Erectile Dysfunction

Impotence or “erectile dysfunction,” happens when a man is unable to maintain or attain a firm erection in order to perform sexual acts. Impotence may also be used to signal other aspects of sex, such as, a decrease sexual desire and inability to have an orgasm or ejaculate. Erectile dysfunction is basically used to describe only the erection problem.

ED or erectile dysfunction may even prevent a total erection, or the maintenance of an erection for long moments. Because of these, erectile dysfunction is not easy to catalog. There is an estimated fifteen to thirty million men living with erectile dysfunction. Based on studies by the National Ambulatory Medical Care Survey, out of one thousand men in the United States, eight men visited the doctor for erectile dysfunction during the middle 80’s. By 1999, this rate had climbed to 22 visits for every 1,000 doctor consultations. Researchers think that the increase is due to the development of drugs, such as Viagra, that have made the discussion of erectile dysfunction widely accepted and treatable. Viagra (Sildenafil citrate) was developed in March, 1998, by Pfizer. There were over two million doctor visits for treatment with Viagra in 1999.

Erectile dysfunction, in the elderly, is often cause by a physical impediment. In older men there is a higher rate of injury and disease than in younger men. Pathologies that damage the nerve endings and diminish the blood circulation to the penis are among the leading causes for ED. Studies report that over five percent of men over 40 years of age and approximately twenty percent of men over 65 years of age suffer from ED.

Regardless of the age, erectile dysfunction is easily corrected nowadays. Men are increasingly looking for advice and help with this problem in order to return to a healthy sexual lifestyle. Urologists are the medical specialists who treat ED, but, about 75% of general physicians prescribed Viagra in 1999, and not the Urologists.

ERECTION PROCESS

The penis consists of three chambers, two of which are called the corpora cavernous and the third that fills the spaces in between with spongy tissue, called corpus spongiosum. A membrane, the tunica albuginea, surrounds the corpora cavernous. Smooth muscle is found in the spongy tissue, among veins, arteries, and fibrous tissue. The urine and sperm is channeled through the urethra, which runs along the corpora cavernous that is surrounded by the spongy tissue.

Physical or mental arousal usually starts an erection. Brain signals and local nerves make the muscles of the corpora cavernous to dilate, enabling an increase blood circulation to the penis, filling any empty space in its length. The penis enlarges due to the pressure caused by the blood in the corpora cavernous. The erection is maintained by the tunica albuginea, which keeps the blood inside the corpora cavernous. The erection is lost when the penis’ muscles contract, thereby lowering the blood flow into the penis.

Figure. Veins (bottom) and arteries (top) entire the entire length, filling the spaces and running through the chambers of the penis, the corpora cavernous and the corpus spongiosum. Erection happens when dilated muscles permit the corpora cavernous to engorge with extra blood flow by the arteries, while the return of the blood through the veins is highly impaired.

History of Viagra

Viagra, with its active ingredient-Sildenafil citrate, is a medication meant to treat erectile dysfunction in men. This drug was created by Pfizer, the pharmaceutical company. Viagra works by inhibiting the cGMP phosphodiesterase type 5 enzyme, which regulates the penis’ blood flow. Sildenafil citrate has been on the market since 1998. Its main competitors are Vardenafil (Levitra) and Tadalafil (Cialis).

Compound UK-92, 480 (Sildenafil citrate) was elaborated by pharmaceutical chemists in the research facility of Pfizer, in England. This compound was first being study for its application in hypertension and angina pectoris. Viagra’s first clinical trials took place in Morriston Hospital, in Swansea. During the phase I of the clinical trial, under Ian Osterloh, data showed that Sildenafil citrate did not improve the symptoms of angina pectoris, but, that it did cause remarkable penile erections. Viagra was patented in 1996, and it was approved for the treatment of erectile dysfunction by the United States Food and Drug Administration on March, 1998. It became the first treatment to be approved to medicate erectile dysfunction in the United States. Afterwards, Viagra’s sales even reached one billion US dollars by 2001.

In the year 2000, Viagra had over 90 percent of the global market sales for pills being prescribed to treat erectile dysfunction. By the year 2007, Viagra’s market share had been reduced to 50 percent, because of the emergence of competitors, such as, Levitra and Cialis.

The patent for Sildenafil citrate, by Pfizer, will expire in the 2011-2013 period. But, the patent is not worldwide as it was nullified in the United Kingdom for the treatment of male impotence.

Viagra is easy to obtain since various websites have it for sale, in which, patients only have to complete an online consultation, consisting of a basic online questionnaire without having to undergo a doctor’s physical examination. Viagra is only available by prescription in most countries. The global market is now flooded with many aphrodisiacs that are called “Natural Viagra,” in order to cash-in the famous brand name. Also, Viagra’s nicknames include, “the blue pill” and “vitamin V.”

How Viagra Operates

Sildenafil citrate works by releasing nitric oxide into the corpus cavernosum portion of the penis. Then, the nitric oxide attaches to the receptors of the enzyme called guanylate cyclase which causes an increment in the levels of the cyclic guanosine monophosphate (cGMP). The cyclic guanosine monophosphate causes the relaxation of muscle by vasodilatation of the intimae section of the helicine arteries, therefore, creating a higher influx of blood into the penis which causes the resulting erection.

Sildenafil citrate’s molecular structure is compatible with cGMP, acting as a competitor binding agent of the cGMP specific phosphodiesterase type 5 (PDE5) in the corpus cavernous of the penis, which results in higher concentrations of cGMP and more durable erections. Sildenafil does not usually cause an erection without sexual stimulation, because it is necessary to activate the NO/cGMP combo. Vardenafil (Levitra) and Tadalafil (Cialis) have a similar function.

Also, liver enzymes metabolize Viagra in the organism. Viagra is then excreted by the kidneys and the liver. If Sildenafil citrate is taken with foods that contain high quantities of fatty acids, its absorption is reduced. The highest plasma concentration of Viagra is then reached approximately after one hour of ingestion, if combined with this kind of greasy foods.

Help, I cannot get it up!!!

Yes, I need help. I am in desperate need of assistance. What can I do? I cannot satisfy my girlfriend. I have not had an erection in the past two months. I think that my girlfriend is already cheating on me. What should I do? Oral sex is not enough for her, as she says "I want a man." But, "I am a man," I tell her. She goes, "does not seem like it." Oh, the pain. I feel the pain that courses through my heart and that flows all the way down to my soul. "I am a man," I keep telling myself. Yes, I am...for that was just a dream that I had last night. Or should I say, nightmare? After waking up, I rushed to the cabinet where I keep my ever trusting supermed, Viagra. Yes, there it was, I had a supply that would last me for at least a month. A supply that would keep my nightmares from become a reality...

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True Story

So, here I was with my best friend sipping on some cold ones, when he suddenly breaks down crying...I was shocked at first, but, immediately asked him "what was the matter?' He, then, explained to me that he had not been able to fulfill his "manly" duty with his wife for over one month due to erection problems. I told him that erectile dysfunction is a common pathology for men over 40 years of age. But, I reassured him that now days this problem is easily resolved by what so many have called the "wonder pill." Yes, Viagra works wonders.

Yes, a month later, he told me that in fact his wife now calls him "Wonder Man."

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