sons of viagra

Sons of Viagra

It won’t “get up” or “stay up,” confessed the shifty eyed man refusing to look his doctor in the eye.  His wife was equally uncomfortable, though it was a toss up as to who was more embarrassed, the doctor or the patient! 

 Men seldom discuss personal problems. It requires a great deal of courage for a man to sit face to face with a medical practitioner confess that his “manhood” is malfunctioning, and he has impotence. Fortunately, more couples are now coming out of the closet, and seeking treatment

A single failure is not erectile dysfunction or impotence. It is a medical problem when there is a persistent failure 75% of the time over a period of 3 months.

About 90% of the urban Indian males develop impotence at some time in their lives.

Rather than have this embarrassing problem evaluated, many men visit the friendly neighbourhood pharmacist, who supplies them with OTC (over the counter ) sidenafil citrate  (common trade name—Viagra) at black market rates. Others prefer alternative medicine laced with dangerous high doses of heavy metals with supposed aphrodisiac properties. Some form long lines in front of the paanwala for his overpriced mysterious “break- the- cot” paan.

Sexual dysfunction is a disease like any other. It needs to be scientifically evaluated and diagnosed before embarking on treatment. The cause may be organic or psychological. 

 The organic dysfunction is better, as, once the cause is treated the impotence resolves. It can be caused by uncontrolled diabetes, hypertension, a high cholesterol, low male hormone levels, abnormal genitalia, chronic liver or kidney disease, spinal cord abnormalities disease or degeneration, and as an aftermath of prostate surgery. Sometimes it is an unexplained side effect of certain medications.

Inadequately and improperly controlled diabetes causes a dysfunction of the autonomic nerves. This affects vascular channels all over the body, particularly and obviously in the penis. Attention to the prescribed diet, regular exercise and adherence to the medication prescribed will usually cure the problem. Uncontrolled diabetes also alters the sex hormone ratios, particularly testosterone, affecting both desire and performance.

Smoking is rightly blamed for a host of diseases. Not only is the quality of the semen in the ejaculate poor, leading to sub fertility, the compromised penile blood supply leads to impotence.

High triglycerides block blood vessels reduces blood supply just when it is needed the most.

Removal of the prostrate may damage the nerves, leading to erectile dysfunction. If men take female hormones for cancer, impotence may occur.

Diseases tumours and degeneration of the spinal cord can lead to impotence.

Sex is not a mechanical action. It is a higher function involving the release of chemicals and neurotransmitters from the brain. A loving cooperative partner and expert counselling can produce vast improvement even if there is a disease process affecting function.

Many medications are touted as miracle cures for impotence. Sidenafil releases neurochemical transmitters with cause expand blood vessels. It takes at least 30 minutes to act and the effect lasts only for 4 hours. The environment also has to be conducive ( not while watching comedy shows) otherwise it will not work. Viagra has side effects. It can produce visual disturbances so driving after taking the tablet is not advised. All blood vessels may be uniformly dilated  and this may produce low blood pressure. It interacts with commonly used medications.

 “Sons of Viagra” or superior versions like varderafil and tadalafil are now available. The onset of action is faster, more specific and long lasting (up to 12 hours). This produces spontaneity, and reduces anxiety. That alone may improve performance.

Hormone replacement is indicated for low testosterone levels.

There are other safer lesser known centrally acting apomophine derivatives that can be placed under the tongue, and do not react with other medications or food. Unfortunately they take around 10 minutes to act (during this time speech may be difficult). Also sometimes up to 6 doses are needed before any effect is seen.

For the brave hearted, there are injections into the penis. These are self administered (may turn off the partner) and the technique has to be carefully learnt to prevent infections and local side effects.

Medicated gels can be directly applied inside the urethra but then again the person cannot lie down or sit for 20 minutes.

A specially designed suction apparatus can be used to  produce an erection.

Penile implants made of silicone can be used but are not very popular as the erection is permanent.

Sex involves two people and impotence is a problem involving a couple. It has to be tackled together. Andrologists (urologists with an interest and training) and psychiatrists can often achieve miracles. Amateur treatment or that of a single partner alone is often unsuccessful despite herbal medicines, alternative therapy and “the sons of Viagra.”