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What is viagra and its alternatives ?

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Psychiatrist
Practicing since : 2000
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i have some problem with E D since i was in me teens and i am 50 and in good healt,' viagra had been a help for the last 10 years but less so now i went to a urologest and did a penile dopper ultrasound it was a very cold setting and he had no personally in and out he told m he told me i i didn't need to get hard for the test.i find that hard to believe? thereadings were indices of 79 and 68 he acted like i was SOL, looking for answerers and a direction to help resolve the issue
Posted Wed, 11 Apr 2012 in Men Sexual Problems
 
 
Answered by Dr. Abhijeet Deshmukh, 3 hours later
Dear XXXXXXX

I assume Viagra has helped you over the last 10 years and you had been taking it off and on as needed. I would like to ask for a bit of information.

1) Do you have any symptoms suggestive of Prostate Hypertrophy? If yes, have you been evaluated for the same?

2) Do you have Diabetes?

If those indices are Peak Flow Rates (cm/s), you may consider them normal. However, it seems the Doppler may give false values if done on a non-erect penis. But Duplex Doppler study requires it to be done on a flaccid penis as well for comparison. You may need to check with your doctor as to what the study was.

At present, the focus of your search should be to ascertain the reason for a recent reduction in response to Viagra. Once you can find that out, you may focus on the ED itself.

I will await your response about Diabetes and Prostrate Hypertrophy. If these are ruled out, you may have to consider the role of development of tolerance to Viagra. Though more research is awaited in this area, there have been reports of diminished response to Viagra over a period of more than 2 years.

To resolve the issues of tolerance, you may have to talk with your doctor. You are probably taking the highest recommended dose of 100mg as needed. Your doctor may provide you with alternatives to Viagra. There are a couple of other drugs in this category. Vardenafil (Levitra) and Tadalafil (Cialis) can be considered as safe options. Cialis, in particular, has been preferred over Viagra due to its faster onset of action, long duration of action (up to 36 hours) and cost effectiveness.

Hope this has helped you. Please write back with the added information and any more queries on this.

Take care.

Abhijeet Deshmukh, MD
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