It’s important to learn how Viagra works for a number of reasons — not least of which is that if you don’t learn how it works, you could actually make yourself sick (or worse) by taking it.
That’s one of the theories behind why Viagra remains ‘prescription only’ in America; although sadly there are probably more commercially- orientated reasons.
All in all, Viagra and its competitors are pretty safe drugs to take; and some people even think that the heart health benefits it provides (remember, sildenafil was originally researched as a drug to treat high blood pressure and angina) mean that we’ll all be taking small, daily doses in a few years, like some people do with Aspirin.
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How Viagra Works
In the human body, one of the most important triggers of an erection is cGMP, or Cyclic guanosine monophosphate. This is a cyclic nucleotide which triggers the body to relax smooth muscle tissue, widen blood vessels and increase blood flow. In a suitably aroused man, this provides an erection.
The enemy of erections is an enzyme called cGMP-specific phosphodiesterase type 5. That enzyme breaks down cGMP, and makes it more difficult to get and sustain an erection. Sildenafil, the active ingredient in Viagra, inhibits the effectiveness of CGMP-specific phosphodiesterase type 5, which helps the body maintain higher levels of cGMP and, in turn, have easier and harder erections.
V1agra’s competitors, like Cialis and Levitra, work in similar ways.
What’s remarkable about drugs like Viagra is that they help most men get and sustain erections no matter what the root cause of their erectile dysfunction — whether it’s psychological or physiological. In clinical trials, 66% of men reported better sexual function as compared to a placebo — but 84% of them were able to have satisfactory sex after taking Viagra, as compared to just 44% who took a placebo. And the medication gets more effective the more you take it — some doctors report that regularly taking Viagra before bed results in stronger night time erections which helps maintain sexual potency even after stopping the drug.
Potential Side Effects
But it’s not all fun and games. Like any form of medication, Viagra does have some side effects.
For the most part, they’re extremely mild, and generally improve after the first few times you take the medication.
Because sildenafil causes a drop in blood pressure, some patients report feeling dizzy, or having flushed skin. Viagra is also a diuretic, so some people report headaches. These can normally be treated with ibuprofen or Aspirin, and drinking plenty of water.
Because of Viagra’s effect on blood flow, it can in rare cases cause blurry vision or even a ‘blue tint’ to regular vision. In very rare cases, this can be as severe as to cause vision loss, and through a similar fashion can cause tinnitus or hearing loss. These are very rare side effects, and are generally mitigated by appropriate dosing.
Finally, the most infamous side effect of Viagra is the dreaded ‘four hour erection.’ In some cases, Viagra leads to an erection that doesn’t soften following climax. If this continues for over four hours, it’s important to seek medical attention at the emergency room, as the blood in the erection can become deprived of oxygen and cause permanent damage to the penile tissue itself.
As noted, these side effects are extremely rare — and as long as you take appropriate doses of the medication, they shouldn’t affect you.
Nevertheless, be aware of them; and seek medical attention if you experience any reaction to the drug.
Things to be Aware Of
Just like with every type of medication, there are things called ‘contraindications’ for drugs like Viagra. These are circumstances in which you shouldn’t take the medication, as it could cause unpleasant side effects.
Because Viagra lowers blood pressure, it’s important for people on heart medication like nitrates to avoid taking “the little blue pill” as it can cause an unsafe drop in blood pressure. The same applies for people taking recreational nitrates like ‘poppers.’
If you have low blood pressure, or recently had a heart attack, Viagra can likewise pose risks to your heart health, and it should be avoided until your doctor tells you you’re healthy enough to have sex again.
If you have retinal disorders, or problems with your eyes or hearing, you need to be careful about using Viagra because of the link between “the little blue pill” and vision and hearing loss.
Finally, you need to be cautious in taking Viagra if you’re under 25. While many men of that age do experience erectile dysfunction (often linked to porn usage) because the cause is more likely psychological than physiological, younger men are more likely to experience the dreaded ‘four hour erection.’ Taking smaller, more appropriate doses is the best option to avoid that.
