Viagra ( Sildenafil )  is a new tablet which can be used for the treatment of men with erectile dysfunction (ED) , which is the inability to achieve or maintain an erection for satisfactory sexual activity.

 What are the common causes of Erectile dysfunction?

There are several possible causes both physical and psychological.

The causes include: Poor blood flow due to blocked arteries or nerve damage to penis, side effects of drugs, excessive alcohol, smoking, diabetes, stroke, severe chronic disease such as kidney and liver disease. Psychological factors are common as well – sexual function is affected in depression, relationship problems, unresolved sexual orientation, stress and anxiety

How does Viagra work and how effective is it?

Viagra works with the body's natural mechanism to control the erection. It works on chemicals in the penis allowing an erection to be achieved and sustained more easily. Effectiveness varies but  mostly 7 out of 10 men will report an improvement in erections on Viagra.

In order for Viagra to work, sexual stimulation is required.

 What other factors affect the success of treatment:

You may need to make lifestyle changes to ensure success; these include quitting smoking, reducing alcohol intake and trying to reduce stress and anxiety

 Does Viagra have aphrodisiac properties?

Viagra does not have aphrodisiac properties. Instead it helps an erection to be achieved and maintained in patients with ED in the presence of sexual stimulation

 What effect does Viagra have on ejaculation/orgasm?

Viagra works to allow the patient to achieve and sustain a natural erection, as a result this may make ejaculation more likely. However, Viagra has not been shown to improve ejaculatory disorders.

 How and when should Viagra be given?

Viagra is to be taken by mouth as needed, approximately one hour before anticipated sexual activity. It carries on working for several hours. If it is taken with food especially fatty foods it can take longer to work.

 What dose Viagra is used?

     The recommended dose is 50 mg except in the elderly when 25mg is used initially. Based on effectiveness and any side effects, the dose may be     increased to l00mg or decreased to 25mg.        The maximum recommended dose is 100mg per day

 Would increasing Viagra's dose improve effectiveness?

Viagra's efficacy is dose related, providing effectiveness of 84% in mixed ED with the maximum dose of 1OOmg.  Doses of over 100mg did not result in increased effectiveness but the number of side effects is increased.

 Would increasing Viagra's dose allow the erection to last longer?

     No, Viagra does not prolong erection. Viagra restores the erectile response to sexual stimulation. Detumescence (return of penis to flaccid state) occurs      after ejaculation.

 What are the main side effects of Viagra?
The three most common side effects of Viagra are

Headache            16%            Flushing          10%            Dyspepsia     7%

In addition, altered vision, most commonly colour tinge to vision, occurs in 3% of patients and is mild and short-lived. No long term visual problems have been reported.

Viagra  is not recommended in patients taking Nitrates for angina as it has been linked with a dangerous drop in Blood pressure  in this group 

     Can the patient drink alcohol when taking Viagra?

There are no known interactions with alcohol. However alcohol consumption is known to impair erectile function, and therefore the combination is not recommended. 

Is Viagra available on the NHS?

The Government proposals suggest that Viagra, and other treatments for impotence, would be available on prescription from GPs for the following groups of men: