What's Healthy, and What's Not, in Bed

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Viagra and Other ED Drugs

Q. My husband has high blood pressure and occasional ED. Can he take Viagra or another of the drugs I've been hearing so much about? What are the differences, and are they equally safe?

A. There are three similar drugs for ED on the market now: Viagra, Levitra, and Cialis. They are all quite safe for healthy men. They are even safe for men with high blood pressure or heart disease, provided they are not taking any nitrate medication (often prescribed for chest pain, or angina) -- the combination can cause a rapid drop in blood pressure and lead to a loss of consciousness or even a heart attack or stroke. These drugs may also interact with other medications, too. About 70 percent of men with ED respond well to Viagra, Levitra, or Cialis. For diabetics the response rate is closer to 50 percent.

All three drugs basically increase blood flow to the penis. They do not create erections, but they improve the erectile response to sexual stimulation. The man still needs to be stimulated in whatever way works for him before he will get an erection. They are prescription drugs, they're expensive and there are side effects, such as headaches, facial flushing, stomach upset, blue-tinged vision, or even an erection that will not subside. (An erection that lasts longer than four hours is a serious medical emergency.)

Viagra, as the first to become available, is being promoted as the drug with the longest proven record of safety and effectiveness. Levitra's active ingredient is more potent than Viagra's, so it tends to produce similar results at a smaller dose, and it acts a little more quickly. Cialis's major selling point is that it is effective for about a day and a half, so some men prefer it to the other two, the effects of which generally disappear after four to six hours. Because of that perceived advantage, Cialis has earned the nickname "the weekender." The hitch is that it takes longer to kick in, and the drug's side effects can also last significantly longer.

Continued on page 4:  Is It Stress or Me?

 

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