations have adapted perspectives more consistent with contemporary general secular culture. Many religions still share the idea that human sexuality was created with the twin purposes of procreation and intimacy and erectile dysfunction treatments are therefore only acceptable once they are taken within a marriage. For example, Christianity teaches that sexual intercourse must take place exclusively within marriage. Outside of marriage it always constitutes grave sin and excludes one from sacramental Communion. Therefore, because sex outside of marriage is immoral, then the use of Viagra — a drug specifically used to assist males to be able to have sexual intercourse — would most naturally be condemned as immoral if used by single men. Within marriage the use of drugs such as Viagra to help overcome pathological conditions can certainly not be immoral.

Similiarly, according to Islamic teachings impotency is a disease and should be dealt with as any disease. To seek a cure for a disease is advised by Prophet Mohammed (P) who said that “God has created no disease unless he created a cure for it as well, except old age”. Islam also warns of several social problems in the use of Viagra indiscriminately, claiming it may lead to more sexual promiscuity and infidelity. Islam forbids celibacy as a form of religious practice, and considers the natural state for humans to be married.

Interestingly the Catholic Church, whose teachings forbid contraception has approved of the use of Viagra. The difference between use of such drugs and artificial contraceptives is that contraceptives do not help overcome a pathological condition. Being fertile is not a pathology. Viagra does not go against nature — it assists nature. Artificial contraception does not assist nature — it goes against nature. One interferes with God’s will, but apparently the other does not.

Judaism also prohibits sexual relations outside of heterosexual marriage, so if Viagra is taken within marriage then is is deemed acceptable. However, the drug was previously prohibited because its coating was considered not kosher, inedible over Passover, when contact with everyday ingredients, known as hametz, is forbidden under Jewish law. A leading Israeli rabbi reversed the ban in 2005,saying that the pill can be swallowed if it is encased in a special soluble kosher capsule first. Viagra’s Israeli manufacturer, Pfizer Pharmaceuticals-Israel, said swallowing the capsule does not breach Jewish law because the Viagra would not come into direct contact with the body.

One religion where Viagra can never hope to secure a foothold is Buddhism. Buddhist monks and nuns of most traditions are expected to refrain from all sexual activity (Japanese Buddhism being a notable exception). A core teaching of Buddha’s foundational first sermon is that “one should not pursue sensual pleasure (kama-sukha), which is low, vulgar, coarse, ignoble and unbeneficial. This is reinforced in many passages of the Sutta Pitaka, such as the Simile of the Quail, where Buddha teaches that sensual pleasures are “filthy, coarse, and ignoble” and “should not be pursued, developed, or cultivated; they should be feared.” In addition, the second of the Four Noble Truths states that the ultimate cause of all suffering is attachment and desire (tanha), and the third states that the way to eliminate suffering is to eliminate attachment and desire. Sexual practices are characterised as both attachment (kama-upadana) and desire (kama-tanha). Sensual desire must be eradicated if one is to progress spiritually.

The treatments for erectile dysfunction, namely Viagra, Cialis and Levitra, get a lot of press time. The pharmaceutical giants that produce them put a lot of time and money into ensuring that their advertising campaigns are duly noticed. What better way to grab attention than to use a celebrity to plug your product. We would like our customers to vote on which celebrity is the best spokesperson for ED

Bob Dole (Born 1923): Republican candidate in the 1996 U.S. Presidential election. In 1999, Bob Dole, who helped test Viagra, appeared in an advertisement sponsored by Pfizer and urged people to get help for the problem, bringing a few seconds of talk about ED (erectile dysfunction) into Americans’ homes for the first time in history. Dole, who had prostate cancer surgery in 1991, does not specifically endorse Viagra in the advertisement. Instead, he tells people to see their doctor and gives a number for the U.S. Urological Foundation. Pfizer said Dole was being paid for the ads but it would not disclose the amount involved. “When I was first diagnosed with prostate cancer I was primarily concerned with ridding myself of the cancer, but secondly, I was concerned about post-operative side-effects like erectile dysfunction, ED, often called impotence,” “There’s a giggle factor. I’ve heard all the Viagra jokes. I’ve been the butt of many of those jokes. But my view is that that may go with the territory

Pele (Born 1940): Brazilian soccer legend, Edson Arantes do Nascimento, known globally as “Pele,” is regarded by many as the greatest footballer of all time. In 2002, Pele headed a worldwide ad campaign launched by the Pfizer pharmaceutical company, taping a series of television ads plugging the benefits of Viagra. “There are loads of men with erectile problems who don’t see a doctor out of embarrassment,” Pele said through a spokesman. “I hope this campaign helps a lot of them.” Whether or not the legend needs help with his game remains a mystery.

