July 6, 2001 — Viagra, the little blue pill that made erectile dysfunction household words, may have some serious competition by this time next year when a new dysfunction pills
erectile dysfunction drug is expected to hit the market.

In clinical studies the experimental drug, called Cialis, improved erections in 85% of the men taking 20 mg of the drug and the drug’s effects last for 24 hours or longer. Viagra usually works for about four hours says Albert Yu, MD, senior director of clinical affairs at ICOS Corporation.

Cialis, pronounced “see-Alice”, is being developed as a joint venture between ICOS Corporation and Eli Lilly and Company. Late last week the manufacturers submitted a new drug application to the FDA. If the process goes smoothly “we expect to begin marketing by late in the second quarter of 2002,” says ICOS spokesperson Lacy Dysfunction erectile pill
.

From former Senator Bob Dole to Playboy founder Hugh Hefner, Viagra proved not only to be an effective treatment but has also caused a sea change in Americans’ attitudes about sexual dysfunction. Once considered a taboo subject, erectile dysfunction is now the subject of television, radio, and newspaper advertisements. For NASCAR fans, Viagra sponsors a race team.

Most men experience erection problems at some time in their lives, but about 30 million American men have chronic problems achieving erection. Erectile dysfunction, or ED as it is often called, can affect men at any age but becomes more common with age and 35% of men aged 60 or older have ED.

Buy sildenafil citrate the size of the market it is not surprising that the makers of Cialis are hoping that lightning will strike twice.

Yu tells WebMD that the new drug is very similar to Viagra, which is known medically as sildenafil. Both drugs, he says, inhibit an enzyme that affects the blood flow to the penis. “By inhibiting this enzyme, PDE5, blood flow is increased,” says Yu.

In studies reported at the recent American Urological Association meeting, 78% of men with mild to severe erectile dysfunction were able to complete intercourse after taking 20 g of the drug. Eighty-five percent of the men said they had improved erections, and 63% said they achieved normal erectile function when taking the drug.

Raymond Rosen, PhD, professor of psychiatry at the Robert Wood Johnson Medical School in New Jersey, tells WebMD that no clinical comparison of Viagra and Cialis has been attempted. “So any statements comparing the two are really hypothetical.” Rosen is a clinical investigator who has been involved in designing trials of Cialis and other drugs.

Rosen says Cialis “appears to have a rapid onset of action. You get an effect in about 30 minutes and it is effective up to 24 hours or possibly longer.”

At this point Rosen says the main advantage of Cialis is this long-acting effect. “People wouldn’t have to plan quite as carefully for when they would have intercourse. For example, if a man is planning to be with a partner all day Saturday, he could take the drug in the morning and have intercourse in the afternoon or evening. It’s less focused, more natural.”

Yu says the new drug appears to be “more specific for PDE5″ than Viagra is and this increased specificity means that the drug may cause fewer side effects than Viagra. Yu says that Viagra is generally well tolerated but that some men who take the drug get “blue tinge vision” because the drug also affects an enzyme called PDE6, which is involved in color perception in the eye. “We have not seen any color vision effects,” in any men treated in clinical trials says Yu.

Rosen agrees that the drug is well tolerated but he says that a small number of men will complain of headaches, flushing and, in a few cases, low-back pain when taking the drug. “But typically men don’t drop out of the studies because of side-effects,” says Rosen.

Cialis, like Viagra, should not be taken by men who are taking nitrates, says Yu. “This is because the drug has the same metabolic pathway as nitrates,” says Yu. He says, however, that the drug can be taken by men “who take any other type of heart or erectile dysfunction drugs
medication. There is no contraindication for men with heart disease.”

The Commission for Health Improvement (CHI) said some centres did not meet targets for answering and dealing with calls.

But the CHI’s first annual report on NHS Direct in England and Wales praised it for providing good quality guidance.

The service handles half a million phone calls and half a million internet inquiries a month.

Since NHS Direct was established five years ago, it has received more than 20 million calls.

Most calls are made in the evenings and weekends when GPs’ surgeries are closed, and a quarter concern children under five.

Patients ring up about a wide variety of health issues, including faddy diets, ovarian cysts, drug dysfunction erectile
and strokes.

Success has meant increasing demand for the service and capacity problems for some call centres Jocelyn Cornwell, Commission for Health Improvement

The CHI found the most common questions included: ‘How should I feed my baby?’, ‘What is the male pill?’, ‘Can I get impotence drugs on the NHS?’ and ‘How do I find an NHS dentist?’

