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"It has the name recognition of Coke and Nike," says Harin Padma-Nathan, clinical professor of urology at the University of Southern California Keck School of Medicine. "But when you ask people about it beyond the name, they really don't understand it."
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Percentage of time Viagra use results in sex: 66%
Percentage of Viagra users who have sex at least once after using the drug for a few weeks: 83%
Average duration of erection with 100 mg of Viagra and 20 minutes of sex videos, among men with erectile dysfunction: 1 minute
Average duration of erection with a placebo and 20 minutes of sex videos, among men with erectile dysfunction: 3.6 seconds
Percentage of men who don't refill their Viagra prescription: 50%
Number of times Pfizer says men should try Viagra before giving up: 8
Percentage of men who stop using Viagra because of side effects: 1%
Decline in erectile function for every decade increase in age: 12%
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Men -- and women -- who use it rarely talk about it openly. But in the U.S., an estimated 34% of all men ages 40 to 70 -- about 20 million men -- suffer from some significant level of erectile dysfunction. Most of them, about 80%, never seek treatment.
That may change next year, when two chemically similar rivals to Viagra are expected to hit the market, further fueling interest in ways to treat erectile dysfunction. And new markets for the drugshoppee are on the horizon. Studies are showing that the drug not only can help some women, but may also work as a preventative, helping healthy men to stave off impotence.
So, from doctors who prescribe it and people who use it, here are the answers to the Sildenafil citrate 100mg Viagra pillquestions many people wonder about -- but rarely ask.
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'''What Happens When a Man First Takes a Sildenafil citrate 100mg Viagra Pill'''?
Absolutely nothing. Pfizer Inc., the maker of Viagra, long has said the drug isn't an aphrodisiac, but many men who take it still expect to feel something.
They don't. Among several men interviewed who have used the drug, not one of them experienced any feeling or sensation after taking the pill. The nothingness is so intense that the most common reaction is a slight panic that the drug isn't going to work.
"That was my worst fear, that it wasn't going to do anything," says Steve Brykman of Los Angeles, who tried Viagra once nine months ago, when he believed job and financial stresses were interfering with his sex life. After taking the pill, "there was nothing at all," says Mr. Brykman, 33 years old. "I just felt completely normal."
Though you may not feel anything, things are happening in the body. As the pill moves into the bloodstream, it starts to block an enzyme called PDE-5. Blocking the enzyme eventually increases blood flow to areas where PDE-5 is most heavily concentrated -- the penis, nose and skin. Diminished blood flow to the penis is the cause of most erectile-dysfunction problems.
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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,"
Sildenafil citrate 100mg Viagra takes about 30 minutes to kick in. Men who don't normally have problems, or who have only mild dysfunction, say it takes only a minor stimulus -- such as the brush of a hand that wouldn't cause arousal under normal circumstances -- to trigger an erection.
For men who have serious erectile dysfunction, getting things going may still require extra effort, partly because of nervousness or embarrassment about unsuccessful past attempts at intercourse.
Because Viagra doesn't increase desire, it's not prescribed for men with desire disorders, such as a low sex drive. However, if the man has lost interest in sex because he has had problems with erections in the past, Viagra may help.
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'''Does Taking Sildenafil citrate 100mg Viagra pill Make a Man More Virile?'''
It might. A surprising new area of research is whether taking a small dose of Viagra every night works as a preventative to stave off impotence, just as people can take an aspirin a day to prevent heart attack.
Though you wouldn't think you'd get much out of Viagra while you're sleeping, it turns out that nighttime erections -- most men get three or four every night -- are crucial to maintaining potency. Because most men don't have several erections during the day, the nocturnal erection, which allows blood and oxygen to flow to the genitals, is nature's way of keeping the penis in working order. The theory is that anything that increases the intensity and duration of nighttime erections is good for long-term potency.
But don't you need a sexual stimulus for Sildenafil citrate 100mg Viagra to work? You do, and the likely trigger for nighttime erections, rapid-eye-movement sleep, is said to be the strongest sexual stimulus a man can experience. The brain shuts down all other activity to the penis and the level of adrenaline, which interferes with erections, plummets.