For the most part, Viagra and similar products are extremely safe to use, and side effects are rare and manageable. You just need to be aware that they exist, and to be sensible about the products you take, and how much you take of them.
Which leads us onto the next question:
Which erectile dysfunction medication is right for you?
There are currently three prescription—only medications for erectile dysfunction — the famous Viagra (sildenafil cirate), Cialis (tadalafil) and Levitra (vardenafil Hydrochloride). All three work in similar ways, but each of them have their own subtle differences which leads most men to have a favourite.
Viagra (sildenafil cirate)
Viagra is, of course, the industry standard erectile dysfunction drug — once commanding a 90% market share, and still making up more than half of all ED drug prescriptions despite competition from Cialis and Levitra.
The most notable things about Viagra are the length of time it takes to produce results — generally 40 minutes to an hour — and the length of time for which its effective. According to the literature, it’s between 4 and 6 hours, although most men report stronger and firmer erections for up to 12 hours afterward.
Viagra is available in three doses — 25mg, 50mg and 100mg.
Obviously, the higher the dose, the more effective it’s supposed to be; but the great thing about Viagra is that less is often more. 25mg gives most men a very satisfactory erection; and doses aren’t generally any more effective over 100mg.
Anecdotally, most men report their erections as being ‘artificially hard’ with Viagra; which is generally not a complaint.
Cialis (tadalafil)
Cialis is a fierce competitor with Viagra for a number of reasons. For a start, its effective in just 20 minutes, as compared to the 40 minutes or an hour it takes for Viagra to work.
Secondly, Cialis remains effective in the blood stream for about 36 hours (and men report benefits for up to 100 hours afterward.) This is why it’s sometimes nicknamed ‘the weekend wonder’ because men can enjoy the benefits of one pill for an entire weekend.
Cialis is also available in a ‘daily dose’ so that men can enjoy the benefits all week long, with no waiting period. This offers total sexual spontaneity — the opportunity to have sex how and when you want, at any time.
Anecdotally, men have reported that the erections they have with Cialis aren’t as unnaturally firm or hard as with Viagra; but a lot of them prefer that.
For daily use, Cialis is available in 2.5mg and 5mg doses. For single- use dosage, it’s available in 10mg and 20mg doses. These are roughly equivalent to Viagra dosages at 50mg and 100mg — so just because the largest Cialis dose is smaller than the smallest Viagra dose, it doesn’t mean it’s any less effective.
Levitra (vardenafil Hydrochloride)
Levitra hits third place in the ED drug line up, but many people swear by it. It functions in much the same way as Viagra and Cialis, and has dosage specifications that are identical to tadalafil.
What makes Levitra different? Well, it’s often prescribed as a second choice, after patients report that Viagra or Cialis didn’t work for them. Although all these medications function in largely the same way, Levitra differs to Viagra because it has a piperazine ring ethyl group as opposed to a methyl group. This works better for some people – and many patients who reported disappointing results with Viagra or Cialis find the benefit they were looking for when they experimented with Levitra.
When it comes to length of efficacy, Levitra stays in the body for around 4 to 5 hours, in a similar fashion to Viagra, but takes between one and two hours to be effective, making it the less spontaneous of the three medications.
Levitra is available in a 2.5mg and 5mg daily dose, and a 10mg and 20mg pill. The 10mg pill is roughly equivalent to 50mg of Viagra, and is the standard starting dose.
Currently, manufacturer Pfizer are looking for approval for a dose that dissolves on the tongue, marketed as Staxyn. This promises to be faster acting and more effective.
Which product is right for you?
This is ultimately a question that’s not easy to answer. Most people first experiment by taking Viagra, which is generally considered the go-to by Insurance Providers.
Depending on the results they get with that, a lot of people will then try Cialis, because it works faster and lasts longer — allowing for a lot more sexual spontaneity.
Finally, if you’re not getting satisfactory results with either of those two, Levitra is the product you should try.
The choice you make is up to you — and might also be dictated by the method in which you get your hands on this medication. Whether going through your medical provider, or purchasing elsewhere, your choice of ED medication might be determined by what your insurance will cover, or what products are actually available for purchase.
