Happy birthday, Viagra!
The drug that moved discussions about male sexual dysfunction from the shadows to the sunshine hit the market 10 years ago this month. Since then, Viagra has become a household word, a ubiquitous punch line and the leader in a multibillion-dollar global industry.
Thanks to savvy marketing of Viagra and similar drugs to a surging boomer population, erectile dysfunction has replaced impotence as the term of choice for a subject once-considered taboo. And the stigma of male sexual dysfunction has all but disappeared. Now, ED drugs hold the allure of rekindled romance for tough-but-tender guys of a certain age.
Physicians have found an additional benefit to ED drugs in screening men's health. Many men who are reluctant to visit the doctor - even when they're sick - are eager to get the benefits of "the little blue pill." But a visit to the doctor to get a prescription may reveal underlying conditions including high blood pressure, undiagnosed or poorly controlled diabetes, heart disease, high cholesterol or other disease.
"More men are visiting the doctor (for ED) and the doctor is able to tell them that it's caused by other problems they need to address," says Dr. John Morley, head of geriatrics at the St. Louis University School of Medicine. ED often is a vascular problem, produced by the condition underlying a heart attack. The blood vessels can be affected the same way."
Learning that ED can be a symptom of undiagnosed disease can be a wakeup call that leads not just to a healthier sex life, but to a healthier lifestyle.
Dr. Arnold Bullock, associate professor of urology at Washington University School of Medicine and a surgeon at Siteman Cancer Center at Barnes-Jewish Hospital, lauded Viagra for helping men overcome their apprehension about surgery for prostate cancer. A major fear of prostate surgery, one that prevents men from getting regular checkups, is the loss of sexual response, he says. Viagra, and its bedfellows, can help a substantial number of men perform sexually while recovering from the surgery, he says.
IMPROVED THERAPY
Viagra also brought ED therapy out of the Dark Ages.
Doctors once believed ED was a psychological problem, Morley says. In 1985, research was undertaken to prove that but couldn't. Instead, research showed that the same problems that caused hypertension, high cholesterol, diabetes and other vascular problems also caused ED.
Now, Bullock says, "Maybe in 10 percent of men the condition can be blamed on a mental (instead of a physical) problem."
In the past, Bullock and Morley said, by the time a man summoned the nerve to go see a doctor for ED, he was depressed and demoralized, and his relationship was foundering.
"In the past it would lead to breakup of families," Morley says. A partner "would believe he was having an affair or had lost interest in her. That's depressing."
That created a chicken-egg dilemma, he says, and physicians wrongly diagnosed the mental problem as causing the physical problem.
Once researchers knew the real cause of ED, major drug companies raced to come up with the cure. Pfizer Inc. won. Today, Viagra still dominates the market with a 70 percent share.
HOW IT WORKS
The family of ED drugs - Viagra, Levitra and Cialis - set off a reaction that includes the production of nitric oxide by from troubled arteries. Nitric oxide is a neurotransmitter - it helps nerves work properly - that causes blood vessels to open up, something vital to erection and other physical responses.
An explanation on Levitra.com says: The open vessels allow blood to flow into a special spongy material in penis. As that material fills, it presses on and closes the vein that normally allows blood to leave. The blood creates the erection.
HOW TO AVOID ED DRUGS
The experts noted two ways to avoid needing ED drugs.
Until men are about 70, regular exercise, a healthy diet and good genes can prevent many of the conditions that cause ED, experts say. After 70, however, men who want to remain sexually active may need testosterone therapy, but that in itself may not be enough.
Or, the American Urological Association says, forget about it. A quiet but sizeable sector of men of all ages are happy to not pursue sex. Many are in happy marriages with women who feel the same way.
Because they don't complain, experts say, there's no way to count them.
By Harry Jackson Jr.
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