An Italian study of 44 men gave half the men 50 milligrams of Viagra before they went to sleep. The men averaged 39 years of age and didn't have erectile dysfunction. Those who took Viagra had significantly longer and more rigid nighttime erections than the men taking a placebo.
Irwin Goldstein, a noted Boston urologist, says about 400 of his patients are using 100 mg of Sildenafil citrate Viagra each night as a preventative measure. "Men say, 'I'm potent. I don't want to become impotent. Is there something I can do?' " says Dr. Goldstein. "It's a very simple strategy for preserving sexual health."
But while it makes sense in theory, whether nighttime Viagra use can prevent impotence is far from proven. Pfizer says it's studying whether nighttime Viagra use can help improve sexual function in patients who have had prostate surgery but it won't present the results until early next year.
Meanwhile, it's worth noting that the best way to prevent impotence is to keep your veins from clogging up in the first place. Don't smoke, eat healthy foods, lose weight and lower your cholesterol.
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Does Viagra Work for Everyone?
"Giving somebody a good erection doesn't necessarily give somebody good sex," says Mike Sweeney, Pfizer's senior medical director of urology.
Men who are regular users of Sildenafil citrate 100mg Viagra say the pill has been a life-changing experience. Gary Haub, 52, of Irving, Texas, says he began suffering from erectile dysfunction about eight years ago. Viagra worked for him the first time he tried it, but he says the real benefit was to restore the intimacy between him and his wife.
"I didn't want to hold hands or put my arm around her at the theater," he says. "When you can't perform, you stop doing all those things. The really wonderful part about this is that, yes, the sex is there, but the neat thing is we're not afraid to touch or hold hands."
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'''Who Is The Typical Sildenafil citrate 100mg Viagra User?'''
He's about 50 years old and has at least one cardiovascular risk factor -- such as high blood pressure, high cholesterol or diabetes. He's married, a little bit overweight, and was unhappy with his sexual function for two or three years before asking about Sildenafil citrate 100mg Viagra. He uses four to six pills a month.
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'''What Happens if You Take Sildenafil citrate 100mg Viagra and You Don't Really Need It?'''
Men who say they don't have any problems achieving or maintaining erections say that using Sildenafil citrate 100mg Viagra dramatically changes the sexual experience, but not always in a good way.
They say taking Sildenafil citrate 100mg Viagra gives them a far more rigid erection that is so intense that it's almost uncomfortable, causing them to lose some sensation and making it difficult to finally achieve orgasm. One person described the feeling like puffing your cheeks full of air and then pushing them out as hard as you can.
Others say the physical reaction happens so effortlessly that it becomes intense long before the man's own level of excitement can catch up, creating a feeling of detachment. "The disembodied feeling is a really profound feeling," says the ViagraStories.com editor, a 33-year-old San Francisco man who has used the drug three times.
Mr. Brykman, managing editor of National Lampoon, used only one of the six pills his doctor gave him, and also says he felt disassociated from the experience. He says that although physically it worked, "it didn't have anything to do with arousal. As far as excitement levels or arousal levels, it didn't live up to my expectations."
Those who have used Sildenafil citrate 100mg Viagra "recreationally," however, say the drug, nonetheless, makes it much easier to sustain an erection and achieve a second erection relatively quickly after orgasm.
"Sildenafil citrate 100mg Viagra helps to improve erectile function which isn't optimal, "If you're a 20-year-old college guy with no diseases and you have great erectile function, it's not going to do anything for you. It can't make it go beyond normal."
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What Happens If a Woman Takes Viagra?
A 47-year-old Cincinnati woman who uses Viagra regularly says that unlike with men, Viagra in women can cause a noticeable sensation when you take it. "I felt like there was a tingling in the pelvic area," she says. "I could almost feel the increase in blood flow. It felt like there was an increase in sensitivity."
The woman's doctor gave her Viagra after a hysterectomy made it nearly impossible to have an orgasm. She says Viagra has given her about 70% of her sexual function back. The level of orgasm "is not the same to what I had prior -- it's not as full," she says. "But it does make it easier."
