THE VIRILITY SOLUTION: THE BEGINNING OF A NEW LIFE
At the suggestion of a friend who was already participating in the Vasomax study, Ron came to see me. After carefully screening him, I concurred with the urologist. For the most part, his health was excellent. He didn’t smoke, and exhibited no signs of hypertension, diabetes, prostate cancer, or Parkinson’s disease, the major ailments typically associated with ED.
I told Ron that his primary symptoms, which included slower arousal time, the need for increased stimulation to achieve an erection, and the inability to maintain an erection, were early signs of ED. He was accepted into the study and before he left that afternoon, I gave him a one-month supply of Vasomax pills, along with diaries that both he and his wife were to fill in as soon as a sexual encounter was over. I told him that a stuffy nose was a possible side effect, and that he might I eel lightheaded or a quickening pulse. He should carefully record any unusual changes he might experience.
Before he left, Ron asked me one more question: “If the pills work lor me, will I have to take them forever?”
I told him what I tell all my patients taking the new medications. Reactions vary from patient to patient, depending on the nature of their particular erectile problems. But if it turned out that Ron did need them indelmitely, I didn’t foresee a problem. “I ook at it this way,” I said. “The help you need is available to you. Just take that little white pill—and live the most satisfying life you can.”
Like so many men whom I’ve treated, Ron now regards his sex life as pre- and post-Vasomax. In the old era, he and his wife would try to have sex once or twice a week, with a lot of uncertainty on Ron’s part. Post-Vasomax, they quickly rediscovered the joys of spontaneous sex. Ron’s fear of inadequacy vanished. And gone forever was the very unpleasant option of having to inject himself.
Ron summed up his experience in a way I’ll always remember. “When I left your office after taking Vasomax for the first time, Amy and I went to dinner. I started to feel differently. I became acutely aware of how lovely she looked, and, all of a sudden, my emotional response to her was matched by a really powerful physical urge. I was overcome with desire for her. In fact, we skipped dessert in the restaurant—and had it at home, if you know what I mean.”
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Men’s Health
THE VIAGRA TESTS
The tests on Viagra (sildenafil) were no different. In the first human trial of the drug, a dozen men in England who were experiencing ED took it three times a day for a week. The results were extremely encouraging but researchers had to pose some realistic questions: Does anyone really want to take a pill three times daily? And who could afford such a costly treatment?
Another short trial was begun. This time, the dozen men took a single dose every day. Remarkably, ten of them showed positive results, and the researchers concluded that the drug was “a well-tolerated and efficacious oral therapy and represents a new class of peripherally acting drugs for the treatment of this condition.”
Phase II drug trials spread beyond the west of England to other parts of the United Kingdom, as well as France and Sweden. In one study, forty-two men, between the ages of thirty-four and seventy, all of whom had experienced ED for at least three years, were divided into two groups. Half took Viagra in 25, 50, or 75 mg doses daily while the others received a placebo. Later, the two groups switched pills. After twenty-eight days, more than 90 percent of the men reported significantly improved sexual performance. This was confirmed by the answers they provided on detailed sexual activity questionnaires. Not only were they filled out by the men taking part in the study, they were answered by their partners as well. It turned out that the men who experienced profound improvement had been taking Viagra.
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Men’s Health
THE VIRILITY SOLUTION: MEDICATIONS
Many times, ED is a side effect of taking a drug. The most common offenders are prescription drugs for high blood pressure, heart ailments, and allergies. Medications used to combat depression, especially the selective serotonin-reuptake inhibitors (SSRIs), such as Prozac, Zoloft, and Paxil, can also be the culprits.
Frequently, if a man is taking more than one medication, the damaging effects are cumulative. For example, I have seen cases where a patient is taking a drug for his depression, and, while he is experiencing some difficulty maintaining an erection, he can still have sex. However, if a second medication, say for hypertension, is added, his sexual performance will be severely impaired. A complete loss of erectile function can result.
The men in these predicaments have sex lives held hostage by the very medications that can save them. It’s an ironic and frustrating situation to be in. I have seen men blame themselves, or their partners, when they weren’t even aware that their problems had a physiological cause.
