Since Viagra was approved by the FDA in 1998, the “little blue pill” has become a household name and part of our culture. But these days there are a host of lesser-known erectile dysfunction drugs on the market, including Cialis, Levitra, Staxyn and Stendra. Dr. David Samadi, vice chairman of the Department of Urology and Chief of Robotics and Minimally Invasive Surgery at the Mount Sinai School of Medicine in New York City, makes sense of all the choices and offers advice on deciding what’s right for you.
As a man ages, sexual performance can decline as a result of blood vessel blockage in penile tissue and lower testosterone levels. This is what Dr. Samadi sees in patients in their early to mid-50s who turn to him with the hope of finding the right medication to help restore function.
“The best thing is always not to take the medication if you can avoid it,” he tells Newsmax Health. “But sometimes [sexual dysfunction] can affect the marriages and the wives and the relationships, so that’s why these medications are important. They are fairly safe. We have a lot of them … They work similar, but there are some differences.”
Dr. Samadi typically first prescribes Viagra or Levitra to patients; they are shorter-acting — lasting around four hours — while Cialis stays in the system longer — up to 24 hours. Different medications work better for different people, so it’s important to try another drug if one doesn’t work.
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“It’s good to try all three at different times and see which one would really work for you,” he says.
Taking the medication an hour before sex and on an empty stomach is critical to its effectiveness, he says. Some men have a big dinner then take their medication, but that’s only going to lead to disappointment.
Most side effects associated with taking the drugs are mild, he explains, and include headaches, nasal congestion, dizziness, and reduced blood pressure. If you are considering taking one of these medications and also take blood pressure medicine, be sure to let your physician know, he advises.
Also, if you take nitrates to prevent or treat chest pain from coronary artery disease, you cannot take erectile dysfunction medication, he says. Taking both can increase the effect of the drugs and lead to a significant drop in blood pressure.
“You have to make sure you absolutely are not taking any nitrates,” Dr. Samadi asserts. “That’s one of the contraindications of taking these medications. If you’re taking nitrates you are absolutely not to touch these medications.”
While commercials advertise the possible side effect of erections that last longer than four hours, Dr. Samadi says he has never seen that condition and men should not fear it.
“What I want people to know is that there are a lot of good treatments out there,” he says. “Talk to your urologist and individualize the care, and we’ll see what’s the best for you. You should enjoy a great quality of life and sex is a big part of this.”
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