Its report said callers found helpline staff to be polite, impotence doctor
and reassuring, and added that demand for the service was increasing.

It was also praised for giving staff the chance to work flexibly, with more than 60% working part-time.

‘Well regarded’

The CHI did find, however, that some call centres were missing, or close to missing, national impotence vacuum pump targets.

Centres should answer 90% of telephone calls within 30 seconds, deal with 90% of calls where patients report symptoms within twenty minutes, and lose fewer than 5% of calls.

Other targets - to process 90% of health information calls within three hours, and ensure less than 0.1% of calls are answered with the engaged tone - are being met, the report said.

Public satisfaction with the service doesn’t necessarily mean that the quality of the advice was good Helen Parker, Which?

Jocelyn Cornwell, CHI’s acting chief executive, said NHS Direct was well regarded by the public and patients, and was proving “very successful”.

“It is now the first port of call for anyone who needs medical help, but is unsure of which part of the health service is best able to help them,” she said.

“Success, however, has meant increasing demand for the service and capacity problems for some call centres.

“There are also complex management arrangements, which can create confusion over the herbal impotence treatment
of policy, practice and performance and a lack of clarity over roles and responsibilities.

“For NHS Direct to build on its success and popularity, these issues need to be resolved.”

‘Saving lives’

Helen Parker, editor of Which? magazine, said an investigation it had carried out into NHS Direct had found “fundamental problems” with the service.

She said staff often failed to spot potential emergencies and patients waited “too long” for medical advice.

“It clearly showed that public satisfaction with the service doesn’t necessarily mean that the quality of the advice was good,” Ms Parker said.

“Most people are not medical experts - which is why they call NHS Direct in the first place - and few have the expertise to tell whether or not they’ve been given good medical advice.

“In fact, high satisfaction levels are more likely to relate to how friendly the staff were or how reassured the patient felt.”

But Health Secretary John Reid said NHS Direct provided an excellent service, which had helped saved lives.

“Each week, 3% of people who ring NHS Direct do not recognise the severity of their symptoms and are transferred to the 999 ambulance service,” he said.

The service also played an essential role in reassuring people about their health, he added.

A herbal remedy for impotence
for the British Medical Association said NHS Direct worked best when it was “fully integrated into primary care, operating
alongside general practice services”.

Men and women have sought aphrodisiacs, agents that arouse or
increase sexual response or desire, since the beginning of time. Aphrodisiacs
may well be the one thing that crosses all barriers — race, culture,
ethnicity, age — making it unanimous: We all want to have better sex.

If you looked hard enough, you could find an authority for
almost any folk belief about the stimulating properties of a substance. And
although the Food and Drug Administration has determined that all these
non-medicinal approaches are ineffective, people still follow their heart’s
desire in search of the perfect catalyst for love.

Foods

One category of foods that were thought to be aphrodisiacs are
foods that resemble genitalia. Eggs and caviar may come to mind, as well as
asparagus, celery, and onions. Clams and oysters also lay claim to aphrodisiac
qualities because of their shape and texture. Oysters, in fact, are high in
zinc — a nutrient that was lacking in people’s diets at one time; eating them
could improve a cialis vs viagra
deficient diet, thus improving a person’s overall
health and increasing his or her sex drive.

Spicy foods have long been considered to be sexual stimulants.
There is some scientific truth to this claim in that foods that are heavily
spiced often contain capsaicin, the active ingredient in cayenne pepper. Eating
capsaicin can cause a ed meds
response — increased heart rate and
metabolism, sometimes even sweating — that is quite similar to the physical
reactions experienced during sex.

Okra is another reputed vegetable of love. Rich in magnesium,
it’s a natural relaxant. It’s also full of iron, folate, zinc, and vitamin B,
all nutrients that keep your sex organs healthy and happy. A little gumbo,
anyone?

Herbs

An herb very commonly associated with love is ginseng. Some say
ginseng is an aphrodisiac because it actually looks like the human body. (The
word ginseng even means “man root.”) Studies have reported sexual
response in animals who have been given ginseng, but there is no evidence to
date of ginseng having any effect on humans.

Yohimbe is an herb found in Africa and India that for centuries
has been thought to possess aphrodisiac qualities. It works by stimulating
nerve centers in the spine, thereby improving the capacity for erection without
increasing sexual excitement. These days, some call it the herbal Viagra.
Unfortunately, there are side effects to taking this herb, which include
anxiety, weakness, overstimulation, paralysis, and hallucinations. Sounds like
a large price to pay for the erectile dysfunction pills
of better sex, don’t you think?