As with men, Viagra gets the blood flowing to the genitals in women. So for women who have difficulty achieving orgasm, vaginal dryness or a lack of sensation, arousal or engorgement, Viagra may help.
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What Are the Most Common Side Effects, and Does Everyone Get Them?
In addition to helping you have sex, Viagra often gives you a headache, a stuffy nose and a flushed, beet-red face. But nobody who uses it seems to mind that much. In studies, only about 1% of people dropped out because of side effects
David Nail, 39, of West Hollywood, Calif., began using Sildenafil citrate 100mg Viagra after a car accident left him with a spinal-cord injury. He says sex is actually better than before his accident and he experiences a stronger orgasm. Initially, the 100 mg of Viagra he used gave him bluish vision and a mild headache. Now he rarely gets a headache, and the vision side effect has stopped.
"I thought, 'If this is the side effect, then I'll be taking this until I'm 100,'" he says. "With Viagra, I am Superman now."
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'''What Types of Erectile Dysfunction Are Most Easily Treated With Sildenafil citrate 100mg Viagra pill?'''
Men whose erectile dysfunction is psychologically based fare best. Among that group, 91% were able to have sex one or more times during treatment. Close behind were men with vascular disease (88%) and those suffering from depression (86%). The remaining categories include men with hypertension (75%), diabetes (70%), ischemic heart disease (69%) and those who've had their prostate removed (47%).
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Does Viagra Work Differently Among People of Different Races?
In the VA review of Viagra studies, Asian men had the most success with Viagra, completing 61% of attempts to have sex, compared with 24% for placebo. Ninety percent reported having sex at least once in the study period.
White men who used Viagra succeeded 45% of the time, compared with 15% for placebo, and 75% managed to have sex at least once. Few blacks were included in the studies, so the data are less meaningful, although they succeeded 53% of the time, compared with 19% for placebo, and 78% reported at least one successful attempt at sex.
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Has Anyone Ever Died After Taking Viagra?
Yes, but it's more likely that it was existing health problems that killed them rather than the drug.
In the nine months after Viagra was first approved, 128 people reportedly died after taking it, including 80 traced to heart attack or stroke. The general feeling among doctors is that it wasn't necessarily the Viagra, but existing cardiovascular problems that would have killed them with or without the drug.
Seven months after the drug was introduced, Pfizer changed its labeling warning doctors to use caution when prescribing the drug to men with uncontrolled high blood pressure, cardiovascular problems or history of recent heart attack. The label had always warned that the drug may increase the blood-pressure-lowering effect of nitrates, such as nitroglycerin patches or nitroglycerin tablets, which are used to treat certain heart conditions.
Pfizer maintains that most men can use the drug safely, and even cites studies that show 1% of all heart attacks are the result of sex. The company also points to a study of 5,391 men in Britain who took Viagra for an average of five months; the study found they didn't have an increased risk of heart attack or stroke. However, it wasn't randomized, so it's not conclusive.
A new study published in September contends regular use of Viagra could actually protect the heart -- but the heart benefit has been shown only in rabbits.
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What Happens If I Take More Than the Recommended Dose?
The size of the dose does matter. In studies of patients who took 50 mg of Sildenafil citrate Viagra, 70% reported improved erections after 12 weeks of use. But that number jumped to 82% with 100 mg of Sildenafil citrate Viagra, the maximum recommended dose.
If 100 mg is good, you might think 200 mg would be better, but that wasn't the case. In studies, 200 mg of Viagra didn't work any better than 100 mg.
In fact, above Sildenafil citrate 100mg Viagra, pretty much all you get out of more Viagra is more side effects. Abnormal vision is a problem only 11% of the time with 100 mg, but jumps to between 40% and 50% with 200 mg, for instance. One-quarter of men who use 200 mg experience facial flushing, while 15% report stomach problems.
There's been little study of what happens when Viagra is taken at very high doses. But in one small study of 20 healthy men who took between 200 mg and 800 mg of Viagra, 95% experienced some side effect that lasted far longer than usual. Vision problems lasted as long as eight hours among the 50% of men who experienced them. And one subject taking 600 mg reported an erection lasting five hours, a potentially harmful problem.
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