Jerry Hall (Born 1956): English American supermodel and actress known also for being Mick Jagger’s long-time companion. Hall was recently appointed as the “Global Ambassador for [Levitra’s] Erectile Dysfunction Campaign.” Bayer HealthCare, is hoping that the global icon will inject much needed sex appeal to their marketing strategy. Hall has declared: “I’m working with Bayer HealthCare to encourage men to confront erectile dysfunction and take action. It might be a conversation with your doctor or maybe with your partner, but it’s never too late to get the most from your love life. A healthy love life is not and should not be the preserve of those in their 20s and 30s. It’s important at all ages”. Hall is the perfect face for Levitra as she is a global sex symbol who embodies an open, confident and bold approach to sex and relationships. According to the Texan -”My mother said it was simple to keep a man, you must be a maid in the living room, a cook in the kitchen and a whore in the bedroom. I said I’d hire the other two and take care of the bedroom bit.”

Let us know which you feel is the best approach to pharma-marketing.

A recent report in the News of the World indicated that men in the north of England spend more money on purchases of erectile dysfunction treatments, such as Viagra, than anywhere else in the country. While the article is accurate in its findings, I feel that the piece didn’t adequately cover the reasons why this may be the case. It’s not simply that more men in the north of the country suffer from erectile dysfunction but rather, it is a question of a health divide in general.

We at Firstmed felt the tone of the article feeds into regional stereotypes. It seemed almost triumphant in its announcement that Northerners aren’t so ‘hard’ after all and that in truth, it is the so-called ‘Southern Softies’ who are sitting pretty, so to speak.

It is true that NHS figures indicate that the highest spending regions (with the notable exception of the London Borough of Islington) are located in the north. Top spenders are from Knowsley in Merseyside, where GPs hand out £148,000 worth of Viagra every year.

The area spends an average of £1.86 per head on impotence treatments. Still in the north-west, Halton and St Helens, Salford, Blackpool, Manchester and Stockport all feature in the top 10 biggest spenders. In contrast, the list of lowest spenders was found to feature mainly southern areas. The southern regions of Barking and Dagenham, Kingston and Richmond, Havering, and Twickenham all feature in a bottom 10, spending as little as 80p per head on the treatment.

However, the article fails to articulate a possible reason for these findings. The reason is simple. The problem is not simply about erectile dysfunction but about a health divide in general

The increase in the incidence of ED in the north is primarily related to the increased rate of health problems strongly associated with erectile dysfunction, such as obesity, diabetes, smoking and cancer. Northern men are the highest rates of obesity in the country. Northern men’s life expectancy is two years shorter than men in the south. The North West and the North East regions have higher than average death rates from smoking-related diseases.

Although there is a significant psychological element inherent in achieving an erection, ED is not ‘all in the head’ as previously believed. In fact physical conditions are causative in 90% of ED cases. There is a long acknowledged and significant north-south health divide in the UK. If it common knowledge that Northern areas have higher obesity rates, more smoking-related deaths and lower life expectancies, than it can hardly be a surprising revelation that the area spends more on ED medication.

West African pharmacist has advised men to avoid stress to reduce their risk of falling victim to conditions such as erectile dysfunction.

Eric Dwamena states that being stressed out can lead to many illnesses such as diabetes and hypertension – otherwise known as high blood pressure.

Further conditions such as erectile dysfunction and blindness can stem from complaints like diabetes, he warned.

Speaking to the Asylum Down Presbyterian Church, Mr Dwamena said: “To avoid unnecessary thinking or stress, be content with what you have, understand yourself and adopt healthy lifestyles,” website ModernGhana.com reports.

He also urged people to take regular exercise and not eat late at night.

The informative speech was part of the church’s health week celebrations through which local people were given free diabetes and hypertension screenings.

According to Bayer, manufacturer of anti-impotence drug Levitra, about 152 million men across the world suffer from erectile dysfunction.

This week, we at Firstmed are continuing to explore some of the more frequent queries we receive from our customers regarding the treatment of erectile dysfunction. Most people on the planet have heard of Viagra at some stage or another. It was launched amid a media storm in 1999 and has subsequently become not only a medical treatment but a part of popular culture. Punch lines aside, Viagra fundamentally remains a treatment for ED, but is it the only one? There are alternatives to the ‘little blue pill’ and many people want to know, are they as good as the original.

Do the New Erectile-Dysfunction Drugs Work as Well as Viagra?

Two drugs, Levitra, from Bayer AG and GlaxoSmithKline PLC, and Cialis, from Eli Lilly & Co., were introduced in 2003 and are Viagra’s closest competitors on the ED market. They work in the same way as Viagra, blocking the same enzyme. Though it’s unlikely any one works better than Viagra overall, slight chemical differences mean that if one brand doesn’t work for a patient, another one might.

The main difference between the three treatments is the time frame in which they remain effective. Viagra lasts up to 4 hours, Levitra up to 8 and Cialis, a whopping 36. This does not mean that you will have an erection for this time period, just the ability to maintain one should you require it. Early studies show Levitra requires a smaller dose and works faster than Viagra with fewer side effects. Cialis has been dubbed the “weekend pill,” because its effects last up to 36 hours and is popular among holiday makers and people who feel more comfortable with a larger window of opportunity.

Which one is the best? Well they all tick different boxes so it really is up to each individual.

If you have tried treatments other than Viagra than let us know. We’d love to hear which you regard as the most effective.