Spanish Fly

No discussion of aphrodisiacs would be complete without mention
of Spanish fly, the most legendary of the love drugs, but also the most
dangerous. Spanish fly, or cantharides, is extracted from dried beetle dung.
Reported sexual excitement after taking Spanish fly stems from its ability to
irritate the urogenital tract, causing a rush of blood to the genital area. And
that’s not the down side! Spanish fly is a poison that burns the mouth and
throat, and can cause urinary infections, scarring of the urethra, and in some
rare cases, death.

Organic Aphrodisiacs

Aside from the groundbreaking release of Viagra, there have
been few laboratory studies on aphrodisiacs. To date, the only evidence of any
organic aphrodisiacs has been anecdotal and subjective.

Sights, sounds, and scents within your reach are the best
precursors for a romp in the hay. Nothing can compare with the sight of your
partner’s lips parted in a smile — or the sound of those three words, “I
love you.” Combined with a healthy dose of mind candy (your imagination),
you’re well on your way to a fabulous night of sexual exploration.

Other Reputed Aphrodisiacs

Rhinoceros horn
Deer antler
Chocolate
Truffles
Clove
Sandalwood
Alder bark
Damiana
Gypsyweed Rose petals
Patchouli
Muira Puama
Catuaba

Nov. 2, 2000 — Say “erectile dysfunction” these days,
and the response is likely to be “Viagra.” Such is the power of
advertising. But there was a time, not that long ago, when psychotherapy was
the mainstay of treatment for what was then known as “impotence.” Has
it become outdated or irrelevant?

It shouldn’t be, say the New England Research Institutes. In a
study published in the American Journal of Epidemiology, the Watertown,
Mass.-based organization analyzed nearly 800 men of whom more than 160 had
erectile dysfunction, and found that men who are submissive are much more
likely to develop erectile dysfunction than those who are not — and that
problem can’t be cured by the little blue pill.

Regardless, psychologists say they are feeling the pinch of the
Viagra revolution. “There’s a very significant drop in the number of men
who come into a therapist now for ED erectile dysfunction,” says Paul
Tobias, PhD, a psychologist in private practice in Santa Monica, Calif.
“Their primary response is to see an internist and get Viagra prescribed –
or not prescribed. As a psychologist, this seems like you deal with the
symptom, not the cause. It’s very easy to use a Band-Aid — but quite often it
doesn’t take care of the root cause.”

But even Tobias admits that Viagra can sometimes be the answer
even when a psychological problem is the primary cause of a failed erection.
Take the case of a man with ed tablets
anxiety — perhaps the most common
psychological cause of erectile dysfunction. If you increase performance by
prescribing Viagra, then the anxiety part of the equation disappears.

But, Tobias says, Viagra is not a fix-all — perhaps especially
when the problems involve younger men. “Younger couples need to work with
someone because the issues are quite often buried — issues of power,
dominance, virility. Often ED is just a symptom of a conflict that exists
between a couple.”

Psychologist Warren Edwards, PhD, remembers the days when
erectile difficulties were thought to be connected to males’ too-early viewing
of a vagina. “In the early 1960s, we talked seriously about that stuff. Now
we’re more recognizing that things have changed — and we’re once again going
back to the idea there’s some organic component in most men’s erectile
dysfunction.”

Edwards, a staff therapist with the Mercy Hospital in Des
Moines, Iowa, points out that the reverse scenario also is true in many cases
– where otherwise soft viagra
healthy men develop erectile dysfunction for
physical reasons, and then develop psychological problems. “I’ve
worked a lot with men in their middle years, and typically they would have some
organic contribution. Maybe they were overweight or had a pain in their
back.” Sex was generic online pharmacy viagra
for these men, he says, so they would resort
to trying to get it over with quickly. That would lead to problems. “If
you’re 60 years old and trying to have sex in a hurry, you’re probably going to
fail.”

Edwards says it’s not new that men with erection problems
consult their medical doctors first. “They always did go to the medical
doctors. Treat erectile dysfunction the best weren’t their first choice. It was in the hope there
was something their doctors could give them. And now there is.” But, he
says, many older couples he’s seen have found a simpler, less expensive (and
safer) solution: a good lubricant.

Tobias suggests that while there may be value in Viagra, the
ads for the drug encourage indiscriminate use: “The ads themselves lead to
tremendous expectations, and Viagra may not even be the answer.” He says:
“No matter how many caveats you put in the ads, all the man hears is the
opening statement: ‘Here’s the solution to your problem.’” Maybe that’s
true, Tobias says — and maybe not.