Sometimes, men will suspect that the medication mix is responsible for, or contributing to, their ED. On their own, they may decide to try lowered dosages or stop taking the drugs altogether. This very dangerous action can be deadly and must be avoided. In the case of hypertensive medication, lack of the drug may cause blood pressure to suddenly soar to-dangerously high levels. The outcome can be a stroke or a heart attack.
Right now, there are more than two hundred medications on the market that can seriously compromise creel ions and sexual performance. Unfortunately, the Food and Drug Administration, the government agency that approves all medication, doesn’t require pharmaceutical companies to reduce potential sexual side effects. But then, men rarely voice their concerns about something as personal as diminished sexual performance. Therefore, reporting erection difficulties brought about by a particular medication to a physician is a rare event. Many doctors aren’t even aware of the problem their prescriptions are causing. And, for those men who do seek help from their doctors, the frequent recommendation is for them to get’psychological counseling, which leaves them, as far as treatment for their ED is concerned, back in the middle of the twentieth century.
When it comes to avoiding certain medications because of their effect on sexual response, there is no simple answer. Not every drug will give each man who uses it trouble. If you suddenly notice that you are having erection problems where none existed before, take a good look at any and all medications that you are using.
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Men’s Health
THE VIRILITY SOLUTION: MODERN METHODESOF CURES
Penile injection therapy came about by chance. In 1980, the French physician Ronald Virag reported that during surgery on the penis, he inadvertently injected an anesthetized patient in the wrong part of the penis with papaverine, a nitrogen-containing substance derived from the opium poppy. The resulting relaxation of the smooth muscle of the penile arterial walls created an unexpected two-hour erection. The mistake by Virag set in motion serious research into the use of injectable medication for relief of ED.
At around the same time, Giles Brindley a British physiologist and research scientist, found that when the drug phenoxybenzamine was injected directly into the corpora cavernosa of the penis, an erection could be produced within a few minutes. Still, even though it was a powerful substance, phenoxybenzamine had serious side effects, including cardiac arrhythmia, nausea, and hyperventilation. Additionally, it was found to be carcinogenic in test animals.
In 1984, in Paris, a New York urologist, Dr. Adrian Zorgniotti, presented his first case studies of self-injection using a dual combination of papaverine and phentolamine. The latter drug interrupts the passage of neurotransmitters, which then causes relaxation of the smooth muscles of the penis. Two years later, Japanese researchers presented evidence that injections of prostaglandin E-l produced powerful erections. Finally, modern medicine had injectable drugs that, used either alone or in combination, were able to give a man an erection whenever he wanted one. Slowly, news of the favorable results with the injectable medication began to spread within the small international community of urologists who were treating ED. Most began utilizing all three—papaverine, phentolamine, and prostaglandin E-l—in what was referred to as “tri-mix.”
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Men’s Health
THE VIRILITY SOLUTION: FOLK MEDECINE
Folk medicine has always been applied whenever a man’s virility showed signs of waning. A seemingly endless succession of herbal potions, drugs, and mechanical devices has been employed over the centuries, from crushed rhinoceros horn and pulverized antelope, deer, and horse testicles, to parings of human nails. In times of desperation, a piece of bone was actually eased into the urethra to stiffen the penis.
The mandrake plant, a member of the nightshade family, was used extensively in medieval Europe, northern Africa, and Asia as both a painkiller and a cure for ED. It is even mentioned in the Old Testament, under the name “dudaim,” as the stimulant used by Jacob. Stemless, with bell-shaped flowers, the plant’s long and thick root, which often divides into two sections, resembles the lower male torso. It contains many alkaloids of medicinal value, making it one of the most discussed plants in medical literature, as well as the subject of myth and superstition. Alkaloids are a diverse group of nitrogen-containing substances produced by plants that have powerful effects on body function; some of the more common alkaloids include atropine, morphine, quinine, and codeine.
And then there was food. Throughout history, edibles, especially those phallic in shape, were employed as virility boosters. Asparagus, bananas, carrots, and cucumbers stood out in this category. Some indigenous tribes in coastal areas traditionally rubbed long, slender fish against their penises in the hope that they would become similarly long and hard.
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Men’s Health
